SURGICAL DEVICE AND ACCESSORIES

• US 20120232339A1
• Filed: 09/02/2010
• Published: 09/13/2012
• Est. Priority Date: 09/02/2009
• Status: Active Grant

• Current Assignee: Laszlo Csiky
• Original Assignee: Laszlo Csiky
• Inventors: Csiky, Laszlo
• Granted Patent: US 9,877,794 B2
• Time in Patent Office: Days
• US Class Current: 600/104
• CPC Class Codes: A61B 1/00128 mechanical, e.g. for tubes or pipes
• CPC Class Codes: A61B 1/00135 Oversleeves mounted on the endoscope prior to insertion
• CPC Class Codes: A61B 1/015 Control of fluid supply or evacuation
• CPC Class Codes: A61B 1/018 for receiving instruments
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0281 Abdominal wall lifters
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/062 Needle manipulators
• CPC Class Codes: A61B 17/072 for applying a row of staples in a single action , e.g. the staples being applied simultaneously
• CPC Class Codes: A61B 17/07207 the staples being applied sequentially
• CPC Class Codes: A61B 17/12013 for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 17/3423 Access ports, e.g. toroid shape introducers for instruments or hands access sites for liquids A61M39/0247
• CPC Class Codes: A61B 17/4241 Instruments for manoeuvring or retracting the uterus, e.g. during laparoscopic surgery
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 2017/00269 endoscopic mucosal resection EMR
• CPC Class Codes: A61B 2017/00278 Transorgan operations, e.g. transgastric
• CPC Class Codes: A61B 2017/00283 with a device releasably connected to an inner wall of the abdomen during surgery, e.g. an illumination source
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00314 : Separate linked members
• CPC Class Codes: A61B 2017/00318 : Steering mechanisms
• CPC Class Codes: A61B 2017/00327 : with actuating members moving in opposite directions
• CPC Class Codes: A61B 2017/00336 : with a protective sleeve, e.g. retractable or slidable
• CPC Class Codes: A61B 2017/0034 : adapted to be inserted through a working channel of an endoscope
• CPC Class Codes: A61B 2017/00539 : hydraulically
• CPC Class Codes: A61B 2017/00575 : for closure at remote site, e.g. closing atrial septum defects
• CPC Class Codes: A61B 2017/00637 : for sealing trocar wounds through abdominal wall
• CPC Class Codes: A61B 2017/00663 : the implement being a suture
• CPC Class Codes: A61B 2017/00818 : Treatment of the gastro-intestinal system
• CPC Class Codes: A61B 2017/00823 : Appendectomy
• CPC Class Codes: A61B 2017/00991 : Telescopic means
• CPC Class Codes: A61B 2017/0409 : Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0417 : T-fasteners
• CPC Class Codes: A61B 2017/0464 : for soft tissue
• CPC Class Codes: A61B 2017/06052 : Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle
• CPC Class Codes: A61B 2017/07214 : Stapler heads
• CPC Class Codes: A61B 2017/2901 : Details of shaft
• CPC Class Codes: A61B 2017/2902 : characterized by features of the actuating rod
• CPC Class Codes: A61B 2017/2906 : Multiple forceps
• CPC Class Codes: A61B 2017/2908 : Multiple segments connected by articulations
• CPC Class Codes: A61B 2017/291 : the position of the handle being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/2925 : Pistol grips
• CPC Class Codes: A61B 2017/2927 : the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/2937 : with flexible part
• CPC Class Codes: A61B 2017/2946 : Locking means
• CPC Class Codes: A61B 2017/306 : holding by means of suction
• CPC Class Codes: A61B 2017/3425 : for internal organs, e.g. heart ports
• CPC Class Codes: A61B 2017/3447 : Linked multiple cannulas
• CPC Class Codes: A61B 2017/3452 : for the rectum, e.g. for hemorrhoid surgery
• CPC Class Codes: A61B 2017/3466 : for simultaneous sealing of multiple instruments
• CPC Class Codes: A61B 2018/00482 : Digestive system
• CPC Class Codes: A61B 2018/00589 : Coagulation
• CPC Class Codes: A61B 2018/00601 : Cutting
• CPC Class Codes: A61B 2034/301 : for introducing or steering flexible instruments inserted into the body, e.g. catheters or endoscopes
• CPC Class Codes: A61B 2034/302 : specifically adapted for manipulations within body cavities, e.g. within abdominal or thoracic cavities
• CPC Class Codes: A61B 2090/08021 : of the patient or his organs
• CPC Class Codes: A61B 34/30 : Surgical robots
• CPC Class Codes: A61B 34/70 : Manipulators specially adapted for use in surgery
• CPC Class Codes: A61B 34/71 : Manipulators operated by drive cable mechanisms
• CPC Class Codes: A61B 90/30 : Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
• CPC Class Codes: A61B 90/361 : Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61B 90/50 : Supports for surgical instruments, e.g. articulated arms

Abstract

The present invention relates to a device developed for surgical interventions comprising (i) an inner end (1) guidable/steerable to the operation field, (ii) an outer end (3) operated by the user and (iii) a middle part (2) which connects both ends (1, 3) together. According to the main concept of the present invention, it further comprises force transmission units extending between the outer (3) and the inner (1) ends, and said force transmission units, the outer and the inner ends and the middle part (2) are designed to transfer the movements of the outer end (3) to the inner end (1) in an identical measure, as if the inner end (1) were the straight continuation of the outer end (3).

Claims

1. Device for surgical interventions, comprising (i) an inner end guidable/steerable to the operation field, (ii) an outer end (3) operated by the user and (iii) a middle part (2) which connects both ends (1, 3) together, characterized in that it comprises force transmission units extending between the outer (3) and the inner (1) ends, and said force transmission units, the outer and the inner ends and the middle part (2) are designed to transfer the movements of the outer end (3) to the inner end (1) in an identical measure, as if the inner end (1) were the straight continuation of the outer end (3).

2-67. -67. (canceled)

68. Device for surgical intervention, comprising an elongated tubular body having (i) an inner end guidable/steerable to an operation field, (ii) an outer end operable by a user and (iii) a middle part which connects said outer end to said inner end, and force transmission units extending between the outer end and the inner end, said force transmission units, together with the tubular body adapted to transfer movement of the outer end to the inner end, as if the inner end were a straight continuation of the outer end, and including (i) a first force transmission unit adapted to transfer bending movement of the outer end to the inner end relative to the middle part at the same rotational angle and in the same rotational direction, and (ii) a second force transmission unit adapted to transfer axial telescopic movement of the outer end to the inner end to the same extent but in the opposite direction.

69. Surgical device according to claim 68 characterized in that there are articulations (4) between the outer end (3) and the middle part (2) and between the inner end (1) and the middle part (2), and the first force transmission unit (12) is designed to transfer the movements of the first articulation (4) to the second articulation (4) and the movements of the second articulation (4) to the first articulation (4).

70. Surgical device according to claim 68 characterized in that the first force transmission unit (12) comprises at least one pair of antagonistic wires (5) extending from the inner end (1) throughout the articulations (4) and the middle part (2) to the outer end (3) opposite to one another.

71. Surgical device according to claim 68 characterized in that the first force transmission unit (12) comprises at least one pusher rod extending from the inner end (1) throughout the articulations (4) and the middle part (2) to the outer end (3).

72. Surgical device according to claim 68 characterized in that the outer end (3) and the inner end (1) is telescopic, and the second force transmission unit is designed to elongate the telescopic inner end (1) when the outer end (3) is compressed, and to contract the telescopic inner end (1) when the telescopic outer end (3) is elongated.

73. Surgical device according to claim 72 characterized in that it has a channel inside, and the second force transmission unit comprises force transmission particles (12)—

advantageously balls—

connected to each other, and said particles (12) fill in the whole length of the channel, and each of them have a hole, and through these holes of the particles (12) travels the motive wire (13).

74. Surgical device according to claim 72 characterized in that it has a channel inside, and the second force transmission unit is a sealed hydraulic unit (14) located inside the channel, which has an outer part (17) inside the outer end (3) and an inner part (16) inside the inner end (1) advantageously with accordion-like folding structures, designed to be elongated and compressed along their longitudinal axis.

75. Surgical device according to claim 72 characterized in that it has a channel inside, and the second force transmission unit is a slidable flexible sheath (108) which is designed to resist compression along the longitudinal axis and to resist torsion around the longitudinal axis.

76. Surgical device according to claim 68 characterized in that the outer end (3), the inner end (1) and the middle part (2) are the components of a surgical instrument (6), and said instrument (6) is located within a trocar sleeve (7).

77. Surgical device according to claim 68 characterized in that the outer end (3), the inner end (1) and the middle part (2) are the components of a trocar sleeve (7), and said trocar sleeve (7) has advantageously an airtight valve (22) located at the outer end (3).

78. Surgical device according to claim 77 characterized in that there is a surgical instrument (6) located within the trocar sleeve (7), and said instrument (6) has an outer end (3), an inner end (1) and a flexible middle part (2).

79. Surgical device according to claim 78 characterized in that the first force transmission unit (12) is situated inside the trocar sleeve (7) which contains the surgical instrument (6), and the second force transmission unit is situated inside the channel of the instrument (6).

80. Surgical device according to claim 79 characterized in that the outer end (3) and the inner end (1) of the surgical instrument (6) is telescopic, and the second force transmission unit comprises force transmission particles (12)—

advantageously balls—

connected to each other, and said particles (12) fill in the whole length of the channel.

81. Surgical device according to claim 79 characterized in that the outer end (3) and the inner end (1) of the surgical instrument (6) is telescopic, and the second force transmission unit is a sealed hydraulic unit (14) situated inside the channel of the surgical instrument (6) which has an outer part (17) inside the outer end (3) and an inner part (16) inside the inner end (1) advantageously with accordion-like folding structures, designed to be elongated and compressed along their longitudinal axis.

82. Surgical device according to claim 79 characterized in that the outer end (3) and the inner end (1) of the surgical instrument (6) is telescopic, and the second force transmission unit is a slideable flexible sheath (108) inside the channel of a surgical instrument (6), which is designed to resist compression along the longitudinal axis and to resist torsion around the longitudinal axis.

83. Surgical device according to claim 79 characterized in that the first force transmission unit (12) is situated in the trocar sleeve (6) which contains the surgical instrument (6), and the instrument (6)—

functioning as a second force transmission unit—

is designed to resist compression along the longitudinal axis and to resist torsion around the longitudinal axis.

84. Surgical device according to claim 77 characterized in that it comprises more than one trocar sleeves (7) with inner ends (1), and at least two trocar sleeves (7) are arranged to determine a step-like structure at their inner ends (1).

85. Surgical device according to claim 84 characterized in that at least one trocar sleeve (7) comprising at least one working channel (27) therein is connected with sliding connection (29) to at least one trocar sleeve (7).

86. Surgical device according to claim 76 characterized in that it has a tube (28) comprising (i) a cylindrical body, (ii) an inner (52) and an outer (53) end, and advantageously (iii) a gas (55) and a suction-irrigation (63) connection, and said tube (28) is feasible to house inside at least one of a member of the group consisting of a surgical instrument (6) and a trocar sleeve, and to be fixed by the inner (1) and the outer (3) ends to a member consisting of abdominal wall (41) and external fixateurs (42).

87. Surgical device according to claim 86 characterized in that on the outer surface of the inner end (52) the tube (28) has a thread (23) with a member of the group consisting of a needle (24) and a stick (51) which can be passed through the abdominal wall (41) and can be fixed to an external fixateur (42).

88. Surgical device according to claim 86 characterized in that on the outer surface of the inner end (52) the tube (28) has a connecting point—

advantageously formed as a member of the group consisting of a groove (11) and a rail (50)—

designed to connect to a control rod (61) which makes the fixation to the abdominal wall (41) possible.

89. Surgical device according to claim 76 characterized in that it has an endoscopic device (66, 103) comprising (i) a cylindrical body, (ii) more than one working channels (27), and advantageously (iii) a gas (55) and a suction-irrigation (63) connection, and at least one working channel (27) is designed to house inside at least one of a member of the group consisting of a surgical instrument (6) and a trocar sleeve (7).

90. Surgical device according to claim 89 characterized in that on the outer surface of the inner end (52) the endoscopic device (66, 103) has a thread (23) with a member of the group consisting of a needle (24) and a stick (51) which can be passed through the abdominal wall (41) and can be fixed to an external fixateur (42).

91. Surgical device according to claim 89 characterized in that on the outer surface of the inner end (52) the endoscopic device (66, 103) has a connecting point—

advantageously formed as a member of the group consisting of a groove (11) and a rail (50)—

designed to connect to a control rod (61) which makes the fixation to the abdominal wall (41) possible.

92. Surgical device according to claim 89 characterized in that the endoscopic device (66) is designed to be at least partially divided at least into two parts by a plane parallel with the longitudinal axis, and said divided parts are connected by sliding connections (29), which are shiftable relative to each other.

93. Surgical device according to claim 89 characterized in that the endoscopic device (103) is non-divided, and at the inner end (52) there is a member of the group comprising an oblique (101) opening (31) and a step-form (100) designed opening (31).

94. A wound closure device-system characterized in that it comprises an implanting tube (85) attachable to other devices and an implanting sheath (82), there are locking elements (84) and an implanting rod (83)—

said implanting rod (83) is operable through its outer end and serves to release these locking elements (84) out of the sheath (82)—

inside the implanting sheath (82), and there are threads (23) connecting to each locking elements (84), and the threads (23) are delivered through the longitudinal split (86) of the sheath (82) and the outer end of the tube (85), and advantageously the implanting tube (85), the sheath (82) and the implanting rod (83) are flexible.

95. A wound closure device-system according to claim 94 characterized in that the inner end of the implanting sheath (82) is sharp and there is a longitudinal split (86)—

originating from the inner end—

on the side of the sheath (82), and the threads (23) enter the tube (85) through the longitudinal split (86) of the sheath (82).

96. An endoscopic stapler characterized in that it has a body portion (90) and a head portion (89) that are connected together advantageously with articulation (4), and also has opposed stapling surfaces (93) on the head portion (89) with a control thread (91)—

that allows tension and relaxation—

extending between their free ends, and said thread (91) is advantageously placed within a longitudinal channel (92) formed inside the head (89) and the body (90) portions of the stapler (88).

97. An endoscopic stapler according to claim 96 characterized in that it comprises a member of the group consisting of an inner working channel (27), a connecting groove (11) and a rail (50)—

allowing an outer accessory device (30), e.g. a camera to connect—

on the body portion (90) of the stapler (88).

98. A protective sheath (71) characterized in that it can be attached to the outer surface of at least one of a member of the group consisting of a trocar sleeve (7), a tube (28) and an endoscopic devices (66, 103) of a surgical device comprising such a member.

99. A protective sheath (71) according to the above claim 98 characterized in that it has cone shape, and it has on the outer end a member of the group consisting of a connecting ring (73) and a tube (97)—

able to connect airtight to the outer end of at least one of a member of the group consisting of a trocar sleeve (7), a tube (28) and an endoscopic device (66, 103)—

, and on the inner end it has an expandable ring (72).

100. An endoscopic balloon tube (56) characterized in that it has two separate inflatable ring-like balloons (45), each balloon (45) has an air duct (57) for insufflations, and said tube (56) can be placed on the inner end (1, 52) region of at least one of a member of the group consisting of a trocar sleeve (7), a tube (28) and an endoscopic device (66, 103) of a surgical device comprising at least one such member.

101. An access catheter (104) insertable into the working channel (27) of a member of the group consisting of a tube (28) and an endoscopic device (66, 103) characterized in that it has at the inner end—

advantageously on the tip—

an electric unit (76) which is designed to cut and to coagulate tissues, and it has an electrical wiring extending along the catheter (104) which can be connected to an electric power supply.

102. An access catheter (104) according to the above claim 101 characterized in that it has a first (77) and a second (78) inflatable separate balloons situated one after another, and (i) the first balloon (77) is located closer to the inner end of the access catheter (104) and it has advantageously an umbrella-like shape, and its diameter—

when inflated—

is larger than the diameter of a member of the group consisting of a tube (28) and an endoscopic device (66, 103), and (ii) the second balloon (78) has a smaller diameter than the diameter of a member of the group consisting of a tube (28) and an endoscopic device (66, 103).

103. A trocar guide (98) for the laparo-endoscopic system characterized in that it has a sharp inner end, a working channel (27), and at least one member of the group consisting of a connecting groove (11) and a rail (50) on the outer surface which makes the sliding connection with at least one trocar sleeve (7) possible.