US20180344141A1

US20180344141A1 - Scope with integral cleaning element for use during a laparoscopic procedure

Info

Publication number: US20180344141A1
Application number: US15/993,357
Authority: US
Inventors: Joanna L. Rosenbaum; Jeanny Chung; Patrick Hubbard; Joseph Prybell; Corrie Threlkeld; Sara Tillman; Brandon Toth; Andrew P. VanDeWeghe; Thomas Wilschke; Jesse Charles Darley; Christopher Alan Harris; Curtis B. Irwin; Stephen A. Latham; Daniel J. Lee; Douglas Rodenkirch; Jeffrey R. Staszak
Original assignee: CareFusion 2200 Inc
Current assignee: CareFusion 2200 Inc
Priority date: 2017-05-31
Filing date: 2018-05-30
Publication date: 2018-12-06
Also published as: WO2018222760A3; US10751085B2; WO2018222767A1; WO2018222760A2; WO2018222760A9; US20180344427A1; US10758267B2; US20180360490A1; WO2018222754A1

Abstract

A scope includes a housing having a distal portion with a distal end. A lens is at the distal end. A cleaning element is operatively coupled to the distal portion of the housing, wherein the cleaning element is movable between a first position and a second position contacting the distal end.

Description

RELATED APPLICATIONS

This application claims the benefit of U.S. Provisional Application No. 62/513,270, filed May 31, 2017, and U.S. Provisional Application No. 62/513,278, filed May 31, 2017, each of which is herein incorporated by reference in its entirety. Further, each of the following applications, filed on Mar. 7, 2017, is herein incorporated by reference in its entirety: U.S. patent application Ser. No. 15/452,169, U.S. patent application Ser. No. 15/452,211, and U.S. patent application Ser. No. 15/452,246.

FIELD OF TECHNOLOGY

The present disclosure relates generally to scopes, such as laparoscopes, trocar assemblies, and related devices, and more specifically, to scopes for use with trocar assemblies, for example, which can be utilized in laparoscopic medical procedures.

BACKGROUND

Laparoscopic surgery is a minimally-invasive surgical technique typically performed with the assistance of one or more medical instruments inserted through a small incision in a patient's body. Laparoscopic surgery is often preferred to traditional and more invasive surgical procedures because of the reduced frequency and degree of certain postoperative side effects, such as postoperative pain, swelling, internal bleeding, and infection risk. The minimally-invasive nature of laparoscopic procedures may also result in decreased recovery times and shorter hospital stays.
Typical medical devices utilized during laparoscopic procedures have instruments mounted on an elongated metal or plastic body that are inserted into the patient's body and maneuvered to a target area within a body cavity (e.g., the abdominal, pelvic, thoracic, or chest cavity, where insufflation may be used to provide additional space in which to maneuver, which requires a fluid-patient barrier to maintain insufflation pressure in the cavity). One or more trocar assemblies are typically first inserted into the patient body at an incision site (for each), and the instruments access the patient body through the trocar assembly(ies).
Often, a medical device including a camera or other image-transmitting device is inserted through a trocar to transmit one or more images or a live video feed from within the body cavity to a medical professional (such as the surgeon). The device may be referred to as a scope or a laparoscope, and its transmission may guide the medical professional's actions during the laparoscopic procedure.
A problem typically experienced during laparoscopic procures involves a compromised image or video feed due to an obstructed lens of the laparoscope. This obstruction may be caused by condensation (e.g., fog) and/or debris such as bodily fluids or displaced tissue encountered by the lens during the procedure. Such obstruction is problematic because the lens of the laparoscope preferably remains contained in a pressurized and sterile environment (e.g., insufflated body cavity), and removing the lens from that environment for cleaning purposes may cause lengthy interruptions prolonging patient anesthesia and increasing a risk of compromised sterility.

SUMMARY

In one aspect, a scope includes a housing having a distal portion with a distal end. A lens is at the distal end. A cleaning element is operatively coupled to the distal portion of the housing, wherein the cleaning element is movable between a first position and a second position contacting the distal end.
In another aspect, a trocar assembly includes a cannula having a proximal portion and an opposing distal portion. The distal portion is configured to extend into a patient body. The cannula defines an access channel between the proximal portion and the distal portion. A scope is movably positioned within the access channel. The scope can be maneuvered through the access channel to a location within the patient body. A cleaning element is operatively coupled to a distal portion of the scope. The cleaning element is configured to contact at least a lens of the scope.
In yet another aspect, a method for cleaning a distal end of a scope includes coupling a cleaning element at a distal portion of the scope. The distal portion is configured to extend into a patient body to a location within the patient body. At least a distal end of the scope is cleaned with the cleaning element by moving the cleaning element with respect to the distal end of the scope.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective view of a distal portion of an example scope for use during a laparoscopic procedure, the example scope having a cleaning element in a first position, in accordance with certain example embodiments;

FIG. 2 is a perspective view of the distal portion of the example scope shown in FIG. 1 with the cleaning element in a second position;

FIG. 3 is a perspective view of a distal portion of an example scope for use during a laparoscopic procedure before cleaning of the distal portion with an integrated cleaning element, in accordance with certain example embodiments;

FIG. 4 is a perspective view of the distal portion of the example scope shown in FIG. 3 as the cleaning element moves across a cover to clean the cover;

FIG. 5 is a perspective view of the distal portion of the example scope shown in FIG. 3 after cleaning of the distal portion with the integrated cleaning element;

FIG. 6 is a perspective view of a distal end of the example scope during cleaning of the distal portion with the integrated cleaning element;

FIG. 7 is a perspective view of a distal portion of an example scope for use during a laparoscopic procedure, the example scope including a band extending laterally across the distal portion with the cleaning element in a second position, in accordance with certain example embodiments;

FIG. 8 is a sectional view of a portion of the distal portion of the example scope shown in FIG. 7 with the band contacting an outer surface of the lens;

FIG. 9 is a perspective view of the distal portion of the example scope shown in FIG. 7 with the cleaning element in a first position after cleaning of the distal portion with the integrated band;

FIG. 10 is a perspective view of a distal end of the example scope including a band extending laterally across the distal portion as the band is advanced;

FIG. 11 is a perspective view of a distal portion of an example scope for use during a laparoscopic procedure, the example scope including a band extending laterally across the distal portion with the cleaning element in a second position, in accordance with certain example embodiments;

FIG. 12 is a perspective view of a portion of the distal portion of the example scope shown in FIG. 11 with the cleaning element in a first position after cleaning of the distal portion with the integrated band;

FIG. 13 is a sectional view of the distal portion of the example scope including a band extending laterally across the distal portion as the band is advanced;

FIG. 14 is a perspective view of a distal portion of an example scope for use during a laparoscopic procedure, the example scope including a cleaning element having an insert with a film extending laterally across the distal portion with the cleaning element in a second position, in accordance with certain example embodiments;

FIG. 15 is a plan view of a distal end of the example scope shown in FIG. 14;

FIG. 16 is a perspective view of a film suitable for use with the cleaning element;

FIG. 17 is a perspective view of the distal portion of the example scope shown in FIG. 14 with the cleaning element in a first position;

FIG. 18 is a perspective view of a distal portion of an example scope for use during a laparoscopic procedure, the example scope including a cleaning element having a film extending laterally across the distal portion with the cleaning element, in accordance with certain example embodiments;

FIG. 19 is a perspective view of a film suitable for use with the cleaning element;

FIG. 20 is a sectional view of the distal portion of the example scope shown in FIG. 18;

FIG. 21 is a perspective view of a distal portion of an example scope for use during a laparoscopic procedure, the example scope including a cleaning element having a film extending laterally across the distal portion with the cleaning element in a second position, in accordance with certain example embodiments;

FIG. 22 is a sectional view of a distal portion of an example scope with a cleaning element in a second position, in accordance with certain example embodiments;

FIG. 23 is a sectional view of the distal portion of the example scope shown in FIG. 22 as the cleaning element moves from the second position to a first position;

FIG. 24 is a sectional view of the distal portion of the example scope shown in FIG. 22 as the cleaning element moves from the second position to the first position;

FIG. 25 is a sectional view of the distal portion of the example scope shown in FIG. 22 with the cleaning element in the first position;

FIG. 26 is a perspective view of a distal portion of an example scope for use during a laparoscopic procedure, the example scope including an integral cleaning element, in accordance with certain example embodiments;

FIG. 27 is a plan view of a distal portion of an example scope for use during a laparoscopic procedure, the example scope including a shield in a second position, in accordance with certain example embodiments;

FIG. 28 is a sectional view of the distal portion of the example scope shown in FIG. 27 with the shield in a first position;

FIG. 29 is a perspective view of the distal portion of the example scope shown in FIG. 27 with the shield in the first position; and

FIG. 30 is a perspective view of a distal portion of an example scope for use during a laparoscopic procedure, in accordance with certain example embodiments.

DETAILED DESCRIPTION

Various embodiments are described below with reference to the drawings in which like elements generally are referred to by like numerals. The relationship and functioning of the various elements of the embodiments may better be understood by reference to the following detailed description. However, embodiments are not limited to those illustrated in the drawings. It should be understood that the drawings may or may not be to scale, and in certain instances details may have been omitted that are not necessary for an understanding of embodiments disclosed herein, such as—for example—conventional fabrication and assembly.
The invention is defined by the claims, may be embodied in many different forms, and should not be construed as limited to the embodiments set forth herein; rather, these embodiments are provided so that this disclosure will be thorough and complete, and will fully convey enabling disclosure to those skilled in the art. As used in this specification and the claims, the singular forms “a,” “an,” and “the” include plural referents unless the context clearly dictates otherwise. Reference herein to any industry and/or governmental standards (e.g., ASTM, ANSI, IEEE, HIPAA, FDA standards) is defined as complying with the currently published standards as of the original filing date of this disclosure concerning the units, measurements, and testing criteria communicated by those standards unless expressly otherwise defined herein.
The terms “proximal” and “distal” are used herein in the common usage sense where they refer respectively to a handle/doctor-end of a device or related object and a tool/patient-end of a device or related object. The terms “about,” “substantially,” “generally,” and other terms of degree, when used with reference to any volume, dimension, proportion, or other quantitative or qualitative value, are intended to communicate a definite and identifiable value within the standard parameters that would be understood by one of skill in the art (equivalent to a medical device engineer with experience in this field), and should be interpreted to include at least any legal equivalents, minor but functionally-insignificant variants, standard manufacturing tolerances, and including at least mathematically significant figures (although not required to be as broad as the largest range thereof).
In example embodiments, such as described herein, a trocar assembly includes a proximal portion. A cannula extends between the proximal portion and a distal portion of the trocar assembly opposite the proximal portion. The distal portion of the trocar assembly is configured to extend into a patient body. The cannula defines or forms an access channel between a first or proximal opening at the proximal portion and a second or distal opening at the distal portion. The access channel is configured to receive a scope, e.g., a laparoscope, such that the scope can be maneuvered through the access channel to extend distally from the distal portion of the trocar assembly at a location within the patient body. The scope includes an integral cleaning element positioned at or coupled to a distal portion of the scope. The cleaning element is configured to contact at least a distal end of the scope, e.g., with the cleaning element in a second position, to periodically clean at least the distal end of the scope, e.g., a lens of an imaging device at the distal end of the scope, to remove condensation (e.g., fog) and/or debris, such as bodily fluids or displaced tissue, from the lens during the procedure. In certain example embodiments, the cleaning element is configured to clean an entire distally facing surface of the lens, e.g., by temporarily occluding an opening at or near a distal end of the housing. With the cleaning element contacting the distally facing surface of the lens a complete cleaning of the entire lens surface can be accomplished.
In example embodiments, the cleaning element is movable between a first position allowing the scope to freely move in a proximal direction and/or a distal direction within the access channel and a second or cleaning position. In the second position, the cleaning element contacts at least the distal portion of the scope to clean desired portions of the scope, e.g., the lens. In certain example embodiments, the cleaning element includes a plurality of members, e.g., a plurality of brushes, bristles, fibers, fingers, leaflets, wipers, pads, projections, or any combination thereof such that the plurality of members contact the scope. The members may be formed of a compliant or flexible material such that each member is movable upon contacting the scope, e.g., to allow the scope to move through a housing of the scope without undesirable contact with or interference from the members, while providing sufficient resilience to facilitate cleaning the distal end of the scope, e.g., the lens.
Referring to FIGS. 1-30, a scope 40, such as a laparoscope or another suitable scope, includes an imaging device, e.g., a lens 42, operatively coupled to an external device for processing data and generating images of a location within the patient body. Lens 42 is configured to generate data signals representative of images at the location within the patient body and transmit the data signals to the external device. In example embodiments, scope 40 is configured to be received within a trocar assembly. More specifically, scope 40 is movably positionable within an access channel formed in a cannula of the trocar assembly. The cannula has a proximal portion and an opposing distal portion. The distal portion of the cannula is configured to extend into a patient body to assist with performing minimally-invasive surgical procedures including, for example, laparoscopic surgical procedures. The inner wall of the cannula forms or defines at least a portion of the access channel, which extends between a first or proximal opening at the proximal portion of the cannula and an opposing second or distal opening at the distal portion of the cannula. The access channel is configured to receive scope 40 such that scope 40 can be maneuvered through the access channel to a location within the patient body.
Referring further to FIGS. 1 and 2, scope 40 includes a cylindrical housing 44 having a proximal portion (not shown in FIGS. 1 and 2) and an opposing distal portion 46 with a distal end 48. In example embodiments, lens 42 is located at distal end 48 and, in certain embodiments, at least partially set in housing 44. An integrated cleaning element 50 is operatively coupled to distal portion 46 of housing 44. In certain example embodiments, cleaning element 50 is movable between a first position and a second position contacting at least a portion of distal portion 46, e.g., lens 42, to remove condensation and/or debris, such as bodily fluids or displaced tissue, from distal portion 46, e.g., lens 42, during a procedure. FIG. 1 shows distal portion 46 of scope 40 with cleaning element 50 in a first position and FIG. 2 shows distal portion 46 of scope 40 with cleaning element 50 in a second position. In the first position, cleaning element 50 allows lens 42 to capture images of the location in the patient body and, in certain embodiments, extend distally from distal end 48 of housing 44 at the location.
As shown in FIGS. 1 and 2, in this embodiment, cleaning element 50 is slidably coupled to a side wall 52 of housing 44 at distal portion 46. In a particular embodiment, cleaning element 50 is slidably positioned within a slot 54 formed in an outer surface 56 of housing 44. Cleaning element 50 is movable between a first position, as shown in FIG. 1, toward a second position, as shown in FIG. 2, substantially contacting an outer surface of lens 42. As cleaning element 50 is moved between the first position and the second position, cleaning element 50 is configured to contact and move across lens 42. Cleaning element 50 is made of or includes a suitable cleaning material to facilitate cleaning lens 42 to remove condensation and/or debris, such as bodily fluids or displaced tissue, from lens 42 and/or other portions of scope 40. Because cleaning element 50 is made of a suitable compliant, flexible or bendable material, such as a suitable shape memory material, cleaning element 50 follows a contour of slot 54 and housing 44 as cleaning element 50 moves between the first position and the second position.
Referring now to FIGS. 3-6, in another example embodiment, scope 40 includes cleaning element 50 having a cover 60 that is rotatably coupled to distal portion 46 of housing 44 at or near distal end 48. FIG. 3 shows distal portion 46 of scope 40 before cover 60 is cleaned using cleaning element 50. FIG. 4 shows distal portion 46 of scope 40 as cleaning element 50 moves across cover 60 to clean cover 60. FIG. 5 shows distal portion 46 of scope 40 after cover 60 is cleaned using cleaning element 50. FIG. 6 shows distal end 48 of scope 40 as cover 60 is cleaned using cleaning element 50. In this embodiment, cover 60 is configured to substantially extend over or enclose lens 42. In a particular embodiment, cover 60 has a dome shape as shown in FIGS. 3-6. A band 62 extends laterally across cover 60. In example embodiments, band 62 has a first end 64 coupled to distal portion 46 at a first point 66 and a second end 68 opposite first end 64 coupled to distal portion 46 at a second point 70 laterally opposing first point 66, as shown in FIG. 6, for example. Band 62 is configured to remain in contact with cover 60 as cover 60 rotates or revolves between the first position and the second position. As cover 60 moves with respect to band 62, band 62 contacts cover 60 with sufficient frictional force to remove condensation and/or debris from cover 60, as shown in FIGS. 3-5.
Referring now to FIGS. 7-13, in example embodiments, cleaning element 50 of scope 40 includes a band 72 extending laterally across lens 42. In these example embodiments, band 72 has a first segment 74 (extending laterally across lens 42) with a suitable cleaning surface configured to contact lens 42. Scope 40, e.g., lens 42, is rotatable with respect to housing 44 such that first segment 74 contacts lens 42 with sufficient frictional force to remove condensation and/or debris from lens 42. Scope 40 or lens 42 can be rotated manually by the user, mechanically, or electronically. FIG. 7 is a perspective view of distal portion 46 of scope 40 including band 72 extending laterally across distal portion 46 with cleaning element 50 in a second position. FIG. 8 is a sectional view of a portion of distal portion 46 shown in FIG. 7 with band 72 contacting an outer surface of lens 42. Once lens 42 is cleaned using band 72, cleaning element 50, e.g., band 72, is movable to a first position to allow lens 42 to move distally with respect to distal end 48 of housing 44, e.g., to extend distally from housing 44. As shown in FIG. 9, band 72 is movable to a first position after cleaning of lens 42 with band 72. Further, after first segment 74 of band 72 is used to clean lens 42, band 72 is advanced through housing 44 such that a sterile second segment 76 adjacent used first segment 74 of band 72 is positioned to contact lens 42 with cleaning element 50 in the second position, as shown in FIG. 10.
Referring further to FIG. 10, in example embodiments, housing 44 includes a first passage 78 on a first lateral side of housing 44 configured to accommodate band 72. During advancement, band 72 is fed through first passage 78, laterally across lens 42, and into a second passage 80 on a second lateral side of housing 44 opposite the first lateral side of housing 44. As band 72 is advanced in a lateral direction, used first segment 74 enters second passage 80 as sterile second segment 76 exits first passage 78 to extend over an opening 82 formed by housing 44 in which lens 42 is positioned.
Similarly, in an example embodiment shown in FIGS. 11-13, cleaning element 50 includes a band 84 extending laterally across lens 42. In this example embodiment, band 84 is made of a different material and/or has different dimensions, e.g., diameter or circumference, from band 72 shown in FIGS. 7-10, while operating similarly to band 72. For example, band 84 may include a plurality of outwardly-extending fibers 85. FIG. 11 is a perspective view of distal portion 46 of scope 40 including band 84 extending laterally across distal portion 46 with cleaning element 50 in a second position. Once lens 42 is cleaned using band 84, cleaning element 50, e.g., band 84, is movable to a first position to allow lens 42 to extend distally from housing 44. FIG. 12 shows distal portion 46 of scope 40 with band 84 in the first position after cleaning lens 42 with band 84. Further, after a first segment 86 of band 84 is used to clean lens 42, band 84 is advanced through housing 44 such that a sterile second segment 88 adjacent used first segment 86 of band 84 is positioned to contact lens 42 with cleaning element 50 in the second position, as shown in FIG. 13.
In another example embodiment as shown in FIGS. 14-17, cleaning element 50 of scope 40 includes an insert 90 configured to be removably positioned within an access channel 92 at a distal portion of a trocar assembly 94. Insert 90 forms a central opening 96 for receiving scope 40, allowing scope 40 to move through central opening 96. Insert 90 includes a first passage, such as a first slit 98, formed through a width of insert 90 (along a longitudinal direction of scope 40) on a first lateral side 100 of central opening 96 and a second passage, such as a second slit 102, formed through the width of insert 90 on a second lateral side 104 of central opening 96 opposite first lateral side 100. A film 106 is movably positioned within first slit 98 and second slit 102. In example embodiments, film 106 extends through first slit 98 in a distal direction, across central opening 96, and through second slit 102 in a proximal direction. Film 106 has a first segment 108, such as a cleaning pad, sponge, or other suitable material, including a cleaning surface 110 configured to contact lens 42, as shown in FIGS. 14 and 15. With cleaning element 50 in a second position, first segment 108 is positioned over central opening 96 such that cleaning surface 110 contacts lens 42. Lens 42 is rotatable with respect to housing 44 such that cleaning surface 110 contacts lens 42 with sufficient frictional force to remove condensation and/or debris from lens 42.
Film 106 also includes a second segment 112 adjacent first segment 108. Second segment 112 forms an opening 114 that is aligned with central opening 96 with cleaning element 50 in a first position to allow lens 42 to extend through central opening 96 and co-axially aligned opening 114, as show in FIG. 17, such that lens 42 extends distally from distal end 48 of housing 44. In this embodiment, after first segment 108 of film 106 is used to clean lens 42, film 106 is advanced through housing 44 such that second segment 112 adjacent first segment 108 is positioned over central opening 96 with opening 114 co-axially aligned with central opening 96. As described above, housing 44 includes first slit 98 formed through a width of insert 90 on first lateral side 100 of central opening 96 and second slit 102 formed through a width of insert 90 on second lateral side 104 of central opening 96 configured to accommodate film 106. During advancement, film 106 is fed through first slit 98, laterally across central opening 96, and into second slit 102. As film 106 is advanced in a lateral direction, used first segment 108 enters second slit 102 as second segment 112 exits first slit 98 to extend over central opening 96 in which lens 42 is positioned.
Referring to FIGS. 18-20, in another example embodiment, cleaning element 50 of scope 40 includes a first passage, such as a first slit 116, formed through housing 44 on a first lateral side 118 of lens 42 and a second passage, such as a second slit 120, formed through housing 44 on a second lateral side 122 of lens 42 opposite first lateral side 118. A film 124 is movably positioned within first slit 116 and second slit 120. In example embodiments, film 124 extends through first slit 116 in a distal direction, across lens 42, and through second slit 120 in a proximal direction. Film 124 has a first segment 126, such as a cleaning pad, sponge, or other suitable material, including a cleaning surface 128 configured to contact lens 42. With cleaning element 50 in a second position, first segment 126 is positioned over lens 42 such that cleaning surface 128 contacts lens 42. Lens 42 is rotatable with respect to housing 44 such that cleaning surface 128 contacts lens 42 with sufficient frictional force to remove condensation and/or debris from lens 42.
Film 124 also includes a transparent second segment 130 adjacent first segment 126. Second segment 130 is positioned over lens 42 with cleaning element 50 in a first position. In this embodiment, after first segment 126 of film 124 is used to clean lens 42, film 124 is advanced through housing 44 such that second segment 130 adjacent first segment 126 is positioned over lens 42. As described above, housing 44 includes first slit 116 formed through housing 44 on first lateral side 118 of lens 42 and second slit 120 formed through housing 44 on second lateral side 122 of lens 42 configured to accommodate film 124. During advancement, film 124 is fed through first slit 116, laterally across lens 42, and into second slit 120. As film 124 is advanced in a lateral direction, used first segment 126 enters second slit 120 as second segment 130 exits first slit 116 to extend over lens 42.
In an example embodiment as shown in FIG. 21, cleaning element 50 includes a film 132 operatively coupled to housing 44 at distal end 48. Film 132 extends between a first lateral side 134 of housing 44 and an opposing second lateral side 136 of housing 44 and contacts lens 42 with cleaning element 50 in a second position. With cleaning element 50 in a first position, film 132 is configured in a retracted state (not shown in FIG. 21) on first lateral side 134 or second lateral side 136 of housing 44 to allow lens 42 to move distally with respect to distal end 48 of housing 44. In this embodiment, film 132 is operatively coupled to housing 44 at distal end 46.
Referring now to FIGS. 22-25, in example embodiments, scope 40 includes cleaning element 50 having an expandable pad 140 initially positioned within an opening 142 formed by housing 44 to at least partially occlude opening 142 with cleaning element 50 in a second position. Expandable pad 140 is displaceable by scope 42. FIG. 22 shows distal portion 46 of scope 40 with expandable pad 140 positioned in opening 142 and cleaning element 50 in the second position. FIGS. 23 and 24 show distal portion 46 of scope 40 shown in FIG. 22 as cleaning element 50 moves from the second position to a first position. FIG. 25 shows distal portion 46 of scope 40 with expandable pad 140 displaced by scope 42 and cleaning element 50 in a first position, allowing scope 42 to move through opening 142 to extend distally with respect to housing 44. Expandable pad 140 has a suitable cleaning surface configured to contact scope 40 to facilitate cleaning lens 42.
A central opening 144, e.g., a slit, is formed through expandable pad 140 such that when lens 42 contacts expandable pad 140 with sufficient force, lens 42 passes through central opening 144 to extend distally from housing 44 as shown in FIG. 25. As lens 42 passes through central opening 144, expandable pad 140 removes condensation and/or debris from lens 42. Expandable pad 140 is moveable in a radially outward direction with lens 42 extending into central opening 144. In this embodiment, expandable pad 140 is made of a suitable resilient material such that expandable pad 140 returns to an initial position substantially covering opening 142 when scope 40 is retracted proximally into housing 44 and cleaning element 50 is in the second position.
Referring to FIG. 26, in another example embodiment, cleaning element 50 of scope 40 includes a handle 150 at a proximal portion 152 of scope 40. An arm 154 is coupled to handle 150 and extends along a length of scope 40 between proximal portion 152 and distal portion 46 of scope 40. One or more blades 156, e.g., a plurality of blades 156, are rotatably coupled to arm 154 at distal end 46 of scope 40. Blades 156 are configured to rotate about a longitudinal axis 158 of arm 154 parallel to a longitudinal axis of scope 40. As blades 156 rotate about longitudinal axis 158 with respect to arm 154, each blade 156 contacts lens 42 to remove condensation and/or debris from lens 42.
As shown in FIGS. 27-29, in another example embodiment, cleaning element 50 of scope 40 includes a protective shield 160 coupled to distal portion 46 of scope 40. Shield 160 extends distally with respect to distal end 48 of scope 40. In a particular embodiment, shield 160 includes a retractable cone 162. With cleaning element 50 in a first position, shield 160 expands radially outward from distal end 48 so as to not obstruct the field of view of lens 42 while preventing or limiting an amount of condensation and/or debris forming on lens 42 during the procedure. With cleaning element 50 in a second position, shield 160 is retractable to cover or enclose lens 42. FIG. 27 shows distal portion 46 of scope 40 including shield 160 in the second position, while FIGS. 28 and 29 show distal portion 46 of scope 40 with shield 160 in the first position.
In another example embodiment as shown in FIG. 30, cleaning element 50 of scope 40 includes a dispenser 164 configured to express a fluid, e.g., a gas or a liquid such as a saline solution, through an annular space 166 defined between housing 44 and lens 42.
In example embodiment as described herein, a trocar assembly includes a cannula having a proximal portion and an opposing distal portion. The distal portion of the cannula is configured to extend into a patient body. The cannula defines an access channel between the proximal portion and the distal portion, wherein the access channel is configured to receive a scope such that the scope can be maneuvered through the access channel to a location within the patient body. The scope is movably positioned within the access channel. A cleaning element operatively coupled to a distal portion of the scope, e.g., integrally coupled to the distal portion of the scope, is configured to contact at least a lens of the scope to remove condensation and/or debris from the lens and/or other portions of the scope during the procedure.
In example embodiments as described herein, a method for cleaning a distal end of a scope, e.g., a lens of the scope, includes coupling a cleaning element at a distal portion of the scope. The distal portion is configured to extend into a patient body to a location within the patient body. At least a distal end of the scope, e.g., the lens, is cleaned with the cleaning element by moving the cleaning element with respect to the distal end of the scope.
In example embodiments, cleaning element 50 includes one or more surfaces configured to contact the distal end of scope 40 with cleaning element 50 in a second position. Further, in certain embodiments, cleaning element 50 is movable between a first position and a second position via contact of cleaning element 50 with scope 40 or lens 42. In certain example embodiments, cleaning element 50 may include one or more members, e.g., a plurality of members, configured to clean lens 42 upon contact with lens 42. Suitable members include, without limitation, one or more, e.g., a plurality of, brushes, bristles, fibers, fingers, leaflets, wipers, bands, pads, projections, or any combination thereof. In certain example embodiments, each member is made or formed of a suitable flexible or compliant material to allow each member to move upon contacting scope 42 to allow scope 42 to freely move with respect to housing 44 as controlled by the user, e.g., the surgeon. While each member may be flexible or compliant, each member has sufficient resilience or rigidity to properly clean lens 42 as well as other portions of scope 10.
As described herein, example trocar assemblies for use during a laparoscopic procedure include a cannula having a distal end for placement into a patient body during the laparoscopic procedure. The distal end of the cannula may include a beveled or sharpened end to facilitate entry of the cannula into the patient body. An obturator may additionally or alternatively be included. The cannula may include certain surface characteristics, such as threads or ridges, to enhance the stability of the trocar assembly when inserted into a body incision.
The cannula may include or may be in fluid communication with a chamber defined by a proximal portion of the trocar assembly. The chamber may have a proximal opening configured to receive medical devices used during laparoscopic surgery, including, without limitation, graspers, dissectors, needles, scissors, clamps, electrodes, forceps, a camera, and/or a laparoscope (a “scope”). A valve may be located in the proximal opening and may form a seal or fluid barrier between the chamber and an external environment (e.g., the ambient room environment). Alternatively or in addition, the valve may be located in another location (such as at a distal opening of the cannula). It may be advantageous for at least one valve to be located at a the proximal opening such that a lens of a scope does not have to pass through the valve prior to cleaning, thereby reducing or eliminating the chance of materials from the valve dirtying the scope's lens after cleaning.
The chamber may be subjected to a continuous sterile and pressurized environment that extends through the cannula and to the body cavity (herein referred to as the “internal environment” even though the continuous region may extend external of the patient body wall, e.g., within the trocar assembly). This may be advantageous if maintaining insufflation of the body cavity is desired during all operation—including cleaning—of a trans-trocar-located scope or other device. Further, the controlled environment of the chamber may reduce fogging of a scope by eliminating or reducing temperature changes and/or changes in humidity.
The valve (which may include more than one valve) may include a particular structure that allows certain medical devices to pass through the proximal opening and into the chamber while maintaining the seal or fluid barrier. For example, the valve may include a duckbill seal, an annular seal structure, or both, but other suitable structures may additionally or alternatively be included. The valve may be formed with a compliant material such that it expands or contracts as necessary for compatibility with scopes of different sizes. For example, on the Shore Hardness Scale, the valve may be formed of a material with a hardness between about Shore A 20 to about Shore A 80, such as from about Shore A 30 to about Shore A 60.
An insufflation inlet may communicate with the chamber and may be configured to control the pressure and other characteristics (e.g., temperature, composition of the atmosphere), which may be advantageous for providing precise control of insufflation of a body cavity during the laparoscopic procedure. The insufflation inlet may include an insufflation valve, and may be in fluid communication with a pump or other suitable pressure source. Advantageously, the flow of gasses or other contents received into the chamber through the insufflation inlet may be introduced in a manner such that the effect of the flow across cleaning element is reduced or eliminated. For example, when the cleaning element (which is described in detail above) is wetted with a cleaning fluid, concerns of increased evaporation due to fluid flow over the cleaning element may be alleviated.
The trocar assembly may provide an entry or point of access into the body for a scope. In non-limiting embodiments, the scope may include a commercially-available rigid laparoscope with a 5 millimeter (mm) or a 10 mm diameter (or any other suitable diameter) with either a non-angled lens or an angled lens, which may be angled at 30 degrees, 45 degrees, or 50 degrees, for example, with respect to the longitudinal axis of the scope. At least a distal end of the scope may include one or more elements designed to magnify, reflect, illuminate, and/or capture images of internal body areas under treatment, and then transmit those images back to the medical professional controlling the procedure (herein referred to as a “viewing element”). The scope may be inserted into the proximal opening of the chamber, may extend through the chamber, and may extend through into the cannula through a distal opening in the bottom wall of the chamber, where the distal opening is in fluid and mechanical communication with the cannula. The scope may further extend distally to the distal end of the cannula and into the body cavity. In some embodiments, a sleeve (not shown, but readily understood as a lining layer) may be located within the cannula, and the scope may pass through the sleeve. Once deployed, the scope may be manipulated by the medical professional moving it distally/proximally, angling it, and/or by rotating it into a particular orientation. Typically, during laparoscopic procedures, scopes can become obstructed when debris (e.g., condensation, displaced tissue, bodily fluids) are encountered and accumulate on a lens of the scope, which may compromise the image or video feed provided to the medical professional.
The surface of the cleaning element may facilitate removal of obstructions from the scope without necessitating removal of the scope from the internal environment. Advantageously, lengthy interruptions (and therefore increased surgical and anesthesia time) due to removing and/or replacing an obstructed scope may be reduced or eliminated. Further, the distal end of the scope may remain in the sterile internal environment during cleaning, which may advantageously alleviate concerns related to loss of sterility within the internal environment due to the removal and re-entry of the scope one or more times for cleaning purposes. Keeping the scope within the internal environment may also reduce or eliminate debris in the form of fogging or condensation caused by exposure to pressure and/or temperature changes when switching between environments. It should also be understood that certain advantages of the present embodiments are generally described as relating to a scope for explanation purposes and may also extend to other types of instruments used during surgical procedures, and therefore “scope” should be understood as including any suitable medical device used during laparoscopic surgery when described in the context of the present embodiments, unless clearly excluded.
The cleaning element may incorporate any suitable structures, materials, and/or cleaning solutions for removing obstructions from the scope. The cleaning element may have a unitary construction, or alternatively may have multiple surfaces or layers with different cleaning characteristics or properties for facilitating multiple treatments. For example, it is contemplated that the cleaning element may have a first region with an abrasive surface for breaking up potential obstructions, a second region including a liquid, a gel, or other material for dissolving or washing away the obstructions, and a third region with an absorbent or adsorbent surface for removing any remaining residue.
The cleaning element may include any suitable cleaning structures or materials, such as sponges, foams (e.g., reticulated or non-reticulated foamed plastic polymers forming open-cell, semi-open cell, or closed-cell foam structures), fibrous materials (e.g., materials with natural (e.g., cellulosic) and/or synthetic fibers), microfiber or wipe materials (e.g., polyethers, polyamides, polyesters, and/or blends of each in a woven or non-woven construction with split or non-split fibers), hydrophilic or hydrophobic materials, fluids, gases, bristles, films, etc. The structures and/or materials of the cleaning element may include hydrophobic properties to assist in absorbing and wicking of various bodily fluids and/or lipophilic characteristics for increased absorption of oils or fats. The cleaning element may be capable of absorbing at least 5 times its original weight of fluids, such as about 15 times its original weight (or more). When the cleaning element includes pores, consistent or variable pore sizes may be consistently or randomly dispersed (or layered) in certain configurations for suitable absorption properties (for example, a the cleaning element may include a micro-porous foam with about 4 pores per inch to about 100 pores per inch). The cleaning element may have a firmness/compliance of about 2 lbs/50 in²to about 80 lbs/50 in², and preferably about 6 lbs/50 in²to about 45 lbs/50 in²(when tested at 25% deflection on a 20 inch by 20 inch by 4 inch specimen). The material(s) of the cleaning element may be formed of a material suitable for use in a medical device (e.g., with suitable biocompatibility, non-linting/no particulate, tear resistance, sterilization or other chemical/solvent compatibility, and radiation stability).
The cleaning element may be multi-layered in some embodiments. For example, a first layer may be configured to absorb a fluid obstruction located on the scope, and a second layer may be configured to retain or discard that fluid. In some embodiments, the first layer may include an open-cell foam with relatively low density (such as polyurethane or silicone foam) that may be used to effectively and quickly absorb (or wick, etc.) the obstructing fluid, and the second layer may include higher-density foam for effectively retaining the fluid. The second layer may be located beneath (e.g., covered by) the first layer, for example. Fibrous materials such as terrycloth and microfiber cloths may additionally or alternatively be used and may be advantageous for providing a streak-free lens surface when wiped against the scope. The solid materials of the cleaning element may be combined or “wetted” with a cleaning fluid, such as an anti-fog fluid, sterile water, saline, or a detergent, for example, which may facilitate the removal of fatty smudges and dried-on debris.
In the event the medical professional's visibility becomes compromised due to obstruction of the scope during surgery, the distal end (or other location) of the scope may then be wiped or swept by pressing and/or rubbing the distal end of the scope on the cleaning element to remove obstructions. As explained above, this cleaning procedure may advantageously be completed without removing the scope from the internal environment in the trocar assembly. In certain embodiments, the cannula may be formed of a transparent or translucent material. When the scope is located in the trocar assembly, the scope (which often includes a light) may illuminate the cannula to increase visibility.
In some embodiments, the cleaning element may be selectable, removable, and/or replaceable. Thus, the trocar assembly may be capable of allowing access into the chamber (e.g., in an operating room prior to a surgery) such that a medical professional can select an appropriate version of the cleaning element and then use that cleaning element with the trocar assembly during the procedure. The cleaning element may additionally or alternatively be replaced during a medical procedure (e.g., if it becomes soiled), and/or may be replaced between medical procedures during reprocessing of the trocar assembly if the trocar assembly is reusable.
Those of skill in the art will appreciate that existing scopes and potential scope designs include at least one non-longitudinal, distal-end-facing surface of the distal end that may be generally or exactly perpendicular to the longitudinal axis of the scope, or which distal-facing surface may be configured at a non-perpendicular angle relative to the longitudinal axis (e.g., 30 degrees off-perpendicular, 45 degrees off-perpendicular). It is further contemplated that the distal-facing surface of the scope may be flat/planar, concave, or convex relative to the major plane of that face. The term “non-longitudinal, distal-end-facing surface” is meant to include the operative end face(s) of a scope in distinction from the longitudinal lateral sides of the scope, which will generally be columnar or cylindrical. Thus, as described in more detail below, the surface characteristics of the cleaning element may be shaped or otherwise configured for compatibility with a variety of distal-facing surfaces of the scope.
Those of skill in the art will appreciate that embodiments not expressly illustrated herein may be practiced within the scope of the claims, including that features described herein for different embodiments may be combined with each other and/or with currently-known or future-developed technologies while remaining within the scope of the claims. This specifically includes that the structure, location, and mechanisms of the disclosed cleaning elements and related structures in the different embodiments illustrated and described with reference to the drawing figures may be combined and elements interchanged within the level of skill in the art as informed by this application, and within the scope of the present claims, which includes that a variety of disclosed individual cleaning element components dimensioned for use encompassed within in laparoscopy trocars may be configured as separable/replaceable components of a larger trocar assembly. Although specific terms are employed herein, they are used in a generic and descriptive sense only and not for purposes of limitation unless specifically defined by context, usage, or other explicit designation. It is therefore intended that the foregoing detailed description be regarded as illustrative rather than limiting. And, it should be understood that the following claims, including all equivalents, are intended to define the spirit and scope of this invention. Furthermore, the advantages described above are not necessarily the only advantages of the invention, and it is not necessarily expected that all of the described advantages will be achieved with every embodiment. In the event of any inconsistent disclosure or definition from the present application conflicting with any document incorporated by reference, the disclosure or definition herein shall be deemed to prevail.

Claims

We claim:

1. A scope, comprising:

a housing having a distal portion with a distal end;

a lens at the distal end; and

a cleaning element operatively coupled to the distal portion of the housing, wherein the cleaning element is movable between a first position and a second position contacting the distal end.

2. The scope of claim 1, wherein the cleaning element is slidably coupled to a side wall of the housing at the distal portion, and as the cleaning element is moved toward the first position, the cleaning element is configured to move across the lens.

3. The scope of claim 2, wherein the cleaning element is made of a shape memory material.

4. The scope of claim 1, wherein the cleaning element further comprises:

a cover rotatably coupled to the distal portion of the housing at the distal end, the cover extending over the lens; and

a band extending laterally across the cover, wherein the band is configured to remain in contact with the cover as the cover revolves between the first position and the second position.

5. The scope of claim 4, wherein the band has a first end coupled to the distal portion at a first point and a second end opposite the first end coupled to the distal portion at a second point laterally opposing the first point.

6. The scope of claim 1, wherein the cleaning element comprises a band extending laterally across the lens, the band having a first segment with a cleaning surface configured to contact the lens as the lens is rotatable with respect to the housing.

7. The scope of claim 6, wherein the band is movable from the second position to the first position to allow the lens to move distally with respect to the distal end of the housing.

8. The scope of claim 6, wherein the band is configured to advance in a lateral direction such that a second segment adjacent the first segment contacts the lens.

9. The scope of claim 1, wherein the cleaning element further comprises:

an insert configured to be removably positioned within an access channel at a distal portion of a trocar assembly, the insert forming a central opening for receiving the scope and comprising a first slit formed through a width of the insert on a first lateral side of the central opening and a second slit formed through the width of the insert on a second lateral side of the central opening opposite the first lateral side; and

a film movably positioned within the first slit and the second slit, the film extending through the first slit in a distal direction, across the central opening, and through the second slit in a proximal direction, the film having a first segment including a cleaning surface configured to contact the lens.

10. The scope of claim 9, wherein the film further comprises a second segment adjacent the first segment, the second segment forming an opening aligned with the central opening to allow the lens to extend through the central opening and the opening.

11. The scope of claim 10, wherein the film is movable to position one of the first segment and the second segment over the central opening.

12. The scope of claim 9, wherein the film further comprises a transparent second segment adjacent the first segment.

13. The scope of claim 1, wherein the cleaning element comprises a film operatively coupled to the housing at the distal end, wherein the film extends between a first lateral side of the housing and an opposing second lateral side of the housing and contacts the lens with the cleaning element in the second position, and, with the cleaning element in the first position, the film is configured in a retracted state on the first lateral side of the housing.

14. The scope of claim 1, wherein the cleaning element comprises an expandable pad positioned within an opening formed by the housing, with the cleaning element in the second position, the expandable pad occludes the opening, the expandable pad including a central opening formed through the expandable pad, the expandable pad moveable in a radially outward direction with the lens extending into the central opening.

15. The scope of claim 1, wherein the cleaning element comprises:

a handle at a proximal portion of the scope;

an arm coupled to the handle and extending along a length of scope between the proximal portion and the distal portion; and

a plurality of blades rotatably coupled to the arm at the distal end of the scope, the plurality of blades configured to contact the lens during rotation of the plurality of blades with respect to the arm.

16. The scope of claim 1, further comprising a shield coupled to the distal portion of the scope, the shield extending distally with respect to the distal end of the scope.

17. The scope of claim 16, wherein the shield comprises a retractable cone, wherein in the first position the shield expands radially outward from the distal end and in the second position the shield covers the lens.

18. The scope of claim 1, wherein the cleaning element further comprises a dispenser configured to express a fluid through an annular space defined between the housing and the lens.

19. A trocar assembly, comprising:

a cannula having a proximal portion and an opposing distal portion, the distal portion configured to extend into a patient body, the cannula defining an access channel between the proximal portion and the distal portion;

a scope movably positioned within the access channel, wherein the scope can be maneuvered through the access channel to a location within the patient body; and

a cleaning element operatively coupled to a distal portion of the scope, wherein the cleaning element is configured to contact at least a lens of the scope.

20. A method for cleaning a distal end of a scope, said method comprising:

coupling a cleaning element at a distal portion of the scope, the distal portion configured to extend into a patient body to a location within the patient body; and

cleaning at least a distal end of the scope with the cleaning element by moving the cleaning element with respect to the distal end of the scope.