Endo-surgical device and method

• US 20080195128A1
• Filed: 02/11/2008
• Published: 08/14/2008
• Est. Priority Date: 02/09/2007
• Status: Active Grant

• Current Assignee: Skeletal Dynamics LLC
• Original Assignee: Skeletal Dynamics LLC
• Inventors: Orbay, Jorge L., Norman, Thomas H., Espinosa, Alejandro, Litke, Ronald G., Valencia, Carlos, Chinock, Randall, Machado, Jorge A.
• Granted Patent: US 8,992,424 B2
• Time in Patent Office: Days
• US Class Current: 606/170
• CPC Class Codes: A61B 1/00048 Constructional features of the display
• CPC Class Codes: A61B 1/00052 positioned at proximal end of the endoscope body
• CPC Class Codes: A61B 1/00066 Proximal part of endoscope body, e.g. handles A61B1/0052 takes precedence
• CPC Class Codes: A61B 1/00105 characterised by modular construction
• CPC Class Codes: A61B 1/00108 characterised by self-sufficient functionality for stand-alone use
• CPC Class Codes: A61B 1/00142 with means for preventing contamination, e.g. by using a sanitary sheath
• CPC Class Codes: A61B 1/313 for introducing through surgical openings, e.g. laparoscopes
• 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 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• CPC Class Codes: A61B 17/320036 adapted for use within the carpal tunnel
• CPC Class Codes: A61B 17/3201 Scissors for biopsy A61B10/02
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 2017/00455 Orientation indicators, e.g. recess on the handle
• CPC Class Codes: A61B 2017/00464 for use with different instruments
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/32113 with extendable or retractable guard or blade
• CPC Class Codes: A61B 2090/068 with a bubble level
• CPC Class Codes: A61B 2090/306 using optical fibres
• CPC Class Codes: A61B 2090/309 using white LEDs
• CPC Class Codes: A61B 90/37 Surgical systems with images on a monitor during operation

Abstract

An endo-surgical device, system and method are provided. The endo-surgical device includes a flared prow that limits the displacement and rotation of the cannula to keep the knife away from tissues that are not intended to be cut. The endo-surgical tool can be utilized as part of a system for performing an endo-surgical procedure

Claims

1. An endo-surgical device, comprising:

a cannula, including a shaft portion and a prow, said prow being located at the distal end of said shaft portion, the walls and bottom of said prow defining a cavity that is open at top of the prow; and

at least a portion of said prow being at least one of wider than said shaft portion or higher than the upper surface of said shaft portion.

2. The endo-surgical device of claim 1, further including a medical device, at least a portion of which is contained within said prow.

3. The endo-surgical device of claim 2, wherein said medical device is a medical diagnostic device.

4. The endo-surgical device of claim 2, wherein said medical device is a surgical device.

5. The endo-surgical device of claim 2, wherein said medical device is a therapeutic device.

6. The endo-surgical device of claim 1, wherein said prow is curved such that the distal end of said prow is above the upper surface of said shaft portion proximal to said prow.

7. The endo-surgical device of claim 6, wherein said cannula includes at least a portion of an imaging device therein.

8. The endo-surgical device of claim 6, wherein the upper surface at the distal edge of the prow has a flat contact surface.

9. The endo-surgical device of claim 8, wherein the flat contact area is formed by closely spaced ribs.

10. The endo-surgical device of claim 1, wherein the greatest width of said prow exceeds the height of said prow at the section of the prow having the greatest width.

11. The endo surgical device of claim 1, wherein the width of said prow is greater than the width of said cannula shaft.

12. The endo-surgical device of claim 1, wherein the cross section of the prow is shaped as an inverted bell.

13. The endo-surgical device of claim 1, further including a handle, wherein the cannula and the handle form a single unit

14. The endo-surgical device of claim 1, wherein the upper edges of said prow are flared, such that the upper edges of said prow gradually diverges distally from the shaft, until a maximum separation is reached, after which, the upper edges converge towards the distal end of said prow.

15. The endo-surgical device of claim 14, further including a cutting implement for performing a surgical operation.

16. The endo-surgical device of claim 14, wherein said cannula includes at least a portion of an imaging device therein.

17. The endo-surgical device of claim 16, wherein said imaging device includes an image sensor.

18. The endo-surgical device of claim 16, wherein the imaging device includes an optical endoscope.

19. The endo-surgical device of claim 16, wherein the proximal end of said cannula shaft includes a connector for connecting the cannula to a handle.

20. The endo-surgical device of claim 19, wherein said connector connects said imaging device to an electronics module in the handle.

21. The endo-surgical device of claim 19, wherein said connector mechanically links an actuator on the handpiece to a mechanism that moves at least one of said prow and said surgical implement.

22. The endo-surgical device of claim 21, wherein said mechanism drops a portion of the prow to expose the surgical instrument.

23. The endo-surgical device of claim 21, wherein said mechanism raises at least a portion of the surgical implement above the upper surface of the prow.

24. The endo-surgical device of claim 21, wherein said mechanism raises at least a portion of the surgical implement above the upper surface of the prow and drops a portion of the prow to further expose the surgical implement.

25. The endo-surgical device of claim 21, wherein said surgical implement is a cutter.

26. A system for performing an endo-surgical procedure, comprising:

a cannula, including a shaft portion and a prow, said prow being located at the distal end of said shaft portion, the walls and bottom of said prow defining a cavity that is open at top of the prow;

at least a portion of said prow being at least one of wider than said shaft portion or higher than the upper surface of said shaft portion;

a surgical instrument, at least a portion of which is contained within said prow;

an imaging device, at least a portion of which is in optical communication with said cavity; and

a display for displaying images obtained from said imaging device.

27. The endo-surgical system of claim 26, wherein said prow is curved such that the distal end of said prow is above the upper surface of said shaft portion.

28. The endo-surgical system of claim 26, wherein the upper edges of said prow are flared, such that the upper edges of said prow gradually diverges distally from the shaft, until a maximum separation is reached, after which, the upper edges converge towards the distal end of said prow.

29. The endo-surgical system of claim 26, wherein said imaging device includes an optical endoscope.

30. The endo-surgical system of claim 26, wherein said imaging device includes an image sensor located in said cannula.

31. The endo-surgical system of claim 30, wherein said imaging device is in communication with an electronics module located outside the handle.

32. The endo-surgical system of claim 30, wherein said system includes a handle and said imaging device is in communication with electronics contained in said handle.

33. The endo-surgical system of claim 32, wherein said electronics contained in said handle are part of an electronics module contained in said handle.

34. The endo-surgical system of claim 33, wherein said cannula is removably connected to said handle through a connector, said connector connecting at least an imaging device in said cannula to said electronics module.

35. A surgical device for performing ECTR, comprising:

a cannula, including a shaft portion and a prow, said prow being located at the distal end of said shaft portion, the walls and bottom of said prow defining a cavity that is open at top of the prow;

at least a portion of said prow being at least one of wider than said shaft portion or higher than the upper surface of said shaft portion; and

a cutting instrument, at least a portion of which is contained within said prow.

36. The endo-surgical device of claim 35, wherein said prow is curved such that the distal end of said prow is above the upper surface of said shaft portion proximal to said prow.

37. The endo-surgical device of claim 35, wherein said cannula includes at least a portion of an imaging device therein.

38. The endo-surgical device of claim 35, wherein the upper surface at the distal edge of the prow has a flat contact surface.

39. The endo-surgical device of claim 38, wherein the flat contact area is formed by closely spaced ribs.

40. The endo-surgical device of claim 35, wherein the greatest width of said prow exceeds the height of said prow at the section of the prow having the greatest width.

41. The endo surgical device of claim 35, wherein the width of said prow is greater than the width of said cannula shaft.

42. The endo-surgical device of claim 35, wherein the cross section of the prow is shaped as an inverted bell.

43. The endo-surgical device of claim 35, further including a handle, wherein the cannula and the handle form a single unit

44. The endo-surgical device of claim 35, wherein the upper edges of said prow are flared, such that the upper edges of said prow gradually diverges distally from the shaft, until a maximum separation is reached, after which, the upper edges converge towards the distal end of said prow.

45. The endo-surgical device of claim 44, wherein said cannula includes at least a portion of an imaging device therein.

46. The endo-surgical device of claim 45, wherein said imaging device includes an image sensor.

47. The endo-surgical device of claim 45, wherein the imaging device includes an optical endoscope.

48. The endo-surgical device of claim 45, wherein the proximal end of said cannula shaft includes a connector for connecting the cannula to a handle.

49. The endo-surgical device of claim 48, wherein said connector connects said imaging device to an electronics module in the handle.

50. The endo-surgical device of claim 48, wherein said connector mechanically links an actuator on the handle to a mechanism that moves at least one of said prow and said cutting instrument.

51. The endo-surgical device of claim 50, wherein said mechanism drops a portion of the prow to expose said cutting instrument.

52. The endo-surgical device of claim 50, wherein said mechanism raises at least a portion of the said cutting instrument above the upper surface of the prow.

53. The surgical device of claim 50, wherein said mechanism raises the cutting instrument along an arcuate path.

54. The endo-surgical device of claim 50, wherein said mechanism raises at least a portion of the cutting instrument above the upper surface of the prow and drops a portion of the prow to further expose the surgical implement.

55. The surgical device of claim 35, wherein, the blade of said cutting instrument is, in a first position, below the upper edges of the prow during insertion.

56. The surgical device of claim 35, wherein, the blade of said cutting instrument is, in a first position, shielded by closely spaced ribs in the cavity of the prow.

57. A method for performing ECTR surgery, comprising the steps of:

providing a cannula, including;

a shaft portion and a prow, the prow being located at the distal end of the shaft portion, the walls and bottom of the prow defining a cavity that is open at top of the prow,

at least a portion of the prow being at least one of wider than the shaft portion or higher than the upper surface of the shaft portion; and

a surgical instrument, at least a portion of which is contained within the prow;

advancing the prow to separate synovium and/or other tissue from the TCL until tactile feedback through the cannula provides an indication that the distal edge of the TCL has been reached with the prow;

after the distal edge of the TCL has been reached, deploying a mechanism in the cannula that moves at least one of the prow and the cutting instrument to expose at least a portion of the cutting instrument; and

with the at least a portion of the cutting instrument exposed, pulling back the cannula to divide the TCL.

58. The method of claim 57, further including the step of, after the advancing step, visually confirming that the distal edge of the TCL has been reached with the prow.

59. The method of claim 57, wherein the upper edge of the distal prow is flared, such that the upper edges of said distal prow gradually increases along the prow distal from the shaft, until a maximum separation is reached, after which, said separation decreases until the upper edges come back together towards the distal end, the flare in the distal prow sized to inhibit the invasion of nerves, tendons and other tissues into the surgical space defined by the cannula.

60. The method of claim 57, wherein the mechanism raises the cutting instrument.

61. The method of claim 60, wherein the cutting instrument is raised along an arcuate path.

62. The method of claim 61, wherein the mechanism also drops at least a portion of the distal prow.

63. The method of claim 57, wherein the mechanism drops at least a portion of the distal prow.