Device for improved visualization of operative sites during surgery

• US 20040034339A1
• Filed: 08/16/2002
• Published: 02/19/2004
• Est. Priority Date: 08/16/2002
• Status: Abandoned Application

• Current Assignee: Regents of the University of California (University of California)
• Original Assignee: Regents of the University of California (University of California)
• Inventors: Meng, Maxwell V., Stoller, Marshall L.
• Application Number:
  US10/222,208
• Publication Number:
  US 20040034339A1
• Time in Patent Office: Days
• US Class Current: 606/1
• CPC Class Codes: A61B 1/3132 for laparoscopy
• CPC Class Codes: A61B 18/1402 Probes for open surgery
• CPC Class Codes: A61B 2017/0046 with a releasable handle; with handle and operating part separable
• CPC Class Codes: A61B 2017/3445 used as instrument channel for multiple instruments
• CPC Class Codes: A61B 2017/347 Locking means, e.g. for locking instrument in cannula
• CPC Class Codes: A61B 2218/006 for smoke evacuation
• CPC Class Codes: A61M 13/003 Blowing gases other than for carrying powders, e.g. for inflating, dilating or rinsing
• CPC Class Codes: A61M 2205/3344 Measuring or controlling pressure at the body treatment site

Abstract

This invention provides a novel surgical device well suited to use in laparoscopic or other (e.g. open surgical) procedures. In certain embodiments, the device comprises a surgical probe, including a handle comprising at least one channel passing through the handle; and at least one conduit passing through the handle, where wherein at least one effector element is inserted into or through the channel, which effector element effects one or more surgical functions; and where the conduit comprises a distal conduit port that directs gas out of the conduit to substantially remove debris and/or fluid from a surface disposed proximal to the effector and/or from the effector element.

Claims

1. A surgical probe, comprising:

a handle;

at least one channel passing through said handle; and

at least one conduit passing through said handle;

wherein at least one effector element is inserted into or through said channel, which effector element effects one or more surgical functions; and

wherein said conduit comprises a distal conduit port that directs gas out of said conduit to substantially remove debris and/or fluid from a surface disposed proximal to said effector element and/or from said effector element.

2. The surgical probe of claim 1, wherein said effector element is removable from said probe.

3. The surgical probe of claim 1, wherein said effector element is permanently affixed to said probe.

4. The surgical probe of claim 1, wherein handle comprises a control to regulate gas flow through said conduit.

5. The surgical probe of claim 1, wherein handle comprises a control to regulate activity of said effector element.

6. The surgical probe of claim 1, wherein handle comprises a nozzle to regulate gas jet shape and/or force.

7. The surgical probe of claim 1, wherein said conduit and said channel are disposed within a tube within said handle.

8. The surgical probe of claim 9, wherein said handle is removable from said tube.

9. The surgical probe of claim 1, wherein said surgical probe is suitable for a laparoscopic procedure.

10. The surgical probe of claim 1, wherein said effector element comprises at least one scalpel or cautery.

11. The surgical probe of claim 1, wherein said effector element comprises one or more forceps.

12. The surgical probe of claim 1, wherein said effector element comprises at least one syringe.

13. The surgical probe of claim 1, wherein at least one of said surgical functions comprises at least one laparoscopic surgical function.

14. The surgical probe of claim 1, wherein said surgical functions are selected from the group consisting of:

visualizing tissue, anesthetizing tissue, incising tissue, cauterizing tissue, dissecting tissue, grasping, desiccating tissue, irrigating tissue, resecting tissue, delivering at least one therapeutic agent to tissue, aspirating fluids from tissue, biopsying tissue, and suturing tissue.

15. The surgical probe of claim 1, wherein said effector is a monopolar cauterization device.

16. The surgical probe of claim 1, wherein said effector is a bipolar cauterization device.

17. The surgical probe of claim 1, wherein said conduit comprises a tube.

18. The surgical probe of claim 1, further comprising at least one non-cumbustible gas source operably connected to said conduit.

19. The surgical probe of claim 18, wherein said non-combustible gas source provides a gas selected from the group consisting of carbon dioxide, helium, and nitrogen.

20. The surgical probe of claim 1, wherein said effector element comprises at least one optical lens.

21. The surgical probe of claim 20, wherein said optical lens is operably connected to at least one monitor to display images formed by said optical lens.

22. The surgical probe of claim 1, wherein said effector element comprises at least one fluid channel.

23. The surgical probe of claim 1, wherein said fluid channel is operably connected to a fluid source.

24. The surgical probe of claim 1, wherein fluid flows out of said fluid channel from said fluid source to irrigate tissue disposed proximal to said surface.

25. The surgical probe of claim 1, wherein said effector element comprises at least one electrode element.

26. The surgical probe of claim 25, wherein said electrode element is operably connected to an electrical energy source.

27. The surgical probe of claim 26, wherein electrical energy is conducted through said electrode element from said electrical energy source to said surface.

28. The surgical probe of claim 27, wherein said electrical energy is sufficient to incises and/or cauterizes tissue disposed proximal to said surface.

29. The surgical probe of claim 1, wherein said effector element comprises at least one fiber optic cable.

30. The surgical probe of claim 29, wherein said fiber optic cable is operably connected to a laser source.

31. The surgical probe of claim 30, wherein radiation is conveyed through said fiber optic cable from said laser source to said surface.

32. The surgical probe of claim 31, wherein said radiation incises and/or cauterizes tissue disposed proximal to said surface.

33. The surgical probe of claim 1, wherein said probe is removably insertable into and through a cannula.

34. The surgical probe of claim 33, wherein said probe comprises a length between about one cm and about 50 cm.

35. The surgical probe of claim 33, wherein said probe is substantially rigid.

36. The surgical probe of claim 1, wherein said handle comprises at least one non-combustible gas source operably connected to said conduit.

37. The surgical probe of claim 1, wherein said handle comprises at least one control operably connected to said conduit and/or operably connectable to said effector element.

38. The surgical probe of claim 37, wherein said control is manually operated.

39. The surgical probe of claim 37, wherein said control is robotically operated.

40. The surgical probe of claim 37, wherein said control comprises at least one switch and/or at least one valve.

41. The surgical probe of claim 37, wherein said control controls at least non-combustible gas flow out of said conduit.

42. The surgical probe of claim 41, wherein said effector element and said non-combustible gas flow are simultaneously operable.

43. The surgical probe of claim 1, wherein a portion of said effector is extendable from a first end of said probe.

44. The surgical probe of claim 43, wherein said portion comprises at least one electrode element.

45. The surgical probe of claim 43, wherein said portion extends between about one mm and about 50 mm from said first end of said probe.

46. The surgical probe of claim 43, wherein at least one edge of said portion is non-linear.

47. The surgical probe of claim 43, wherein said portion comprises a shape selected from the group consisting of:

a regular n-sided polygon, an irregular n-sided polygon, a triangle, a square, a rectangle, a trapezoid, a circle, and an oval.

48. A method of performing a surgical procedure, said method comprising:

providing a surgical probe according to claim 1;

and

operating said probe to produce a flow of a non-combustible gas through said conduit to remove blood or debris from the tip of a surgical effector comprising said probe and/or from a tissue surface, while said probe is inserted into the body cavity of a mammal.

49. The method of claim 48, wherein said effector is a cauterization device.

50. The method of claim 48, wherein said effector is a monopolar cauterization device.

51. The method of claim 49, wherein said method further comprises operating said cauterization device to cut a tissue or organ.

52. The method of claim 51, wherein said tissue is a kidney tissue.

53. The method of claim 51, wherein said tissue is a liver tissue.

54. The method of claim 49, wherein said method further comprises operating said cauterization device reduce or stop bleeding.

55. The method of claim 54, wherein said tissue is a kidney tissue.

56. The method of claim 54, wherein said gas further comprises a pharmaceutically active agent.

57. The method of claim 56, wherein said pharmaceutically active agent is a microbicide and/or an antibiotic.

58. The method of claim 48, said method comprising operating said probe to irrigate a surgical site with a fluid.

59. The method of claim 58, wherein said fluid comprises saline.

60. The method of claim 48, wherein said non-combustible gas is selected from the group consisting of carbon dioxide, nitrogen, and helium.

61. The method of claim 48, wherein said non-combustible gas is carbon dioxide.

62. The method of claim 48, wherein said debris comprises one or more materials selected from the group consisting of fluidic material, cellular material, acellular material.

63. The method of claim 48, wherein said debris comprises one or more materials selected from the group consisting of blood, urine, cerebrospinal fluid, lymphatic fluid, and bile.

64. The method of claim 48, wherein said debris comprises one or more materials selected from the group consisting of an organ, cartilage, and bone.

65. The method of claim 48, wherein tissue surface comprises an internal bodily surface.

66. The method of claim 48, wherein said tissue surface comprises an external bodily surface.

67. The method of claim 48 wherein said tissue surface comprises a lumenal surface.

123. A method of performing a surgical procedure, said method comprising:

providing a surgical probe according claim 1;

and

operating said probe to produce a flow of a non-combustible gas through said conduit wherein said gas comprises an aerosolized agent and said flow of gas delivers said agent to a surgical site.

124. The method of claim 123, wherein said agent is a pharmaceutically active agent.

125. The method of claim 124, wherein said pharmaceutically active agent is a microbicide and/or an antibiotic.

68. A surgical device, comprising:

a handle;

wherein

at least one channel passes through said handle; and

at least one conduit passes through said handle;

wherein said channel can receive and support a surgical effector inserted into or through said channel; and

wherein said conduit comprises a distal conduit port that directs gas out of said conduit to substantially remove debris and/or fluid from a surface disposed proximal to a surgical effector tip when said surgical effector is inserted into said channel.

69. The device of claim 68, wherein handle comprises a control to regulate gas flow through said conduit.

70. The device of claim 68, wherein handle comprises a control to regulate gas activity of said surgical effector element.

71. The device of claim 68, wherein said conduit and said channel are disposed within a tube within said handle.

72. The device of claim 71, wherein said handle is removable from said tube.

73. The device of claim 68, wherein said surgical probe is suitable for a laparoscopic procedure.

74. The device of claim 68, wherein said surgical probe is suitable for use in an open surgical procedure.

75. The device of claim 68, wherein said surgical effector comprises at least one scalpel or cautery.

76. The device of claim 68,, wherein said effector is a cauterization device.

77. The device of claim 68,, wherein said effector is a monopolar cauterization device.

78. The device of claim 68, further comprising at least one non-cumbustible gas source disposed within said handle.

79. The device of claim 68, wherein said handle comprises at least one control operably connected to said conduit and/or operably connectable to said surgical effector.

80. The device of claim 79, wherein said control is manually operated.

81. The device of claim 79, wherein said control is robotically operated.

82. The device of claim 79, wherein said control comprises at least one switch and/or at least one valve.

83. The device of claim 79, wherein said control element controls at least non-combustible gas flow out of said conduit.

84. The device of claim 79, wherein said surgical effector and said non-cumbustible gas flow are simultaneously operable.

85. A kit comprising:

a container containing a surgical device comprising;

a handle comprising;

at least one channel passes through said handle; and

at least one conduit passes through said handle;

wherein said channel can receive and support a surgical effector inserted into or through said channel; and

wherein said conduit comprises a distal conduit port that directs gas out of said conduit to substantially remove debris and/or fluid from a surface disposed proximal to a surgical effector tip when said surgical effector is inserted into said channel.

86. The kit of claim 85, further comprising one or more surgical effectors that are insertable into the channel comprising said handle.

87. The kit of claim 86, wherein said one or more surgical effectors comprises an effector having a surgical functions selected from the group consisting of:

visualizing tissue, anesthetizing tissue, incising tissue, cauterizing tissue, dissecting tissue, desiccating tissue, irrigating tissue, resecting tissue, delivering at least one therapeutic agent to tissue, aspirating fluids from tissue, biopsying tissue, and suturing tissue.

88. The kit of claim 86, wherein said one or more surgical effectors is a cauterization device.

89. The kit of claim 88, further comprising one or more replaceable tips for said cauterization device.

90. The kit of claim 85, further comprising a set of instructions that directs use of said surgical device.

91. A surgical system, comprising:

a probe comprising at least one electrode and at least one conduit,

wherein said electrode is operably connected to an electrical energy source and at least a portion of said electrode extends from a first end of said probe, and wherein electrical energy is conducted through said portion from said electrical energy source to tissue disposed proximal to said portion to incise and/or cauterize said tissue, and

wherein said conduit is operably connected to at least one non-cumbustible gas source and at least one terminus of said conduit is disposed proximal to said first end of said probe component, and wherein a non-combustible gas is flowed through said conduit from said non-combustible gas source and out of said terminus to substantially remove debris from tissue disposed proximal to said portion and/or from said portion; and

,

a handle connected to said probe, which handle comprises at least one control to control electrical energy conduction from said electrical energy source and/or non-combustible gas flow from said non-combustible gas source.

92. The surgical system of claim 91, wherein said probe is removably insertable into and through a cannula.

93. The surgical system of claim 91, wherein said probe comprises a length between about one cm and about 50 cm.

94. The surgical system of claim 91, wherein said probe is substantially rigid.

95. The surgical system of claim 91, wherein said electrode element is integral with said probe.

96. The surgical system of claim 91, wherein at least one edge of said portion is non-linear.

97. The surgical system of claim 91, wherein said portion extends between about one mm and about 50 mm from said first end of said probe component.

98. The surgical system of claim 91, wherein said portion comprises a shape selected from the group consisting of:

a regular n-sided polygon, an irregular n-sided polygon, a triangle, a square, a rectangle, a trapezoid, a circle, and an oval.

99. The surgical system of claim 91, wherein said conduit comprises a tube.

100. The surgical system of claim 91, wherein said terminus comprises at least one nozzle to focus said non-combustible gas that is flowed out of said terminus.

101. The surgical system of claim 91, wherein said non-combustible gas comprises carbon dioxide.

102. The surgical system of claim 91, wherein said handle comprises said electrical energy source.

103. The surgical system of claim 91, wherein said handle comprises said non-combustible gas source.

104. The surgical system of claim 91, wherein said control is manually operated.

105. The surgical system of claim 91, wherein said control is robotically operated.

106. The surgical system of claim 91, wherein said control comprises at least one switch and/or at least one valve.

107. A method of substantially removing debris from a surface and/or from a surgical device, said method comprising:

providing said surgical device, which surgical device comprises at least one effector element that effects one or more surgical functions and at least one conduit, which conduit is operably connected to at least one non-combustible gas source; and

,

flowing a non-combustible gas from said non-combustible gas source out of said conduit to substantially remove said debris from said surface disposed proximal to said effector element and/or from said effector element.

108. The method of claim 107, wherein said surgical device comprises an open surgical device and/or a minimally invasive surgical device.

109. The method of claim 107, wherein said non-combustible gas comprises carbon dioxide.

110. The method of claim 107, wherein said debris comprises fluidic, cellular, and/or acellular debris.

111. The method of claim 107, wherein at least one of said surgical functions comprises at least one laparoscopic surgical function.

112. The method of claim 107, wherein said surgical device comprises at least one cavity into or through which said effector element is removably inserted.

113. The method of claim 112, wherein said effector element is selected from the group consisting of:

an electrode element, a laser fiber optic cable, and a mechanical device.

114. The method of claim 107, wherein said effector element is integral with said surgical device.

115. The method of claim 114, wherein said effector element is selected from the group consisting of:

an electrode element, a laser fiber optic cable, and a mechanical device.

116. The method of claim 107, wherein said device comprises said effector element and said conduit, and said method further comprises:

inserting at least a segment of said device into and through a cannula disposed through a body wall of a patient prior to flowing the non-combustible gas.

117. The method of claim 107, said method further comprising insufflating a body cavity of said patient by flowing a quantity of said non-combustible gas out of said conduit prior to said flowing step.

118. The method of claim 107, said method further comprising effecting said surgical functions with said effector element.

119. The method of claim 107, wherein said surgical device comprises at least one cavity into or through which said effector element is removably inserted, and wherein said method further comprises exchanging a different effector element with said effector element to a effect a different surgical function.

120. The method of claim 119, wherein said surgical functions are selected from the group consisting of:

visualizing tissue, anesthetizing tissue, incising tissue, cauterizing tissue, dissecting tissue, desiccating tissue, irrigating tissue, resecting tissue, delivering at least one therapeutic agent to tissue, aspirating fluids from tissue, and suturing tissue.

121. The method of claim 119, wherein said debris is substantially removed simultaneous with effecting said surgical functions.

122. The method of claim 119, wherein said debris is substantially removed prior to effecting said surgical functions.