Bendable ultrasonic probe and sheath for use therewith

• US 5,469,853 A
• Filed: 06/22/1994
• Issued: 11/28/1995
• Est. Priority Date: 12/11/1992
• Status: Expired due to Fees

• Current Assignee: W. L. Gore & Associates (W.L. Gore & Associates)
• Original Assignee: Tetrad Corporation
• Inventors: Oakley, Clyde G., Dietz, Dennis R., Ranalletta, Joseph V., Douglas, Stephen J., Law, Wing K.
• Primary Examiner(s): MANUEL, GEORGE C
• Application Number:
  US08/264,016
• Time in Patent Office: 524 Days
• Field of Search: 128/660.09, 128/660.10, 128/662.03, 128/662.05, 128/662.06
• US Class Current: 600/463
• CPC Class Codes: A61B 10/04 Endoscopic instruments
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61B 8/0833 involving detecting or locating foreign bodies or organic structures
• CPC Class Codes: A61B 8/0841 for locating instruments
• CPC Class Codes: A61B 8/12 in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• CPC Class Codes: A61B 8/445 Details of catheter construction
• CPC Class Codes: A61B 8/4488 the transducer being a phased array

Abstract

A bendable ultrasonic probe useful in endosurgical operations is provided having a therapy channel with a shape that is substantially unaffected by bending of the probe. The probe can be used to convey substantially nonbendable tools to the vicinity of an ultrasonic device that has been repositioned by bending the probe. A sheath is provided having a rigid, self-supporting body portion that may be used with the bendable ultrasonic probe. The sheath may have a therapy channel for conveying surgical tools. Also, the sheath may have a flexible balloon on one end for accommodating the bendable portion of the probe, which is disposed in the flexible balloon.

Claims

1. A surgical medical apparatus that facilitates conveyance into a patient'"'"'s body of substantially nonbendable surgical tools to the vicinity of an ultrasonic device on a bendably movable carrier, the apparatus comprising:

a handle portion designed to remain outside of a patient'"'"'s body and which may be grasped by a surgeon to manipulate the apparatus during use;

a carrier attached to said handle portion and longitudinally extending away from said handle portion, said carrier designed for insertion into the patient'"'"'s body during a surgical operation;

an ultrasonic device attached to said carrier and designed for insertion into and use inside of the patient'"'"'s body, said ultrasonic device being capable of transmitting an ultrasonic signal into tissue within the patient'"'"'s body and/or receiving an ultrasonic signal from tissue within the patient'"'"'s body that is located within a field of view of said ultrasonic device and generating an electrical signal representative of said ultrasonic signal that can be manipulated to produce an image of said tissue; and

a therapy channel extending longitudinally with said carrier and providing a passageway with a defined shape and through which surgical tools can be conveyed from outside of the patient'"'"'s body to inside of the patient'"'"'s body during a surgical operation, wherein said therapy channel has an exit port through which a surgical tool can exit into a patient'"'"'s body during a surgical operation;

wherein said carrier has a bendable portion that can be bent relative to said handle so as to effect repositioning of said ultrasonic device within the patient'"'"'s body, wherein said defined shape of said passageway through said therapy channel is substantially unaffected by bending of said bendable portion of said carrier so that bendable and substantially nonbendable tools can be conveyed through said therapy channel, and wherein said handle portion is located closer to said exit port than said handle portion is located to said bendable portion of said carrier.

2. The surgical medical apparatus as recited in claim 1, wherein:

said therapy channel passes through said carrier.

3. The surgical medical apparatus as recited in claim 1, further comprising:

a sheath for covering at least a portion of said carrier and through which said therapy channel passes.

4. The surgical medical apparatus as recited in claim 1, further comprising:

a sheath for covering at least a portion of said carrier and through which said therapy channel passes; and

means for orienting said sheath to said carrier such that a surgical tool exiting said therapy channel can be positioned within said field of view of said ultrasonic device.

5. The surgical medical apparatus as recited in claim 1, wherein:

said therapy channel is capable of being used to convey surgical tools that are selected from the group consisting of cryoprobes, electrocautery probes and laser probes.

6. The surgical medical apparatus as recited in claim 1, wherein:

said therapy channel is substantially circular in cross-section and has a minimum inside diameter of larger than about 0.5 mm.

7. The surgical medical apparatus as recited in claim 1, wherein:

said bendable portion of said carrier comprises a pinned joint.

8. The surgical medical apparatus as recited in claim 1, wherein:

said bendable portion of said carrier comprises a plurality of vertebrae.

9. The surgical medical apparatus as recited in claim 1, wherein:

said bendable portion of said carrier comprises a spring that is biased to bend said bendable portion.

10. The surgical medical apparatus as recited in claim 1, wherein:

said bendable portion of said carrier comprises an angled notch into one side of said bendable portion such that bending of said bendable portion to close said angled notch positions said bendable portion at a predetermined bend angle.

11. The surgical medical apparatus as recited in claim 1, wherein:

said bendable portion comprises means for biasing said bendable portion at an angle and means for limiting said angle;

wherein, when said bendable portion is disposed in a hollow interior of an open ended vessel, said bendable portion has a first angle and when said bendable portion exits said open ended vessel, said means for biasing cooperates with said means for limiting to automatically reposition said bendable portion from said first angle to a second angle.

12. The surgical medical apparatus as recited in claim 11, wherein:

said vessel is a cannula.

13. The surgical medical apparatus as recited in claim 11, wherein:

said vessel is a sheath.

14. The surgical medical apparatus as recited in claim 1, wherein:

said therapy channel is a lumen.

15. The surgical medical apparatus as recited in claim 1, wherein:

said therapy channel has an exit port through which a surgical tool can exit from said therapy channel into the patient'"'"'s body during a surgical operation; and

wherein said bendable portion can be bent so as to effect repositioning of said ultrasonic device from a first position to a second position that is a greater angle relative to said exit port than said first position.

16. The surgical medical apparatus as recited in claim 1, wherein:

said bendable portion includes means for limiting the position of said bendable portion to avoid damaging a tool extending out from said therapy channel.

17. The surgical medical apparatus as recited in claim 1, wherein:

said surgical medical apparatus is an endosurgical medical apparatus designed for use through a surgical port providing an entry into the patient'"'"'s body.

18. A surgical medical apparatus comprising:

a handle portion designed to remain outside of a patient'"'"'s body and which may be grasped by a surgeon to manipulate the apparatus during use;

a carrier attached to said handle portion and longitudinally extending away from said handle portion, said carrier designed for insertion into the patient'"'"'s body during a surgical operation;

a sheath for covering at least a portion of said carrier and through which said therapy channel passes, said sheath comprises a longitudinally extending structural wall that defines a longitudinally extending hollow interior for accommodating at least a portion of said carrier, wherein said structural wall of said body portion is substantially self-supporting so that said structural wall maintains substantially the same shape with said carrier disposed in said hollow interior as without said carrier disposed in said hollow interior;

said sheath further comprising a balloon operatively attached to said structural wall so that said balloon closes said hollow interior at one end thereof;

an ultrasonic device attached to said carrier and designed for insertion into and use inside of the patient'"'"'s body, said ultrasonic device being capable of transmitting an ultrasonic signal into tissue within the patient'"'"'s body and/or receiving an ultrasonic signal from tissue within the patient'"'"'s body that is located within a field of view of said ultrasonic device and generating an electrical signal representative of said ultrasonic signal that can be manipulated to produce an image of said tissue; and

a therapy channel extending longitudinally with said carrier and providing a passageway with a defined shape and through which surgical tools can be conveyed from outside of the patient'"'"'s body to inside of the patient'"'"'s body during a surgical operation;

wherein said carrier has a bendable portion that can be bent relative to said handle so as to effect repositioning of said ultrasonic device within the patient'"'"'s body, wherein said defined shape of said passageway through said therapy channel is substantially unaffected by bending of said bendable portion of said carrier so that bendable and substantially nonbendable tools can be conveyed through said therapy channel; and

wherein said balloon can accommodate movement of at least a portion of said bendable portion of said carrier.

19. The surgical medical apparatus as recited in claim 18, wherein:

said handle portion, elongated carrier and ultrasonic device are part of an ultrasonic probe; and

said sheath is engagingly attached to said surgical ultrasonic probe by an engaging structure on said sheath that is keyed to a complimentary engaging structure on said ultrasonic probe.

20. A surgical medical apparatus comprising:

a handle portion designed to remain outside of a patient'"'"'s body and which may be grasped by a surgeon to manipulate the apparatus during use;

a carrier attached to said handle portion and longitudinally extending away from said handle portion, said carrier designed for insertion into the patient'"'"'s body during a surgical operation;

an ultrasonic device attached to said carrier and designed for insertion into and use inside of the patient'"'"'s body, said ultrasonic device being capable of transmitting an ultrasonic signal into tissue within the patient'"'"'s body and/or receiving an ultrasonic signal from tissue within the patient'"'"'s body that is located within a field of view of said ultrasonic device and generating an electrical signal representative of said ultrasonic signal that can be manipulated to produce an image of said tissue; and

a therapy channel extending longitudinally with said carrier and providing a passageway with a defined shape and through which surgical tools can be conveyed from outside of the patient'"'"'s body to inside of the patient'"'"'s body during a surgical operation;

wherein said carrier has a bendable portion that can be bent relative to said handle so as to effect repositioning of said ultrasonic device within the patient'"'"'s body, wherein said defined shape of said passageway through said therapy channel is substantially unaffected by bending of said bendable portion of said carrier so that bendable and substantially nonbendable tools can be conveyed through said therapy channel; and

wherein the surgical medical apparatus comprises an angle sensor capable of generating an electrical signal that is representative of an angle of a bend in said bendable portion of said carrier.

21. A surgical medical apparatus comprising:

a handle portion designed to remain outside of a patient'"'"'s body and which may be grasped by a surgeon to manipulate the apparatus during use;

a carrier attached to said handle portion and longitudinally extending away from said handle portion, said carrier designed for insertion into the patient'"'"'s body during a surgical operation;

an ultrasonic device attached to said carrier and designed for insertion into and use inside of the patient'"'"'s body, said ultrasonic device being capable of transmitting an ultrasonic signal into tissue within the patient'"'"'s body and/or receiving an ultrasonic signal from tissue within the patient'"'"'s body that is located within a field of view of said ultrasonic device and generating an electrical signal representative of said ultrasonic signal that can be manipulated to produce an image of said tissue; and

a therapy channel extending longitudinally with said carrier and providing a passageway with a defined shape and through which surgical tools can be conveyed from outside of the patient'"'"'s body to inside of the patient'"'"'s body during a surgical operation, wherein said therapy channel has an exit port through which a surgical tool can exit into a patient'"'"'s body during a surgical operation;

wherein said carrier has a bendable portion that can be bent relative to said handle so as to effect repositioning of said ultrasonic device within the patient'"'"'s body, wherein said defined shape of said passageway through said therapy channel is substantially unaffected by bending of said bendable portion of said carrier so that bendable and substantially nonbendable tools can be conveyed through said therapy channel; and

wherein the medical surgical apparatus comprises means for displaying a video image of the expected path that a surgical tool would have upon exiting said therapy channel relative to the position of said ultrasonic device.

22. A surgical medical apparatus that facilitates conveyance into a patient'"'"'s body of substantially nonbendable surgical tools to the vicinity of an ultrasonic device on a bendably movable carrier, the apparatus comprising:

a handle portion designed to remain outside of a patient'"'"'s body and which may be grasped by a surgeon to manipulate the apparatus during use;

a carrier attached to said handle portion and longitudinally extending away from said handle portion, said carrier designed for insertion into a patient'"'"'s body during a surgical operation;

an ultrasonic device attached to said carrier and designed for insertion into and use inside of the patient'"'"'s body, said ultrasonic device being capable of transmitting an ultrasonic signal into tissue within a patient'"'"'s body and/or receiving an ultrasonic signal from tissue within the patient'"'"'s body that is located within a field of view of said ultrasonic device and generating an electrical signal representative of said ultrasonic signal that can be manipulated to produce an image of said tissue; and

a therapy channel extending longitudinally with said carrier and providing a substantially straight passageway through which surgical tools can be conveyed from outside of the patient'"'"'s body to inside of the patient'"'"'s body during a surgical operation, said therapy channel having an exit port from which surgical tools can exit from said substantially straight passageway into the patient'"'"'s body;

wherein said carrier has a bendable portion that can be bent relative to said handle so as to effect repositioning of said ultrasonic device from a first position to a second position, said passageway through said therapy channel remaining substantially straight during said repositioning of said ultrasonic device.

23. The surgical medical apparatus as recited in claim 22, wherein:

said handle portion, carrier, ultrasonic device and therapy channel are part of an ultrasonic probe; and

wherein said therapy channel passes longitudinally through said carrier.

24. The surgical medical apparatus as recited in claim 22, wherein:

said handle portion, carrier and ultrasonic device are part of an ultrasonic probe and said therapy channel is a part of a sheath disposed over at least a portion of said carrier;

wherein said therapy channel is part of a sheath comprising a body portion having a structural wall and a hollow interior adjacent said structural wall, at least a portion of said carrier being disposed in said hollow interior; and

wherein said structural wall of said body portion is substantially self-supporting so that said structural wall maintains substantially the same shape with said carrier disposed in said hollow interior of said body portion as without said carrier disposed in said hollow interior.

25. An ultrasonic apparatus that facilitates conveyance into a patient'"'"'s body of substantially nonbendable surgical tools to the vicinity of an ultrasonic device on a bendably movable carrier, the apparatus comprising:

a handle portion designed to remain outside of a patient'"'"'s body and which may be grasped by a surgeon to manipulate the apparatus during use;

a carrier attached to said handle portion and longitudinally extending away from said handle portion, said carrier designed for insertion into the patient'"'"'s body during a surgical operation, said carrier comprising a substantially straight, substantially nonbendable first portion and a bendable second portion, said first portion located closer to said handle portion than said second portion, as measured longitudinally along said carrier;

an ultrasonic device operatively attached to said carrier and designed for insertion into and use inside of the patient'"'"'s body, said ultrasonic device being capable of transmitting an ultrasonic signal into tissue within a patient'"'"'s body and/or receiving an ultrasonic signal from tissue within the patient'"'"'s body that is located within a field of view of said ultrasonic device and generating an electrical signal representative of said ultrasonic signal that can be manipulated to produce an image of said tissue; and

a therapy channel extending longitudinally through said carrier and providing a substantially straight tubular passageway through which surgical tools can be conveyed from outside of the patient'"'"'s body in the vicinity of said handle portion to inside of the patient'"'"'s body in the vicinity of said ultrasonic device, said therapy channel having an entry port for receiving surgical tools outside of the patient'"'"'s body and an exit port through which surgical tools can exit said therapy channel inside of the patient'"'"'s body, said therapy channel being oriented with said ultrasonic device so that a surgical tool exiting said exit port can be positioned within the field of view of said ultrasonic device;

wherein, as measured longitudinally along said carrier, said exit port is closer to said handle portion than either of said bendable second portion of said carrier and said ultrasonic device, and said bendable second portion of said carrier is closer to said handle portion than said ultrasonic device, and wherein, upon bending said bendable second portion of said carrier, said ultrasonic device can be repositioned from a first position to a second position that is a greater angle from said exit port than said first position, and wherein said passageway through said therapy channel remains substantially straight upon bending of said bendable second portion of said carrier.

26. A surgical medical apparatus that combines an ultrasonic probe having a bendable portion with a protective sheath providing a sanitary covering of the probe while facilitating movement into and out of a patient'"'"'s body, the apparatus comprising:

(a) an ultrasonic probe having;

i) a handle portion designed to remain outside of a patient'"'"'s body and which may be grasped by a surgeon to manipulate the apparatus during use;

ii) a carrier attached to said handle portion and longitudinally extending away from said handle portion; and

iii) an ultrasonic device attached to said carrier and being capable of receiving an ultrasonic signal from tissue within the patient'"'"'s body that is located within a field of view of said ultrasonic device and generating an electrical signal representative of said ultrasonic signal that can be manipulated to produce an image of said tissue; and

(b) a sheath in which at least a portion of said ultrasonic probe is disposed, said sheath having;

i) a first end designed for insertion into the patient'"'"'s body;

ii) a second end designed to remain outside of the patient'"'"'s body; and

iii) a body portion longitudinally extending from said first end toward said second end designed for insertion into the patient'"'"'s body during a surgical operation, said body portion comprising a longitudinally extending structural wall and a longitudinally extending hollow interior adjacent said structural wall with at least a portion of said carrier of said ultrasonic probe being disposed within said hollow interior, said body portion having an opening to said hollow interior at said first end through which said carrier of said ultrasonic probe could exit said body portion; and

iv) a flexible balloon adjacent said first end that substantially entirely covers said opening;

wherein said at least a part of said ultrasonic device and at least a part of a bendable portion of said ultrasonic probe are disposed in said balloon, and wherein said structural wall of said body portion of said sheath is substantially self-supporting so that said structural wall maintains substantially the same shape with said ultrasonic probe disposed in said hollow interior as without said ultrasonic probe disposed in said hollow interior.

27. The surgical medical apparatus as recited in claim 26, wherein:

said sheath comprises a therapy channel providing a passageway through which surgical tools can be conveyed from outside of the patient'"'"'s body through said body portion of said sheath to inside of the patient'"'"'s body during a surgical operation.

28. The surgical medical apparatus as recited in claim 26, wherein:

said surgical ultrasonic probe has a keyed engagement structure for engaging a complimentary keyed engagement structure on said sheath to orient said therapy channel with ultrasonic device such that a surgical tool exiting said therapy channel can be positioned within the field of view of said ultrasonic device.