WO2002071957A1 - Surgical apparatus and a surgical procedure for removal of an object through an aperture - Google Patents

Surgical apparatus and a surgical procedure for removal of an object through an aperture Download PDF

Info

Publication number
WO2002071957A1
WO2002071957A1 PCT/ZA2002/000031 ZA0200031W WO02071957A1 WO 2002071957 A1 WO2002071957 A1 WO 2002071957A1 ZA 0200031 W ZA0200031 W ZA 0200031W WO 02071957 A1 WO02071957 A1 WO 02071957A1
Authority
WO
WIPO (PCT)
Prior art keywords
members
aperture
surgical
procedure
attachment means
Prior art date
Application number
PCT/ZA2002/000031
Other languages
French (fr)
Inventor
Anna Susanna Ducharme
Original Assignee
Ducharme, Leonard, Arthur
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Ducharme, Leonard, Arthur filed Critical Ducharme, Leonard, Arthur
Publication of WO2002071957A1 publication Critical patent/WO2002071957A1/en

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/2812—Surgical forceps with a single pivotal connection
    • A61B17/2816—Pivots
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00287—Bags for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0042—Surgical instruments, devices or methods, e.g. tourniquets with special provisions for gripping
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/08—Accessories or related features not otherwise provided for
    • A61B2090/0813—Accessories designed for easy sterilising, i.e. re-usable

Definitions

  • the invention relates to a surgical apparatus and to a surgical procedure using said apparatus.
  • the invention relates to a surgical instrrument and to a method of removal of an object from inside the abdominal cavity of a patient during endoscopic and laproscopic surgery.
  • the inventor is aware of a need for a surgical apparatus which permits the removal of objects too large to be removed through a port made by an endoscopic apparatus.
  • ports through the skin and other body tissue are provided through which an endoscopic surgical apparatus is used to remove, for example, a gallbladder.
  • the larger dimension ports are 10/12 mm in diameter making the entry wound quite small. In some cases the circumference of the object to be removed is larger than the diameter of the wound and it becomes difficult to remove such an object using an endoscopic apparatus.
  • an endoscopic apparatus limits the amount of pulling force that can be applied, thereby further hampering the removal of objects through a small wound.
  • the inventor thus proposes an apparatus and a surgical procedure which at least partially provides for the above identified need.
  • the invention provides a surgical apparatus, said apparatus including two unattached members each having a jaw and an attachment means for releaseably attaching to the other of the two members, said jaws together providing gripping means for gripping an object to be removed through an aperture in a body.
  • the jaws may be spoon-shaped.
  • the jaws may be teardrop-shaped.
  • the member may have a hand grippable portion spaced from the jaw by a shaft.
  • the attachment means may be provided on the shafts of the members.
  • the attachment means may be in the form of a clamp, a bolt and nut passing through an eye of each shaft, a clip arrangement, or the like.
  • the attachment means may permit limited movement of the members relative to each other when they are attached.
  • the attachment means may permit pivotal movement of the members relative to each other.
  • the apparatus may be made of a sterilisable material, for re-use.
  • the apparatus may be disposable.
  • Each jaw may co-operate with the other jaw to capture an object to be removed.
  • the apparatus may be manufactured in a number of sizes.
  • the members may be from 200 mm to 600 mm long, for example 485 mm long, of which the jaws are from 12 mm to 30 mm long, for example 15 mm long, and the shaft is from 200mm to 500 mm long, for example 350 mm long.
  • Such an apparatus may have jaws having a cross sectional diameter, perpendicular to the longitudinal axis of the apparatus, of from 10 to 20 mm
  • the invention extends to a surgical procedure for removing an object through an aperture, said procedure including: inserting a portion of a first of two members of a surgical apparatus as described above through an aperture into the body of a patient;
  • the procedure may include the prior steps of making an incision in the body of the patient to provide the aperture.
  • the procedure may include the prior step of using an endoscope port from the aperture prior to insertion of either of the members.
  • the procedure may include the prior step of draining some or all of the fluid associated with the object, from the object.
  • the invention extends to laproscopic and endoscopic surgery using the apparatus as described above.
  • Figure 1 shows, in pictorial view, a surgical apparatus broadly in accordance with the invention
  • Figure 2 shows, in pictorial view, the use of the apparatus of Figure 1.
  • reference numeral 10 generally indicates a surgical apparatus broadly in accordance with the invention.
  • the surgical apparatus 10 includes two members 12, 14 each having a jaw 16, 18 and an attachment means 20, 22 for releaseably attaching member 12 to member 14.
  • the jaws 16, 18 are spoon-shaped with the upper end 24 being tear-drop shaped for ease of removal through aperture 42 without tearing or damaging the surrounding tissue.
  • the members 12, 14 have hand grippable portions 26, 28 shaped complementarily to a human hand to permit a strong gripping thereof to assist in the withdrawal of the apparatus 10 through the aperture 42.
  • the portions 26, 28 are spaced from the jaws 16, 18 by shafts 30, 32.
  • the attachment means 20, 22 are provided on the shafts 30, 32 of the members 12, 14 and are in the form of an eye 34 provided in each shaft 30, 32 through which a nut and bolt 36 pass when the members 12, 14 are attached to each other.
  • the attachment means 20, 22 may be in the form of a clamp, a clip arrangement, or the like.
  • the attachment means 20, 22 permits some pivotal movement of the members 12, 14 relative to each other so as to facilitate the gripping of the object to be removed.
  • the extent of the pivoting is not such so as to allow the apparatus 10 to be inserted in an assembled state through an aperture 42 to grip the object tong-fashion.
  • the members 12, 14 are inserted through the aperture 42 separatley and attached to each other via the attachment means 20, 22 which extend from out of the aperture 42 thereby to securely grip the object to be removed.
  • the apparatus 10 is withdrawn through the aperture 42 with the object securely gripped between the jaws 16, 18 with the leading edge 24 for withdrawal of the jaws 16, 18 presenting the smallest dimension of a tear-drop profile to the aperture 42 thereby to allow easing of the jaws 16, 18 and the object through the aperture 42 without tearing the tissue 44 surrounding the aperture 42.
  • the apparatus 10 is made of a sterilisable material, such as stainless steel, for sterilisation by either heat or chemical means, re-use.
  • the apparatus 10 may be made in a variety of sizes.
  • the members 12, 14 may be 485 mm long, of which the jaws 16, 18 are 15 mm long and the shaft 30, 32 is 350 mm long.
  • Such an apparatus has jaws 16, 18 which have a combined cross sectional diameter when the members 12, 14 are attached to each other in an operative condition, perpendicular to the longitudinal axis of the apparatus, of from 10 to 20 mm
  • Figure 2 is shown the use of the apparatus 10 of Figure 1 in use in a surgical procedure for removing an object through an aperture 42 in a body 40.
  • the procedure includes the prior step of making an incision in the body 40 of the patient to provide the aperture 42.
  • the procedure includes the prior step of using an endoscope port 46 from the aperture 42 prior to insertion of either of the members 12, 14.
  • the procedure may include the prior step of draining some or all of the fluid associated with the object, from the object, for example, where the object is a gall bladder.

Abstract

The invention provides a surgical apparatus (10) including two members (12, 14) each having a jaw (16, 18) and an attachment means (20, 22) for releaseably-attaching member (12) to member (14). When the members (12) and (14) are attached then the jaws (16, 18) work together in providing gripping means for gripping an object to be removed through an aperture in a body. The invention further provides a surgical procedure using the apparatus (10).

Description

SURGICAL APPARATUS FOR REMOVAL OF ANOBJECT THROUGH AN APERTURE
FIELD OF THE INVENTION
The invention relates to a surgical apparatus and to a surgical procedure using said apparatus. In particular, the invention relates to a surgical instrrument and to a method of removal of an object from inside the abdominal cavity of a patient during endoscopic and laproscopic surgery.
BACKGROUND TO THE INVENTION
The inventor is aware of a need for a surgical apparatus which permits the removal of objects too large to be removed through a port made by an endoscopic apparatus.
During endoscopic surgery, ports through the skin and other body tissue are provided through which an endoscopic surgical apparatus is used to remove, for example, a gallbladder. The larger dimension ports are 10/12 mm in diameter making the entry wound quite small. In some cases the circumference of the object to be removed is larger than the diameter of the wound and it becomes difficult to remove such an object using an endoscopic apparatus.
Furthermore, an endoscopic apparatus limits the amount of pulling force that can be applied, thereby further hampering the removal of objects through a small wound. The inventor thus proposes an apparatus and a surgical procedure which at least partially provides for the above identified need.
SUMMARY OF THE INVENTION
The invention provides a surgical apparatus, said apparatus including two unattached members each having a jaw and an attachment means for releaseably attaching to the other of the two members, said jaws together providing gripping means for gripping an object to be removed through an aperture in a body.
The jaws may be spoon-shaped.
The jaws may be teardrop-shaped.
The member may have a hand grippable portion spaced from the jaw by a shaft.
The attachment means may be provided on the shafts of the members.
The attachment means may be in the form of a clamp, a bolt and nut passing through an eye of each shaft, a clip arrangement, or the like.
The attachment means may permit limited movement of the members relative to each other when they are attached. The attachment means may permit pivotal movement of the members relative to each other.
The apparatus may be made of a sterilisable material, for re-use.
The apparatus may be disposable.
Each jaw may co-operate with the other jaw to capture an object to be removed.
The apparatus may be manufactured in a number of sizes. Thus the members may be from 200 mm to 600 mm long, for example 485 mm long, of which the jaws are from 12 mm to 30 mm long, for example 15 mm long, and the shaft is from 200mm to 500 mm long, for example 350 mm long. Such an apparatus may have jaws having a cross sectional diameter, perpendicular to the longitudinal axis of the apparatus, of from 10 to 20 mm
The invention extends to a surgical procedure for removing an object through an aperture, said procedure including: inserting a portion of a first of two members of a surgical apparatus as described above through an aperture into the body of a patient;
locating the jaw portions of said first and second members in a gripping position about the object; and attaching said members to each other to securely grip the object for removal through the aperture.
The procedure may include the prior steps of making an incision in the body of the patient to provide the aperture.
The procedure may include the prior step of using an endoscope port from the aperture prior to insertion of either of the members.
The procedure may include the prior step of draining some or all of the fluid associated with the object, from the object.
The invention extends to laproscopic and endoscopic surgery using the apparatus as described above.
DESCRIPTION OF THE DRAWING
The invention will now be described, by way of non limiting example only, with reference to the accompanying diagrammatic drawings.
In the drawings,
Figure 1 shows, in pictorial view, a surgical apparatus broadly in accordance with the invention; and Figure 2 shows, in pictorial view, the use of the apparatus of Figure 1.
In the Figures, reference numeral 10 generally indicates a surgical apparatus broadly in accordance with the invention.
The surgical apparatus 10 includes two members 12, 14 each having a jaw 16, 18 and an attachment means 20, 22 for releaseably attaching member 12 to member 14.
When the members 12 and 14 are attached then the jaws 16, 18 work together in providing gripping means for gripping an object 48 to be removed through an aperture 42 (see Figure 2) in a body 40.
The jaws 16, 18 are spoon-shaped with the upper end 24 being tear-drop shaped for ease of removal through aperture 42 without tearing or damaging the surrounding tissue.
The members 12, 14 have hand grippable portions 26, 28 shaped complementarily to a human hand to permit a strong gripping thereof to assist in the withdrawal of the apparatus 10 through the aperture 42. The portions 26, 28 are spaced from the jaws 16, 18 by shafts 30, 32.
The attachment means 20, 22 are provided on the shafts 30, 32 of the members 12, 14 and are in the form of an eye 34 provided in each shaft 30, 32 through which a nut and bolt 36 pass when the members 12, 14 are attached to each other. However, in other embodiments not shown the attachment means 20, 22 may be in the form of a clamp, a clip arrangement, or the like.
The attachment means 20, 22 permits some pivotal movement of the members 12, 14 relative to each other so as to facilitate the gripping of the object to be removed. However, the extent of the pivoting is not such so as to allow the apparatus 10 to be inserted in an assembled state through an aperture 42 to grip the object tong-fashion. Thus the members 12, 14 are inserted through the aperture 42 separatley and attached to each other via the attachment means 20, 22 which extend from out of the aperture 42 thereby to securely grip the object to be removed.
Once the members 12, 14 are attached to each other the apparatus 10 is withdrawn through the aperture 42 with the object securely gripped between the jaws 16, 18 with the leading edge 24 for withdrawal of the jaws 16, 18 presenting the smallest dimension of a tear-drop profile to the aperture 42 thereby to allow easing of the jaws 16, 18 and the object through the aperture 42 without tearing the tissue 44 surrounding the aperture 42.
The apparatus 10 is made of a sterilisable material, such as stainless steel, for sterilisation by either heat or chemical means, re-use.
The apparatus 10 may be made in a variety of sizes. For example the members 12, 14 may be 485 mm long, of which the jaws 16, 18 are 15 mm long and the shaft 30, 32 is 350 mm long. Such an apparatus has jaws 16, 18 which have a combined cross sectional diameter when the members 12, 14 are attached to each other in an operative condition, perpendicular to the longitudinal axis of the apparatus, of from 10 to 20 mm
In Figure 2 is shown the use of the apparatus 10 of Figure 1 in use in a surgical procedure for removing an object through an aperture 42 in a body 40.
In addition to what is described above, the procedure includes the prior step of making an incision in the body 40 of the patient to provide the aperture 42.
The procedure includes the prior step of using an endoscope port 46 from the aperture 42 prior to insertion of either of the members 12, 14.
The procedure may include the prior step of draining some or all of the fluid associated with the object, from the object, for example, where the object is a gall bladder.
The inventor believes it to be an advantage of the invention as illustrated that it permits a surgeon to apply a bigger pulling force to an object to be removed than with present endoscopic surgical apparatus. Also, the inventor believes it an advantage of the invention as illustrated, that the field of endoscopic surgery is broadened to include the removal of rigid, soild, hard tissue, or foreign matter not capable of removal by present endoscopic surgical apparatus.
The disclosure in the priority application forms an integral part of the disclosure in this specification and is to be considered as if specifically reproduced herein.

Claims

Claims
1. A surgical apparatus, said apparatus including two unattached members each having a jaw and an attachment means for releaseably-attaching to the other of the two members, said jaws together providing gripping means for gripping an object to be removed through an aperture in a body.
2. An apparatus as claimed in claim, wherein the jaws are spoon-shaped.
3. An apparatus as claimed in claim 1 or claim 2, wherein the jaws are teardrop- shaped.
4. An apparatus as claimed in any one of the preceding claims, wherein one or more of the members have a hand grippable portion spaced from the jaw by a shaft.
5. An apparatus as claimed in any one of the preceding claims, wherein the attachment means is provided on the shafts of the members.
6. An apparatus as claimed in claim 5, wherein the attachment means is in the form of a clamp, a bolt and nut passing through an eye of each shaft, a clip arrangement, or the like.
7. An apparatus as claimed in any one of the preceding claims, wherein the attachment means permits limited movement of the members relative to each other when they are attached.
8. An apparatus as claimed in claim 7, wherein the attachment means permits pivotal movement of the members relative to each other.
9. An apparatus as claimed in any one of the preceding claims, wherein the apparatus is made of a sterilisable material.
10. An apparatus as claimed in any one of the preceding claims, wherein each jaw co-operates with the other jaw to capture an object to be removed.
11. A surgical procedure for removing an object through an aperture, said procedure including: inserting a portion of a first of two members of a surgical apparatus as described above through an aperture into the body of a patient;
locating the jaw portions of said first and second members in a gripping position about the object; and
attaching said members to each other to securely grip the object for removal through the aperture.
12. A procedure as claimed in claim 11 , including the prior step of making an incision in the body of the patient to provide the aperture.
13. A procedure as claimed in claim 11 or claim 12, including the prior step of using an endoscope port from the aperture prior to insertion of either of the members.
14. A procedure as claimed in any one of claims 11 to 13, including the prior step of draining some or all of the fluid associated with the object, from the object.
15. Laproscopic surgery performed using the apparatus as claimed in any one of claims 1 to 10.
16. Endoscopic surgery performed using the apparatus as claimed in any one of claims 1 to 10.
17. A surgical apparatus as claimed in claim 1 , substantially as herein described and illustrated.
18. A surgical procedure as described in any one of claims 11, 15 and 16, substantially as herein described with reference to Figure 2.
19. A new apparatus or a new surgical procedure substantially as herein described.
PCT/ZA2002/000031 2001-03-12 2002-03-12 Surgical apparatus and a surgical procedure for removal of an object through an aperture WO2002071957A1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
ZA2001/02020 2001-03-12
ZA200102020 2001-03-12

Publications (1)

Publication Number Publication Date
WO2002071957A1 true WO2002071957A1 (en) 2002-09-19

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Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/ZA2002/000031 WO2002071957A1 (en) 2001-03-12 2002-03-12 Surgical apparatus and a surgical procedure for removal of an object through an aperture

Country Status (1)

Country Link
WO (1) WO2002071957A1 (en)

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR545734A (en) * 1922-01-10 1922-10-19 Advanced Forceps
DE527109C (en) * 1929-06-01 1931-06-13 Martin Loth Device for ligating deep blood vessels
US5626606A (en) * 1995-07-11 1997-05-06 Schellpfeffer; Michael A. Laparoscopic tissue retrieval forceps
US5702404A (en) * 1996-06-03 1997-12-30 Willingham; Suzan E. Stool extractor

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR545734A (en) * 1922-01-10 1922-10-19 Advanced Forceps
DE527109C (en) * 1929-06-01 1931-06-13 Martin Loth Device for ligating deep blood vessels
US5626606A (en) * 1995-07-11 1997-05-06 Schellpfeffer; Michael A. Laparoscopic tissue retrieval forceps
US5702404A (en) * 1996-06-03 1997-12-30 Willingham; Suzan E. Stool extractor

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