Method and instrument assembly for removing organ

• US 5,234,439 A
• Filed: 08/06/1992
• Issued: 08/10/1993
• Est. Priority Date: 08/06/1992
• Status: Expired due to Term

• Current Assignee: Granit Medical Innovations LLC
• Original Assignee: Naomi L. Nakao, Peter J. Wilk
• Inventors: Wilk, Peter J., Nakao, Naomi L.
• Primary Examiner(s): Pellegrino, Stephen C.
• Assistant Examiner(s): DAWSON, GLENN K
• Application Number:
  US07/926,762
• Time in Patent Office: 369 Days
• Field of Search: 128/749, 128/DIG. 24, 606/1, 606/110, 606/114, 606/113, 606/127, 606/39-52, 600/37
• US Class Current: 606/114
• 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 2017/00287 Bags for minimally invasive surgery

Abstract

A method for removing a gall bladder comprises the steps of (a) providing a surgical instrument including a flexible loop and a flexible web member connected to said loop to form a capture pocket, the loop defining a mouth opening of the pocket, (b) closing the cystic duct, (c) severing the cystic duct, and (d) passing the loop around a portion of the gall bladder including a closed and severed segment of the cystic duct, thereby enclosing the gall bladder portion in the capture pocket. The method further comprises the steps of (e) severing connective tissue between the gall bladder and the adjacent liver subsequently to the passing of the loop around the bladder, (f) maintaining the gall bladder portion surrounded by the capture pocket during the severing of the connective tissue, and (g) shifting the loop relative to the gall bladder to enclose a greater portion of the gall bladder in the capture pocket upon a severing of some of the connective tissue between the gall bladder and the adjacent liver. The method is adaptable to removing other internal organs, particularly organs which are coupled to adjacent tissue masses via connective tissue.

Claims

1. A method for removing an organ internal to a patient, said organ being coupled to internal tissues via at least a mass of connective tissue, the method comprising the steps of:

providing a surgical instrument including a flexible loop and a flexible web member connected to said loop to form a capture pocket, said loop defining a mouth opening of said pocket;

passing said loop around a portion of the organ, thereby enclosing the organ portion in said capture pocket;

subsequent to said step of passing, severing connective tissue between the organ and adjacent tissues;

maintaining said organ portion surrounded by said capture pocket during said step of severing connective tissue; and

upon a severing of some of the connective tissue between the organ and the adjacent tissues, shifting said loop relative to the organ to enclose a greater portion of the organ in said capture pocket.

2. The method defined in claim 1 wherein the organ to be removed is operatively coupled to adjacent organs via at least one duct-like connection, further comprising the steps of closing the duct-like connection and severing the duct-like connection.

3. The method defined in claim 2 wherein said steps of closing and severing the duct-like connection are performed prior to said step of passing, said organ portion including a closed and severed segment of the duct-like connection.

4. The method defined in claim 2 wherein said organ is a gall bladder and said duct-like connection is a cystic duct.

5. The method defined in claim 1, further comprising the step of constricting said loop about the organ after completion of said step of passing, thereby grasping the organ in the constricted loop.

6. The method defined in claim 5, further comprising the step of exerting force on said loop to pull the organ away from the adjacent tissues during said step of severing connective tissue.

7. The method defined in claim 5 wherein said loop is connected to a distal end of an elongate slider member slidably inserted through an elongate tubular member, said step of constricting comprising a step of pulling said elongate slider member in a proximal direction through said tubular member, thereby drawing at least a portion of said loop into a distal end of said tubular member.

8. The method defined in claim 1, further comprising the step of exerting force on said loop to pull the organ away from the adjacent tissues during said step of severing connective tissue.

9. The method defined in claim 1, further comprising the step of moving said loop relative to the organ to surround the entire organ upon a severing of all connective tissue between the organ and the adjacent tissues.

10. The method defined in claim 1 wherein the method is a laparoscopic technique, said steps of closing, severing, passing, and shifting being implemented through trocar sleeves extending through the abdominal wall.

11. The method defined in claim 1 wherein said web member is a net.

12. The method defined in claim 1 wherein the organ to be removed is an ovary.

13. The method defined in claim 1 wherein the organ to be removed is an appendix.

14. The method defined in claim 1 wherein the organ to be removed is a uterus.

15. The method defined in claim 1 wherein the organ to be removed is a section of bowel.

16. A method for removing a gall bladder, comprising the steps of:

piercing an abdominal wall of a patient to form a pair of openings in said abdominal wall;

disposing a first tubular cannula in one of said openings;

disposing a second tubular cannula in another of said openings;

providing a first surgical instrument including a flexible loop and a flexible web member connected to said loop to form a capture pocket, said loop defining a mouth of said pocket;

inserting said loop and said web member through said first tubular cannula into the abdomen of the patient;

inserting a second surgical instrument through said second tubular cannula into the abdomen of the patient;

passing said loop around a portion of a gall bladder including a closed and severed cystic duct segment, thereby enclosing the gall bladder portion in said capture pocket;

subsequent to said step of passing, using said second surgical instrument to sever connective tissue between the gall bladder and the adjacent liver;

maintaining said gall bladder portion surrounded by said capture pocket during said step of using said second surgical instrument; and

upon a severing of some of the connective tissue between the gall bladder and the adjacent liver, shifting said loop relative to the gall bladder to enclose a greater portion of the gall bladder in said capture pocket.

17. The method defined in claim 16, further comprising the step of constricting said loop about the gall bladder after completion of said step of passing, thereby grasping the gall bladder in the constricted loop.

18. The method defined in claim 17, further comprising the step of exerting force on said loop to pull the gall bladder away from the liver during said step of severing connective tissue.

19. The method defined in claim 17 wherein said loop is connected to a distal end of an elongate slider member slidably inserted through an elongate tubular member, said step of constricting comprising the step of pulling said elongate slider member in a proximal direction through said tubular member, thereby drawing at least a portion of said loop into a distal end of said tubular member.

20. The method defined in claim 16, further comprising the step of moving said loop relative to the gall bladder to surround the entire gall bladder upon a severing of all connective tissue between the gall bladder and the liver.