Endoscopic surgery (e.g., laparoscopy) is a procedure wherein surgery is performed through a series of small openings or incisions in a patient. This type of surgery may reduce or eliminate the need for large incisions and may change some otherwise open surgical procedures such as gall bladder removal to simple outpatient surgery. Consequently, the patient's recovery time may change from weeks to days. These types of surgeries may be used for repairing defects or for the removal of diseased tissue or organs from areas of the body such as the abdominal recess. In some of these procedures, biological material or tissue may be removed or excised from the body through a small opening such as an incision, a small natural orifice, or through a small diameter laparoscopic access port such as a trocar.
Various types of tissue retrieval pouches or bags have been developed to allow for the removal of tissue through a small opening, orifice, or port in an endoscopic surgical procedure. Various instruments have also been devised for introducing, opening, positioning, and closing tissue retrieval bags within a patient; and for removing the bags and enclosed tissue from the surgical site. Some exemplary retrieval bags and associated instruments are disclosed in U.S. Pat. No. 5,465,731, entitled “Specimen Retrieval Pouch and Method for Use,” issued Nov. 14, 1995, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 5,480,404, entitled “Surgical Tissue Retrieval Instrument,” issued Jan. 2, 1996, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 5,647,372, entitled “Specimen Retrieval Pouch and Method for Use,” issued Jul. 15, 1997, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 5,971,995, entitled “Surgical Pouch Instrument,” issued Oct. 26, 1999, the disclosure of which is incorporated by reference herein; and U.S. Pat. No. 6,409,733, entitled “Specimen Retrieval Bag,” issued Jun. 25, 2002, the disclosure of which is incorporated by reference herein.
While a variety of tissue retrieval devices have been made and used, it is believed that no one prior to the inventor(s) has made or used an invention as described herein.
While the specification concludes with claims which particularly point out and distinctly claim the invention, it is believed the present invention will be better understood from the following description of certain examples taken in conjunction with the accompanying drawings. In the drawings, like numerals represent like elements throughout the several views.
The drawings are not intended to be limiting in any way, and it is contemplated that various embodiments of the invention may be carried out in a variety of other ways, including those not necessarily depicted in the drawings. The accompanying drawings incorporated in, and forming a part of, the specification illustrate several aspects of the present invention, and together with the description serve to explain the principles of the invention; it being understood, however, that this invention is not limited to the precise arrangements shown.
The following description of certain examples should not be used to limit the scope of the present invention. Other features, aspects, and advantages of the versions disclosed herein will become apparent to those skilled in the art from the following description, which is by way of illustration, one of the best modes contemplated for carrying out the invention. As will be realized, the versions described herein are capable of other different and obvious aspects, all without departing from the invention. Accordingly, the drawings and descriptions should be regarded as illustrative in nature and not restrictive.
I. Exemplary Retrieval Bag Deployment
When designing a specimen retrieval instrument, an area to consider is the modes used to deploy a retrieval bag from the instrument once the instrument has been positioned within a patient. The following section will discuss several deployment modes that may include use of a resilient loop, a pivoting loop, or telescoping arm. Based on the teachings herein, other deployment modes will be apparent to those of ordinary skill in the art.
A. Exemplary Resilient Loop
Referring to
Specimen retrieval instrument 100 includes a rod 104, an introducer tube 106, a sheath 108, a loop 110, and a retrieval bag 112. Rod 104 is fixedly positioned within introducer tube 106 in the present example. However, in some other versions as will be described in greater detail below, rod 104 may me configured to reciprocate within introducer tube 106. Sheath 108 is configured to translate relative to introducer tube 106. In particular, and as will also be described in greater detail below, sheath 108 is translatable from a distal position (
In some alternative versions, sheath 108 is removable from introducer tube 106 by pulling sheath 108 off of introducer tube 106 in a distal direction; rather than providing proximal retractability of sheath 108. By way of example only, sheath 108 may be configured like a sleeve or sock, and a separate instrument (e.g., conventional tissue graspers, etc.) may be used to pull sheath 108 distally off of resilient loop 110 and retrieval bag 112. In addition or in the alternative, sheath 108 may have a perforation or other weakening feature that may be breached to remove sheath 108 by tearing sheath 108 away from introducer tube 106. As yet another merely illustrative alternative, sheath 108 may be formed of an environmentally sensitive material. For instance, sheath 108 may be configured to dissolve or substantially weaken in the presence of bodily fluid, certain temperatures, or other environmental parameters that may be associated with the interior of a patient. Still other various ways in which sheath 108 may be configured and/or operable will be apparent to those of ordinary skill in the art in view of the teachings herein. Furthermore, sheath 108 may even be omitted in some versions.
As noted above, loop 110 is resiliently biased to maintain a substantially circular shape when not constricted by other components. Retrieval bag 112 is associated with loop 110 such that retrieval bag 112 opens when loop 110 assumes its substantially circular shape. For example, as shown in
Referring to
In use, specimen retrieval instrument 100 may initially have the arrangement shown in
In some versions, specimen retrieval instrument 100 is configured such that retrieval bag 112 may be removed from specimen retrieval instrument 100 while retrieval bag 112 is within the patient. Some such versions facilitate removal of retrieval bag 112 separate from removal of the other components of specimen retrieval instrument 100. In some versions, this may be accomplished by, among other ways, retrieval bag 112 being removable from loop 110. For instance, in some versions specimen retrieval instrument 100 may include a closure string connected to retrieval bag 112 and having a slipknot attachment to rod 104, introducer tube 106, or sheath 108. Pulling the slipknot loose and retracting introducer tube 106 may permit detachment of retrieval bag 112 and the closure string from the other components of specimen retrieval instrument 100. In some such versions, a user may pull the closure string to close retrieval bag 112. By way of example only, such a closure mechanism may be configured in accordance with the teachings of U.S. Pat. No. 6,409,733, entitled “Specimen Retrieval Bag,” issued Jun. 25, 2002, which is incorporated herein by reference. Still in other versions, it may be feasible to incorporate a closure string with retrieval bag 112, and to release retrieval bag 112 from specimen retrieval instrument 100 such that retrieval bag 112 may be removed from the patient separate from other components of specimen retrieval instrument 100.
While the above description provides adequate disclosure to enable one of ordinary skill in the art to make and use specimen retrieval instrument 100, based on the teachings herein, those of ordinary skill in the art will appreciate that various other modifications may provide additional features or functionality. For example, while the above versions were described as having both a sheath 108 and an introducer tube 106, in some versions introducer tube 106 may be omitted; while in other versions sheath 108 may be omitted. In some versions modifications may include rod 104 or introducer tube 106 having features operable with features of sheath 108 or other components to prevent inadvertent retraction of sheath 108 and premature opening of loop 110 and retrieval bag 112. For example, rod 104 may include a lock or stop that may be released once a user is ready to open loop 110 and retrieval bag 112. Still in other versions, modifications may include rod 104 having features operable with features of sheath 108 or other components to prevent inadvertent advancement of sheath 108 after initial deployment of loop 110 and opening of retrieval bag 112. For example, rod 104 may be associated with a resilient tab configured to engage a corresponding opening in a sidewall of sheath 108 upon deployment of loop 110. The engagement between the resilient tab and the opening in the sidewall of sheath 108 may act as a locking mechanism that prevents inadvertent advancement of sheath 108, and therefore inadvertent premature closure of loop 110 and retrieval bag 112. Other ways in which inadvertent retraction and/or advancement of sheath 108 may be avoided through various features of specimen retrieval instrument 100 will be apparent to those of ordinary skill in the art in view of the teachings herein.
In some versions, modifications may include providing loop 110 in various sizes with various sized retrieval bags 112. In other words, loop 110 and/or retrieval bag 112 may be modular in nature, and may come in a kit having loops 110 and/or retrieval bags 112 in various sizes. In some such versions, the desired sized loop 110 and retrieval bag 112 may be attached to rod 104 prior to insertion of specimen retrieval instrument 100 within a patient.
Referring to
As shown in
Once retrieval bag 112 is ready to be removed from the patient, the various modes for closing and removing retrieval bag 112 described above may be adapted for use with versions incorporating folded/twisted loop 110. For example, in some versions, retrieval bag 112 may be separable from loop 110 by use of a closure string as discussed above. In other versions, loop 110 may be naturally biased to fold to a closed position when sheath 108 contacts proximal portion 134 of deployed loop 110 with a sufficient force.
While the above description provides adequate disclosure to enable one of ordinary skill in the art to make and use specimen retrieval instrument 100 incorporating a folded loop, based on the teachings herein, those of ordinary skill in the art will appreciate that various other modifications may provide additional features or functionality. For example, numerous fold patterns may be suitable for use in versions incorporating a folded loop 110. For example, some fold patterns, materials, and/or section configurations, etc., may create more or less potential energy within loop 110 that will influence how rapidly loop 110 unfolds and opens upon deployment. Still various other suitable features, components, configurations, and operabilities that may be incorporated into specimen retrieval instrument 100 will be apparent to those of ordinary skill in the art in view of the teachings herein.
B. Exemplary Pivoting Loop
In some alternative versions, sheath 208 is removable from rod 204 by pulling sheath 208 off of rod 204 in a distal direction; rather than providing proximal retractability of sheath 208. By way of example only, sheath 208 may be configured like a sleeve or sock, and a separate instrument (e.g., conventional tissue graspers, etc.) may be used to pull sheath 208 distally off of resilient loop 210 and retrieval bag 212. In addition or in the alternative, sheath 208 may have a perforation or other weakening feature that may be breached to remove sheath 208 by tearing sheath 208 away from rod 204. As yet another merely illustrative alternative, sheath 208 may be formed of an environmentally sensitive material. For instance, sheath 208 may be configured to dissolve or substantially weaken in the presence of bodily fluid, certain temperatures, or other environmental parameters that may be associated with the interior of a patient. Still other various ways in which sheath 208 may be configured and/or operable will be apparent to those of ordinary skill in the art in view of the teachings herein. Furthermore, sheath 208 may even be omitted in some versions.
As noted above, loop 210 is resiliently biased to maintain a substantially circular shape when not constricted by other components. Retrieval bag 212 is associated with loop 210 such that retrieval bag 212 opens when loop 210 assumes its substantially circular shape. For example, as shown in
As shown in
A pin 230 extends upwardly from distal portion 224 of recess 220 in the present example. Loop 210 is substantially secured between pin 230 and camming projection 226 in the present example, such that pin 230 and camming projection 226 together substantially secure loop 210 to rod 204. A cap (not shown) or other component/feature may be provided at the top of pin 230 to further secure loop 210. As can be seen from
In the present example, once the distal end of specimen retrieval instrument 200 is suitably inserted in a patient, the position of rod 204 relative to the patient remains substantially constant while sheath 208 is retracted relative to rod 204 and relative to the patient to reveal loop 210 and retrieval bag 212. In some other versions, once the distal end of specimen retrieval instrument 200 is suitably inserted in a patient, the position of sheath 208 relative to the patient remains substantially constant while rod 204 is advanced relative to sheath 208 and relative to the patient to reveal loop 210 and retrieval bag 212. Various suitable configurations for handle assemblies that may facilitate translation of rod 204 relative to sheath 208 will be apparent to those of ordinary skill in the art in view of the teachings herein.
In use, specimen retrieval instrument 200 may initially have the arrangement shown in
In some versions, specimen retrieval instrument 200 is configured such that retrieval bag 212 may be removed from specimen retrieval instrument 200 while retrieval bag 212 is within the patient. Some such versions facilitate removal of retrieval bag 112 separate from removal of the other components of specimen retrieval instrument 200. In some versions, this may be accomplished by, among other ways, retrieval bag 212 being removable from loop 210. For instance, in some versions specimen retrieval instrument 200 may include a closure string connected to retrieval bag 212 and having a slipknot attachment to rod 204 or sheath 208. Pulling the slipknot loose and retracting rod 204 may permit detachment of retrieval bag 212 and the closure string from the other components of specimen retrieval instrument 200. In some such versions, a user may pull the closure string to close retrieval bag 212. By way of example only, such a closure mechanism may be configured in accordance with the teachings of U.S. Pat. No. 6,409,733, entitled “Specimen Retrieval Bag,” issued Jun. 25, 2002, which is incorporated herein by reference. Still in other versions, it may be feasible to incorporate a closure string with retrieval bag 212, and to release retrieval bag 212 from specimen retrieval instrument 200 such that retrieval bag 212 may be removed from the patient separate from other components of specimen retrieval instrument 200.
While the above description provides adequate disclosure to enable one of ordinary skill in the art to make and use specimen retrieval instrument 200, based on the teachings herein, those of ordinary skill in the art will appreciate that various other modifications may provide additional features or functionality. For example, in some versions modifications may include rod 204 having features operable with features of sheath 208 or other components to prevent inadvertent retraction of sheath 208 and premature opening of loop 210 and retrieval bag 212. For example, rod 204 may include a lock or stop that may be released once a user is ready to open loop 210 and retrieval bag 212. Still in other versions, modifications may include rod 204 having features operable with features of sheath 208 or other components to prevent inadvertent advancement of sheath 208 after initial deployment of loop 210 and opening of retrieval bag 212. For example, rod 204 may be associated with a resilient tab configured to engage a corresponding opening in a sidewall of sheath 208 upon deployment of loop 210. The engagement between the resilient tab and the opening in the sidewall of sheath 208 may act as a locking mechanism that prevents inadvertent advancement of sheath 208, and therefore inadvertent premature closure of loop 210 and retrieval bag 212. Other ways in which inadvertent retraction and/or advancement of sheath 208 may be avoided through various features of specimen retrieval instrument 200 will be apparent to those of ordinary skill in the art in view of the teachings herein.
In some versions, modifications may include providing loop 210 in various sizes with various sized retrieval bags 212. In other words, loop 210 and/or retrieval bag 212 may be modular in nature, and may come in a kit having loops 210 and/or retrieval bags 212 in various sizes. In some such versions, the desired sized loop 210 and retrieval bag 212 may be attached to rod 204 prior to insertion of specimen retrieval instrument 200 within a patient. Still various other suitable features, components, configurations, and operabilities that may be incorporated into specimen retrieval instrument 200 will be apparent to those of ordinary skill in the art in view of the teachings herein.
C. Exemplary Telescoping Arm
As can be seen from
In some alternative versions, sheath 308 is removable from introducer tube 306 by pulling sheath 308 off of introducer tube 306 in a distal direction; rather than providing proximal retractability of sheath 308. By way of example only, sheath 308 may be configured like a sleeve or sock, and a separate instrument (e.g., conventional tissue graspers, etc.) may be used to pull sheath 308 distally off of support arm assembly 342 and retrieval bag 312. In addition or in the alternative, sheath 308 may have a perforation or other weakening feature that may be breached to remove sheath 308 by tearing sheath 308 away from introducer tube 306. As yet another merely illustrative alternative, sheath 308 may be formed of an environmentally sensitive material. For instance, sheath 308 may be configured to dissolve or substantially weaken in the presence of bodily fluid, certain temperatures, or other environmental parameters that may be associated with the interior of a patient. Still other various ways in which sheath 308 may be configured and/or operable will be apparent to those of ordinary skill in the art in view of the teachings herein. Furthermore, sheath 308 may even be omitted in some versions.
As shown in
Referring to
As noted above, support arm assembly 342 of the present example is resiliently biased to assume an arcuate configuration as shown in
In the present example, a first end 316 of the top edge of retrieval bag 312 is secured to plug 350; while a second end 318 of the top edge of retrieval bag 312 is secured to a proximal portion of first arm 344. A plurality of loops 314 are secured to the top edge of retrieval bag 312, between ends 316, 318. Loops 314 are further secured to support arm assembly 342. In particular, as shown in
In some versions, the telescoping action of arms 346, 348 may occur using one or more springs or spring-like members positioned within arms 344, 346, 348. The springs or spring-like members may be biased to extend arms 346, 348 when support arm assembly 342 is not constrained by introducer tube 306 or other components. In such versions, as support arm assembly 342 is ejected from within introducer tube 306, springs or spring-like members work to extend arms 346, 348 such that support arm assembly 342 and retrieval bag 312 open.
In some versions, the telescoping action of arms 346, 348 may occur using a push cable or other similar structure that extends through introducer tube 306 or actuating rod 304 and connects with plug 350 of support arm assembly 342. Such a cable may have sufficient tensile strength to allow pushing through the cable yet have sufficient flexibility to permit transverse bending of the cable. Once support arm assembly 342 is ejected from introducer tube 306 by distal advancement of thumb ring 314, the cable may then be advanced distally to cause arms 346, 348 to telescopically extend thereby opening support arm assembly 342 and retrieval bag 312. In the same manner, retracting the cable after extending arms 346, 348 causes arms 346, 348 to telescopically retract thereby closing support arm assembly 342 and retrieval bag 312. In some versions, the cable may further be used to eject support arm assembly 342 from introducer tube 306 instead of distally advancing thumb ring 314.
In some versions, the telescoping action of arms 346, 348 may be controlled through advancement or retraction of thumb ring 314 and associated actuating rod 304. For example, as shown in
In use, prior to deployment of support arm assembly 342, specimen retrieval instrument 300 may initially have the configuration shown in
In some versions, ends 316, 318 are configured such that they are substantially secured to each other after support arm assembly 342 reaches the configuration shown in
In some versions, specimen retrieval instrument 300 is configured such that retrieval bag 312 may be removed from specimen retrieval instrument 300 while retrieval bag 312 is within the patient. Some such versions facilitate removal of retrieval bag 312 separate from removal of the other components of specimen retrieval instrument 300. In some versions, this may be accomplished by, among other ways, retrieval bag 312 being removable from loop support arm assembly 342 as noted above. Furthermore, in some versions specimen retrieval instrument 300 may include a closure string connected to retrieval bag 312 and having a slipknot attachment to actuating rod 304. Pulling the slipknot loose and retracting introducer tube 306 may permit detachment of retrieval bag 312 and the closure string from the other components of specimen retrieval instrument 300. In some such versions, a user may pull the closure string to close retrieval bag 312. By way of example only, such a closure mechanism may be configured in accordance with the teachings of U.S. Pat. No. 6,409,733, entitled “Specimen Retrieval Bag,” issued Jun. 25, 2002, which is incorporated herein by reference. Still in other versions, it may be feasible to incorporate a closure string with retrieval bag 312, and to release retrieval bag 312 from specimen retrieval instrument 300 such that retrieval bag 312 may be removed from the patient separate from other components of specimen retrieval instrument 300.
While the above description provides adequate disclosure to enable one of ordinary skill in the art to make and use specimen retrieval instrument 300, based on the teachings herein, those of ordinary skill in the art will appreciate that various other modifications may provide additional features or functionality. For example, in some versions modifications may include actuating rod 304 and/or sheath 308 comprising features operable with features of introducer tube 306 or other components to prevent inadvertent retraction of sheath 308 (and/or inadvertent extension of actuating rod 304) and premature deployment of support arm assembly 342. For example, sheath 308 and/or actuating rod 304 may include a lock or stop that may be released once a user is ready to deploy support arm assembly 342. Still in other versions, modifications may include actuating rod 304 comprising features operable with features of introducer tube 306 or other components to prevent inadvertent retraction of actuating rod 304 after initial deployment of support arm assembly 342. For example, actuating rod 304 may be associated with a resilient tab configured to engage a corresponding opening in a sidewall of introducer tube 306 upon deployment of support arm assembly 342. The engagement between the resilient tab and the opening in the sidewall of introducer tube 306 may act as a locking mechanism that prevents inadvertent retraction of actuating rod 304 and therefore inadvertent premature retraction of support arm assembly 342. Other ways in which inadvertent retraction and/or advancement of sheath 308 and/or actuating rod 304 may be avoided through various features of specimen retrieval instrument 300 will be apparent to those of ordinary skill in the art in view of the teachings herein.
In some versions, modifications may include providing support arm assembly 342 with various lengths of telescopic arms such that support arm assembly 342 is provided in a variety of sizes that may be further paired with various sized retrieval bags 312. In such versions, the desired size support arm assembly 342 and retrieval bag 312 may be attached to actuating rod 304 prior to insertion of specimen retrieval instrument 300 within a patient. Still various other suitable features, components, configurations, and operabilities that may be incorporated into specimen retrieval instrument 300 will be apparent to those of ordinary skill in the art in view of the teachings herein.
II. Exemplary Retrieval Bag Opening Assistance
Another area to consider when designing a specimen retrieval instrument is the modes used to facilitate opening of a retrieval bag once the bag has been deployed from the specimen retrieval instrument. The following section will discuss several exemplary retrieval bag assistance modes, which may include use of a spiral reinforced rib retrieval bag, an unrolling stay, and a twist actuation. Based on the teachings herein, other deployment modes will be apparent to those of ordinary skill in the art.
A. Exemplary Spiral Reinforced Rib Retrieval Bag
Retrieval bag 412 of the present example comprises a membrane 452, a plurality of ribs 454 associated with membrane 452, and a spiral member 456. Retrieval bag 412 is secured to the distal end of an actuating rod 404 such that translation of actuating rod 404 may cause retrieval bag 412 to translate in unison with actuating rod 404. In the present example, actuating rod 404 is translatable from a proximal position within introducer tube 408 (
Spiral member 456 is collapsible to fit within introducer tube 408 or some other component of distal portion 400 of the specimen retrieval instrument. Spiral member 456 is biased such that the looping portions that comprise spiral member 456 have a diameter consistent with the diameter of the retrieval bag opening defined by membrane 452. In particular, top portions of spiral member 456 define diameters that are greater than diameters defined by bottom portions of spiral member 456, such that the diameter defined by spiral member 456 gets progressively smaller from the top of spiral member 456 toward the bottom of spiral member 456. It should be understood that spiral member 456 may compress in various ways. For instance, spiral member 456 may compress along an axis that is vertically transverse to the longitudinal axes defined by actuating rod 404 and introducer tube 408. In other words, spiral member 456 may compress along an axis that is vertical in the views shown in
In use, once distal portion 400 of specimen retrieval instrument is positioned within a patient, retrieval bag 412 may be deployed from within introducer tube 408 by any suitable means, e.g. extending actuator rod 404 distally relative to the patient or retracting introducer tube 408 proximally relative to the patient. After deployment, spiral member 456 releases from its constrained position forcing retrieval bag 412 to its fully open position. Working separately from, or in conjunction with, spiral member 456, ribs 454 also operate to assist retrieval bag 412 in reaching the fully open position. After a specimen has been collected within retrieval bag 412, retrieval bag 412 may be closed and subsequently removed from within the patient by any suitable means described previously.
While the above description provides adequate disclosure to enable one of ordinary skill in the art to make and use a specimen retrieval instrument incorporating a spiral rib reinforced retrieval bag 412, based on the teachings herein, those of ordinary skill in the art will appreciate that various other modifications may provide additional features or functionality. For example, retrieval bag 412 may be adapted to fit with or work with other types of specimen retrieval instruments, not just that shown in
B. Exemplary Unrolling Stay
In addition to loop 510 being adaptable to fit within introducer tube 508, retrieval bag 512 is collapsible to fit within introducer tube 508 as well. Stay 558 is secured to membrane 552, such as by being adhered to membrane 552 and/or being inserted in a pocket of membrane 552, etc. As shown in
In use, once distal portion 500 of specimen retrieval instrument is positioned within a patient, retrieval bag 512 may be deployed from within introducer tube 508 by any suitable means, e.g. extending an actuator rod distally or retracting introducer tube 508 proximally, etc. After deployment, stay 558 releases from its constrained rolled-up position forcing retrieval bag 512 to its unfurled open configuration. A resilient bias of loop 510 may also assist in opening retrieval bag 512. After a specimen has been collected within retrieval bag 512, retrieval bag 512 may be closed by retracting loop 510, or pulling a closure string as discussed previously. Retrieval bag 512 may then be removed from within the patient by any suitable means described previously or otherwise.
While the above description provides adequate disclosure to enable one of ordinary skill in the art to make and use a specimen retrieval instrument incorporating unrolling stay 558 in retrieval bag 512, based on the teachings herein, those of ordinary skill in the art will appreciate that various other modifications may provide additional features or functionality. For example, retrieval bag 512 may be adapted to fit with or work with other types of specimen retrieval instruments, not just that shown in
C. Exemplary Twist Actuation
Prior to the position shown in
Rotation of second loop 660 may to transition from the configuration shown in
Once a specimen has been captured within retrieval bag 612, first loop 610 may be retracted proximally to contact introducer tube 608. Such contact with introducer tube 608 may overcome the resilient bias of first loop 610, thereby causing first loop 610 to close. This action similarly may close retrieval bag. In addition or in the alternative, and as described above, retrieval bag 612 may be closed through the use of a closure string. In any event, once a specimen has been captured within retrieval bag 612, retrieval bag 612 and other components of the specimen retrieval instrument may be removed from the patent by any suitable means as described previously or otherwise.
III. Exemplary Alternative Instrument
Retrieval bag 780 is secured to resilient hoop 770, such that retrieval bag 780 is retracted or deployed with actuating rod 752 relative to shaft 750. In other words, retrieval bag 780 is configured to fit with resilient hoop 770 within shaft 750. Retrieval bag 780 may be folded, rolled, wadded up, or otherwise manipulated to fit within shaft 750. Furthermore, retrieval bag 780 may be configured in accordance with the teachings relating to any retrieval bag mentioned herein; or retrieval bag 780 may have any other suitable configuration. Resilient hoop 770 is resiliently biased to assume the expanded, generally circular configuration shown in
Handle portion 720 includes a slider 722, a cinching trigger 724, and a locking trigger 726. Slider 722 is coupled with the proximal end of actuating rod 752, and is operable to translate actuating rod 752 longitudinally within shaft 750. In particular, slider 722 may be slid distally to advance resilient hoop 770 and thereby deploy resilient hoop 770 and retrieval bag 780 from within shaft 750. Of course, slider 722 may be modified, substituted, or supplemented in a variety of ways (or even be omitted) as will be apparent to those of ordinary skill in the art in view of the teachings herein. Cinching trigger 724 is coupled with a closure string (not shown), which is fed through retrieval bag 780 to selectively cinch retrieval bag 780 closed. In particular, cinching trigger 724 is operable to cinch retrieval bag 780 closed by squeezing cinching trigger 724 toward pistol grip 728 of handle portion 720. Cinching trigger 724 is resiliently biased away from pistol grip 728 in the present example, such that an operator will be squeezing cinching against the resilient bias of a spring or other component when the operator is cinching retrieval bag 780. In some versions, locking trigger 726 is operable to lock a cinched configuration of retrieval bag 780. For instance, in some versions, the operator will squeeze cinching trigger 724 until a desired cinching position is obtained, and then the operator will actuate locking trigger 726 to substantially secure the selected cinching position, such that the locking trigger 726 prevents the resilient bias of cinching trigger 724 from un-cinching retrieval bag 780 when cinching trigger 724 is released. As another merely illustrative variation, a ratcheting mechanism may substantially lock the cinching position of cinching trigger 724 and retrieval bag 780; and locking trigger 726 may release the ratcheting mechanism to permit adjustment of a cinched position. Like slider 722, triggers 724, 726 may be modified, substituted, or supplemented in a variety of ways (or even be omitted) as will be apparent to those of ordinary skill in the art in view of the teachings herein.
In use, the distal end of shaft 750 may be introduced to a surgical site via a trocar or other device, etc. Slider 722 may be advanced distally to deploy resilient hoop 770 and retrieval bag 780 within the patient. A specimen may then be placed within retrieval bag 780. Next, cinching trigger 724 may be actuated to cinch retrieval bag 780; and locking trigger 726 may be actuated to lock a cinched position. The distal end of specimen retrieval instrument 700 may then be removed from the patient substantially simultaneously with the trocar or other access port device. Alternatively, specimen retrieval instrument 700 may be removed from the patient, in whole or in pieces, separate from removal of the trocar from the patient. In addition or in the alternative, some versions of specimen retrieval instrument 700 may permit removal of retrieval bag 780 from specimen retrieval instrument 700 before anything is withdrawn from the patient. In some such versions, portions of specimen retrieval instrument 700 may be removed from the patient separately from and before removal of retrieval bag 780 from the patient. If desired, an integral string or other feature may be used to remove retrieval bag 780 from the patient after at least part of specimen retrieval instrument has been removed from the patient. Still various other suitable features, components, configurations, and operabilities that may be incorporated into specimen retrieval instrument 700 will be apparent to those of ordinary skill in the art in view of the teachings herein.
As noted above, the various versions of specimen retrieval instruments described herein, including but not limited to the various versions of retrieval bags described herein, may be used in a conventional endoscopic procedure that includes the insertion of the introducer tube or other component through a small opening, e.g., an incision, natural orifice, or trocar access port, etc. Of course, specimen retrieval instruments described herein may be used in conjunction with any other suitable surgical or medical procedure, such as endoscopic/laparoscopic procedures, open surgical procedures, or robotic-assisted surgery, etc. Still other various settings and combinations in which specimen retrieval instruments described herein may be used will be apparent to those of ordinary skill in the art in view of the teachings herein.
While several specimen retrieval instruments, and components thereof, have been discussed in detail above, it should be understood that the components, features, configurations, and methods of using the specimen retrieval instruments discussed are not limited to the contexts provided above. In particular, components, features, configurations, and methods of use described in the context of one of the specimen retrieval instruments may be incorporated into any of the other specimen retrieval instruments. One merely exemplary additional feature that may be provided in any of the specimen retrieval instruments described herein includes retrieval bags having various sizes and geometries. For example, some specimen retrieval instruments may be designed with small, medium, or large retrieval bags. It should also be understood that any of the specimen retrieval instruments and tissue retrieval bags described herein may be capable of receiving tissue specimens and removing tissue specimens from a patient without such tissue specimens needing to be morcellated or otherwise reduced in size before being received and removed by the specimen retrieval instrument and bag. Still other additional and alternative suitable components, features, configurations, and methods of using the specimen retrieval instruments will be apparent to those of ordinary skill in the art in view of the teachings herein.
Other features and modifications that will be appreciated based on the teachings herein involve methods of attaching a retrieval bag to any of the various arms and loops or other components of a specimen retrieval instrument described above. For example, retrieval bags may be configured with one or more sleeves, slots, pockets, loops, slits, etc., for receiving any of the various arms and loops described above. In other versions, retrieval bags may be connected to any of the various arms, loops, or other components using suitable mechanical or chemical means. It will further be appreciated that in some versions the retrieval bag may be detachable from the other components of the specimen retrieval instrument, while in some other versions the retrieval bag may be inseparable from the specimen retrieval instrument. Still other additional and alternative suitable components, features, configurations, and methods of attaching retrieval bags with the other components of a specimen retrieval instrument will be apparent to those of ordinary skill in the art in view of the teachings herein.
While several retrieval bags and deployment mechanisms have been discussed in detail above, it should be understood that the components, features, configurations, and methods of using the bags and deployment mechanisms discussed are not limited to the contexts provided above. In particular, components, features, configurations, and methods of use described in the context of one of the retrieval bags may be incorporated into any of the other retrieval bags. One merely exemplary additional feature that may be provided in any of the retrieval bags described herein is one or more weld lines. Such weld lines may be intermittent or continuous along the length of the bag. Such weld lines, offering alternating areas of stiffness along the surface of the bag, may enhance the closure of a bag due to the tendency of areas of lesser stiffness to buckle, deform, or fold. In this way, a retrieval bag may be forced or encouraged to buckle or fold in a desired manner as the bag is closed. Still other additional and alternative suitable components, features, configurations, and methods of using the above-described retrieval devices will be apparent to those of ordinary skill in the art in view of the teachings herein.
While the tissue retrieval instruments of the above-described examples are actuated manually by advancing a thumb ring distally relative to finger rings, retracting a sheath relative to an introducer tube, advancing a slider, or in some other manual fashion, etc., it should be understood that any of the tissue retrieval instruments described herein may instead be actuated in any other suitable fashion. By way of example only, a tissue retrieval instrument may instead be actuated electromechanically (e.g., using one or more electrical motors, solenoids, etc.), pneumatically, and/or hydraulically. Various suitable ways in which such alternative forms of actuation may be provided in a tissue retrieval instrument will be apparent to those of ordinary skill in the art in view of the teachings herein. Similarly, various other suitable ways in which a tissue retrieval instrument may be actuated will be apparent to those of ordinary skill in the art in view of the teachings herein.
It should be understood that any of the retrieval bags described herein may have various types of construction. By way of example only, any of the retrieval bags described herein may be constructed from at least one layer of an elastomeric or polymeric material such as but not limited to polyurethane, polyethylene, polypropelene, polyester (Dura-lar), Poly-isoprene, silicone, vinyl, or a polytetrafluroethyelene (Teflon®). For example, any retrieval bag described herein may comprise a single layer of elastomeric or polymeric material. Alternatively, any retrieval bag described herein may be formed of two or more layers of material. For instance, two or more layers of a retrieval bag wall may be aligned and joined together by adhesives, heat welding, heat staking, RF welding, ultrasonically welding, or other suitable method of attachment. Any retrieval bag described herein may also be cut at an angle to provide a taper or special shapes suitable for specific organs of body (e.g., tissue shapes, etc.), which may facilitate removal of the retrieval bag from a patient. Furthermore, any retrieval bag described herein may incorporate flexible metal meshes, thermoformed plastic meshes, fabrics, or aramid fibers such as Kevlar® for reinforcement. Still other suitable materials that may be used to form retrieval bags as described herein, including combinations of materials, will be apparent to those of ordinary skill in the art in view of the teachings herein. Similarly, various other suitable compositions of the walls of the retrieval bags described herein, including but not limited to various structures, components, and features that may be incorporated into the walls of the retrieval bags described herein, will be apparent to those of ordinary skill in the art in view of the teachings herein.
In any of the above described tissue retrieval instruments, the tissue retrieval bag may include a fold-over flap (not shown) for closing the bag. For instance, such a fold-over flap may be used instead of (or in addition to) using a string to effect closure of the bag. Such a fold-over flap may include an adhesive (e.g., pressure sensitive adhesive, etc.) that substantially keeps the flap in a closed position after the flap has been moved to a closed position. A peel-away strip or similar feature may be used to cover such an adhesive before the flap is closed. A conventional grasping instrument or other type of device may be used to peel the peel-away strip and/or close the flap over the mouth of the bag while the bag is still inside the patient. In some other variations, a tissue retrieval bag may be formed at least in part of a material that provides significant static adhesion or other type of adhesion to itself. For instance, the interior surfaces of the tissue retrieval bag may be configured to adhere to each other and/or to adhere to tissue/objects placed in the bag, to reduce the likelihood of tissue/objects in the bag falling out of the bag. In some such versions, a closure string is omitted. Other suitable variations of a tissue retrieval bag will be apparent to those of ordinary skill in the art in view of the teachings herein.
Versions of the devices disclosed herein have application in conventional endoscopic and open surgical instrumentation as well as application in robotic-assisted surgery.
Versions of the devices disclosed herein can be designed to be disposed of after a single use, or they can be designed to be used multiple times. Versions may, in either or both cases, be reconditioned for reuse after at least one use. Reconditioning may include any combination of the steps of disassembly of the device, followed by cleaning or replacement of particular pieces, and subsequent reassembly. In particular, embodiments of the device may be disassembled, and any number of the particular pieces or parts of the device may be selectively replaced or removed in any combination. Upon cleaning and/or replacement of particular parts, embodiments of the device may be reassembled for subsequent use either at a reconditioning facility, or by a surgical team immediately prior to a surgical procedure. Those skilled in the art will appreciate that reconditioning of a device may utilize a variety of techniques for disassembly, cleaning/replacement, and reassembly. Use of such techniques, and the resulting reconditioned device, are all within the scope of the present application.
By way of example only, versions described herein may be sterilized before and/or after a procedure. In one sterilization technique, the device is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and device may then be placed in a field of radiation that can penetrate the container, such as gamma radiation, x-rays, or high-energy electrons. The radiation may kill bacteria on the device and in the container. The sterilized device may then be stored in the sterile container for later use. A device may also be sterilized using any other technique known in the art, including but not limited to beta or gamma radiation, ethylene oxide, or steam.
Having shown and described various versions in the present disclosure, further adaptations of the methods and systems described herein may be accomplished by appropriate modifications by one of ordinary skill in the art without departing from the scope of the present invention. Several of such potential modifications have been mentioned, and others will be apparent to those skilled in the art. For instance, the examples, versions, geometrics, materials, dimensions, ratios, steps, and the like discussed above are illustrative and are not required. Accordingly, the scope of the present invention should be considered in terms of the following claims and is understood not to be limited to the details of structure and operation shown and described in the specification and drawings.