Endoscopic method of cleaning and operating on a site within a patient

• US 5,535,759 A
• Filed: 11/23/1994
• Issued: 07/16/1996
• Est. Priority Date: 11/02/1994
• Status: Expired due to Fees

• Current Assignee: Peter J. Wilk
• Original Assignee: Peter J. Wilk
• Inventors: Wilk, Peter J.
• Primary Examiner(s): Pellegrino, Stephen C.
• Assistant Examiner(s): DAWSON, GLENN K
• Application Number:
  US08/344,380
• Time in Patent Office: 601 Days
• Field of Search: 604/19, 604/21, 604/22, 604/24, 604/43, 604/49, 604/53, 604/93, 604/264, 604/282, 600/153, 600/156, 606/1, 606/110, 606/113, 606/43-50, 606/205-209, 128/898
• US Class Current: 128/898
• CPC Class Codes: A61B 1/015 Control of fluid supply or evacuation
• CPC Class Codes: A61B 1/018 for receiving instruments
• CPC Class Codes: A61B 1/126 provided with means for cleaning in-use
• CPC Class Codes: A61B 17/221 Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions surgical snare instruments A61B17/32056
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• 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 18/1485 having a short rigid shaft for accessing the inner body through natural openings
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/00287 Bags for minimally invasive surgery
• 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 2017/2212 having a closed distal end, e.g. a loop
• CPC Class Codes: A61B 2017/2215 having an open distal end
• CPC Class Codes: A61B 2018/1407 Loop
• CPC Class Codes: A61B 2018/141 Snare
• CPC Class Codes: A61M 3/0279 Cannula; Nozzles; Tips; their connection means

Abstract

A surgical method utilizes an endoscope with an elongate flexible insertion member and (i) an endoscopic instrument guide having a plurality of lumens, (ii) a flexible irrigation member slidably insertable through one of the lumens and (iii) an auxiliary endoscopic surgical instrument slidably insertable through another of the lumens. The irrigation member has a distal end provided with a multiplicity of apertures spaced from one another both longitudinally and circumferentially. Upon introduction of the endoscope insertion member into a patient, the endoscopic instrument guide is moved through the biopsy channel so that a distal end of the endoscopic instrument guide emerges from the biopsy channel. The irrigating member is then slid through endoscopic instrument guide so that the distal end of the irrigation member emerges therefrom. Upon operatively connecting a proximal end of the irrigation member to a source of pressurized liquid, liquid from the source is sprayed in a substantially uniform cylindrical distribution through the apertures at the distal end of the irrigation member, thereby cleaning organic debris from a site inside the patient. A distal end portion of the auxiliary endoscopic surgical instrument is ejected from the endoscopic instrument guide and used to perform an operation on organic tissues at the cleaned site inside the patient.

Claims

1. An endoscopic surgical method comprising the steps of:

providing an endoscope with an elongate flexible insertion member insertable into a patient, said insertion member having a biopsy channel;

also providing (i) a primary tubular member having a plurality of lumens, (ii) a secondary tubular member slidably insertable through one of said lumens and (iii) an auxiliary endoscopic surgical instrument slidably insertable through another of said lumens, said secondary tubular member having a distal end provided with a multiplicity of apertures distributed in a cylindrical locus;

inserting said insertion member into a patient;

moving said primary tubular member through said biopsy channel so that a distal end of said primary tubular member emerges from said biopsy channel inside the patient;

sliding said secondary tubular member in said one of said lumens so that the distal end of said secondary tubular member emerges from said one of said lumens inside the patient;

operatively connecting a proximal end of said secondary tubular member to a source of pressurized liquid;

upon completion of said steps of inserting, moving sliding and connecting, spraying liquid from said source in a substantially uniform cylindrical distribution through said apertures at the distal end of said secondary tubular member, thereby cleaning organic debris from a site inside the patient;

ejecting a distal end portion of said instrument from said another of said lumens inside the patient; and

upon ejection of the distal end portion of said instrument and upon a cleaning of said site during said step of spraying, using said instrument to perform an endoscopic surgical operation on organic tissues at said site.

2. The method defined in claim 1 wherein said step of sliding is performed after said step of moving.

3. The method defined in claim 1 wherein said step of operatively connecting includes the step of opening a valve to enable liquid flow from said source and along said secondary tubular member to said apertures.

4. The method defined in claim 1 wherein said step of ejecting is performed after said step of spraying.

5. The method defined in claim 1 wherein said instrument is an endoscopic graspers, said step of using said instrument including the step of grasping said organic tissues with said graspers.

6. The method defined in claim 1 wherein said instrument is an endoscopic biopsy forceps, said step of using said instrument including the step of taking a biopsy of said organic tissues.

7. The method defined in claim 1 wherein said instrument is an endoscopic cauterization snare, said step of using said instrument including the steps of placing said snare about said organic tissues and conducting electrical current to said loop and into said organic tissues.

8. The method defined in claim 1 wherein said instrument is a laser transmitting optical fiber, said step of using said instrument including the steps of transmitting laser radiation along said fiber and directing said laser radiation from a distal tip of said fiber to said organic tissues.