Surgical apparatus

• US 4,256,113 A
• Filed: 12/08/1977
• Issued: 03/17/1981
• Est. Priority Date: 12/08/1977
• Status: Expired due to Term

• Current Assignee: Dale L. Chamness
• Original Assignee: Dale L. Chamness
• Inventors: Chamness, Dale L.
• Primary Examiner(s): Burr, Edgar S.
• Assistant Examiner(s): Feyrer, James R.
• Application Number:
  US05/858,712
• Time in Patent Office: 1,195 Days
• Field of Search: 128/303 R, 128/303.1, 128/303.12, 128/303.13, 128/303.14, 128/303.15, 128/303.16, 128/303.17, 128/303.18, 128/319, 128/320, 128/306 , 128/307, 128/308, 128/4, 128/5, 128/6, 128/7, 128/8, 128/9, 128/309
• US Class Current: 606/47
• CPC Class Codes: A61B 17/32056 Surgical snare instruments for removing or smashing calculi A61B2017/2212; tonsillotomes A61B17/26
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• CPC Class Codes: A61B 2017/00292 mounted on or guided by flexible, e.g. catheter-like, means
• CPC Class Codes: A61B 2017/2929 with a head rotatable about the longitudinal axis of the shaft
• CPC Class Codes: A61B 2018/00196 reciprocating lengthwise
• CPC Class Codes: A61B 2018/1407 Loop
• CPC Class Codes: A61B 2018/1861 with an instrument inserted into a body lumen or cavity, e.g. a catheter

Abstract

A surgical cannula includes a sheath having proximal and distal ends, a member disposed within the sheath and movable longitudinally therein, the movable member having proximal and distal ends, and a surgical instrument operable by movement of the distal end of the movable member with respect to the distal end of the sheath. The cannula further includes an operating assembly comprising a body or handle which slidably receives a slide for movement longitudinally of the body. The body defines a generally cylindrical interior and the slide includes a pair of longitudinally spaced apart walls having the same general shape as the cross section of the cylinder. The walls are provided with aligned apertures which rotatably receive a stem. The stem includes proximal and distal ends, and the proximal end of the movable member is fixedly attached to the distal end of the stem. The proximal end of the sheath is fixedly attached to the body portion of the handle. The stem is provided with a thumbwheel which is accessible through the side wall of the body, the thumbwheel being manipulatable to rotate the movable member in the sheath. The slide includes a rack, and the body supports an additional thumbwheel having pinion gear teeth formed thereon, the pinion gear teeth engaging the rack. Manipulation of the second-mentioned thumbwheel causes the slide to move longitudinally within the body to move the movable member longitudinally within the sheath.

Claims

1. In a surgical apparatus including a sheath having proximal and distal ends, a snare wire extending within the apparatus and having proximal and distal ends, a loop formed at the distal end of the snare wire, and means for protracting the distal end of the snare wire including the loop from, and retracting the distal end of the snare wire including the loop into, the distal end of the sheath, the loop being formed with a double offset bend in a plane extending longitudinally of the cannula through the loop, such that partial retraction of the loop into the distal end of the sheath causes the loop to move parallel to the first plane and perpendicular to a second plane which is perpendicular to the first plane and parallel to the longitudinal extent of the cannula.

2. The apparatus of claim 1 wherein the loop is somewhat W-shaped in the plane extending longitudinally of the cannula through the loop.

3. For use with a surgical apparatus including a sheath having proximal and distal ends, a movable member disposed within the sheath and movable longitudinally therein, the movable element having proximal and distal ends, and a surgical instrument operable by movement of the distal end of the movable member with respect to the distal end of the sheath, an operating assembly comprising a body shaped to provide a hand grip and a body interior, a slide slidably received in the body interior and a stem rotatably mounted on the slide for movement longitudinally with the slide, first rotary means for engaging the slide and second rotary means for engaging the stem, the body including a distal end for fixed attachment of the proximal end of the sheath thereto, the distal end of the body defining an aperture through which the proximal end of the movable member movably extends, the proximal end of the movable member being coupled to the stem, the first rotary means being selectively rotatable to move the slide, and thus the movable member, longitudinally of the sheath, and the second rotary means being selectively rotatable to rotate the stem, and thus the movable member, with respect to the sheath.

4. The apparatus of claim 3 wherein the proximal end of the stem includes means defining a terminal for attachment to a source of electrical energy and a conductor providing electrical contact between the terminal and the proximal end of the movable member, the movable member including an electrically conductive portion.

5. The apparatus of claim 3 wherein the body includes means defining a generally cylindrical interior and the slide includes means providing a pair of walls spaced apart longitudinally of the cylinder axis and shaped to slide in the cylinder.

6. The apparatus of claim 5 wherein the walls have substantially the same shape as the body interior wall.

7. An apparatus including a flexible sheath having proximal and distal ends, a flexible member disposed within the sheath and movable longitudinally therein, the movable member having proximal and distal ends, and a surgical instrument operable by movement of the distal end of the movable member with respect to the distal end of the sheath, an operating assembly comprising first means for moving the movable member longitudinally with respect to the sheath, second means for rotating the movable member within the sheath, and a body for supporting the first and second means, the body including a distal end for fixed attachment of the proximal end of the sheath thereto, the distal end of the body further defining an aperture through which the proximal end of the movable member movably extends, the proximal end of the movable member being coupled to the first and second means for movement thereby, the first means including a slide supported in the body for movement longitudinally thereof, the body including means defining a generally cylindrical interior wall and the slide including means providing a pair of walls spaced apart longitudinally of the cylinder axis and shaped to slide in the cylinder, the second means comprising a stem rotatably mounted with respect to the first means, the stem having proximal and distal ends, the proximal end of the movable member being fixedly attached to the distal end of the stem.

8. The apparatus of claim 7 wherein the stem includes a thumbwheel for manipulation to rotate the stem with respect to the first means, the thumbwheel being accessible through the body.

9. The apparatus of claim 8 wherein the thumbwheel is axially slidably mounted on the stem.

10. An apparatus including a flexible sheath having proximal and distal ends, a flexible member disposed within the sheath and movable longitudinally therein, the movable member having proximal and distal ends, and a surgical instrument operable by movement of the distal end of the movable member with respect to the distal end of the sheath, an operating assembly comprising first means for moving the movable member longitudinally with respect to the sheath, second means for rotating the movable member within the sheath, and a body for supporting the first and second means, the body including a distal end for fixed attachment of the proximal end of the sheath thereto, the distal end of the body further defining an aperture through which the proximal end of the movable member movably extends, the proximal end of the movable member being coupled to the first and second means for movement thereby, the first means including a carriage supported in the body for movement longitudinally thereof, the body including means defining a generally cylindrical interior wall and the carriage including means shaped to slide in the cylinder, the second means comprising a stem rotatably mounted with respect to the first means, the stem having proximal and distal ends, the proximal end of the movable member being fixedly attached to the distal end of the stem.

11. The apparatus of claim 10 wherein the stem includes a thumbwheel for manipulation to rotate the stem with respect to the first means, the thumbwheel being accessible through the body.

12. The apparatus of claim 11 wherein the proximal end of the stem includes means defining a terminal for attachment to a source of electrical energy, the stem further including means providing electrical contact between the terminal and the proximal end of the movable member, the movable member also being conductive.

13. The apparatus of claim 11 wherein the thumb wheel is axially slidably mounted on the stem.

14. For use in operating a surgical cannula including a sheath and a snare provided at its distal end with a loop adapted for withdrawal into the sheath, an operating handle comprising a stem for attaching to the proximal end of the snare, a slide for rotatably supporting the stem and a body for slidably supporting the slide, the slide being slidable longitudinally within the body, the slide including means defining a rack and the body including means providing a combination thumbwheel and pinion gear engaging the rack, the pinion gear being accessible through the body for rotation to move the rack to project the loop from, and retract the loop into, the end of the sheath, respectively.

15. The apparatus of claim 14 wherein the stem includes means defining a thumbwheel freely movable longitudinally of the stem and fixed for rotation with the stem, the thumbwheel being accessible without the body, rotation of the thumbwheel causing rotation of the stem and rotation of the loop about the axis of the distal end of the snare within the sheath.

16. For use with a surgical apparatus including a sheath having proximal and distal ends, a movable member disposed within the sheath and movable longitudinally therein, the movable member having proximal and distal ends, and a surgical instrument operable by movement of the distal end of the movable member with respect to the distal end of the sheath, an operating assembly comprising a body shaped to provide a hand grip and a body interior, a slide slidably received in the body interior and a stem rotatably mounted on the slide for movement longitudinally with the slide, first rotary means for engaging the slide and second rotary means for engaging the stem, the body including a distal end for fixed attachment of the proximal end of the sheath thereto, the distal end of the body defining an aperture through which the proximal end of the movable member movably extends, the proximal end of the movable member being coupled to the stem, the first rotary means being selectively rotatable to move the slide, and thus the movable member, longitudinally of the sheath, and the second rotary means being selectively rotatable to rotate the stem, and thus the movable member, with respect to the sheath, the slide comprising a portion defining a rack and the first rotary means including a first thumbwheel rotatably mounted in, and accessible through, the body, the periphery of the first thumbwheel providing pinion gear teeth to engage the rack, manipulation of the first thumbwheel causing movement of the slide.

17. The apparatus of claim 16 wherein the second rotary means includes a second thumbwheel longitudinally slidably mounted on, and fixed for rotation with the stem for manipulation to rotate the stem with respect to the slide, the second thumbwheel being accessible through the body.

18. An apparatus including a sheath having proximal and distal ends, a member disposed within the sheath and movable longitudinally therein, the movable member having proximal and distal ends, and a surgical instrument operable by movement of the distal end of the movable member with respect to the distal end of the sheath, an operating assembly comprising first means for moving the movable member longitudinally with respect to the sheath, second means for rotating the movable member within the sheath, and a body for supporting the first and second means, the body including a distal end for fixed attachment of the proximal end of the sheath thereto, the distal end of the body further defining an aperture through which the proximal end of the movable member movably extends, the proximal end of the movable member being coupled to the first and second means for movement thereby, the first means including a carriage supported in the body for movement longitudinally thereof, the body including means defining a generally cylindrical interior wall and the carriage including means shaped to slide in the cylinder, the carriage comprising a portion defining a rack, the first means further including a first thumbwheel rotatably mounted in the body, the periphery of the first thumbwheel providing pinion gear teeth to engage the rack, manipulation of the first thumbwheel causing movement of the carriage.

19. An apparatus including a sheath having proximal and distal ends, a member disposed within the sheath and movable longitudinally therein, the movable member having proximal and distal ends, and a surgical instrument operable by movement of the distal end of the movable member with respect to the distal end of the sheath, an operating assembly comprising first means for moving the movable member longitudinally with respect to the sheath, second means for rotating the movable member within the sheath, and a body for providing a hand grip and for supporting the first and second means, the body including a distal end for fixed attachment of the proximal end of the sheath thereto, the distal end of the body further defining an aperture through which the proximal end of the movable member movably extends, the proximal end of the movable member being coupled to the first and second means for movement thereby, the first means including a slide supported in the body for movement longitudinally thereof, the body including means defining a generally cylindrical interior wall and the slide including means shaped to slide in the cylinder, the slide comprising a portion defining a rack, the first means further including a first thumbwheel rotatably mounted in the body, the periphery of the first thumbwheel providing pinion gear teeth to engage the rack, manipulation of the first thumbwheel causing movement of the slide, the second means comprising a stem rotatably mounted with respect to the first means, the stem having proximal and distal ends, the proximal end of the movable member being fixedly attached to the distal end of the stem, and a second thumbwheel movably mounted on the stem for manipulation to rotate the stem with respect to the first means, the first and second thumbwheels being accessible through the body.

20. The apparatus of claim 19 wherein the proximal end of the stem includes means defining a terminal for attachment to a source of electrical energy, the stem further including means providing electrical contact between the terminal and the proximal end of the movable member, the movable member also being conductive.

21. An apparatus including a sheath having proximal and distal ends, a member disposed within the sheath and movable longitudinally therein, the movable member having proximal and distal ends, and a surgical instrument operable by movement of the distal end of the movable member with respect to the distal end of the sheath, an operating assembly comprising first means for moving the movable member longitudinally with respect to the sheath, second means for rotating the movable member within the sheath, and a body for supporting the first and second means, the body including a distal end for fixed attachment of the proximal end of the sheath thereto, the distal end of the body further defining an aperture through which the proximal end of the movable member movably extends, the proximal end of the movable member being coupled to the first and second means for movement thereby, the first means including a carriage supported in the body for movement longitudinally thereof, the body including means defining an interior and the carriage including means shaped to slide in the body interior, the carriage including a portion defining a worm follower, and the first means including a worm supported for rotation in the body and engaged by the follower.

22. The apparatus of claim 21 and further comprising an electric motor, the work being coupled to the motor for rotation thereby to drive the carriage longitudinally of the body.