APPARATUS AND METHODS FOR HYBRID ENDOSCOPIC AND LAPAROSCOPIC SURGERY

• US 20130150832A1
• Filed: 12/27/2012
• Published: 06/13/2013
• Est. Priority Date: 02/27/2009
• Status: Active Grant

• Current Assignee: Modular Surgical, Inc.
• Original Assignee: Modular Surgical, Inc.
• Inventors: Belson, Amir, Leary, James J.
• Granted Patent: US 8,858,538 B2
• Time in Patent Office: Days
• US Class Current: 606/1
• CPC Class Codes: A61B 1/00087 Tools A61B17/00234 takes precedence
• CPC Class Codes: A61B 1/044 for absorption imaging
• CPC Class Codes: A61B 1/3132 for laparoscopy
• 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 17/00 Surgical instruments, devices or methods, e.g. tourniquets A61B18/00 takes precedence; contraceptive devices, pessaries, or applicators therefor A61F6/00; eye surgery A61F9/007; ear surgery A61F11/00
• 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 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0483 Hand-held instruments for holding sutures A61B17/0469 takes precedence; other holders for needles or sutures A61B17/06061; surgical forceps A61B17/28; surgical pincettes A61B17/30
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/3201 Scissors for biopsy A61B10/02
• 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 2017/00278 Transorgan operations, e.g. transgastric
• CPC Class Codes: A61B 2017/00362 Packages or dispensers for MIS instruments A61B2017/0479 takes precedence
• CPC Class Codes: A61B 2017/00411 actuated by application of energy from an energy source outside the body
• CPC Class Codes: A61B 2017/00464 for use with different instruments
• CPC Class Codes: A61B 2017/00477 Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61B 2017/00539 hydraulically
• CPC Class Codes: A61B 2017/00544 pneumatically
• CPC Class Codes: A61B 2017/00876 magnetic
• 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 2017/2931 : with releasable head
• CPC Class Codes: A61B 2017/2943 : Toothed members, e.g. rack and pinion
• CPC Class Codes: A61B 2090/306 : using optical fibres
• CPC Class Codes: A61B 2090/3614 : using optical fibre
• CPC Class Codes: A61B 34/30 : Surgical robots
• CPC Class Codes: A61B 34/37 : Master-slave robots A61B34/35 takes precedence
• CPC Class Codes: A61B 90/361 : Image-producing devices, e.g. surgical cameras

Abstract

Apparatus and methods are described allow the techniques of endoscopic and laparoscopic surgery to be combined into a minimally invasive hybrid surgical technique called NOTES-assisted laparoscopic surgery. Manual and robotic-controlled versions of a modular laparoscopic tool are described having a small diameter shaft that is delivered laparoscopically to a surgical site. Larger diameter working tips are delivered through a NOTES delivery tube inserted to the surgical site through a natural orifice and joined to the shaft of the modular laparoscopic tool. Larger diameter working tips improve the effectiveness of the modular laparoscopic tools and the number and size of laparoscopic ports used can also be reduced.

Claims

1. A tool tip cassette comprising:

a plurality of tool carriers flexibly connected along a line;

a surgical working tip removably placed in each tool carrier;

wherein the tool carriers may be arranged in a straight line when being inserted through an introducing tool and may be reconfigured to a curved line when placed in a body cavity.

2. A tool tip cassette as in claim 1, further comprising an overtube having a passage for delivering the tool carriers to a surgical site.

3. A tool tip cassette as in claim 2, further comprising an elongate tether member attached to the tool tip carriers, wherein the elongate tether member can be used to draw the tool carriers back to the overtube after they are delivered to the surgical site.

4. A tool tip cassette as in claim 1, wherein adjacent tool carriers are connected by hinges so that the carriers can be delivered through curved or tortuous paths to a surgical site.

5. A tool tip cassette as in claim 4, wherein the tool carriers are spring-loaded to curved after passing through the introducing tool.

6. A tool tip cassette as in claim 1, wherein said tool carriers have openings on their upper surfaces that removably receive the surgical working tips and are attached by hinges on their sides so that the carriers can assume a curved configuration with the openings facing upwardly when the bottoms of the carriers are stably placed on top of an organ.

7. A tool tip cassette as in claim 1, further comprising a structure which provides a stable position when cassette is in the body cavity.

8. A tool tip cassette as in claim 7, where the structure comprises a base, legs, or means for attaching the cassette to an internal abdominal wall.

9. A tool tip cassette as in claim 2, wherein the tool carriers rotate to present the proximal connection ends of the working tips after the cassette passes through the overtube.

10. A tool tip cassette as in claim 9, wherein the tool carriers are spring loaded to rotate automatically upon exiting the overtube.

11. A tool tip cassette as in claim 1, wherein the cassettes carries a selection of tools intended to perform a specific procedure.

12. A tool tip cassette comprising:

a plurality of tool carriers connected along a line;

a surgical working tip removably placed in each tool carrier; and

means for stabilizing the plurality of tool tip carriers so that the carriers can be placed on a surface within an abdominal cavity without flipping over.

13. A tool tip cassette as in claim 12, wherein the stabilizing means comprises hinged connections that permit the tool carriers to be arranged in a straight line when being inserted through an introducing tool and to be reconfigured to a curved line when placed in a body cavity.

14. A tool tip cassette as in claim 12, wherein the stabilizing means comprises a support leg mechanism.

15. A tool tip cassette as in claim 12, wherein the stabilizing means comprises a wire base mechanism.

16. A tool tip cassette as in claim 12, wherein the stabilizing means comprises an attachment for an abdominal wall.

17. A tool tip cassette as in claim 12, further comprising an overtube having a passage for delivering the tool carriers to a surgical site.

18. A tool tip cassette as in claim 17, further comprising an elongate tether member attached to the tool tip carriers, wherein the elongate tether member can be used to draw the tool carriers back to the overtube after they are delivered to the surgical site.

19. A tool tip cassette as in claim 12, wherein said tool carriers have openings on their upper surfaces that removably receive the surgical working tips and are attached by hinges on their sides so that the carriers can assume a curved configuration with the openings facing upwardly when the bottoms of the carriers are stably placed on top of an organ.

20. A tool tip cassette as in claim 13, wherein the tool carriers rotate to present the proximal connection ends of the working tips after the cassette passes through the overtube.

22. A tool tip cassette as in claim 12, wherein the cassette carries a selection of tools intended to perform a specific procedure.

21. A tool tip cassette as in claim 21, wherein the tool carriers are spring loaded to rotate automatically upon exiting the overtube.