Optical surgical device with scraping tool

• US 5,536,234 A
• Filed: 03/08/1995
• Issued: 07/16/1996
• Est. Priority Date: 08/18/1993
• Status: Expired due to Term

• Current Assignee: Allen Newman
• Original Assignee: Vista Medical Technologies Inc (Jefferies Financial Group, Inc.)
• Inventors: Newman, Allen
• Primary Examiner(s): Apley, Richard J.
• Assistant Examiner(s): Leubecker, John P.
• Application Number:
  US08/400,919
• Time in Patent Office: 496 Days
• Field of Search: 600/104, 600/105, 600/116, 600/127, 600/129, 600/135, 600/156, 604/96, 604/280, 604/20, 604/46, 604/47, 604/55, 606/159, 606/160, 606/161, 128/757, 128/758, 128/750
• US Class Current: 600/104
• CPC Class Codes: A61B 1/00091 Nozzles
• CPC Class Codes: A61B 1/00135 Oversleeves mounted on the endoscope prior to insertion
• CPC Class Codes: A61B 1/00142 with means for preventing contamination, e.g. by using a sanitary sheath
• CPC Class Codes: A61B 1/015 Control of fluid supply or evacuation
• CPC Class Codes: A61B 1/127 with means for preventing fogging A61B1/253 takes precedence
• CPC Class Codes: A61B 1/303 for the vagina, i.e. vaginoscopes
• CPC Class Codes: A61B 1/307 for the urinary organs, e.g. urethroscopes, cystoscopes
• CPC Class Codes: A61B 2090/062 penetration depth
• CPC Class Codes: A61B 2217/005 with suction drainage system
• CPC Class Codes: A61B 2217/007 with irrigation system
• CPC Class Codes: A61B 90/36 Image-producing devices or illumination devices not otherwise provided for

Abstract

An optical surgical device includes a detachable, disposable semi-flexible sheath for insertion into a patient'"'"'s body. The sheath is provided with plurality of channels. One of the channels receives an endoscope for optical examination of an operative site within the patient. The remaining channels may be used for suction, drainage or irrigation of the operative site. The distal end of the sheath defines a hook-like scraping tool for removing tissue from the patient in the field of view of the endoscope.

Claims

1. An optical surgical apparatus operable with an optical viewing device for examination of the genitourinary tract of a patient, the apparatus comprising:

a disposable tube-shaped member having;

an open proximal end and an open distal end, the tube-shaped member being semi-flexible and dimensioned for comfortable insertion into the genitourinary tract of a patient, the overall diameter of the distal end being in the range of about 3 mm to about 7 mm, and the distal half of the tube-shaped member being slightly curved for ease of insertion and viewing access within a patient;

at least two channels integrally formed within the tube-shaped member and extending between the open proximal end and the open distal end, including an endoscope channel for removably receiving the optical viewing device, and an irrigation channel for directing fluid to the operative site and to clean the distal end of the optical viewing device; and

a port at the open proximal end of the tube-shaped member communicating with the endoscope channel, for removably receiving the optical viewing device;

wherein the distal end of the tube-shaped member defines a scraping tool for soft tissue, and the endoscope channel is positioned at the distal end of the member for causing the optical viewing device, when received in the endoscope channel, to provide a view of a soft-tissue surface being scraped by the scraping tool.

2. The optical surgical apparatus of claim 1, wherein the the port at the proximal end of the endoscope channel is co-axial with the tube-shaped member.

3. The optical surgical apparatus of claim 1, wherein the diameter of the distal end of the channel which receives the optical viewing device is approximately 1 mm.

4. The optical surgical apparatus of claim 1, wherein the tube-shaped member tapers from the proximal end to the distal end.

5. An optical surgical system for examination of the genitourinary tract of a patient, comprising:

a disposable tube-shaped member having a plurality of integral channels extending therethrough, the tube-shaped member having an open proximal end and an open distal end, the tube-shaped member being semi-flexible and dimensioned for comfortable insertion into the genitourinary tract of a patient, the overall diameter of the distal end being in the range of about 3 mm to about 7 mm, and the distal half of the tube-shaped member being slightly curved for ease of insertion and viewing access within a patient;

an optical viewing device removably received by one of the channels in the tube-shaped member at the open proximal end of the tube-shaped member and having a field of view at the distal end of the tube-shaped member;

an irrigation supply in flow communication with another one of the channels in the tube-shaped member, such channel being positioned for directing irrigation fluid to the operative site and to clean the distal end of the optical viewing device; and

scraping means for scraping soft tissue in the field of view of the optical viewing device; and

means for removing scraped tissue and fluid from the patient, the means for removing tissue and fluid being coupled to another channel in the tube-shaped member defining a drainage channel, wherein the tissue and fluid enter the drainage channel at the open distal end of the tube-shaped member and exit the drainage channel at the open proximal end of the tube-shaped member.

6. The optical surgical system of claim 5, wherein the the proximal end of the channel receiving the optical viewing device is co-axial with the tube-shaped member.

7. The optical surgical system of claim 5, wherein the diameter of the distal end of the channel which receives the optical viewing device is approximately 1 mm.

8. The optical surgical system of claim 5, wherein the drainage channel has the largest diameter of the plurality of channels in the tube-shaped member.

9. An optical surgical system for examination of tissue and fluid in the genitourinary tract of a patient, comprising:

a disposable sheath having a plurality of integral channels extending therethrough, the plurality of integral channels defining at least first, second and third channels, the sheath having a proximal end and a distal end, the distal end of the sheath for inserting into the patient, the sheath being semi-flexible and dimensioned for comfortable insertion into the genitourinary tract of a patient, the overall diameter of the distal end of the sheath being in the range of about 3 mm to about 7 mm, and the distal half of the sheath being slightly curved for ease of insertion and viewing access within a patient;

an optical viewing device removably received by the first channel in the sheath at the proximal end of the sheath, wherein the optical viewing device extends from the proximal end to the distal end of the sheath and has a field of view at the distal end of the sheath;

an irrigating source in flow communication with the second channel in the sheath, the irrigating source including an irrigating solution to irrigate the patient and clean the distal end of the optical viewing device; and

the distal end of the sheath having a scraping tool for removing tissue from the patient in the field of view of the optical viewing device, the scraping tool being proximate to the third channel in the sheath, wherein scraped tissue and fluid enter the third channel at the distal end of the sheath and exit the third channel at the proximal end of the sheath.

10. The optical surgical system of claim 9, wherein the first channel containing the optical viewing device is disposed between the second and third channels.

11. The optical surgical system of claim 9, wherein the optical viewing device comprises a bundle of optic fibers.

12. The optical surgical system of claim 9, further comprising an eyepiece coupled to the optical viewing device at the proximal end of the sheath, wherein the eyepiece extends along the same line as the sheath.

13. The optical surgical system of claim 12, further comprising a gasket coupled to the eyepiece for preventing leakage of tissue, fluid, and irrigating solution into the eyepiece.

14. The optical surgical system of claim 12, wherein the eyepiece includes a locking member for attaching to the optical viewing device.

15. The optical surgical system of claim 12, wherein the eyepiece includes a focusing mechanism for magnifying and focusing an image viewed through the optical viewing device.

16. The optical surgical system of claim 12, further comprising a removal/irrigation port for coupling to external sources of removal and irrigation, the removal/irrigation port being disposed at an angle from the eyepiece coupled to the optical viewing device at the proximal end of the sheath.

17. The optical surgical system of claim 16, further comprising a brace for supporting the angle between the removal/irrigation port and the eyepiece.

18. An endoscope assembly for optical examination of tissue and fluid around an operative site within the genitourinary tract of a patient, comprising:

a disposable sheath having a plurality of integral channels extending therethrough, and having a proximal end and a distal end, the distal end of the sheath having a tip for inserting into the operative site and defining a scraping tool for scraping soft tissue at the operative site, the sheath being semi-flexible and dimensioned for comfortable insertion into the genitourinary tract of a patient, the overall diameter of the distal end of the sheath being in the range of about 3 mm to about 7 mm, and the distal half of the sheath being slightly curved for ease of insertion and viewing access within a patient;

a fiber-optic viewing device removably received by one of the channels in the sheath defining a viewing channel, wherein the fiber-optic viewing device extends from the proximal end of the sheath to the tip of the distal end of the sheath and has a field of view at the distal end of the sheath, which field of view overlaps the operative site when the scraping tool is scraping tissue at the operative site;

irrigation means for irrigating the operative site with an irrigating solution, the irrigation means coupled to another one of the channels in the sheath defining an irrigation channel, wherein the irrigating solution simultaneously cleans the fiber-optic viewing device; and

drainage means for removing tissue and fluid from the operative site, the drainage means coupled to another one of the channels in the sheath defining a drainage channel, wherein the tissue and fluid from the operative site enter the drainage channel at the distal end of the sheath and exit the drainage channel at the proximal end of the sheath.

19. The endoscope assembly of claim 18, wherein the viewing channel is disposed between the irrigation and drainage channels.

20. The endoscope assembly of claim 18, wherein the drainage channel has the largest diameter of the plurality of channels in the sheath.

21. The endoscope assembly of claim 18, further comprising:

an eyepiece coupled to the fiber-optic viewing device at the proximal end of the sheath, wherein the eyepiece extends along the same line as the sheath, and

a drainage/irrigation port for coupling to external sources of removal and irrigation, wherein the irrigation channel and the drainage channel are separated from the viewing channel such that the drainage/irrigation port is skewed at an angle away from the eyepiece at the proximal end of the sheath to facilitate easier manipulation and rotation of the sheath during the examination.

22. The endoscope assembly of claim 21, wherein the eyepiece further includes:

a locking member for attaching the eyepiece to the fiber-optic viewing device, and

a focusing mechanism for magnifying and focusing an image viewed through the fiber-optic viewing device.

23. A method of making an optical surgical apparatus for optically examining tissue and fluid around an operative site within the genitourinary tract of a patient, comprising the steps of:

providing a disposable sheath having a plurality of channels extending therethrough, an open proximal end and an open distal end defining a scraping tool, the distal end of the sheath for inserting to the operative site, wherein a first one of the channels defines a viewing channel, a second one of the channels defines an irrigation channel, and a third one of the channels defines a drainage channel, the sheath being semi-flexible and dimensioned for comfortable insertion into the genitourinary tract of a patient, the overall diameter of the distal end of the sheath being in the range of about 3 mm to about 7 mm, and the distal half of the sheath being slightly curved for ease of insertion and viewing access within a patient;

inserting an endoscope into the viewing channel in the sheath, the endoscope extending from the proximal end of the sheath to the distal end of the sheath, the proximal end of the sheath and endoscope defining a viewing port, the endoscope having, at the distal end of the sheath, a field of view in the vicinity of the scraping tool;

attaching an eyepiece to the viewing port; and

separating a drainage/irrigation port from the eyepiece, the drainage/irrigation port for coupling to external sources of drainage and irrigation.

24. A method of using an optical surgical apparatus for optically examining tissue and fluid at an operative site within the genitourinary tract of a patient, comprising the steps of:

inserting an endoscope into one of a plurality of channels extending through a disposable sheath, the sheath having a proximal end and a distal end, the distal end defining a scraping tool for scraping tissue at the operative site the endoscope extending from the proximal end of the sheath to the distal end of the sheath, the proximal end of the sheath and endoscope defining a viewing port, further wherein the plurality of channels define an irrigation channel and a drainage channel, the sheath being semi-flexible and dimensioned for comfortable insertion into the genitourinary tract of a patient, the overall diameter of the distal end of the sheath being in the range of about 3 mm to about 7 mm, and the distal half of the sheath being slightly curved for ease of insertion and viewing access within a patient;

coupling sources of drainage and irrigation to the drainage and irrigation channels;

inserting the distal end of the sheath to the operative site;

scraping soft tissue at the operative site with the scraping tool while viewing the operative site through an eyepiece coupled to the viewing port; and

discarding the sheath following the above steps.

25. The method of claim 24, further comprising the step of irrigating the operative site with an irrigating solution through the irrigation channel.

26. The method of claim 24, further comprising the step of removing tissue, fluid and irrigating solution from the operative site through the drainage channel.