US 20090076323 A1
An optical obturator apparatus includes an obturator sleeve defining a longitudinal axis and having a longitudinal bore for receiving surgical instrumentation and a transparent window mounted to the obturator sleeve and being dimensioned and configured to pass through tissue. The transparent window is mounted for movement between a first position in general alignment with the longitudinal axis of the obturator sleeve and a second position radially displaced from the longitudinal axis to thereby expose the longitudinal bore of the obturator sleeve to permit passage of the surgical instrumentation. The transparent window may include a cutting blade, or alternatively two cutting blades, adapted to penetrate tissue
1. A surgical optical access system, which comprises:
a cannula assembly having a cannula with open proximal and distal ends and a seal housing having a seal and being mounted on the proximal end of the cannula, the cannula defining a longitudinal bore for reception of surgical instrumentation;
a window for permitting passage of light into the cannula and being mounted on the distal end of the cannula; and
locking structure for securing an endoscope within the cannula assembly, the window permitting the passage of light to the endoscope when the endoscope is disposed within the cannula.
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The present application is a divisional application which claims the benefit of and priority to U.S. patent application Ser. No. 11/095,413 filed Mar. 31, 2005, the entire contents of which are incorporated herein by reference.
1. Technical Field
The present disclosure relates to an apparatus for penetrating body tissue during minimally invasive surgical procedures, such as endoscopic or laparoscopic procedures. More particularly, the present disclosure relates to an access assembly having a transparent window for providing visual observation during penetration of the peritoneum or other body tissue.
2. Background of the Related Art
Minimally invasive surgical procedures including endoscopic and laparoscopic procedures permit surgery to be performed on organs, tissue and vessels far removed from an opening within the tissue. Laparoscopic and endoscopic procedures are performed in the interior of the abdomen through a small incision such as, for example, a narrow endoscopic tube or cannula inserted through a small entrance incision in the skin. Typically, after the abdominal cavity is insufflated, a trocar is used to puncture the cavity wall, i.e., the peritoneal lining, to create a pathway to the underlying surgical site. Generally, the trocar includes a stylet or obturator having a sharp tip for penetrating the body cavity, which is positioned coaxially within an outer cannula. The obturator is removed, leaving the outer cannula in place for reception of instrumentation utilized to perform the surgical procedure. An example of a known trocar is described in commonly assigned U.S. Pat. No. 6,319,266 to Stellon, which issued Nov. 21, 2001, the contents of which are incorporated herein in its entirety by reference. However, with known trocars, advancement of the obturator through tissue is typically performed blind, i.e., without visualization of the tissue being entered. Obturators allowing visualization include U.S. Pat. Nos. 5,334,150, 5,431,151 and 5,441,041.
Accordingly, the present disclosure provides an optical access assembly which permits direct visualization of body tissue during penetration of the body cavity. Moreover, the optical access assembly of the present disclosure provides an improved structure for direct visualization of the body tissue being penetrated and serves as a conduit for subsequent introduction of surgical instrumentation required for performance of the surgical procedure.
In one preferred embodiment, an optical obturator apparatus includes an obturator sleeve defining a longitudinal axis and having a longitudinal bore for receiving surgical instrumentation and a transparent window mounted to the obturator sleeve and being dimensioned and configured to pass through tissue. The transparent window is mounted for movement between a first position in general alignment with the longitudinal axis of the obturator sleeve and a second position radially displaced from the longitudinal axis to thereby expose the longitudinal bore of the obturator sleeve to permit passage of the surgical instrumentation. The transparent window may include a cutting blade, or alternatively two cutting blades, adapted to penetrate tissue.
A control member is connected to the transparent window and at least partially extends along the obturator sleeve. The control member is actuable to move the transparent window between the first position and the second position. The control member is adapted to rotate about an axis of rotation to cause movement of the transparent window between the first position and the second position. In this regard, the transparent window is adapted for pivotal movement about the axis of rotation to move between the first position and the second position thereof. The control member may be adapted to move in a longitudinal direction from a normal position to an extended position to displace the transparent window relative to the obturator sleeve.
An anti-rotation member may be associated with the transparent window to prevent pivotal movement of the transparent window when the transparent window is in the normal position thereof. The anti-rotational member includes a key extending from one of the transparent window and the obturator sleeve, the key receivable within a keyed port defined in the other of the transparent window and the obturator sleeve. The key is removed from the keyed port upon movement of the control member to the extended position.
A manually manipulative member may be operatively connected to the control member. The manually manipulative member is movable to move the control member.
In another preferred embodiment, a surgical optical viewing system includes an optical obturator having an obturator sleeve defining a longitudinal axis and a longitudinal bore for reception of surgical instrumentation. The optical obturator includes a transparent window for permitting passage of light into the obturator sleeve. The transparent window has at least two separable window sections. The at least two separable window sections are adapted for radial displacing movement to expose the longitudinal bore and to permit passage of the surgical instrumentation used for performing a surgical procedure. The transparent window may define a tapered configuration and at least one cutting blade adapted to penetrate tissue.
The optical viewing system may further include a surgical instrument positionable within the longitudinal bore of the obturator sleeve. The at least two separable sections of the transparent window are adapted for radially displacing movement in response to longitudinal movement of the surgical instrument relative to the obturator sleeve. In this regard, the surgical instrument is engageable with interior surfaces of the at least two separable sections of the transparent window upon relative longitudinal movement of the surgical instrument and the obturator sleeve to radially displace the at least two separable sections.
Preferred embodiments of the present disclosure are described hereinbelow with references to the drawings, wherein:
Referring now in detail to the drawing figures, in which, like reference numerals identify similar or identical elements, there is illustrated in
Generally, optical access assembly 100 includes housing 102, sleeve 104 secured to housing 102 and extending distally therefrom and window 106 operatively connected to the distal end of sleeve 104. Housing 102 may incorporate several components connected to each other by conventional means or may be a single component. As best depicted in
With reference to
A manual manipulative handle 124 extends radially outwardly from the proximal end of control member 120. Handle 124 is advantageously dimensioned for gripping engagement by the user and is actuable to effectuate rotational and/or longitudinal movement of control member 120 and thus corresponding movement of window 106. More specifically, handle 124 is mechanically connected to control member 120 in a manner whereby rotational movement of the handle 124 about handle axis h causes corresponding rotational movement of the control member 120 about axis c. Any means for transferring this rotational motion are envisioned including, e.g., the bevel gear arrangement depicted in
Sleeve 104 further defines keyed notch 132 in its distal end. Keyed notch 132 serves to prevent rotation of window 106 during introduction within the body tissue.
Referring now to
Window 106 is generally tapered in configuration, e.g., bulbous, hemispherical, or pyramidal conically-shaped, to facilitate passage through body tissue. Window 106 may include an image directing member (not shown) for directing optical images into longitudinal bore 118 of sleeve 104 or back to an image apparatus. The image directing member may be a lens, an optical prism, an optical mirror, or like image directing medium.
As best depicted in
Window 106 further includes anti-rotation key 136. Anti rotation key 136 resides within keyed notch 134 of sleeve 104 to prevent rotation of the sleeve 104 during introduction of window 106.
In operation, the peritoneal cavity is insufflated to raise the cavity wall to provide greater access to tissue and organs therewithin. An endoscope 200 is inserted into optical access assembly 100, i.e., through housing 102 and into longitudinal bore 118, as shown in
The procedure is continued by positioning window 106 against the body tissue t and advancing the assembly 100 to permit cutting blade 134 to penetrate the tissue. A skin incision may be made before pressing window 106 against the tissue, if desired. During penetration of the body tissue, the surgeon observes the underlying tissue through the endoscope 200 to ensure there is no undesired contact with organs, tissue, etc. lying beneath the peritoneal lining. In instances where a video system is utilized, the surgeon simply observes the penetration of body tissue t via any known video monitor. Once the surgeon penetrates the body tissue t as observed through the endoscope 200, the surgeon discontinues the application of force. For example, in penetration of the abdominal wall, the surgeon can observe the peritoneum and penetration thereof.
After penetration into the underlying body cavity, handle 124 is moved in the distal direction within slot 130 of obturator sleeve 104 to move control member 120 from its normal operative position depicted in
With reference to
Cannula assembly 500 may be similar to any conventional cannula assembly adapted for use in laparoscopic surgery. Cannula assembly 500 includes cannula housing 502 and cannula 504 extending from the cannula housing 502. An internal seal assembly may be mounted within cannula housing 502 for sealed reception of a surgical instrument such as an endoscope. One suitable seal system is disclosed hereinabove in connection with the discussion of
In operation, cannula assembly 500 is positioned within optical access assembly 400 followed by insertion of an endoscope 200 within the cannula assembly 500. Endoscope 200 is positioned within access assembly 400 such that distal lens element 202 of endoscope 200 does not extend beyond the distal end of access assembly 400 as shown in
With reference to
In further embodiments, the optical access assembly is as discussed above in connection with
In further embodiments, the optical access assembly is as discussed above in connection with
In each of the embodiments discussed above, the window may or may not include cutting blades. The window may have any shape, such as pyramidal, conical, dolphin-nosed, hemispherical, etc. In each of the embodiments discussed above, the endoscope may include an eyepiece, and/or a connection to imaging equipment which may include a computer. In each of the embodiments discussed above, the movement of the window, jaws, or window sections is driven by an electric motor, hydraulic driver or manual drive and may be controlled utilizing electrical or mechanical methods.
It will be understood that various modifications can be made to the embodiments of the present invention herein disclosed without departing from the spirit and scope thereof. For example, various diameters for the obturator assembly, cannula assembly, as well as various diameters for the surgical instruments are contemplated. Also, various modifications may be made in the configuration of the parts. Therefore, the above description should not be construed as limiting the invention but merely as exemplifications of preferred embodiments thereof. Those skilled in the art will envision other modifications within the scope and spirit of the present invention as defined by the claims appended hereto.