METHOD AND APPARATUS FOR PERFORMING RETRO PERITONEAL DISSECTION

• US 20110257478A1
• Filed: 04/20/2011
• Published: 10/20/2011
• Est. Priority Date: 04/20/2010
• Status: Active Grant

• Current Assignee: Jeffrey B. Kleiner
• Original Assignee: Spinewindow LLC
• Inventors: Adair, Jeffrey, Kleiner, Jeffrey, Wiggins, Kevin
• Granted Patent: US 8,864,654 B2
• Time in Patent Office: Days
• US Class Current: 600/104
• CPC Class Codes: A61B 1/05 characterised by the image sensor, e.g. camera, being in the distal end portion
• CPC Class Codes: A61B 1/0607 for annular illumination
• CPC Class Codes: A61B 1/0676 at distal tip of an endoscope
• CPC Class Codes: A61B 1/0684 using light emitting diodes [LED]
• 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 17/3421 Cannulas
• CPC Class Codes: A61B 2017/00022 Sensing or detecting at the treatment site
• CPC Class Codes: A61B 2017/00991 Telescopic means
• CPC Class Codes: A61B 2017/0256 for the spine
• CPC Class Codes: A61B 2017/0262 with a provision for protecting nerves
• CPC Class Codes: A61B 2090/306 using optical fibres
• CPC Class Codes: A61B 2090/309 using white LEDs
• CPC Class Codes: A61B 5/4893 Nerves
• CPC Class Codes: A61B 90/361 Image-producing devices, e.g. surgical cameras

Abstract

The foregoing application describes a system and method of performing a minimally invasive surgical operation. More specifically, the invention involves the use of disposable cannula and slender dilators of variable lengths, which incorporate a source of illumination to carry light to a surgical site and video capabilities for capturing and displaying images from a CMOS or CCD camera device. According to one embodiment, fiber optics run semi-circumferentially or along walls of the cannula/dilator and terminate at about a centimeter from the distal end of the cannula/dilator, thereby preventing illumination from “bottoming out” at the floor of the incision. According to one alternate embodiment, the light fibers may be fashioned in an annulus around one or more camera chips to provide illumination and video of the surgical site. In still another embodiment, the light fibers may be replaced by light emitting diodes in a more remote light source or alternatively at the distal-tip of the CMOS or CCD camera device.

Claims

1. A cannula comprising:

A first or proximal end and a second or distal end and a generally tubular body therebetween;

a bore through the generally tubular body of the cannula extending from the first end to the second end;

a camera insert comprising one or more CMOS or CCD camera devices;

wherein the cannula further comprises at least one slot about a surface of the bore of the cannula for receiving the camera insert within the at least one slot of the cannula; and

wherein the cannula includes at least one first channel for inserting one or more fastening devices and at least one second channel for inserting one or more illumination devices.

2. The cannula according to claim 1 wherein the cannula may be coupled to a second cannula to extend the effective length of the coupled cannula.

3. The cannula according to claim 2 wherein the second cannula is attached to the first cannula by a compression relief formed about the first end of the second cannula which is dimensioned to fit in compression with the second end of the first cannula.

4. The cannula according to claim 2 wherein the second cannula varies in length to accommodate surgery in various portions of a patient'"'"'s body.

5. The cannula according to claim 2 wherein the second cannula is asymmetrical about its length.

6. The cannula according to claim 1 wherein the one or more CMOS or CCD camera devices further comprise wide-angle optics suitable for providing a three dimensional image on an associated display.

7. The cannula according to claim 1 wherein the camera insert is comprised of a thin, generally stem-shaped plastic composite insert that is received within the at least one slot in a tongue and groove fashion.

8. The cannula according to claim 1 wherein the camera insert is attached to a surface of the bore of the cannula magnetically.

9. The cannula according to claim 1 wherein the cannula has a asymmetrical, ovoid, egg-shaped, crescent-shaped, half-sphere, half-oval round cross-sectional shape.

10. The cannula according to claim 1 wherein the one or more CMOS or CCD devices further comprises at least one wireless transmitter for transmitting images captured by the one or more CMOS or CCD devices to a display.

11. The cannula according to claim 1 wherein the cannula has a width in the range of about 15-35 millimeters.

12. The cannula according to claim 1 wherein the cannula is formed of substantially sterile material, and may further comprise biocompatible polymers, elastomers, ceramics, aluminum or other metals

13. The cannula according to claim 1 wherein the second end of the cannula is adjustable to a desired conformation.

14. The cannula according to claim 1 wherein the second end of the cannula further comprises at least one exterior slot for securing to an anchor or guide wire for affixing the cannula to one or more anatomical features of a patient.

15. The cannula according to claim 1 further comprising one or more electrical probes at or adjacent the second end of the cannula for identifying the presence and location of nerves in the patient.

16. The cannula of claim 15 wherein the probes may be comprised of one or more electrodes powered at a low level to sense the position of a para-spinal nerve through electromyographic monitoring.

17. The cannula according to claim 1 further comprising an expandable tip at the second end of the cannula for detecting the presence and relative position of para-spinal nerves.

18. The cannula according to claim 1 wherein the one or more illumination devices are comprised of fiber optic strands or bundles.

19. The cannula according to claim 1 wherein the one or more illumination devices are arranged circumferentially along one or more walls of the cannula.

20. The cannula according to claim 1 wherein the one or more illumination devices terminate at least a centimeter from the second end of the cannula.

21. The cannula according to claim 1 wherein the one or more illumination devices are arranged in an annulus around the one or more CMOS or CCD camera devices to enhance illumination at the surgical site.

22. The cannula according to claim 1 wherein the one or more illumination devices are comprised of one or more light emitting diodes.

23. The cannula according to claim 1 wherein the at least one second channel for inserting one or more illumination devices exists substantially the entire length of the cannula.

24. The cannula according to claim 1 wherein the one or more illumination devices are comprised of fiber optic strands or bundles for transmitting light.

25. A surgical tool comprising:

a shaft connecting a operating end of the tool with a working end of the tool;

a disposable insert that is attachable to the shaft of the tool;

the disposable insert further comprising at least one CMOS or CCD video imaging device, which permits a user to view images captured by the at least one CMOS or CCD imaging device;

wherein the at least one CMOS or CCD video imaging device further comprises at least one wireless transmitter for transmitting data wirelessly to at least one display for displaying images captured by the at least one CMOS or CCD camera device.

26. The surgical tool according to claim 25 further comprising one or more illumination devices arranged in an annulus around the one or more CMOS or CCD video imaging devices to enhance illumination at the surgical site.

27. A dilator comprising:

at least one lumen extending further than the length of the dilator;

a plurality of fiber optic strands and/or light emitting diode devices coupled to the dilator;

one or more electrical probes at the distal end of the dilator which are connected to electrical leads at the opposite end of the dilator;

wherein the one or more electrical probes are provided to assist the surgeon in identifying the presence and location of nerves as the dilator is advanced within a patient'"'"'s body and for establishing a path for subsequent surgical instruments;

wherein the plurality of fiber optic strands and/or light emitting diode devices illuminate the area immediately surrounding the distal end of the dilator for enhancing vision of the anatomy through which the dilator is inserted.

28. The dilator according to claim 27 further comprising at least one CMOS or CCD video imaging device at or near the distal end of the dilator for capturing photographic images of the patient'"'"'s anatomy and the surgical site.

29. The dilator according to claim 27 having a diameter in the range of approximately 2.5 millimeters to 10 millimeters.

30. The dilator according to claim 27 wherein the material of the dilator is preferably selected from the group consisting of aluminum, iron, titanium, steel, stainless steel, surgical stainless steel of the general alloy type of iron, carbon, chromium (12-20%) molybdenum (0.2-3%) and nickel (8-12%), martensitic steel, grade 316L austenitic steel, grade 316LVM austenitic steel, grade 316 stainless steel, medical grade plastic and PEEK.

31. The dilator according to claim 27 having a length in the range of 50-500 millimeters.