Endoscopic Translumenal Surgical Systems

• US 20070260121A1
• Filed: 05/08/2006
• Published: 11/08/2007
• Est. Priority Date: 05/08/2006
• Status: Abandoned Application

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Smith, Richard, Cropper, Michael, Bakos, Gregory
• Application Number:
  US11/382,182
• Publication Number:
  US 20070260121A1
• Time in Patent Office: Days
• US Class Current: 600/175
• CPC Class Codes: A61B 1/00142 with means for preventing contamination, e.g. by using a sanitary sheath
• CPC Class Codes: A61B 17/3417 Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating syringe needles A61M5/32; dilators A61M29/00
• CPC Class Codes: A61B 2017/00278 Transorgan operations, e.g. transgastric
• CPC Class Codes: A61B 2017/00296 mounted on an endoscope
• CPC Class Codes: A61B 2017/2905 flexible
• CPC Class Codes: A61B 90/361 Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61B 90/40 Apparatus fixed or close to patients specially adapted for providing an aseptic surgical environment

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. An endoscope insertion assembly device, comprising:

an elongate flexible trocar sleeve having an inner lumen extending therethrough for longitudinally receiving an endoscope therein; and

an end cap positionable within a distal end of the trocar sleeve and shaped to penetrate and guide the trocar sleeve through tissue, the end cap being removably disposable over a distal end of an endoscope.

2. The device of claim 1, wherein at least a portion of the end cap is transparent to allow images to be viewed therethrough.

3. The device of claim 1, wherein the end cap includes a portion adapted to be disposed over an endoscope, and a distal portion extending from the proximal portion and forming a viewing window to allow images to be viewed therethrough.

4. The device of claim 3, wherein the distal portion includes a substantially planar region for facilitating viewing therethrough.

5. The device of claim 3, wherein the distal portion is in the shape of a parabola for facilitating viewing therethrough.

6. The device of claim 3, wherein the proximal portion is formed from a resilient material to facilitate engagement with an endoscope.

7. The device of claim 3, wherein the distal portion includes a bore formed therethrough for receiving an endoscopic accessory.

8. The device of claim 1, wherein the trocar sleeve includes a tapered distal portion that tapers toward an outer surface of the end cap to form a substantially continuous outer surface with the end cap.

9. The device of claim 1, wherein the trocar sleeve includes at least one seal disposed therein which permits the passage of the end cap and an endoscope coupled to the end cap while limiting or preventing the passage of fluid or gas therethrough.

10. The device of claim 1, wherein the end cap includes at least one blade formed thereon for cutting tissue.

11. The device of claim 10, wherein the at least one blade is coupled to an energy source selected from the group consisting of an electrosurgical generator, an ultrasonic generator, a laser, and a heat source.

12. The device of claim 1, wherein the end cap includes at least one paddle extending outward from an outer surface thereof and configured to be rotated to separate tissue.

13. An endoscopic insertion device, comprising:

an end cap having a proximal housing configured to be removably disposed over a distal end of an endoscope, and a distal housing shaped to be inserted through tissue, at least a portion of the distal housing of the end cap being transparent to allow an optical image gathering unit in an endoscope to view and gather and image therethrough.

14. The device of claim 13, wherein the distal housing includes a substantially planar region to facilitate viewing therethrough.

15. The device of claim 13, wherein the distal housing is in the shape of a parabola for facilitating viewing therethrough.

16. The device of claim 13, wherein the proximal housing is formed from a resilient material to facilitate engagement with an endoscope.

17. The device of claim 13, wherein the distal housing of the end cap includes at least one blade formed thereon for cutting tissue.

18. The device of claim 13, wherein the distal housing of the end cap includes a bore formed therethrough for receiving an endoscopic accessory.

19. A method of using the device of claim 13, comprising:

mating the end cap to the distal end of an endoscope and using the end cap and endoscope in an endoscopic surgical procedure;

removing the end cap from the distal end of the endoscope;

cleaning the endoscope; and

disposing a second end cap over the distal end of the endoscope to prepare the device for re-use.

20. A translumenal introducer kit, comprising:

a plurality of end caps, each end cap including a proximal portion removably disposable over a distal end of an endoscope, and a distal portion configured to be inserted through tissue.

21. The kit of claim 20, wherein the plurality of end caps differ in size.

22. The kit of claim 20, wherein at least a portion of the distal portion of the plurality of end caps is transparent to allow an optical image gathering unit in an endoscope to view and gather and image therethrough.

23. The kit of claim 20, further comprising an elongate flexible trocar sleeve disposable over an endoscope and at least a portion of an end cap when the trocar sleeve and one of the plurality of end caps are disposed over an endoscope.

24. The kit of claim 20, further comprising at least one of a guide wire, needle knife, and sphinctertome disposable through a bore formed in at least one of the plurality of end caps.

25. The kit of claim 20, wherein at least one of the plurality of end caps includes a substantially planar region to facilitate viewing therethrough.

26. The kit of claim 20, wherein each end cap includes a proximal portion configured to receive and engage the distal end of an endoscope.

27. The kit of claim 20, wherein at least one of the plurality of end caps includes at least one blade formed thereon for cutting tissue.

28. A method for accessing a body cavity, comprising:

guiding a distal portion of an endoscope to position an end cap disposed on a distal end of the endoscope adjacent to tissue to be penetrated; and

advancing the end cap through the tissue to guide the distal end of the endoscope through the tissue and into a body cavity;

wherein an image of an area surrounding the distal end of the endoscope is used to guide the endoscope translumenally and to advance the end cap through the tissue, the image being gathered by an image gathering unit disposed within the distal end of the endoscope.

29. The method of claim 28, wherein the endoscope is guided over an endoscopic accessory pre-disposed through the tissue and the end cap is advanced over the endoscopic accessory and expands the tissue as it passes therethrough.

30. The method of claim 28, further comprising removing the endoscope and the end cap from a flexible trocar sleeve disposed around the endoscope such that the flexible trocar sleeve forms a working channel that extends from outside of the patient'"'"'s body, translumenally, through the tissue, and into the body cavity.

31. The method of claim 30, further comprising, after removing the endoscope and the end cap from a flexible trocar sleeve, removing the end cap from the endoscope and inserting the endoscope into the flexible trocar sleeve.

32. The method of claim 28, further comprising, prior to advancing the end cap through tissue, inserting an endoscopic accessory through the endoscope and through a bore formed in the end cap, and cutting the tissue with the endoscopic accessory.