Endoscopic Translumenal Surgical Systems

• US 20070260117A1
• Filed: 05/08/2006
• Published: 11/08/2007
• Est. Priority Date: 05/08/2006
• Status: Active Grant

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Zwolinski, Andrew, Cropper, Michael
• Granted Patent: US 7,963,912 B2
• Time in Patent Office: Days
• US Class Current: 600/121
• CPC Class Codes: A61B 1/00071 Insertion part of the endoscope body A61B1/0055 takes precedence
• CPC Class Codes: A61B 1/0008 characterised by distal tip features
• CPC Class Codes: A61B 1/00135 Oversleeves mounted on the endoscope prior to insertion
• CPC Class Codes: A61B 1/00142 with means for preventing contamination, e.g. by using a sanitary sheath
• CPC Class Codes: A61B 1/00151 using everted tubes
• CPC Class Codes: A61B 1/313 for introducing through surgical openings, e.g. laparoscopes

Abstract

Methods and devices are provided for performing translumenal (e.g., transoral and transanal) procedures. In general, the methods and devices utilize a trocar assembly or trocar end cap that can facilitate insertion of an endoscope through tissue. In one embodiment, a flexible trocar assembly is provided and includes an obturator having an inner lumen formed therethrough for receiving an endoscope therein, and a distal end that is adapted to facilitate insertion of the endoscope through tissue and that is adapted to facilitate viewing therethrough. The trocar assembly can also include a trocar sleeve that is disposable over the obturator. In use, once the trocar assembly is inserted through tissue, the trocar sleeve can function as a placeholder, allowing the endoscope and obturator to be removed. The endoscope can then be removed from within the obturator and reinserted through the trocar sleeve for use in performing various other procedures. In other embodiments, rather than using a trocar that houses the endoscope, an end cap can be removably disposed over a distal end of the endoscope. The present invention also provides methods and devices for shielding an endoscope during insertion through a body lumen, and in particular for preventing contact between the endoscope (or trocar sleeve) and the body lumen, thus preventing bacteria from being carried into a body cavity.

Claims

1. A method for introducing an endoscopic device, comprising:

positioning a proximal end of a flexible sheath in proximity to an opening of a body lumen;

attaching a distal end of the flexible sheath to an endoscopic device;

advancing a portion of the sheath through the body lumen while the proximal and distal ends of the sheath remain in proximity to the opening of the body lumen; and

advancing the endoscopic device, with the distal end of the flexible sheath attached thereto, through the body lumen, the flexible sheath forming a barrier between the endoscopic device and the body lumen.

2. The method of claim 1, wherein advancing a portion of the sheath comprises advancing at least one support rod between the proximal and distal ends of the sheath to advance a portion of the sheath into the body lumen.

3. The method of claim 1, wherein the body lumen comprises an esophagus and the proximal end of the sheath is disposed in an oral cavity at the opening of the esophagus.

4. The method of claim 1, wherein the body lumen comprises an esophagus and the sheath prevents direct contact between the endoscopic device and the esophagus.

5. The method of claim 1, wherein the portion of the sheath is advanced translumenally into a patient'"'"'s stomach.

6. The method of claim 1, further comprising positioning a distal end of the endoscopic device within a patient'"'"'s stomach.

7. The method of claim 6, further comprising inserting an endoscopic accessory through the endoscopic device, and forming a puncture hole in the stomach to access the patient'"'"'s abdominal cavity.

8. The method of claim 7, wherein the endoscopic accessory comprises a flexible trocar having a transparent distal tip shaped to penetrate and guide the flexible trocar sleeve through tissue to thereby insert the endoscopic device through tissue.

9. A method for introducing an endoscopic device, comprising:

advancing a mid-portion of a sheath through a body lumen and into a stomach cavity, the sheath having proximal and distal ends that remain external to the body lumen;

advancing an endoscopic device, with the distal end of the sheath coupled thereto, through the sheath to position a distal end of the endoscopic device within the stomach cavity, the sheath preventing contact between the body cavity and the endoscopic device.

10. The method of claim 9, wherein advancing a mid-portion of the sheath comprises advancing at least one support rod between the proximal and distal ends of the sheath to advance the mid-portion of the sheath into the body lumen.

11. The method of claim 9, wherein the body lumen comprises an esophagus and the proximal end of the sheath is disposed in an oral cavity at the opening of the esophagus.

12. The method of claim 9, further comprising inserting an endoscopic accessory through the endoscopic device, and forming a puncture hole in the stomach to access the patient'"'"'s abdominal cavity.

13. The method of claim 12, wherein the endoscopic accessory comprises a flexible trocar having a transparent distal tip shaped to penetrate and guide the flexible trocar sleeve through tissue to thereby insert the endoscopic device through tissue.

14. An endoscopic insertion system, comprising:

an endoscopic device configured to be introduced translumenally; and

an elongate flexible sheath having proximal and distal ends with an inner lumen extending therethrough and configured to receive the endoscopic device, the proximal end of the flexible sheath having a shape adapted to be disposed within a patient'"'"'s mouth, and the distal end of the flexible sheath being configured to mate to the endoscopic device.

15. The system of claim 14, further comprising at least one support rod adapted to advance a portion of the flexible sheath into a body lumen.