Multi-Purpose Minimally Invasive Instrument That Uses a Micro Entry Port

• US 20080287926A1
• Filed: 08/02/2008
• Published: 11/20/2008
• Est. Priority Date: 08/02/2008
• Status: Active Grant

• Current Assignee: Tarek Ahmed Nabil Abou El Kheir
• Original Assignee: Tarek Ahmed Nabil Abou El Kheir
• Inventors: Abou El Kheir, Tarek Ahmed Nabil
• Granted Patent: US 7,666,181 B2
• Time in Patent Office: Days
• US Class Current: 606/1
• CPC Class Codes: A61B 17/3201 Scissors for biopsy A61B10/02
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 17/3478 Endoscopic needles, e.g. for infusion biopsy needles A61B10/0233; catheters with injection needles A61M25/0067
• CPC Class Codes: A61B 2017/00362 Packages or dispensers for MIS instruments A61B2017/0479 takes precedence
• CPC Class Codes: A61B 2017/2931 with releasable head
• CPC Class Codes: A61B 2017/3405 using mechanical guide means
• CPC Class Codes: A61B 2017/3443 with means for adjusting the length of a cannula

Abstract

A multi-purpose minimally invasive instrument having a small diameter elongated rod with a distal end that receives different interchangeable tools for a variety of uses, and also a handle used by an operator to control the interchangeable tool by manipulating the electricity it receives from a generator. The rod enters a cavity through a very small diameter telescopic port, which provides it with added support during its use. Interchangeable tools comprising imaging/surgical/sensing/electromagnet/radiofrequency/laser/heat-generating probes and/or other devices enter the cavity, supported by an introducer removed after tool attachment, one-at-a-time through a regular-size port that is concurrently used by an endoscope/camera. The instrument is adaptable for therapeutic, investigative, and/or other applications, in any space. An important medical benefit is the usage of many tools simultaneously while employing only one regular-size port and a very small diameter port for each additional tool used, which expedites patient recovery with excellent cosmetic outcome.

Claims

1. A multi-purpose minimally invasive instrument for medical, non-medical, surgical, therapeutic, and investigative applications in spaces and cavities having a wall blocking access thereto, and also having a larger entry port opening and at least one smaller entry port opening formed in the wall, said instrument comprising:

a handle;

an electrically operated tool that uses electrical power to perform at least one function, said electrically operated tool has a working end configured for performing said at least one function and an opposed connecting end;

a small diameter elongated rod having a first end in fixed association with said handle, and a second end configured for removable engagement with said connecting end of said electrically operated tool;

an introducer with a pivoting cradle configured for engaging and transporting said electrically operated tool through the larger entry port opening in the wall, said pivoting cradle also configured for easy release of said electrically operated tool once said connecting end of said operated tool becomes engaged with said second end of said elongated rod, said introducer further comprising a longitudinal bore configured and dimensioned to allow insertion of an optical system so that said introducer and the optical system can concurrently extend through the larger entry port opening in the wall, and said introducer also having a control knob configured to adjust the degree of tilting of said cradle for tool attachment from a location outside the space;

supportive entry port means adapted for providing an entry means for said elongated rod through the smaller entry port opening in the wall and support of said elongated rod during its use, said supportive entry port means also comprising a first part configured for extending through the smaller entry port opening in the wall and a second part configured for connection to said handle;

electrical transmission means adapted for connecting said handle and said electrically operated tool to a power source; and

activation means adapted for initiating, controlling, and terminating said electrically operated tool in performing said at least one function, said activation means also adapted for electrical communication with said electrical transmission means, whereby when said introducer is inserted through the larger entry port opening in the wall visually guided by an optical system concurrently inserted with said introducer through the wall via positioning within said longitudinal bore of said introducer, and when said cradle of said introducer also engages and transports said electrically operated tool through the wall, and further under guidance of the optical system said supportive entry port means is positioned to provide an entry means for said elongated rod through the smaller entry port opening in the wall and said elongated rod is inserted through said supportive entry port means so that its second end extends beyond the wall and also beyond said supportive entry port means, under the guidance of the optical system said control knob can then be used to manipulate said cradle while said handle is used to manipulate said elongated rod for joining said connecting end of said electrically operated tool with said second end of said elongated rod, whereby said electrically operated tool is released from said cradle and thereafter said introducer is removed from the larger entry port opening in the wall with the optical system being concurrently removed, the optical system is then reintroduced through the larger entry port opening in the wall so that said electrically operated tool via said electrical transmission means and said activation means can perform said at least one function under optical system guidance, and after said electrically operated tool has performed said at least one function, said optical system is removed from the larger entry port opening in the wall, said introducer is then re-inserted through the larger entry port opening in the wall visually guided by said optical system concurrently inserted with said introducer through the wall via positioning within said longitudinal bore of said introducer, under optical system guidance said introducer with said optical system, said control knob is then used to manipulate said cradle while said handle is concurrently used to manipulate said elongated rod for removing said connecting end of said electrically operated tool from said second end of said elongated rod and transferring said electrically operated tool from said elongated rod to said cradle, after which said introducer is removed from the larger entry port opening in the wall with said electrically operated tool secured to said cradle and further with said optical system also being concurrently removed from the larger entry port opening.

2. The instrument of claim 1 wherein said handle has a movable arm and a fixed arm, with said movable arm configured and positioned to start in a neutral position relative to said fixed arm so that movement of said movable arm can be in two opposing directions, toward and away from said fixed arm to cause said electrically operated tool to perform a first function and a second function each with the intensity thereof being proportional to the amount movable arm deployment away from said neutral starting position;

further comprising at least two biasing springs positioned and configured to allow an operator manipulating said handle to sense an increase in resistance with an increase in operator-applied force to said movable arm when the force applied moves said movable arm out of said neutral starting position and away from said fixed arm, and also to sense an increase in resistance with an increase in operator-applied force to said movable arm when the force applied moves said movable arm out of said neutral starting position in the opposite direction and toward said fixed arm, said biasing springs also configured to store potential energy when said movable arm is moved out of said neutral starting position that assists in returning said movable arm to said neutral starting position when the operator-applied force is decreased; and

wherein said first end of said small diameter elongated rod is in fixed association with said fixed arm of said handle.

3. The instrument of claim 2 further comprising arcuate guide means adapted for directing the movement of said biasing springs when said movable arm is not in said neutral starting position, with said arcuate guide means also configured for use in controlling the amount and polarity of the electrical current transmitted to said electrically operated tool.

4. The instrument of claim 1 wherein said first part of said supportive entry port means comprises a tube having a very small diameter dimension and said second part of said supportive entry port means comprises at least two tubes in telescopic relation to one another, said supportive entry port means also adapted for allowing easy twisting and turning movement of said elongated rod without similar twisting and turning movement of said first part, said supportive entry port means further adapted for allowing free movement of said elongated rod toward and away from a targeted working area within the space or cavity where it is used without similar movement of said first part, and said supportive entry port means also adapted for supporting said elongated rod and moving with it as one unit when said elongated rod is moved laterally and subjected to laterally applied forces.

5. The instrument of claim 1 wherein said supportive entry port means further comprises a stop ring with ball bearings engaged between said first part and said second part of said supportive entry port means.

6. The instrument of claim 1 wherein said electrically operated tool is selected from a group consisting of surgical probes, imaging probes, sensor probes, clamping devices, cutting instruments, laser cutting instruments, laser coagulating instruments, laser probes, electromagnets, heat-generating probes, image sensing probes, ultrasound probes, magnetic resonance imaging probes, and radio frequency probes.

7. The instrument of claim 1 wherein said electrically operated tool further comprises a linear solenoid configured for receiving electrical power from a power source via said electrical transmission mean and producing movement needed for said electrically operated tool to perform said at least one function after electrical power from the power source is received.

8. The instrument of claim 1 wherein said introducer further comprises at least one exterior channel configured and dimensioned for protecting the portion of said electrical transmission means providing electrical communication between a power source and said electrically operated tool.

9. The instrument of claim 8 wherein said introducer further comprises features selected from a group consisting of cradles comprising transparent material and beveled surfaces configured for facilitating removal of said electrical transmission means from said exterior channel.

10. The instrument of claim 1 further comprising a sheath configured for supporting an optical system and said electrical transmission means while they extend through the larger entry port opening formed in the wall after said electrically operated tool has been joined to said elongated rod and said introducer has been removed from the wall, said sheath having a central opening extending therethrough that is configured and dimensioned for insertion of an optical system, said sheath also comprising at least one longitudinally-extending external channel configured and dimensioned for protecting the portion of said electrical transmission means providing electrical communication between a power source and said electrically operated tool, said sheath further comprising opposing ends and an enlarged diameter dimension on one of said opposing ends that has sufficient size to prevent said sheath from moving completely through the larger entry port opening in the wall.

11. The instrument of claim 1 wherein said elongated rod comprises material configured for transmitting electricity to said electrically operated tool in a way that eliminates a need for external wiring.

12. A method of using the instrument of claim 1 for medical, non-medical, surgical, therapeutic, and investigative applications in spaces and cavities having a wall blocking access thereto, and also having a larger entry port opening and at least one smaller entry port opening formed in the wall, said method comprising the steps of:

(a) providing a power source, at least one electrically operated tool, and an optical system;

(b) using said electrical transmission means to connect said handle and a first said at least one electrically operated tool to a power source;

(c) connecting the first said at least one electrically operated tool to said cradle of said introducer;

(d) positioning said optical system within said longitudinal bore of said introducer;

(e) using said introducer to transport the first said at least one electrically operated tool and said optical system through the larger entry port opening in the wall while visually guided by said optical system, and also while said optical system is inserted through said longitudinal bore of said introducer;

(f) while visually guided by said optical system extending through the larger entry port opening that is positioned within said longitudinal bore of said introducer, positioning said supportive entry port means to provide an entry means for said elongated rod through the smaller entry port opening in the wall;

(g) connecting said second end of said supportive entry port means to said handle;

(h) while visually guided by said optical system inserting said elongated rod through said supportive entry port means so that its second end extends beyond the wall and also beyond said supportive entry port means;

(i) joining said connecting end of the first said at least one electrically operated tool with said second end of said elongated rod under guidance of said optical system and by using said control knob to manipulate said cradle while at the same time using said handle to manipulate said elongated rod;

j) also under guidance of said optical system and through use of said control knob and said handle, releasing the first said at least one electrically operated tool from said cradle;

(k) removing said introducer from the larger entry port opening in the wall with concurrent removal of said optical system;

(l) re-inserting said optical system through the larger entry port opening in the wall;

(m) using said handle, said electrical transmission means, and said activation means to cause the first said at least one electrically operated tool to perform said at least one function under guidance of said optical system inserted through the larger entry port opening; and

(n) after the first said at least one electrically operated tool has performed said at least one function under optical system guidance provided via the larger entry port opening, removing said optical system from the larger entry port opening in the wall;

(o) inserting said introducer through the larger entry port opening in the wall while visually guided by said optical system, and also while said optical system is inserted through said longitudinal bore of said introducer;

(p) under optical system guidance using said control knob to manipulate said cradle while at the same time using said handle to manipulate said elongated rod to disengage the first said at least one electrically operated tools from said second end of said elongated rod and reestablish connection between the first said at least one electrically operated tool and said cradle;

(q) under optical system guidance provided via the larger entry port opening in the wall while said optical system is positioned within said longitudinal bore of said introducer, removing said elongated rod from said supportive entry port means;

(r) under optical system guidance removing said supportive entry port means from the smaller entry port opening in the wall such that in endoscopic applications a micro opening sufficiently small is left in a patient that allows for expedited patient recovery with excellent cosmetic outcome;

(s) under optical system guidance removing said introducer from the larger entry port opening in the wall with concurrent removal of the first said at least one electrically operated tool and said optical system; and

(t) for each additional said at least one electrically operated tool provided and needed to perform a function while joined to said connective end of said one elongated rod after the first said at least one electrically operated tool, repeating in succession and under guidance of said optical system as needed said above steps (b) through (p) for the first said at least one electrically operated tool, until the last said at least one electrically operated tool has performed its function while joined to said connective end of said one elongated rod.

13. The method of claim 12 further comprising the steps of:

providing a plurality of elongated rods each in fixed association with a separate one of said handles and one said supportive entry port means for each of said elongated rods provided;

using said steps (f) through (h) above for each of said elongated rods and one of said supportive entry port means selected for association therewith to provide an entry means through the smaller entry port opening in the wall for said elongated rod, and also for connecting said selected and associated supportive entry port means to said handle fixed to said elongated rod, and further for positioning said elongated rod through said selected and associated supportive entry port means so that said second end of said elongated rod extends beyond the wall and also beyond said selected and associated supportive entry port means;

using said steps (b) through (g) above, and also said steps (i) through (m) above for connecting one of said electrically operated tools to said second end of each of said elongated rods extending beyond the wall;

using said steps (n) through (p) above to remove in succession all of said electrically operated tools previously connected to one of said elongated rods extending beyond the wall;

using said step (t) above for connecting and removing each additional one of said electrically operated tools needed for attachment in succession to any of said elongated rods; and

removing each said elongated rod and each said supportive entry port means via steps (q) and (r) above.

14. The method of claim 13 wherein the order of said three steps of using said electrical transmission means to connect said handle and a first one of said electrically operated tools to said power source, connecting said electrically operated tool to said cradle, and positioning said optical system within said longitudinal bore of said introducer is not critical, and further wherein the order of said step of connecting said second end of said supportive entry port means to said handle relative to said step of inserting said elongated rod through said supportive entry port means is also not critical, and in addition wherein when said elongated rod is made from electrically conductive material said step of connecting said electrically operated tool to said power source can occur after said step of joining said connecting end of said electrically operated tool with said second end of said elongated rod.

15. The method of claim 12 wherein said first part of said supportive entry port means comprises a tube having a very small diameter dimension and said second part of said supportive entry port means comprises at least two tubes in telescopic relation to one another, said supportive entry port means also adapted via a stop ring with ball bearings engaged between said first part and said second part for allowing easy twisting and turning movement of said elongated rod without similar twisting and turning movement of said first part, said supportive entry port means further adapted for allowing free movement of said elongated rod toward and away from a targeted working area within the space or cavity where it is used without similar movement of said first part, and said supportive entry port means also adapted for supporting said elongated rod and moving with it as one unit when said elongated rod is moved laterally and subjected to laterally applied forces.

16. The method of claim 12 wherein said handle has a movable arm and a fixed arm, with said movable arm configured and positioned to start in a neutral position relative to said fixed arm so that movement of said movable arm can be in two opposing directions, toward and away from said fixed arm;

and further comprising the steps of providing at least two biasing springs and positioning said biasing springs to allow an operator manipulating said handle to sense an increase in resistance with an increase in operator-applied force to said movable arm when the force applied moves said movable arm out of said neutral starting position and away from said fixed arm, and also to sense an increase in resistance with an increase in operator-applied force to said movable arm when the force applied moves said movable arm out of said neutral starting position in the opposite direction and toward said fixed arm, and wherein said positioning of said biasing springs also allows said biasing springs to store potential energy when said movable arm is moved out of said neutral starting position that assists in returning said movable arm to said neutral starting position when the operator-applied force is decreased; and

the steps of further providing arcuate guide means, positioning said arcuate guide means for directing movement of said biasing springs when said movable arm is not in said neutral starting position, and wherein said positioning of said arcuate guide means also allows control of the amount and polarity of the electrical current transmitted to said electrically operated tool, and further comprising the step of manipulating said handle to move said movable arm toward said fixed arm to cause said electrically operated tool to perform a first function with the intensity of said first function being proportional to the amount movable arm deployment away from said neutral starting position; and

in addition comprising the step of manipulating said handle to move said movable arm away from said fixed arm to cause said electrically operated tool to perform a second function with the intensity of said second function being proportional to the amount movable arm deployment away from said neutral starting position in the opposite direction.

17. The method of claim 12 wherein said electrically operated tool further comprises a linear solenoid configured for receiving electrical power from a power source via said electrical transmission mean and producing movement needed for said electrically operated tool to perform said at least one function after electrical power from the power source is received.

18. The method of claim 12 wherein said introducer further comprises features selected from a group consisting of cradles comprising transparent material, exterior channels configured and dimensioned for protecting the portion of said electrical transmission means providing electrical communication between a power source and said electrically operated tool, and beveled surfaces configured for facilitating removal of said electrical transmission means from said exterior.

19. The method of claim 12 further comprising the step of providing a sheath configured for supporting said optical system and said electrical transmission means while they extend through the larger entry port opening formed in the wall after said electrically operated tool has been joined to said elongated rod and said introducer has been removed from the wall, said sheath having a central opening extending therethrough that is configured and dimensioned for insertion of an optical system, said sheath also comprising at least one longitudinally-extending external channel configured and dimensioned for protecting the portion of said electrical transmission means providing electrical communication between a power source and said electrically operated tool, said sheath further comprising opposing ends and an enlarged diameter dimension on one of said opposing ends that has sufficient size to prevent said sheath from moving completely through the larger entry port opening in the wall, and further comprising the step of inserting said sheath through the larger entry port opening in the wall when said introducer is not present therein and concurrently positioning said sheath relative to said optical system and said electrical transmission means so that said optical system extends through said central opening and said electrical transmission means extends through said at least one longitudinally-extending external channel, and entanglement of said electrical transmission means and said optical system is avoided.

20. The method of claim 12 wherein said elongated rod comprises material configured for transmitting electricity to said electrically operated tool in a way that eliminates a need for external wiring, and further comprising the step of connecting said electrically operated tool to said power source after said step of joining said connecting end of said electrically operated tool with said second end of said elongated rod.