WO2003077773A1 - Ecarteur laparoscopique/thorascopique - Google Patents

Ecarteur laparoscopique/thorascopique Download PDF

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Publication number
WO2003077773A1
WO2003077773A1 PCT/US2002/008131 US0208131W WO03077773A1 WO 2003077773 A1 WO2003077773 A1 WO 2003077773A1 US 0208131 W US0208131 W US 0208131W WO 03077773 A1 WO03077773 A1 WO 03077773A1
Authority
WO
WIPO (PCT)
Prior art keywords
body part
catheter
distal end
support device
shaft
Prior art date
Application number
PCT/US2002/008131
Other languages
English (en)
Inventor
John M. Levin
Original Assignee
Levin John M
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 Levin John M filed Critical Levin John M
Priority to PCT/US2002/008131 priority Critical patent/WO2003077773A1/fr
Priority to AU2002254247A priority patent/AU2002254247A1/en
Publication of WO2003077773A1 publication Critical patent/WO2003077773A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/0218—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors 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
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12009—Implements for ligaturing other than by clamps or clips, e.g. using a loop with a slip knot
    • A61B17/12013—Implements for ligaturing other than by clamps or clips, e.g. using a loop with a slip knot for use in minimally invasive surgery, e.g. endoscopic surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/132—Tourniquets
    • A61B17/1322—Tourniquets comprising a flexible encircling member
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/30—Surgical pincettes without pivotal connections

Definitions

  • This invention relates generally to surgical instruments, and more specifically, to laparoscopic and thorascopic instruments that engage and support a body part.
  • a body part especially of tubular shape (e.g., bowel, fallopian tube, esophagus, appendix, etc.) to be worked upon by, or isolated from, a surgical device (e.g., dissector, scissors, biopsy instrument, etc.). Morever, during these and other surgical procedures, it is quite common to employ a clamp or other gripping device to immobilize or engage a body part to be acted upon or isolated from, a laparoscopic/thorascopic surgical instrument which may cause undesired trauma to that body part.
  • a surgical device e.g., dissector, scissors, biopsy instrument, etc.
  • laparoscopic in referring either to a surgical procedure or a surgical device, or instrument, is intended to include within its scope thorascopic procedures, devices or instruments, unless the context of the reference to laparoscopic clearly indicates otherwise.
  • One exemplary embodiment of the invention is described as a support device for engaging and temporarily supporting a desired body part of the patient's body comprising an insertion device and a catheter or manipulating device.
  • the insertion device punctures a covering of a body tissue to provide a passageway for access to the desired body part.
  • the catheter (or manipulator) extends through the passageway, engages and temporarily supports a desired body part in a non-traumatic manner, and includes a shaft made of a material that is sufficiently flexible to bend to a desired straight or curved orientation and is sufficiently rigid to maintain the desired orientation. A distal end of the shaft bends about the desired body part to form a loop and secure the desired body part within the loop.
  • the retractor is an elongate member including a generally curved distal end, and is formed with an elastic memory for this latter configuration.
  • the curved distal end is adapted to at least partially encircle a body part to be retracted.
  • Yet another exemplary embodiment of the invention is described as a method for engaging and temporarily supporting a desired body part of a patient's body comprising puncturing a covering of a body tissue to provide a passageway for insertion of a catheter into an area of the desired body part, inserting a shaft of the catheter into the passageway, engaging the body part by directing a distal end of the shaft about the desired body part to form a loop, and securing the desired body part within the loop.
  • Still another exemplary embodiment of the invention is described as a support system for engaging and temporarily supporting a desired body part of a patient's body, comprising an elongated hollow needle, a catheter, and a grasping device.
  • the elongated hollow needle includes a distal sharp end that punctures and penetrates a covering of a body tissue, with the needle defining a cylindrical compartment that provides the passageway for access to the desired body part.
  • the catheter extends through the passageway to engage the body part.
  • the catheter includes a shaft made of a material that is sufficiently flexible to bend to a desired straight or curved orientation and is sufficiently rigid to maintain the desired orientation.
  • the grasping device directs a distal end of the shaft about the desired body part to form a loop for securing the desired body part.
  • Fig. 1 is an exploded isometric view showing a support device in accordance with a preferred embodiment of the invention
  • Fig. 2 is a sectional view illustrating the support device of Fig. 1 extending into a body cavity;
  • Fig. 3 is a sectional view of the supporting device of Figs. 1 and 2 after the insertion device has been retracted from an abdomen wall;
  • Fig. 4 is a sectional view illustrating the supporting device of Fig. 3 with a shaft forming a loop;
  • Fig. 5 is an enlarged view illustrating the supporting device of Fig. 4 gripping, or supporting, an internal body part;
  • Fig. 6 is an elevational view illustrating a catheter in accordance with another preferred embodiment of the invention.
  • Fig. 7 is an enlarged sectional view of the catheter shown in Fig. 6 and an insertion device that together form a supporting device in accordance with yet another preferred embodiment of the invention
  • Fig. 8 is a sectional view illustrating the supporting device shown in Fig. 7;
  • Fig. 9 is a sectional view illustrating the supporting device of Figs. 7 and 8, but being manipulated about a body part.
  • the present invention relates to a unique laparoscopic/thorascopic support device that engages and supports a body part in a non-traumatic manner while it is being acted upon by a laparoscopic/thorascopic surgical instrument.
  • the laparoscopic/thorascopic support device of the invention is capable of lifting or otherwise moving a body part into a desired position to be operated upon or isolated from a surgical site.
  • a support device 10 of a preferred embodiment of this invention includes an elongate, balloon catheter 12 that is connectable to a syringe (not shown) at a proximal end thereof, in a conventional manner.
  • the catheter 12 is sufficiently rigid to retain a desired orientation as it is being manipulated within the abdomen of a patient to move under, or partially about a body part to be supported.
  • the catheter may be formed of plastic and resilient metals, such as titanium.
  • the catheter 12 is a double lumen member including two balloons 14, 16 spaced apart from each other at a distal end. Spaced proximally of the balloons and attached to the outer wall of the catheter body is a loop or eyelet 18 including a central passage 20 for receiving the distal end 22 of the catheter, in a manner which will be explained hereinafter.
  • the catheter can be of a single lumen type, and can employ a single balloon (e.g., 14) at the distal end thereof.
  • a single balloon e.g., 14
  • a double lumen catheter is employed with two balloons 14 and 16, for purposes that will become apparent by the discussion that follows.
  • the balloons 14 and 16 are normally in a collapsed condition, until filled with a fluid injected into the catheter from a syringe at the proximal end thereof, in a conventional manner.
  • the balloons are relatively stiff; similar to balloons employed in balloon angioplasty procedures in human arteries.
  • an insertion device 30 includes an upper cap member 31 and a lower, or distal, needle 33.
  • the needle 33 has a width of, for example, about 14 gauge, and is employed to puncture the abdomen32 of a patient, and thereby provide a passageway for the catheter 12 to be inserted into an area of the body near the body part 34 to be acted upon.
  • the insertion device is retracted, as shown in Fig. 3, to move the distal sharp edge 35 of the needle 33 into a region outside of the patient's body.
  • a clip 36 in the form of a split sleeve defining a cylindrical compartment 38 therethrough is inserted about the distal end of the needle 33 of the insertion device 30, and about an adjacent section of the catheter 12.
  • This clip 36 is of a well-known construction, and is employed to prevent the distal needle 33 of the device 30 from canting, or rotating, relative to the catheter 12 and thereby cutting the catheter 12 during a surgical procedure.
  • the clip 36 also functions as a keeper, with the lower, or distal surface 40 thereof engaging the outer surface of the abdomen and thereby maintaining the catheter 12 in a desired orientation and position within the patient's body.
  • the clip 36 prior to applying the clip 36 to the needle 33 and the catheter 12, it is important that the catheter 12 be properly located in the operating site.
  • a laparoscopic grasping device 50 of any suitable design is inserted through a trocar or other passage 51 in a different area of the abdomen from the insertion device 30 and the catheter 12, and then is directed into the operating site near the body part 34 to be acted upon, to grip a region of the catheter 12 adjacent the distal end thereof, (See Figs. 4 and 5) and manipulate that region about the body part 34 to be supported.
  • the distal region of the catheter 12 is then directed through the central passage 20 of the loop or eyelet 18; preferably with the collapsed balloons 14 and 16 being located on opposed sides of the eyelet 18.
  • a syringe (not shown) connected to the proximal end of the catheter 12 in a well-known manner is operated to direct fluid into both inner and outer lumens of the catheter 12 to thereby expand the balloons 14 and 16 on opposite sides of the eyelet 18, as is shown most clearly in Fig. 5.
  • the catheter 12 supports the body part 34 in a non-traumatic fashion, and the engagement of the balloons 14 and 16 on opposite sides of the eyelet 18 retains the catheter 12 about the body part 34 and prevents the catheter 12 from cinching down and crimping, or otherwise traumatizing, the body part 34.
  • the catheter 12 can then be manipulated to position the body part 34 in a desired orientated relative to the operating instruments and the surgical field to permit a laparoscopic surgical procedure to be carried out in an efficient, safe manner.
  • a single balloon can be employed in lieu of the double lumen-double balloon arrangement described above, hi this case, the single balloon 14 will be positioned through the eyelet 18 and then expanded by fluid directed into the balloon 14 from the syringe to thereby lock the catheter 12 about a desired body part.
  • the catheter 12 it may be possible for the catheter 12 to actually cinch down and undesirably crimp the body part 34. Therefore, for surgical procedures in which there is a significant concern regarding the possibility of crushing the body part to be acted upon, the double lumen-double balloon arrangement described earlier is preferred.
  • a separate disc-shaped keeper member (not shown) can be disposed solely about the catheter 12 in a region below the clip 36, to provide the function of maintaining the catheter 12 in a proper position within the operating site.
  • FIG. 1 an alternative embodiment of the invention in the form of a support device/retractor is illustrated at 100.
  • the support device/retractor 100 is directed into the operating site through an insertion device 102, which can be the same as insertion device 30.
  • the insertion device 102 includes an upper cap member 104 and a lower, or distal hollow needle 106.
  • This insertion device 102 like the device 30, is employed to percutaneously puncture a patient's skin, to thereby provide an entry passageway for the support device/retractor 100 of this invention.
  • the support device/retractor 100 initially is formed with a shaft 107 having a curved distal end 108 that is sufficiently rigid to maintain its curvature during use, but is sufficiently springy to be manually moved into a substantially linear or straight condition generally aligned with elongate section 110 of the shaft 107 as shown within the hollow needle 106 of the insertion device 102.
  • the shaft 107 of the support device/retractor 100 is made of a material having sufficient elastic memory for its initially formed condition so that the distal end 108 automatically will return to its curved configuration illustrated in Fig. 6, after an instrument employed to straighten the distal end 108 has been removed.
  • the curved distal end 108 of the support device/retractor 100 initially is straightened so that it can be directed through the central passage of the insertion device 102, and after passage therethrough, the distal end 108 reassumes its curved configuration due to its elastic memory for that orientation.
  • the insertion device 102 can be partially retracted, and the clip 36 employed, in the same manner as described above in connection with the support device 10 (e.g., see Fig. 9).
  • the curved distal end 108 in one use of the support device, can be employed as a conventional retractor to push against tissue or organs that are obstructing a surgical site/procedure.
  • tissue or organs that are obstructing a surgical site/procedure.
  • the support device/retractor 100 of this invention can be employed for this latter purpose.
  • the support device/retractor 100 of this invention can be employed in a number of other surgical environments where other organs or tissue need to be removed from the surgical site.
  • a separate, manipulating instrument 120 can be employed to open up the curved distal end 108 while it is in the surgical field, and then direct the open end about the organ or body part 34 to be supported by the support device/retractor 100 in a manner similar to that described earlier in connection with the support device of the first embodiment of the invention. Thereafter, the manipulating instrument 120 is removed from the support device/retractor 100, thereby permitting the distal end 108 of the support device/retractor 100 to move toward its originally formed, curved configuration due to its elastic memory, to thereby at least partially encircle and support the organ 34 or other tissue to be acted upon and/or removed from the surgical site. (Fig. 9)
  • the shaft 107 of the support device/retractor 100 can be formed from any suitable material that is compatible with body tissues; that is capable of being formed into a shaped configuration; that has an elastic memory for its initially formed configuration and that is capable of being straightened or otherwise reoriented to a second position for permitting the support device/retractor 100 to be directed into a patient's body through an insertion device 102, while still retaining the elastic memory of the shaft 107 for its initially formed, unstraightened configuration.
  • the support device/retractor 100 includes a shaft 107 that can be straightened to be received within the insertion device 102, and the shaft 107 includes an elastic memory for its initially formed, curved configuration.
  • Suitable materials usable to form the shaft 107 of the support device/retractor 100 include plastic materials which can be elastically oriented and set so as to retain memory for its deformed configuration, and also certain metals, such as titanium. Materials having an elastic memory for an initially formed configuration, while being physically movable into a straight or other configuration, are well known to persons skilled in the art; the specific material employed not constituting a limitation on the broadest aspects of this invention.
  • the support device/retractor 100 includes an elongate member or shaft 107 made of a material having elastic memory.
  • the shaft 107 can be one (1) or two (2) millimeter diameter titanium wire or rod; it being understood that the specific dimensions and materials of the shaft 107 do not constitute a limitation on the broadest aspect of this invention.
  • the shaft 107 could also be formed with a coiled wire. What is important is that the shaft 107 have an elastic memory for its formed configuration.
  • the retractor 100 is an elongate member or shaft 107 preferably in the form of a rod or wire.
  • the shaft 107 is initially formed into a generally "J" configuration, having a U-shaped loop at the curved distal end 108 of the shaft 107 for encircling a body part 34 to be retracted.
  • the retractor 100 is flexed into an orientation for passage through a central passage of a catheter or insertion device 102.
  • the curved distal end 108 of the retractor 100 assumes its pre-formed, generally U-shaped configuration do to its memory for that preformed configuration.
  • the curved distal end 108 is positioned, or manipulated, to encircle a body part 34 to be retracted, and the retractor 100 then is employed to provide its desired retracting function. This positioning or manipulation can be provided as needed with the manipulating instrument 120, as best seen in Fig. 7 and described above.
  • the material of the retractor 100 is designed so that the holding power of the U-shaped loop at the curved distal end 108, i.e., the force it can experience without opening up, preferably will be in the range of five to six pounds; however, for many applications the holding power can be substantially less, e.g., on the order of one pound or less.
  • the body part 34 retained by the retractor 100 is manipulated out of the curved distal end 108 with or without aid from the mampulation instrument 120 as needed.
  • the retractor 100 is then removed from the body through the insertion device 102.
  • a configuration e.g. linear, conforming to the configuration of the passage in the insertion device 102 to permit removal of the retractor 100 from the patient's internal body cavity.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne un dispositif support laparoscopique/thorascopique qui vient en contact avec une partie du corps et la porte d'une manière non traumatique, tout en étant actionné par un instrument chirurgical. Ledit dispositif peut soulever ou déplacer une partie du corps vers une position voulue en vue de l'opérer ou de l'isoler d'une autre partie du corps. Ledit dispositif comporte un dispositif (30) d'insertion qui perfore l'enveloppe d'un tissu corporel afin de créer un passage d'accès à la partie du corps et à un cathéter (12). Le cathéter (12) traverse le passage et vient en contact avec la partie du corps voulue et la supporte provisoirement d'une manière non traumatique. Le cathéter (ou le dispositif manipulateur) comporte un arbre à base d'un matériau suffisamment souple pour se plier dans une orientation droite ou incurvée, et suffisamment rigide pour conserver l'orientation voulue, la partie du corps voulue étant ainsi maintenue à l'intérieur d'une boucle.
PCT/US2002/008131 2002-03-15 2002-03-15 Ecarteur laparoscopique/thorascopique WO2003077773A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
PCT/US2002/008131 WO2003077773A1 (fr) 2002-03-15 2002-03-15 Ecarteur laparoscopique/thorascopique
AU2002254247A AU2002254247A1 (en) 2002-03-15 2002-03-15 Laparoscopic/thorascopic support device

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/US2002/008131 WO2003077773A1 (fr) 2002-03-15 2002-03-15 Ecarteur laparoscopique/thorascopique

Publications (1)

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WO2003077773A1 true WO2003077773A1 (fr) 2003-09-25

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PCT/US2002/008131 WO2003077773A1 (fr) 2002-03-15 2002-03-15 Ecarteur laparoscopique/thorascopique

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AU (1) AU2002254247A1 (fr)
WO (1) WO2003077773A1 (fr)

Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5106369A (en) * 1990-11-28 1992-04-21 Board Of Regents, The University Of Texas System Percutaneous umbilical cord stabilizer
US5281236A (en) * 1992-06-23 1994-01-25 Boston Scientific Corporation Method and device for intracorporeal knot tying
US5486183A (en) * 1990-10-09 1996-01-23 Raychem Corporation Device or apparatus for manipulating matter
US5613973A (en) * 1995-03-10 1997-03-25 Wilson Greatbatch Ltd. Laraposcopic surgical grasper having an attachable strap
US5857999A (en) * 1995-05-05 1999-01-12 Imagyn Medical Technologies, Inc. Small diameter introducer for laparoscopic instruments
DE19746057A1 (de) * 1997-10-17 1999-04-22 Bisping Hans Juergen Vorrichtung zur Fixierung von Sonden und Kathetern
US5921918A (en) * 1996-03-26 1999-07-13 Riza; Erol D. Surgical retractor
WO2001072231A2 (fr) * 2000-03-24 2001-10-04 Boston Scientific Limited Procede et appareil permettant de positionner un element diagnostique ou therapeutique sur un tissu corporel et element masque utilise avec cet element

Patent Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5486183A (en) * 1990-10-09 1996-01-23 Raychem Corporation Device or apparatus for manipulating matter
US5106369A (en) * 1990-11-28 1992-04-21 Board Of Regents, The University Of Texas System Percutaneous umbilical cord stabilizer
US5281236A (en) * 1992-06-23 1994-01-25 Boston Scientific Corporation Method and device for intracorporeal knot tying
US5613973A (en) * 1995-03-10 1997-03-25 Wilson Greatbatch Ltd. Laraposcopic surgical grasper having an attachable strap
US5857999A (en) * 1995-05-05 1999-01-12 Imagyn Medical Technologies, Inc. Small diameter introducer for laparoscopic instruments
US5921918A (en) * 1996-03-26 1999-07-13 Riza; Erol D. Surgical retractor
DE19746057A1 (de) * 1997-10-17 1999-04-22 Bisping Hans Juergen Vorrichtung zur Fixierung von Sonden und Kathetern
WO2001072231A2 (fr) * 2000-03-24 2001-10-04 Boston Scientific Limited Procede et appareil permettant de positionner un element diagnostique ou therapeutique sur un tissu corporel et element masque utilise avec cet element

Also Published As

Publication number Publication date
AU2002254247A1 (en) 2003-09-29

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