|Publication number||USRE42050 E1|
|Application number||US 10/841,427|
|Publication date||Jan 18, 2011|
|Filing date||May 7, 2004|
|Priority date||Apr 13, 1998|
|Also published as||US6383195|
|Publication number||10841427, 841427, US RE42050 E1, US RE42050E1, US-E1-RE42050, USRE42050 E1, USRE42050E1|
|Inventors||Marlon S. Richard|
|Original Assignee||Richard Marlon S|
|Export Citation||BiBTeX, EndNote, RefMan|
|Patent Citations (12), Referenced by (1), Classifications (11), Legal Events (2)|
|External Links: USPTO, USPTO Assignment, Espacenet|
This application claims the benefit of priority of U.S. Provisional Application Serial No. 60/081,609 filed Apr. 13, 1998.
1. Field of the Invention
The present invention relates to laparoscopic instruments and, more particularly, to laparoscopic specimen removal apparatuses.
2. General Background
One of the biggest concerns in laparoscopic surgery is the number of laparoscopic instruments required to perform the surgical procedure and thus the number of incisions in the patient to insert such instruments. Therefore, several attempts have been made to integrate the functions of different laparoscopic instruments in such a manner that the number of incisions or trocar sites required to carry out the surgical procedure is minimized. However, any such integration of functions should not complicate the overall surgical procedure but instead simplify.
Before extracting the tissue or specimen from the patient's cavity, the tissue/specimen is placed in a receptacle such as, a bag, web or sheath to minimize further exposure of the other organs from the possibly diseased tissue/specimen being removed. As can be surmised, the bag or receptacle must be opened and/or deployed and, preferably, closed while in the patient cavity.
Several laparoscopic instruments have been patented which are used to assist in tissue removal during laparoscopic surgery.
U.S. Pat. No. 5,630,822, issued to Hermann et al., discloses a laparoscopic tissue removal device which includes a grasper coaxially mounted within an expandable sheath and including jaws for grabbing a specimen. However, a second tool must be used to tie off the sheath. Additionally, the use of other conventional laparoscopic grasping tools to push the mass into the flared end of the sheath is disclosed.
U.S. Pat. Nos. 5,190,555, issued to Wetter et al.; 5,336,227, issued to Nakao et al.; and, 5,352,184, issued to Goldberg et al. all disclose laparoscopic tools with a bag for capturing tissue, closing the bag via a drawstring and withdrawing it back through the tool.
U.S. Pat. Nos. 5,496,330, issued to Bates; 5,658,296, issued to Bates et al.; and, 5,197,968, issued to Clement all disclose a laparoscopic tools where the tool has a flexible basket for the tissue capture.
U.S. Pat. Nos. 5,176,687, issued to Hasson et al. and 5,312,417, issued to Wilk disclose laparoscopic tools with an open ended bag to capture tissue samples. In the Hasson et al. patent ('687), though a laparoscopic removal tool can be inserted through the bag, the bag must be pulled down out of a sleeve and opened with the assistance of a second tool, such as, forceps. The bag in '687 is made of a membrane which is not rigid and has no rigid supports to allow it to open on its own inside a patient. In the Wilk patent ('417), the receiver portion or open ended web (bag) is provided with support means to open and expand the open ended web (bag). Numerous proposals are suggested to open the receiver portion or web including complicated techniques using hydraulic or pneumatic circuits. Nevertheless, the invention described in '417 does not disclose any means in the laparoscopic cannula assembly which serves to close the open end of the web (bag) and, more specifically, the support means supporting the web (bag).
U.S. Pat. Nos. 5,190,1555, 5,336,227, 5,352,184, 5,496,330, 5,312,417, 5,197,968, 5,176,687; 5,630,822, 5,658,296, 5,423,830 are incorporated herein by reference.
U.S. Pat. Nos. 5,465,731 and 5,647,372, both of which are assigned to United States Surgical Corporation, disclose a specimen removal pouch and applicator which includes a pouch closed via a drawstring. An additional forceps or grasper inserted though another cannula may be need to unroll the pouch if necessary. The disclosed specimen removal pouch and applicator is not adapted to have a laparoscopic grasper or other laparoscopic instrument inserted coaxially through the applicator.
U.S. Pat. No. 5,480,404, issued to Kammerer et al., discloses a surgical tissue retrieval instrument including a collapsible pouch having a cinching mechanism. The instrument of Kammerer et al., like the applicator disclosed in '731 and '372, is not adapted to have a laparoscopic grasper or other laparoscopic instrument inserted coaxially therethrough.
U.S. Pat. No. 5,423,830, issued to Schneebaum et al., discloses an instrument assembly having a capture component including a web member attached to spring biased ribs which opens into a cup-shaped configuration when ejected. A vacuum or suction source is provided to provided a negative pressure to assist in clamping the web member and ribs around the tissue/specimen. The instrument assembly of Schneebaum is not adapted to have the cauterization loop inserted coaxially through the web.
U.S. Pat. No. 5,074,867, issued to Wilk, discloses a membrane or web having stings or filaments attached to the periphery or corners thereof. Forceps or the like are used to stretch the membrane until it assumes a substantially opened position which is shown as a flat sheet-like profile. The strings are used to surround the membrane or web around the specimen or organ.
As can be readily seen, there is a continuing need for a laparoscopic specimen removal apparatus including a laparoscopic specimen extractor having a specimen bag having support means for allowing the bag to be opened and closed without the use of a separate laparoscopic tool; and, a specimen grasper coaxially mountable within the specimen bag.
The preferred embodiment of the laparoscopic specimen removal apparatus of the present invention solves the aforementioned problems in a straight forward and simple manner. What is provided is an apparatus for removing specimens from a patient during laparoscopic surgery comprising a laparoscopic specimen extractor having a specimen bag having support means for allowing the bag to be opened and closed without the use of a separate laparoscopic tool; and, a specimen grasper coaxially mountable within the specimen bag.
Broadly, the laparoscopic specimen extractor comprises:
The support means cinches closed to a generally elliptical or football shape.
In view of the above, it is an object of the present invention to provide a laparoscopic specimen removal apparatus which includes a laparoscopic specimen extractor having a cage lined with a liner or bag which automatically expands and opens to a “tulip” shape when deployed and means secured to the cage for cinching closed distal ends or tips of the cage when opened.
Another object of the invention is to provide such a cage or support means with a plurality of spring biased strips having tips wherein a first set of the strip tips are tied together via a first drawstring and a second set of the strip tips are tied togther via a second drawstring. Pulling the first and second drawstrings cinches closed the tips and, thus, the liner or bag attached to the cage.
A further object of the present invention is to provide such a cage or support means which when closed the plurality strips are essentially straight, when opened forms a “tulip” shape and when cinched closed forms an “elliptical” or “football” shape.
A further object of the present invention is to provide a support means which include rigid but flexible strips which are secured to the bag.
It is a still further object of the present invention to provide such a laparoscopic specimen extractor with a cinching closed means including first and second drawstrings and a means for pulling the drawstrings simultaneously to cinch close the cage or support means.
It is a still further object of the present invention to provide the cage or support means with a plurality of strips wherein each strip has a free end twisted approximately 90° (ninety degrees) with respect to the rest of the strip to form a twisted section and a hole is bored in such twisted section. This twisted section is substantially perpendicular to the center axis of inner tube assembly and thus the cage. Likewise, the center of the holes in the twisted sections is substantially perpendicular to said center axis. Thereby, as the tips (twisted section) is cinched closed via the drawstring the twisted section are drawing toward each other so that an “elliptical” or “football” shape is created.
In view of the above objects, it is a feature of the present invention to provide a laparoscopic specimen extractor which is simple to use and further does not complicate the tissue surgical procedure but instead simplifies it.
Another feature of the present invention is to provide a laparoscopic specimen extractor which is relatively simple structurally and thus simple to manufacture.
A major advantage of the laparoscopic specimen extractor it its utilization of a unique specimen entrapment system which compresses and forms the specimen into a “dilator” or “football” shaped package in which its cross section's diameter is much smaller than its length. This aerodynamic shape has the advantage of exiting a smaller incision with significantly less effort than conventional bag type retrieval systems which form the specimen into a “spherical” or basketball” shape which is difficult to pull through a small incision.
Another advantage of the present invention is the ability of the laparoscopic specimen extractor, through a single site, to (1) insert a grasping laparoscopic instrument through (coaxially) the extractors' center; (2) retrieve a specimen and pull the specimen into the specimen cage/bag assembly via the coaxially inserted grasping laparoscopic instrument; (3) compress the specimen cage/bag assembly into an aerodynamic package; (4) aspirate and/or morcelate the specimen in a protective environment; and, (5) remove the specimen from the patient's cavity.
The above and other objects, features and advantages of the present invention will become apparent from the drawings, the description given herein, and the appended claims.
For a further understanding of the nature and objects of the present invention, reference should be had to the following description taken in conjunction with the accompanying drawings in which like parts are given like reference numerals and, wherein:
The laparoscopic specimen extractor 10 in general comprises a specimen cage/bag assembly 15, an outer tube assembly 40, serving as the container for the specimen cage/bag assembly 15, and an inner tube assembly 50 which is slidably coupled in the outer tube assembly 40 and has the specimen cage/bag assembly 15 on its patient end.
The outer tube assembly 40 is fabricated of surgical-grade stainless steel or any other biocompatible material having a diameter of 10 mm with a wall thickness of approximately 0.25 mm. A collar 60, made of the same material as the outer tube assembly 40, is 13 mm in diameter and 10 mm long with a wall thickness of approximately 1.5 mm. The collar 60 is axially fused to the operator end of the outer tube assembly 40. The collar 60 has a groove approximately 1 mm wide cut into the inner circumference, positioned 1.5 mm from the open end of the collar 60. Such groove accommodates a 9.5 mm surgical grade O-ring 65 which provides an air-tight seal with the inner tube assembly 50.
A finger ring assembly 70, made of surgical-grade stainless steel, or any other biocompatible material, is mounted at the collar end or, in other words, the operator end, of the outer tube assembly 40, surrounding the collar 60. The finger ring assembly 70 contains two (2) rings 71 oriented across from each other, resembling finger holes of a large syringe. The rings 71 have approximately a 15 mm inner diameter and a 3 mm ring thickness or width and are positioned approximately 20 mm from the collar end of the tube assembly 40 to the ring's centers. The total length of the outer tube assembly 40 is approximately 200 mm.
The inner tube assembly 50 is fabricated of surgical grade stainless seel or any other biocompatible material. The inner tube assembly 50 has an outer diameter of 9.5 mm with a wall thickness of approximately 0.25 mm and a length of 200 mm. The inner tube assembly 50 has external threads (not shown), on the operator end, 8 mm long with an outer diameter of approximately 11 mm. An internally threaded end cap 74, which has an integrated thumb cradle 72, is threaded onto the operator end of the inner tube assembly 50.
Referring also to
Referring now to
Like end cap 74, end cap 74′ is provided with a bored hole 75′, for the insertion of the laparoscopic instrument 80 and the bored side holes 76′ (only one shown) for the passage of the two (2) drawstrings 28 and 38. The free ends of the draw strings 28 and 38 are affixed or tied to the sliding finger squeeze slide 93 slidably mounted on rod or handle 91. In the exemplary embodiment, when the operator squeezes the fingers on finger squeeze slide 93, sliding finger squeeze slide 93 slides upward toward palm rest 92 thereby simultaneously pulling drawstrings 28 and 38 to cinch close cage 20.
Referring now to
Like end cap 74′, end cap 74″ is provided with a bored hole 75″, for the insertion of the laparoscopic instrument 80 and the bored side holes 76″ for the passage of the two (2) drawstrings 28 and 38. The free ends of the draw strings 28 and 38 are affixed or tied to the sliding finger squeeze slide 93′ slidably mounted on rod or handle 91′ via holes 93a′ and 93b′. Longitudinal bore holes 93a′ and 93b′ are position in close proximity to the outer perimeter edge of squeeze slide 93′ so the operator's fingers can be positioned on the underside of squeeze slide 93′ between the drawstrings 28 and 38 and rod or handle 91′.
Referring now to
The squared finger rings 71′ are integrated with jacket 79 having a bored hole therethrough. The operator end of the outer tube assembly 40 has affixed thereto jacket 79 such that jacket 79 is stationary.
Referring now to
Since the cage/bag assembly 15 of
Since the spring loaded strips 21-26 protrude out of the end of the inner tube assembly 50 approximately 105 mm, the total length of the spring loaded strips 21-26 forming the cage 20 or support means ejected from the patient end of outer tube assembly 40 may be varied in accordance with the size of the specimen 30. Moreover, as the total length of the spring loaded strips is varied, the amount of expansion or flaring of these spring biased strips 21-26 is varied proportionally.
Referring also to
Referring also to
The drawstring 28, which is 400 mm long and made of #0 silk suture or any biocompatible ligature, is tied with an appropriate knot through the hole 27 of strip 21; the other end is passed or threaded through the hole 27 in the strips 22, 23 and 24 making a 90° (ninety degree) turn running parallel along the top of strip 24, through one of the holes 34 in the retaining collar 33, through the center of the inner tube assembly 50, and exiting through one of the holes 76 or 76′ in the end cap 74 or 74′. The end of drawstring 28 is tied off to a ring 29 or any approximate handle assembly 90 or 90′, in the manner as described above. When the drawstring 28 is pulled, strips 21, 22, 23 and 24 will be drawn together. More specifically, the ends or tips of spring loaded strips 21-24 are drawn together.
A second drawstring 38, which is 400 mm long and, likewise, made of #0 silk suture or any biocompatible ligature, is tied with an appropriate knot through the hole 27 of strip 24; the other end is passed through the hole 27 in strips 25, 26 and 21 making a 90° (ninety degree) turn running parallel along the top of the strip 21, through the other one of holes 34 in the retaining collar 33, through the center of the inner tube assembly 50, exiting through the other one of holes 76 or 76′ in the end cap 74 or 74′. The end of drawstring 38 is tied off to the same ring 29 or any appropriate handle assembly 90 or 90′, as is the other drawstring 28. When the drawstring 38 is pulled, the strips 24, 25, 26 and 21 will be drawn togther. More specifically, the ends or tips of spring loaded strips 21 and 24-26 are drawn together.
When both drawstrings 28 and 38 are pulled simultaneously all the ends or tips of the six (6) spring loaded strips 21-26 will be drawn together, thus forming a substantially “elliptically” or “football” shaped cage 20 or support means, as best seen in
A cylindrical liner or bag 32 made of surgical grade plastic, such as the material found in U.S. Surgical's Endo Catch, would be suitable for this application and is positioned inside the spring loaded strips 21-26 and hemmed around the drawstrings 28 and 38 and the strip ends or tips. The other end of the cylindrical liner or bag 32 is secured to the inner circumferential wall of the patient end of the inner tube assembly 50 and is held in place by a medical grade bag retaining ring 35. The bag retaining ring 35, having an opening of 6 mm, is positioned in front of the internal retaining collar 33. This liner or bag 32 prevents leakage of specimen fluids during extraction.
All of the above individual measurements and dimensions could be reduced by 99.999% or enlarged by 10,000% to fit a specific application.
The laparoscopic specimen extractor 10 is assembled by inserting the inner rube assembly 50 inside the outer tube assembly 40 through the operator end.
The inner tube assembly 50 has two (2) positions, retracted (
The operation of the laparoscopic specimen extraction 10 of the laparoscopic specimen removal apparatus 100 is described below. The laparoscopic specimen extractor 10 is inserted, patient-end first, into a trocar or open incision in the retracted position, as best seen in FIG. 1. The laparoscopic specimen extractor 10 is then deployed by inserting two (2) fingers in the finger rings 71 on the outer tube assembly 40 and placing the thumb in the thumb cradle 72 on the end cap 74. The operator slowly squeezes his thumb and fingers together, pushing the inner tube assembly 50 in the outer tube assembly 40 until the specimen cage/bag assembly 15 is fully exposed, as best seen in FIG. 2.
The operator then removes said plug (not shown) in end cap 74 of the inner tube assembly 50 and inserts the grasping instrument 80 through the hole 75, through the center of the inner tube assembly 50 and the specimen cage/bag assembly 15, and grasps the specimen 30, as best seen in FIG. 2. The operator then pulls the specimen 30 into the cage/bag assembly 15, as far as possible, by retracting grasping laparoscopic instrument 80, as best seen in FIG. 3. After the specimen 30 is placed in the cage/bag assembly 15, the operator pulls the drawstrings 28 and 38 via ring 29 causing the end or tips of the specimen cage 20 or support means and, thus, liner 32 to be cinched closed, trapping the specimen 30 inside. After the specimen 30 has been placed in the cage/bag assembly 15, the grasping laparoscopic instrument 80 should be manipulated to release or deposit the specimen 30 in the cage/bag assembly 15 before fully retracting the grasping laparoscopic instrument 80.
The grasping instrument 80 can then be removed from the inner tube assembly 50 by fully retracting the grasping instrument 80 from the inner tube assembly 50 and an aspirator or morcelator may be inserted to remove tissue and fluids to further reduce the size of the specimen 30. The operator then extracts the laparoscopic specimen extractor 10 through the trocar or open site.
From the forgoing, it can be readily seen that an advantage of the laparoscopic specimen extractor 10 is its ability, through a single site, to (1) insert a grasping laparoscopic instrument 80 through (coaxially) the extractors' center; (2) retrieve a specimen 30 and pull the specimen 30 into the specimen cage/bag assembly 15 via the coaxially inserted grasping laparoscopic instrument 80; (3) compress the specimen cage/bag assembly 15 into an aerodynamic package; (4) aspirate and/or morcelate the specimen 30 in a protective environment; and, (5) remove the specimen 30 from the patient's cavity.
Referring now to the operation of the embodiment shown in
The operation of the laparoscopic specimen extraction the laparoscopic specimen removal apparatus 100′ (
Because many varying and differing embodiments may be made within the scope of the inventive concept herein taught and because many modifications may be made in the embodiment herein detailed in accordance with the descriptive requirement of the law, it is to be understood that the details herein are to be interpreted as illustrative and not in a limiting sense.
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|International Classification||A61B17/24, A61B19/00, A61B17/22, A61B17/00|
|Cooperative Classification||A61B17/221, A61B2017/00287, A61B2017/2215, A61B90/40, A61B17/22031|
|Dec 13, 2013||REMI||Maintenance fee reminder mailed|
|May 7, 2014||LAPS||Lapse for failure to pay maintenance fees|