GB2535517A

GB2535517A - Tissue bag and method of morcellating tissue

Info

Publication number: GB2535517A
Application number: GB1502837.6A
Authority: GB
Inventors: Alan Dickson James
Original assignee: Gyrus Medical Ltd
Current assignee: Gyrus Medical Ltd
Priority date: 2015-02-20
Filing date: 2015-02-20
Publication date: 2016-08-24
Anticipated expiration: 2035-02-20
Also published as: US20160242752A1; US10206666B2; GB2535517B; GB201502837D0

Abstract

A tissue bag for surrounding tissue 2 during a surgical procedure comprises a bag body 6 capable of forming an enclosure, an opening 9 in the bag body, and one or more inflatable ribs 8 located on the bag body. The ribs 8 are such that inflation of the one or more ribs to a first extent causes the bag to deploy to an open position in which the bag is capable of being placed over tissue 2 with the tissue received through the opening 9. Inflation of the one or more ribs 8 to a second further extent causes the bag to envelop the tissue with the opening 9 being smaller in diameter than in the open position. The ribs may each include at least first and second discrete longitudinal portions 10, 11 with an angled end face 15 therebetween.

Description

TISSUE BAG AND METHOD OF MORCELLATING TISSUE

This invention relates to a tissue bag for use in the encapsulation of tissue, and to a method for morcellating tissue such as a female uterus. Due to the perceived risks associated with the "seeding" of cancerous tissue, the morcellation of tissue is often earned out in a tissue bag surrounding or containing the tissue. An example of such a tissue bag is given in US patent 5,037,379. In the (issue bag of US 5,037,379, a morcellating instrument is introduced into the hag in order to morcellate the tissue into smaller pieces before the hag is removed from the body of the patient.

The present invention attempts to provide an improvement to this type of morcellation process. Accordingly, a tissue bag for surrounding tissue during a surgical procedure comprises a hag body capable of forming an enclosure, an opening in the hag body, and one or more inflatable ribs located on the hag body, the ribs being such that inflation of the one or more ribs to a first extent causes the hag to deploy to an open position in which the bag is capable of being placed over tissue with the tissue received through the opening, and that inflation of the one or more ribs to a second further extent causes the hag to envelop the tissue with the opening being smaller in diameter than in the open position.

The inflation of the one or more ribs first causes the tissue bag to open so as to enclose the tissue, and then further inflation causes the hag to close over the tissue enveloping it within the bag. The one or more inflatable ribs preferably extend longitudinally with respect to the opening. The longitudinal direction of the one or more ribs allows them to effect the shaping of the bag as it first encloses and then envelops the tissue. The inflation of the one or more ribs may also allow the tissue bag to manoeuvre itself between adjacent tissue structures, and may avoid the necessity for intervention with tissue graspers or the like.

Preferably, the tissue bag includes a plurality of inflatable ribs located on the bag body. In one convenient arrangement the tissue bag includes a plurality of inflatable ribs extending longitudinally at equally spaced intervals around the circumference of the tissue bag.

According to a first construction, the one or more inflatable ribs each include at least first and second discrete longitudinal portions. The first and second longitudinal portions are preferably conjoined by an end face disposed at a non-orthogonal angle to the longitudinal axis of the rib. The non-orthogonal end face between the portions causes the rib (and hence the tissue bag) to adopt a curved configuration so as to first enclose and then envelop the tissue. Preferably, the angle between the longitudinal axis of the first portion and that of the second portion is between 10 and 45 degrees, typically between 15 and 30 degrees, and preferably around 20 to 25 degrees.

Typically, the one or more inflatable ribs include at least first, second and third discrete longitudinal portions, again conveniently with the second and third discrete longitudinal portions being conjoined by an end face disposed at a non-orthogonal angle to the longitudinal axis of the rib. Once again, the angle between the longitudinal axis of the second portion and that of the third portion is typically between 10 and 45 degrees, typically between 15 and 30 degrees, and preferably around 20 to 25 degrees. The angled first, second and third portions, especially if repeated in a plurality of ribs spaced around the tissue bag, causes the bag to assume a shaped configuration as it is deployed, opening over the tissue and then enveloping it.

According to an alternative construction, the one or more inflatable ribs each include a longitudinal section with an upper and a lower surface, the upper surface being of a greater length than that of the lower surface. The difference between the length of the upper and lower surfaces causes the rib to assume a curved configuration as it is inflated, thereby providing the necessary guidance for the tissue bag to envelop the tissue one it has been located in position. Conveniently, the one or more inflatable ribs have a generally triangular cross-section. Typically, the base of the triangle constitutes the lower surface, and the apex of the triangle constitutes the upper surface.

According to a further alternative construction, the one or more inflatable ribs each have a generally circular cross-section. The one or more inflatable ribs each typically include a plurality of adhesions disposed along one longitudinal axis thereof. Conveniently, the adhesions are equally spaced along the longitudinal axis. The adhesions serve to ensure that one surface of the rib expands less readily than the other, causing the rib to assume a bent or curved shape when inflated. Typically, each of the adhesions is formed by applying a small amount of adhesive to the rib.

Whichever construction is employed, the one or more inflatable ribs are preferably such that they inflate to form an arc having a radius of between 5 cm and 15 cm, and preferably between 7 and 10 cm. This shape adopted when the rib is inflated, especially when reproduced by other ribs present on the tissue bag, helps to provide the tissue bag with its unique deployment regime.

Typically, the opening of the tissue hag is provided with a drawstring which can be pulled in order to close the opening. In this way, once the (issue bag has been deployed to enclose and envelop the tissue, the drawstring can be pulled in order to close the opening and capture the tissue within the hag. Conveniently, the tissue hag is mounted on an elongate introducer element capable of manipulating the tissue bag into position. The introducer element is preferably provided with a lumen through which an inflation gas can be supplied to the one or more inflatable ribs, in order to inflate them when required.

The invention further resides in a method of encapsulating tissue for surgical purposes, comprising the steps of i) introducing a tissue bag into the body of a patient, the tissue bag including a hag body capable of forming an enclosure, an opening in the hag body, and one or more inflatable ribs located on the bag body, ii) inflating the one or more ribs to a first extent such that the bag deploys to an open position, iii) placing the bag over the tissue to be enclosed, with the tissue being received through the opening. and iv) further inflating the one or more ribs to a greater extent such that the bag envelops the tissue with the opening being smaller in diameter than in the open position.

The method conveniently includes the further step of pulling a drawstring to close the opening once the ribs have been inflated to envelop the tissue.

The invention further resides in a method of morcellating a uterus, comprising the steps of i) introducing a tissue hag into the body of a patient, the tissue hag including a bag body capable of forming an enclosure, an opening in the bag body, and one or more inflatable ribs located on the bag body, ii) inflating the one or more ribs to a first extent such that the hag deploys to an open position, iii) placing the bag over the uterus, with the uterus being received through the opening, iv) further inflating the one or more ribs to a greater extent such that the hag envelops the uterus with the opening being smaller in diameter than in the open position, and v) morcellating the uterus within the tissue bag. The invention will now be further described, by way of example only, with reference to the accompanying drawings, in which Figure 1 is a schematic side view of a tissue bag in accordance with the present invention, Figures 2 to 4 are schematic side views showing the tissue bag of Figure 1 being placed over a female uterus, Figures 5 and 6 are schematic side views showing the tissue bag of Figure 1 with a female uterus within the bag, Figures 7A & 7B are respective cross-sectional and side views showing portions of an inflatable rib similar to those shown in the tissue bag of Figure 1, Figure 7C is a schematic side view showing an embodiment of inflatable rib using the portions of Figures 7A & 7B, Figure SA & 8B are schematic cross-sectional and side views showing an inflatable rib according to an alternative embodiment of tissue bag according to the invention, Figure 9A is a schematic cross-sectional view showing an inflatable rib according to an alternative embodiment of tissue bag according to the invention, Figure 9B is a schematic side view of the rib of Figure 9A in a generally non-inflated condition, and Figure 9C is a schematic side view of the rib of Figure 9A in an inflated condition.

Referring to Figure 1, a patient is shown generally at 1, with target tissue such as a uterus shown at 2. A port is shown at 3, inserted into the body 4 of the patient.

Inserted through the port 3 is an introducer in the form of a hollow sleeve 5 with a tissue hag 6 mounted at its distal end. A tube 7 is provided to supply an insufflation gas through the sleeve 5 to the hag 6.

The surgeon manipulates the sleeve 5 such that the tissue bag 6 is adjacent the uterus 2, and activates the supply of insufflation gas. The gas is supplied to a series of inflatable ribs 8 running longitudinally with respect to the bag 6. As the ribs 8 start to inflate, the hag 6 expands as shown in Figure 2, with an opening 9 in the hag allowing the bag to start to enclose the uterus.

As the ribs 8 inflate further as shown in Figure 3, each rib is formed of a first portion 10 and a second portion 11, with an elbow 12 therehetween. The second portions 11 of the ribs are deployed at an angle to the first portions 10, such that the tissue bag 6 adopts a generally spherical shape enfolding itself around the uterus 2 and generally enveloping it. The opening 9 becomes restricted due to the converging angle of the second portions 11 of the ribs 8, ensuring that the uterus 2 is captured within the hag.

Figure 4 shows how, when the ribs 8 are fully inflated, the tissue bag 2 fully envelops the uterus 2. The tissue bag can then be detached from the sleeve 5, and the tissue hag rotated as shown in Figure 5, using a drawstring 13 attached to the opening 9 and running through the sleeve 5. The sleeve 5 may be unscrewed to release the tissue bag 6, or a drawstring (not shown) pulled in order to release a connecting pin (also not shown). The tissue bag 6 contains a non-return valve (not shown) in order that the ribs 8 remain inflated once the supply of insufflation gas is removed.

At this point, the drawstring 13 can be pulled further from within the sleeve 5. closing the opening 9, and sealing the uterus 2 within the tissue bag. This is the position shown in Figure 6, which allows for the uterus 2 to be morcellated within the tissue bag 6, by means of a morcellating instrument (not shown) such as that described in published PCT application W02005/112806.

Figures 7A, 7B & 7C show an alternative design of rib 8, in which the ribs have a circular cross-section. Ribs 8 each have first portion 10 and second portion 11 as previously described, but also a third portion 14 as shown in Figure 7C. Between the first portion 10 and the second portion 11 is an angled end face 15, while a further angled end face 16 lies between the second portion 11 and the third portion 14. End face 15 lies at an angle of 30 degrees to the orthogonal with respect to the first portion 10. End lace 15 similarly lies at an angle of 30 degrees to the orthogonal with respect to the second portion 11, such that the longitudinal axes of portions 10 & 11 differ by approximately 60 degrees when the ribs 8 are inflated.

Similarly, the end face 16 lies at an angle of approximately 30 degrees to the orthogonal with respect to the second portion 11 and the third portion 14, such that there is an angle of approximately 60 degrees between the second and third portions when the ribs 8 are inflated. In this way, as the ribs 8 are inflated, they adopt an angled formation such that the tissue bag 6 assumes a domed shape to envelope and enclose the uterus 2.

Figures 8A & 8B show an alternative design of the ribs 8, in which each rib has a triangular cross-section as shown in Figure 8A. Each rib 8 has an upper edge 17 corresponding to the apex of the triangle, and a lower edge 18 corresponding to the base of the triangle. The upper edge 17 is longer than the lower edge 18, such that as the rib 8 is inflated, it is forced to assume a curved shape as shown in Figure 8B. With each of the ribs being formed in this way, the tissue bag 6 is encouraged to assume a 15 generally domed shape enveloping and enclosing the uterus 2 as the bag is deployed. Figures 9A, 9B and 9C show a further alternative design of the ribs 8, this time once again having a circular cross-section as shown in Figure 9A. The upper edge 17 of each rib is this time the same length as the lower edge 18, but the lower edge 18 is provided with a series of blobs of adhesive 19. Each blob of adhesive adheres to a particular local area of the tissue bag, restricting its ability to expand at that point. This means that the lower edge 18 is unable to expand as readily as the upper edge 17, resulting hi the ribs 8 assuming a curved shape when they are inflated. As with the construction of Figures 8A & 8B, the curved shape of the ribs ensures that the tissue bag envelops the uterus 2 as the tissue bag is deployed.

Whichever of the various combinations is employed, the tissue bag 6 can be deployed over the uterus 2, and will envelop the uterus due to the shaped nature of the inflatable ribs 8. The tissue bag of the present invention provides a tissue bag which is easier to deploy, and more effective in achieving its purpose of enclosing and separating its target tissue.

Claims

Claims 1. A tissue bag for surrounding tissue during a surgical procedure, the tissue bag comprising a bag body capable of forming an enclosure, an opening in the bag body, and one or more inflatable ribs located on the hag body, the ribs being such that inflation of the one or more ribs to a first extent causes the bag to deploy to an open position in which the bag is capable of being placed over tissue with the tissue received through the opening, and that inflation of the one or more ribs to a second further extent causes the bag to envelop the tissue with the opening being smaller in diameter than in the open position.
2. A (issue bag according to claim 1, wherein the one or more inflatable ribs extend longitudinally with respect to the opening.
3. A tissue bag according to claim 1 or claim 2, wherein the tissue bag includes a plurality of inflatable ribs located on the hag body.
4. A tissue bag according to claims 2 and 3, wherein the tissue bag includes a plurality of inflatable ribs extending longitudinally at equally spaced intervals around the circumference of the tissue hag.
5. A tissue bag according to any preceding claim, wherein the one or more inflatable ribs each include at least first and second discrete longitudinal portions.
6. A (issue bag according to claim 5, wherein the firs( and second longitudinal portions are conjoined by an end face disposed at a non-orthogonal angle to the longitudinal axis of the rib.
7. A tissue hag according to claim 6, wherein the angle between the longitudinal axis of the first portion and that of the second portion is between 10 and 45 degrees.
8. A tissue hag according to any of claims 5 to 7, wherein the one or more inflatable ribs include at least first, second and third discrete longitudinal portions.
9. A tissue bag according to claim 8, wherein the second and third discrete longitudinal portions are conjoined by an end face disposed at a non-orthogonal angle to the longitudinal axis of the rib.
10. A tissue hag according to claim 9, wherein the angle between the longitudinal axis of the second portion and that of the third portion is between 10 and 45 degrees.
11. A tissue bag according to any of claims 1 to 4, wherein the one or more inflatable ribs each include a longitudinal section with an upper and a lower surface, the upper surface being of a greater length than that of the lower surface.
12. A tissue hag according to claim 11, wherein the one or more inflatable ribs have a generally triangular cross-section.
13. A (issue bag according to claims 11 and 12, wherein the base of the triangle constitutes the lower surface, and the apex of the triangle constitutes the upper surface.
14. A tissue bag according to any of claims 1 to 4, wherein the one or more inflatable ribs each have a generally circular cross-section.
15. A tissue bag according to claim 14, wherein the one or more inflatable ribs each include a plurality of adhesions disposed along one longitudinal axis thereof
16. A tissue hag according to claim 15, wherein the plurality of adhesions are equally spaced along the longitudinal axis.
17. A tissue bag according to claim 15 or claim 16, wherein each of the adhesions is formed by applying a small amount of adhesive to the rib.
18. A tissue bag according to any of claims 11 to 17, wherein the one or more inflatable ribs are such that they inflate to form an arc having a radius of between 5 cm and 15 cm.
19. A tissue bag according to any preceding claim, wherein the opening is provided with a drawstring which can be pulled in order to close the opening.
20. A tissue bag according to any preceding claim, wherein the tissue bag is mounted on an elongate introducer element capable of manipulating the tissue bag into position.
21. A tissue hag according to claim 20, wherein the introducer element is provided with a lumen through which an inflation gas can be supplied to the one or more inflatable ribs.
22. A method of encapsulating tissue for surgical purposes, comprising the steps of i) introducing a tissue bag into the body of a patient, the tissue bag including a hag body capable of forming an enclosure, an opening in the bag body, and one or more inflatable ribs located on the bag body, ii) inflating the one or more ribs to a first extent such that the bag deploys to an open position, iii) placing the bag over the tissue to be enclosed, with the tissue being received through the opening, and iv) further inflating the one or more ribs to a greater extent such that the bag envelops the tissue with the opening being smaller in diameter than in the open position.
23. A method according to claim 22, further including the step of pulling a drawstring to close the opening once the ribs have been inflated to envelop the tissue.
24. A method of morcellating a uterus, comprising the steps of i) introducing a tissue bag into the body of a patient, the tissue bag including a bag body capable of forming an enclosure, an opening in the bag body, and one or more inflatable ribs located on the bag body, ii) inflating the one or more ribs to a first extent such that the hag deploys to an open position, iii) placing the bag over the uterus, with the uterus being received through the opening, iv) further inflating the one or more ribs to a greater extent such 10 that the bag envelops the uterus with the opening being smaller in diameter than in the open position, and v) morcellating the uterus within the tissue bag.Amended claims have been filed as follows:-Claims 1. A tissue bag for surrounding tissue during a surgical procedure, the tissue bag comprising a bag body capable of forming an enclosure, an opening in the bag body, and one or more inflatable ribs located on the hag body, the ribs being such that inflation of the one or more ribs to a first extent causes the bag to deploy to an open position in which the bag is capable of being placed over tissue with the tissue received through the opening, and that inflation of the one or more ribs to a second further extent causes the bag to envelop the tissue with the opening being smaller in diameter than in the open position.2. A (issue bag according to claim 1, wherein the one or more inflatable ribs extend longitudinally with respect to the opening.3. A tissue bag according to claim 1 or claim 2, wherein the tissue bag includes a plurality of inflatable ribs located on the hag body.4. A tissue bag according to claims 2 and 3, wherein the tissue bag includes a plurality of inflatable ribs extending longitudinally at equally spaced intervals around the circumference of the tissue hag.5. A tissue bag according to any preceding claim, wherein the one or more inflatable ribs each include at least first and second discrete longitudinal portions.6. A (issue bag according to claim 5, wherein the firs( and second longitudinal portions are conjoined by an end face disposed at a non-orthogonal angle to the longitudinal axis of the rib.7. A tissue hag according to claim 6, wherein the angle between the longitudinal axis of the first portion and that of the second portion is between 10 and 45 degrees.8. A tissue hag according to any of claims 5 to 7, wherein the one or more inflatable ribs include at least first, second and third discrete longitudinal portions.9. A tissue bag according to claim 8, wherein the second and third discrete longitudinal portions are conjoined by an end face disposed at a non-orthogonal angle to the longitudinal axis of the rib.10. A tissue hag according to claim 9, wherein the angle between the longitudinal axis of the second portion and that of the third portion is between 10 and 45 degrees.11. A tissue bag according to any of claims 1 to 4, wherein the one or more inflatable ribs each include a longitudinal section with an upper and a lower surface, the upper surface being of a greater length than that of the lower surface.12. A tissue hag according to claim 11, wherein the one or more inflatable ribs have a generally triangular cross-section.13. A (issue bag according to claims 11 and 12, wherein the base of the triangle constitutes the lower surface, and the apex of the triangle constitutes the upper surface.14. A tissue bag according to any of claims 1 to 4, wherein the one or more inflatable ribs each have a generally circular cross-section.15. A tissue bag according to claim 14, wherein the one or more inflatable ribs each include a plurality of adhesions disposed along one longitudinal axis thereof 16. A tissue hag according to claim 15, wherein the plurality of adhesions are equally spaced along the longitudinal axis.17. A tissue bag according to claim 15 or claim 16, wherein each of the adhesions is formed by applying a small amount of adhesive to the rib.18. A tissue bag according to any of claims 11 to 17, wherein the one or more inflatable ribs are such that they inflate to form an arc having a radius of between 5 cm and 15 cm.19. A tissue hag according to any preceding claim, wherein the opening is provided with a drawstring which can he pulled in order to close the opening.20. A tissue bag according to any preceding claim, wherein the tissue bag is mounted on an elongate introducer element capable of manipulating the tissue hag into position.21. A tissue bag according to claim 20, wherein the introducer element is provided with a lumen through which an inflation gas can be supplied to the one or more inflatable ribs.O