In many surgical procedures, a surgical material is introduced into a body cavity and placed over a wound or tissue defect. For example, in a hernia repair procedure, a mesh is placed over a hernia in order to repair it. Many different meshes have been developed for this purpose. For example, meshes having different thicknesses and other structural properties are used for different size hernias. Moreover, meshes have been coated with materials to reduce inflammation of adjacent tissues and to minimize adhesions.
In all these repair methods there is a need for an apparatus for quickly introducing and manipulating a prosthetic material while performing open or laparoscopic procedures. Conventional methods, including a variety of mesh applicators, are inefficient, time consuming and unreliable. The mesh is often difficult to attach to the rod and thus may slip about the rod. As a result, the mesh may not unfurl through the opening in the housing. Alternatively, the mesh may crumple within the housing.
Consistent with an aspect of the present disclosure a surgical tool is provided that comprises a sheath having an opening. The opening extends along a length of the sheath, the sheath having an inner surface that defines a cavity. The surgical tool also includes a shaft having a surface. The cavity of the sheath is adapted to receive the shaft and a material disposed about the shaft. A plurality of protrusions are also provided that extend from the surface of the shaft. The plurality of protrusions are provided at a plurality of locations along a length of the shaft, and the plurality of protrusions are configured to grip a first portion of the material. Upon rotation of the shaft within the cavity, a second portion of the material is output from the opening for application to a biological tissue.
Consistent with a further aspect of the present disclosure, a surgical tool is provided that comprises a first shaft configured such that a material may be wrapped around the first shaft. The surgical tool also includes a second shaft spaced from the first shaft by a gap. A first member is also provided having first and second recessed portions. The first recessed portion is configured to receive a first end portion of the first shaft, and the second recessed portion is configured to receive a first end portion of the second shaft. In addition, a second member is provided that has first and second recessed portions. The first recessed portion of the second member is configured to receive a second end portion of the first shaft, and the second recessed portion of the second member is configured to receive a second end portion of the second shaft. The first end portion of the first shaft is provided opposite the second end portion of the first shaft, and the first end portion of the second shaft is provided opposite the second end portion of the second shaft. A first portion of the surgical material is inserted through the gap between the two shafts such that the two shafts will grip the first portion of the surgical material. Upon rotation of the two shafts together within the cavity a second portion, of the material is output from the opening for application to a biological tissue.
Additional objects will be set forth in part in the description which follows, or may be learned by practice of the disclosure. The objects and advantages of the will be realized and attained by means of the elements and combinations particularly pointed out in the appended claims.
It is to be understood that both the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of the invention, as claimed.
The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate several embodiments and together with the description, serve to explain the principles of the disclosure.
a and 4b show example of the surgical tool consistent with the present disclosure with a mesh retained (
a illustrates a cross-sectional view of the surgical tool of
a-13d illustrate different views of tips of a shaft consistent with the present disclosure.
Consistent with an aspect of the present disclosure, surgical material is contained within the sheath while it is introduced into the abdominal cavity, thereby preventing a premature discharge of the mesh before it is properly positioned over the defect. As a result, material introduction is low risk, quick, inexpensive and reproducible. Specifically, the surgical material is prevented from folding over on itself and will provide the necessary control to achieve the desired registration and orientation of the surgical material within the abdominal cavity. Commonly used composite materials including relatively thin meshes that are structurally weak as well as thick, rigid materials can be reliably positioned so that the coated or adhesion barrier side of the material will typically be placed toward the bowel while the uncoated side will face the abdominal wall. In this manner, adhesion formation and viscus erosion can be prevented. Furthermore thick, large sheets of a surgical material can be compressed onto the apparatus, eliminating complications associated with use of large-bore cannulas. In addition, components of the apparatus protect the surgical material from damage as it is transported through a hard trocar material. Alternatively, the apparatus can be inserted directly into a trocar opening once the trocar is removed. Benefits to this disclosure include a shaft that is populated with spines, bristles or rounded features that gently grasp any surgical material preventing it from slipping on the shaft and faciliting tightly winding it onto the shaft. As a result large-sized, stiff materials as well as delicate thin materials can be compressed within this device for easy application to the defect site. Another benefit is the outer sheath of the device that protects the surgical material that is wound onto the shaft preventing damage to the material when it is inserted into a trocar in order to execute laparoscopic procedures. Another benefit is a specially designed tunnelling member that facilities insertion into the trocar as well as an aid in positioning the surgical material at the defect site once the material has been released from the shaft. The combination of controlled release of the material from the device with placement assistance of the distal tip, facilitates the correct registration of composite materials to ensure that the coated or postoperative adhesion barrier surface is positioned toward abdominal tissues. Another benefit is a seal within the device to prevent escape of suffalation gas during a laparoscopic procedure.
Reference will now be made in detail to the present exemplary embodiments, examples of which are illustrated in the accompanying drawings. Wherever possible, the same reference numbers will be used throughout the drawings to refer to the same or like parts.
The operation of surgical tool 10 will next be described with reference to
a shows a cross-sectional view AA from
a and 13b illustrate examples of tunneling members or tips that may be placed at the distal end 98 of sheath 100.
Tips or tunneling members 103 and 126 permit easy movement of surgical tool 10 without snagging or damaging underlying biological tissue. Accordingly, surgical tool 10 may be readily positioned over a desired location, and the mesh or other surgical material may be properly deployed in the manner described above.
As noted above and consistent with aspects of the present disclosure, protrusions provided along the shaft are provided to facilitate gripping of the mesh, thereby facilitating crimp-free deployment and accurate positioning of the mesh over the surgical site, such as hernia, preventing damage or irritation to adjacent tissues and possible reducing the formation of postoperative adhesions. Alternatively, the mesh may be gripped by securing a portion thereof in a gap between two closely spaced shafts.
Other embodiments will be apparent to those skilled in the art from consideration of the specification and practice of the invention disclosed herein. For example, in each of the above-noted examples, the shafts may be made of a suitable plastic or metal. It is intended that the specification and examples be considered as exemplary only, with a true scope and spirit of the invention being indicated by the following claims.
This application claims priority to U.S. Provisional Patent Application Ser. No. 61/066,071 filed on Feb. 15, 2008, which is incorporated by reference herein in its entirety.
This work was supported in part by the National Institute of Diabetes and Digestive and Kidney Diseases grant number 2R44 DK062571. The government has certain rights in the invention.
Number | Date | Country | |
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61066071 | Feb 2008 | US |