Lavage with tissue cutting cannula

• US 5,505,210 A
• Filed: 05/11/1993
• Issued: 04/09/1996
• Est. Priority Date: 11/06/1989
• Status: Expired due to Fees

• Current Assignee: Mectra Labs, Inc.
• Original Assignee: Mectra Labs, Inc.
• Inventors: Clement, Thomas P.
• Primary Examiner(s): HINDENBURG, MAX F
• Application Number:
  US08/060,423
• Time in Patent Office: 1,064 Days
• Field of Search: 128/751-754, 606/167, 606/170
• US Class Current: 600/566
• CPC Class Codes: A61B 10/02 Instruments for taking cell samples or for biopsy A61B10/0038 and A61B10/0045 take precedence; needle locating or guiding means A61B17/3403; samplers for enzymology or microbiology C12M1/26; sampling or preparing biological specimens G01N33/48
• CPC Class Codes: A61B 10/0275 with sample notch, e.g. on the side of inner stylet
• CPC Class Codes: A61B 10/0283 with vacuum aspiration, e.g. caused by retractable plunger or by connected syringe A61B10/025, A61B10/0266 take precedence
• CPC Class Codes: A61B 10/04 Endoscopic instruments
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• CPC Class Codes: A61B 17/3203 Fluid jet cutting instruments
• CPC Class Codes: A61B 17/320783 through side-hole, e.g. sliding or rotating cutter inside catheter
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• CPC Class Codes: A61B 18/1482 having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
• CPC Class Codes: A61B 18/20 using laser
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 18/26 for producing a shock wave, e.g. laser lithotripsy
• CPC Class Codes: A61B 2017/0023 disposable
• CPC Class Codes: A61B 2017/0046 with a releasable handle; with handle and operating part separable for prosthetic joint-implanting tools A61F2/4603
• CPC Class Codes: A61B 2017/22072 with an instrument channel, e.g. for replacing one instrument by the other in cannulas A61B17/3417
• CPC Class Codes: A61B 2090/306 using optical fibres
• CPC Class Codes: A61B 90/04 Protection of tissue around surgical sites against effects of non-mechanical surgery, e.g. laser surgery protection of eyes against laser radiation A61F9/022
• CPC Class Codes: A61M 1/7411 by changing the size of a vent in combination with changing the cross-section of the line A61M1/7413
• CPC Class Codes: A61M 1/7413 by changing the cross-section of the line
• CPC Class Codes: A61M 1/774 : Handpieces specially adapted for providing suction as well as irrigation, either simultaneously or independently
• CPC Class Codes: A61M 1/84 : Drainage tubes; Aspiration tips for negative pressure wound therapy A61M1/90; for surgical cutting instruments A61B17/32
• CPC Class Codes: A61M 1/85 : with gas or fluid supply means, e.g. for supplying rinsing fluids or anticoagulants for negative pressure wound therapy A61M1/92, A61M1/94; combined with tracheal tubes A61M16/0463; dental instruments with combined rinsing and aspirating A61C17/0208
• CPC Class Codes: A61M 39/223 : Multiway valves

Abstract

The present invention relates to an irrigation and suction lavage assembly for irrigation, suction, and removal of body tissue. The assembly includes a rigid conduit piece, an inner cannula, a movable outer cannula with a cutter, and an independently movable actuated valve to control irrigation and suction.

Claims

1. An irrigation and suction lavage assembly for irrigation and removal of irrigation fluid and body tissue during surgery, the assembly being operable by one hand of a surgeon, the assembly comprising:

a conduit piece;

an inner cannula defining an interior region and having a distal end, first means formed adjacent the distal end for cutting tissue, and a proximal end rigidly coupled to the conduit piece;

valve means coupled to the conduit piece for controlling the flow of irrigation fluid and body tissue through the conduit piece and the inner cannula; and

an outer cannula having a distal end and second means formed adjacent the distal end for cutting tissue, the inner cannula being coaxially positioned inside the outer cannula, the first and second cutting means being axially positioned to cut tissue in response to movement of the outer cannula.

2. The assembly of claim 1, wherein the outer cannula is resiliently coupled to the conduit piece for movement relative to the inner cannula.

3. The assembly of claim 2, wherein the outer cannula includes means for engaging a digit of the surgeon'"'"'s hand to permit one-handed movement of the outer cannula by the surgeon.

4. The assembly of claim 3, wherein the engaging means includes resilient means for coupling the engaging means to the conduit piece and a trigger for engaging a digit of a surgeon'"'"'s hand, the trigger being pulled toward the conduit piece and released to reciprocate the outer cannula, the resilient means urging the outer cannula away from the conduit piece in response to release of the trigger.

5. The assembly of claim 3, wherein the engaging means includes resilient means for coupling the engaging means to the conduit piece and an outrigger for engaging a digit of a surgeon'"'"'s hand, the outrigger being pushed away from the conduit piece and released to reciprocate the outer cannula, the resilient means urging the outer cannula toward the conduit piece in response to release of the outrigger.

6. The assembly of claim 1, wherein the first cutting means includes a first notch formed adjacent a distal end of the inner cannula and the second cutting means includes a second notch formed adjacent a distal end of in the outer cannula, the first and second notches being alignable to allow tissue to enter the interior region through the notches, the first and second notches cooperating to cut the entered tissue in response to movement of the first notch past the second notch.

7. The assembly of claim 1, further comprising first means coupled to the proximal end of the inner cannula for breachably sealing the proximal end of the inner cannula to allow a surgical instrument to be sealingly inserted into the inner cannula.

8. The assembly of claim 7, wherein the conduit piece includes a channel, the assembly further comprising second means coupled to the channel for sealing the channel to allow a surgical instrument to be sealingly inserted into the channel and the inner cannula.

9. The surgical assembly of claim 1, wherein the valve means is located in the conduit piece.

10. An irrigation and suction lavage assembly for irrigation and removal of irrigation fluid and body tissue during surgery, the assembly being operable by one hand of a surgeon, the assembly comprising:

a conduit piece;

an inner cannula defining an interior region and having a distal end, first means formed adjacent the distal end for cutting tissue, the inner cannula being coupled to the conduit piece;

valve means coupled to the conduit piece for controlling the flow of irrigation fluid and body tissue through the conduit piece and the inner cannula; and

an outer cannula having a distal end and second means formed adjacent the distal end for cutting tissue, the inner cannula being coaxially positioned inside the outer cannula, the first and second cutting means being axially positioned to cut tissue in response to reciprocating movement of the outer cannula; and

means coupled to the outer cannula for engaging a digit of the surgeon'"'"'s hand to allow the surgeon to move the outer cannula relative to the inner cannula.

11. The assembly of claim 10, wherein the engaging means is resiliently coupled to the conduit piece and includes means for storing mechanical energy during movement of the outer cannula relative to the inner cannula.

12. The assembly of claim 11, wherein the storing means is configured to store energy when the engaging means is pulled toward the conduit piece by the surgeon and to release the stored mechanical energy upon disengagement of the engaging means by the surgeon.

13. The assembly of claim 11, wherein the storing means is configured to store energy when the engaging means is pushed away from the conduit piece by the surgeon and to release the stored mechanical energy upon disengagement of the engaging means by the surgeon.

14. The assembly of claim 10, further comprising first means coupled to a proximal end of the inner cannula for breachably sealing the proximal end of the inner cannula to allow a surgical instrument to be sealingly inserted into the inner cannula.

15. The assembly of claim 14, wherein the conduit piece includes a channel, the assembly further comprising second means coupled to the channel for sealing the channel to allow a surgical instrument to be sealingly inserted into the channel and the inner cannula.

16. The surgical assembly of claim 10, wherein the valve means is located in the conduit piece.

17. An irrigation and suction lavage assembly for irrigation and removal of irrigation fluid and body tissue during surgery, the assembly comprising:

an outer cannula having a side wall defining a first cutting surface for cutting tissue, the outer cannula being movable between a rest position and a ready-for-cutting position;

an inner cannula coaxially positioned inside the outer cannula and having a proximal end, the inner cannula defining an interior region and having a second cutting surface;

first means coupled to a proximal end of the inner cannula for breachably sealing the proximal end to allow a surgical instrument to be sealingly inserted into the inner cannula;

valve means coupled to the inner cannula for controlling the flow of irrigation fluid and body tissue through the inner cannula; and

means coupled to the outer cannula for moving the outer cannula relative to the inner cannula in response to movement of a digit of the surgeon'"'"'s hand to cut tissue.

18. The assembly of claim 17, further comprising resilient means coupled to the moving means and the outer cannula for moving the outer cannula to the rest position from the ready-to-cut position.

19. The assembly of claim 18, wherein the moving means includes a trigger for engaging the first digit of the surgeon'"'"'s hand, the trigger being configured to be pulled toward the conduit piece to move the outer cannula from the rest position to the ready-to-cut position.

20. The assembly of claim 17 further comprising means for actuating the valve means by movement of a second digit of the surgeon'"'"'s hand.

21. The assembly of claim 17, wherein the valve means includes a valve body housing a valve therein, the valve body being shaped to have a manually grippable body and form a pistol grip, wherein said valve body defines a channel extending therethrough in fluid communication with the inner cannula.

22. The surgical assembly of claim 17, wherein the valve means is located in the conduit piece.

23. A surgical assembly for removal of body tissue, the assembly comprising:

a rigid outer cannula defining a cannula interior, the cannula having a proximal end and a distal end, the distal end being insertible and positionable into a patient'"'"'s body, and the cannula defining a cutting surface opening adjacent the distal end to permit access to the cannula interior for capture of body tissue in the cannula interior, the rigidity of the cannula causing the distal end thereof to move in the same direction and distance as the proximal end;

a rigid inner cannula with a cutting surface and passageway therein, said inner cannula supporting the outer cannula and having its cutting surface cooperate with the cutting surface of the rigid outer cannula for cutting body tissue;

means for moving the outer cannula relative to the inner cannula;

a conduit piece rigidly attached to the inner cannula which supports the outer cannula for movement, the conduit piece having at least one channel defined therein in fluid communication with the cooperating cutting surface on the outer and inner cannula;

moveable valve means rigidly coupled to the rigidly attached conduit piece and inner cannula for controlling flow through said one channel;

the rigidly coupled conduit piece and valve means having a handgrip portion for holding and accurately positioning the distal end of the inner cannula at a desired location in the patient by movement of the handgrip portion to direct the distal end of the inner cannula to the desired location;

suction means connected to the at least one channel for removing body tissue cut by the cutting surface through the cannula and conduit piece;

mean to move the valve means;

wherein both the means for moving the cutter and the valve means can be actuated by a digit of the hand gripping the hand grip portion while the hand moves the rigidly attached conduit piece and inner cannula to position the distal end of the inner cannula at the desired location in the patient.

24. The surgical assembly of claim 23, wherein the means to move the outer cannula is resiliently biased to position the cutting surfaces into a non-cutting position such that a push action against the resilient bias moves the cutter for cutting.

25. The surgical assembly of claim 23, wherein the hand grip portion for rigidly gripping the rigidly coupled valve means and conduit piece is a surface surrounding the valve means.

26. The surgical assembly of claim 24, wherein the hand grip portion for rigidly gripping the rigidly coupled valve means and conduit piece is a surface surrounding the valve means.

27. The surgical assembly of claim 23, wherein the valve means is located in the conduit piece.

28. The surgical assembly of claim 24, wherein the valve means is located in the conduit piece.

29. The surgical assembly of claim 25, wherein the valve means is located in the conduit piece.

30. The surgical assembly of claim 25, wherein the valve means is located in the conduit piece.

31. The surgical assembly of claim 23, wherein the valve means also controls flow of irrigation fluid to the patient through said one channel.

32. The surgical assembly of claim 24, wherein the valve means also controls flow of irrigation fluid to the patient through said one channel.

33. A lavage assembly for surgery, irrigation, suction, and removal of body tissue, the assembly comprising:

a rigid cannula defining a cannula interior, the cannula having a proximal end and a distal end, the distal end being insertible and positionable in a patient'"'"'s body, and the cannula defining a cannula opening adjacent the distal end to permit access to the cannula interior for capture of body tissue in the cannula interior;

a cutter moveable outside the cannula interior for cutting body tissue entering the cannula opening;

means for moving the cutter;

an independently actuated vane means rigidly connected to the cannula to control irrigation and suction flow to the cannula interior, regardless of movement or lack of movement of the cutter;

means to actuate the valve means;

wherein the cannula and valve means are integrated into a rigid structure to be held in one hand such that movement of the rigidly coupled valve means and cannula by a users hand allows the distal end of the cannula to be accurately positioned at a specific location in the patients body; and

wherein the means for moving the cutter and the means to actuate the valve means are both operable by a hand of the user as it moves the rigidly coupled valve means and cannula to accurately position the distal end of the cannula in the patient.

34. The surgical assembly of claim 33, wherein the means to move the cutter is resiliently biased to position the cutter into a non-cutting position such that a push action against the resilient bias moves the cutter for cutting.

35. The surgical assembly of claim 33, wherein there is a hand grip portion for the rigidly coupled valve means and cannula, which hand grip portion is a surface surrounding the valve means.

36. The surgical assembly of claim 34 wherein there is a hand grip portion for the rigidly coupled valve means and cannula, which hand grip portion is a surface surrounding the valve means.

37. The surgical assembly of claim 33 wherein the cannula supports the cutter.

38. The surgical assembly of claim 34 wherein the cannula supports the cutter.

39. The surgical assembly of claim 35 wherein the cannula supports the cutter.

40. The surgical assembly of claim 36 wherein the cannula supports the cutter.

41. The surgical assembly of claim 33 wherein the cannula has an opened distal end to allow communication between the cannula interior and the patient.

42. The surgical assembly of claim 34 wherein the cannula has an opened distal end to allow communication between the cannula interior and the patient.

43. The surgical assembly of claim 35 wherein the cannula has an opened distal end to allow communication between the cannula interior and the patient.

44. The surgical assembly of claim 36 wherein the cannula has an opened distal end to allow communication between the cannula interior and the patient.

45. The surgical assembly of claim 37 wherein the cannula has an opened distal end to allow communication between the cannula interior and the patient.

46. The surgical assembly of claim 38 wherein the cannula has an opened distal end to allow communication between the cannula interior and the patient.

47. The surgical assembly of claim 39 wherein the cannula has an opened distal end to allow communication between the cannula interior and the patient.

48. The surgical assembly of claim 40 wherein the cannula has an opened distal end to allow communication between the cannula interior and the patient.