RETRACTION OF TISSUE FOR SINGLE PORT ENTRY, ROBOTICALLY ASSISTED MEDICAL PROCEDURES

• US 20070287889A1
• Filed: 06/13/2007
• Published: 12/13/2007
• Est. Priority Date: 06/13/2006
• Status: Active Grant

• Current Assignee: Intuitive Surgical Operations, Inc. (Intuitive Surgical Holdings, LLC)
• Original Assignee: Intuitive Surgical Incorporated (Intuitive Surgical Holdings, LLC)
• Inventors: MOHR, CATHERINE J.
• Granted Patent: US 8,517,933 B2
• Time in Patent Office: Days
• US Class Current: 600/207
• CPC Class Codes: A61B 1/00082 Balloons
• CPC Class Codes: A61B 1/00087 Tools A61B17/00234 takes precedence
• CPC Class Codes: A61B 1/00193 adapted for stereoscopic vision
• CPC Class Codes: A61B 1/313 for introducing through surgical openings, e.g. laparoscopes
• CPC Class Codes: A61B 1/32 Devices for opening or enlarging the visual field, e.g. of a tube of the body dilators A61M29/00
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 34/70 Manipulators specially adapted for use in surgery
• CPC Class Codes: A61B 34/72 Micromanipulators
• CPC Class Codes: A61B 90/37 Surgical systems with images on a monitor during operation

Abstract

A single port entry surgical instrument has an elongated structure with lumens through which surgical tools and an image capturing device may be inserted and controllably extended out of its distal end for performing a medical procedure, a tubular-shaped balloon disposed around the elongated structure, and an expandable retractor disposed around the balloon so that when the balloon is inflated, the retractor expands and locks in an expanded configuration to retract extraneous tissue. The port entry may be secured using the expandable retractor or sealed using another inflatable balloon disposed around the proximal end of the elongated structure and centered in the port entry.

Claims

1. A surgical instrument comprising:

an elongated structure having proximal and distal ends and a first lumen extending between the proximal and distal ends;

a surgical tool inserted within the first lumen, wherein the surgical tool has a distal end adapted with an end effector and a proximal end adapted with an interface for controllably manipulating the end effector for performing a medical procedure;

a balloon disposed around an outer surface of the elongated structure; and

an expandable retractor disposed around an outer surface of the balloon so that the expandable retractor is expanded and locks in an expanded configuration when the balloon is expanded to sufficient volume.

2. The surgical instrument according to claim 1, wherein the expandable retractor is configured so as to be collapsible by controlled action of the end effector while the balloon is deflated.

3. The surgical instrument according to claim 2, wherein the expandable retractor has an element which causes the expandable retractor to collapse when the element is manipulated.

4. The surgical instrument according to claim 1, wherein the expandable retractor is predominantly formed of a biodegradable material.

5. The surgical instrument according to claim 1, wherein the expandable retractor is predominantly formed of a bioabsorbable material.

6. The surgical instrument according to claim 1, wherein the expandable retractor is predominantly formed of a material that is non-absorbable until exposed to an activator chemical which causes controlled dissolution of the material.

7. The surgical instrument according to claim 1, wherein the balloon has a light reflector coating so as to enhance an image of an object captured by an image capturing device.

8. The surgical instrument according to claim 1, wherein the elongated structure has a second lumen extending between the proximal and distal ends of the elongated structure, and further comprising:

a camera unit inserted within the second lumen and having at least one camera and a light source extending out of the distal end of the elongated structure;

wherein the balloon has a light reflector coating so as to enhance an image of an object captured by the at least one camera.

9. The surgical instrument according to claim 1, wherein the elongated structure is shaped so as to have a convex cross section.

10. The surgical instrument according to claim 9, wherein the expandable retractor is cylindrical in shape.

11. The surgical instrument according to claim 9, wherein the balloon is tubular in shape.

12. A method for retracting extraneous tissue using a surgical instrument configured with a balloon disposed around the surgical instrument so that the surgical instrument extends within a core formed in the balloon, and an expandable retractor disposed around the balloon so that the expandable retractor is expanded and locks in an expanded configuration when the balloon is expanded to sufficient volume, comprising:

robotically positioning the surgical instrument so that the expandable retractor retracts the extraneous tissue when the expandable retractor is expanded to and locked in its expanded configuration;

expanding the balloon so that the expandable retractor is expanded to and locked in its expanded configuration,

deflating the balloon; and

robotically moving an end effector of the surgical instrument towards a target tissue while the expanded retractor remains locked and in place so as to continue retracting the extraneous tissue.

13. The method according to claim 12, further comprising:

robotically positioning the end effector of the surgical instrument so as to be capable of performing a medical procedure on the target tissue; and

re-inflating the balloon so as to brace the surgical instrument against the expanded retractor.

14. The method according to claim 13, further comprising:

robotically performing the medical procedure using the surgical instrument;

deflating the balloon;

robotically manipulating the end effector of the surgical instrument in order to collapse the expandable retractor.

15. The method according to claim 14, wherein the robotic manipulation of the end effector to collapse the expandable retractor comprises:

robotically grasping an element attached to the expandable retractor using the end effector; and

robotically manipulating the element using the end effector so that the manipulated element causes the expandable retractor to collapse from its expanded configuration.

16. The method according to claim 15, further comprising:

removing the expandable retractor along with the surgical instrument following completion of the medical procedure on the target tissue.

17. The method according to claim 12, wherein the balloon is tubular shaped.

18. The method according to claim 17, wherein the expandable retractor is cylindrically shaped.

19. A method for securing an entry port for a surgical instrument through an anatomic structure, wherein the surgical instrument is configured with a tubular-shaped balloon disposed around the surgical instrument so that the surgical instrument extends within a core formed in the tubular-shaped balloon, and a retractor disposed around the tubular-shaped balloon in an unexpanded configuration having an outer diameter less than an inner diameter of the entry port and expandable so that the retractor is expanded and locks in an expanded configuration having an outer diameter slightly more than the inner diameter of the entry port when the tubular-shaped balloon is expanded to sufficient volume, comprising:

robotically positioning the surgical instrument so that the retractor in its unexpanded configuration is approximately centered in the entry port;

expanding the tubular-shaped balloon so that the retractor is expanded to and locked in its expanded configuration;

deflating the tubular-shaped balloon; and

robotically moving the surgical instrument towards a target tissue while the retractor remains in its expanded configuration to secure the entry port.

20. The method according to claim 19, further comprising:

robotically manipulating an end effector of the surgical instrument to cut a hole through the body structure so as to form the entry port.

21. The method according to claim 19, further comprising:

robotically performing a medical procedure on the target tissue using the surgical instrument;

robotically moving the surgical instrument back towards the entry port; and

robotically manipulating an end effector of the surgical instrument to collapse the retractor from its expanded configuration.

22. A method for sealing an entry port for a surgical instrument through an anatomic structure, wherein the surgical instrument is configured with a tubular-shaped balloon disposed around the surgical instrument so that the surgical instrument extends within a core formed in the tubular-shaped balloon, comprising:

robotically positioning the surgical instrument so that the tubular-shaped balloon in its unexpanded configuration is approximately centered in the entry port; and

expanding the tubular-shaped balloon so that the expanded tubular-shaped balloon forms a seal around the entry port; and

robotically moving an end effector of the surgical instrument towards a target tissue for performing a medical procedure on the target tissue using the end effector.

23. The method according to claim 22, further comprising:

insufflating a body cavity sealed by the expanded tubular-shaped balloon, with a gas provided through a lumen of the surgical instrument.

24. The method according to claim 23, further comprising:

deflating the tubular-shaped balloon after completing the medical procedure; and

robotically removing the surgical instrument out of the cavity area through the entry port.