Tissue morcellator system and method

• US 5,618,296 A
• Filed: 07/24/1995
• Issued: 04/08/1997
• Est. Priority Date: 07/24/1995
• Status: Expired due to Fees

• Current Assignee: Endomedix Corporation/Box 330
• Original Assignee: Endomedix Corporation/Box 330
• Inventors: Limonta, Frans, Dial, Larry A., Sorensen, John T.
• Primary Examiner(s): Buiz, Michael Powell
• Assistant Examiner(s): RASCHE, PATRICK WILLIAM
• Application Number:
  US08/507,054
• Time in Patent Office: 624 Days
• Field of Search: 606/167, 606/114, 606/180, 606/184, 604/22, 128/749, 128/751, 128/752, 128/753, 128/754
• US Class Current: 606/180
• CPC Class Codes: A61B 17/32002 with continuously rotating, oscillating or reciprocating cutting instruments
• CPC Class Codes: A61B 17/3474 Insufflating needles, e.g. Veress needles
• CPC Class Codes: A61B 2017/00287 Bags for minimally invasive surgery
• CPC Class Codes: A61B 2017/320024 Morcellators, e.g. having a hollow cutting tube with an annular cutter for morcellating and removing tissue
• CPC Class Codes: A61B 2217/005 with suction drainage system
• CPC Class Codes: A61B 2217/007 with irrigation system

Abstract

A morcellation system and method for reducing and removing tissue or other matter contained within a mammalian body. A portal apparatus, having a central opening, is inserted into a small incision. Thereafter, a hollow-bore morcellator device is nestable within the central opening of the portal device. The hollow-bore morcellator device includes a rotatable shaft which extends downwardly into the body cavity, and upon which an annular cutting ring is mounted. An elongate suction probe is passable downwardly through the hollow-bore morcellator device, and is usable to engage (by suction force) a mass of tissue or other matter, and to repeatedly lift such mass into contact with the rotating annular cutting ring of the morcellator shaft. A tissue containment chamber may be positioned on the proximal end of the suction probe such that segments of tissue or matter separated by the annular cutting ring may be aspirated through the suction probe and collected within the collection chamber. The morcellator system may be utilized in conjunction with a flexible tissue containment bag. The tissue containment bag is preferably engageable with the portal apparatus to facilitate insertion of the morcellator device thereinto. Also, the system may include a pressurization system for passing positive pressure gas into the tissue containment bag. The passing of gas into the bag may be coordinated with the removal of gas withdrawn through the suction probe to ensure that the containment bag remains fully expanded during the suction operation.

Claims

1. A tissue morcellation system comprising:

a portal apparatus having an opening extending therethrough, said portal apparatus being insertable through an incision formed in a mammalian body such that the opening of the portal apparatus provides a passageway into the mammalian body;

a morcellator device insertable through the opening of said portal apparatus, said morcellator device comprising;

i) a drive motor;

ii) a shaft extending downwardly from said drive motor and being rotatable thereby, said shaft having a distal end;

iii) a cutting element positioned on the distal end of said shaft; and

iv) a hollow passageway which extends longitudinally through said drive motor, through said shaft, and through said cutting element; and

an elongate, non-rotatable suction probe having a proximal end, a distal end, a suction lumen extending longitudinally therethrough and an outer surface, said suction probe being operatively coupled to a vacuum source for selectively creating suction pressure within the suction lumen, and insertable through the hollow passageway and moveable back and forth within said passageway such that the distal end of the probe will engage, by suction pressure, a mass of matter located within said mammalian body and will lift said mass of matter into contact with the cutting element of said morcellator device such that a portion of said mass of matter may be severed by said cutting element and drawn out of the body through the lumen of said suction probe.

2. The system of claim 1 further comprising:

a containment sac for containing said mass of matter within the body, said containment sac having a mouth through which the shaft of the morcellator device, and the suction probe, may be inserted.

3. The system of claim 2 wherein said containment sac mouth is deployable in relation to the opening of said portal apparatus such that, when the morcellator device is inserted into the opening of said portal apparatus, the shaft of the morcellator device will extend into said containment sac.

4. The system of claim 2 further comprising:

a gas inlet passageway formed in said portal apparatus to permit positive pressure gas to be infused into said containment sac.

5. The system of claim 2 wherein said portal apparatus comprises:

an outer ring member;

an inner ring member positionable within said outer ring member, said inner ring member having said opening extending downwardly therethrough, said inner ring member having an outer surface which is configured to nest within said outer ring member, in abutting contact with said outer ring member.

6. The system of claim 5 wherein the mouth of said containment sac is extractable from said mammalian body through said incision and initially deployable within said outer ring member such that, when said inner ring member is nested within said outer ring member, the containment sac will be compressively held between said inner ring member and said outer ring member, such that the central opening in said inner ring member provides a passageway which leads into the containment sac.

7. The system of claim 2 wherein said containment sac further comprises:

a plurality of first connectors formed about the mouth of said containment sac;

and wherein said portal apparatus further comprises;

a plurality of second connectors formed on said portal apparatus, said second connectors on said portal apparatus being connectable to said first connectors on said containment sac to hold said containment sac in a substantially fixed position relative to said portal apparatus.

8. The system of claim 2 further comprising means for infusing fluid into said containment sac to maintain sufficient pressure within the sac to prevent the said sac from collapsing.

9. The system of claim 8 wherein:

said portal apparatus is constructed to engage and hold the mouth of said tissue containment sac such that, when said morcellator device is inserted through said opening of said portal apparatus, the morcellator device will extend into said containment sac; and

said means for controlling the pressure within said containment sac comprises a gas infusion pathway formed in said portal apparatus for infusing gas into said containment sac.

10. The system of claim 9 wherein said morcellator device, said portal apparatus and said containment sac are configured such that, when said morcellator device is inserted into the opening of said portal apparatus, a seal is formed between said morcellator device and said portal apparatus to prevent leakage therebetween of gas from the interior of said containment sac.

11. The system of claim 8 further comprising:

means for coordinating the mass flow of gas infused into the containment sac with the mass flow of gas withdrawn through said suction probe to maintain at least a minimum pressure within said containment sac.

12. The system of claim 8 further comprising:

means for coordinating the mass flow of gas infused into said containment sac with the volume of gas removed from containment sac through said suction probe, to thereby maintain at least a predetermined minimum pressure within said containment sac to prevent collapse thereof.

13. The system of claim 12 wherein said means for coordinating comprises:

means for infusing a pressure-regulated mass flow of make-up gas into said containment sac, said mass flow of make-up gas being adequate to maintain said sufficient pressure within said sac to prevent said sac from collapsing when gas is removed from said sac through said suction probe.

14. The system of claim 1 wherein said suction probe further comprises:

a containment vessel positioned on the proximal end of said suction probe to receive and contain matter which has been separated from said mass of matter by said cutting element, and which has subsequently been aspirated through said suction probe.

15. The system of claim 14 wherein a proximal portion of the suction probe extends into said containment vessel.

16. The system of claim 15 wherein said containment vessel is vertically disposed during use and defines upper, middle, and lower interior regions, and wherein said proximal portion of said suction probe extends into the upper interior region of said containment vessel.

17. The system of claim 1 wherein said portal apparatus comprises:

a rigid body having the opening extending downwardly therethrough, said rigid body incorporating a lower portion which is sized and configured to pass through an incision of approximately 1 cm in length.

18. The system of claim 17 wherein:

the opening of said portal apparatus is analogous in size and configuration to portions of said morcellator device, such that said morcellator device may be nested within the central opening of said portal apparatus.

19. The system of claim 1 wherein said portal apparatus further comprises:

an obturator member insertable into the opening of said portal apparatus to close off said opening of said portal apparatus.

20. The system of claim 19 wherein said portal apparatus further comprises:

means for engaging and holding said obturator member within said portal apparatus.

21. The system of claim 20 wherein said means for engaging and holding said obturator comprises:

at least one lug formed on said obturator member; and

at least one receiving groove formed in said portal apparatus to receive and frictionally hold said lug of said obturator member.

22. The system of claim 20 wherein said morcellator device is sized and configured to nest within and be supported by the opening of said portal apparatus.

23. The system of claim 22 wherein said morcellator device further comprises:

means for engaging and holding said morcellator device within said portal apparatus.

24. The system of claim 23 wherein said means for engaging and holding said morcellator device comprises:

at least one lug formed on said morcellator device; and

at least one receiving groove formed in said portal apparatus to receive and frictionally hold said lug of said morcellator device.

25. The system of claim 1 wherein the cutting element of said morcellator device comprises an annular cutting ring positioned on the distal end of said shaft.

26. The system of claim 13 wherein said annular cutting ring is removable from said shaft.

27. The system of claim 13 wherein said annular cutting ring has an annular cutting edge formed on the distal end thereof, such that when a mass of matter having a diameter larger than that of said cutting ring is lifted into contact with said cutting ring, the distal cutting edge of said cutting ring will sever a generally cylindrical portion of said mass.

28. The system of claim 1 further comprising:

a seal element associated with the hollow passageway of said morcellator device to prevent backflow of gas through said passageway.

29. The system of claim 27 wherein said seal element comprises a sealing member positionable on top of said drive motor, said sealing member having an opening formed therein in alignment with said hollow passageway of said morcellator device, and an elastomeric seal disposed transversely within said passageway said elastomeric seal having an opening formed therein such that:

i) when said suction probe is not inserted into said hollow passageway, said opening will be no larger in cross sectional area than said suction probe, thereby limiting the mass flow of gas which may escape through said hollow passageway, and

ii) when said suction probe is inserted through said hollow passageway, said opening will seal about said suction probe to form a substantially gas tight seal around said suction probe, while allowing said suction probe to be moved back and forth within said hollow passageway.

30. A morcellator device for morcelling matter within a mammalian body, said device comprising:

a drive motor;

a shaft extending downwardly from said drive motor, said shaft having a distal end;

a cutting element positioned on the distal end of said shaft;

a hollow passageway which extends longitudinally through said drive motor, through said shaft, and through said cutting element; and

an elongate suction probe having a proximal end, a distal end, a suction lumen extending longitudinally therethrough and an outer surface, said suction probe being operatively coupled to a vacuum source for selectively creating suction pressure within the suction lumen;

said drive motor being operative to rotatably drive said shaft and said cutting element such that, while said shaft and said cutting element are rotating, said suction probe may be passed through said hollow passageway and moved back and forth therewithin beyond said cutting element such that the distal end of said suction probe may engage, by suction pressure, a mass of matter located beyond said cutting element, and subsequently move said mass of matter into contact with said cutting element so as to effect morcellation of said mass of matter by said cutting element in a manner wherein a portion of said mass of matter is severed by said cutting element and drawn through the suction lumen of said suction probe.

31. The morcellator device of claim 30 further comprising:

a containment chamber connected to the proximal end of said suction probe for receiving and collecting portions of said mass of matter which have been drawn through the suction lumen of said suction probe.

32. A method for morcelling and removing a mass of matter located within a mammalian body, said method comprising:

a) forming an incision of less than 3 cm in said mammalian body;

b) inserting, through said incision, a morcellator device comprising;

a drive motor;

a shaft extending downwardly from said drive motor, said shaft having a distal end;

a cutting element positioned on the distal end of said shaft; and

a hollow passageway which extends longitudinally through said drive motor, through said shaft, and through said cutting element;

said drive motor being operative to rotatably drive said shaft and said cutting element such that, while said shaft and said cutting element are rotating, a separate suction probe operatively coupled to a vacuum source for selectively creating suction pressure therewithin may be passed through said hollow passageway and beyond said cutting element to engage, by suction pressure, a mass of matter located beyond said cutting element, and to subsequently move said mass of matter into contact with said cutting element so as to effect morcellation of said mass of matter by said cutting element;

c) energizing the drive motor of said morcellator device to cause said shaft and said cutting element to rotate;

d) advancing the suction probe through the hollow passageway of said morcellator device until said suction probe engages, by suction pressure, the mass of matter located within said mammalian body;

e) retracting said suction probe to lift said mass of matter into contact with the rotating cutting element of said morcellator device such that a portion of said mass of matter will be severed by said cutting element and drawn, out of the mammalian body, through said suction probe.

33. The method of claim 32 wherein said method further comprises:

f) repeating steps d and e until the entire mass of matter has been removed from said mammalian body.

34. The method of claim 32 further comprising:

g) providing a collection chamber connected to said suction probe such that the portions of the mass of matter drawn through the suction probe will be received and collected within said collection chamber.

35. The method of claim 32 further comprising:

initially inserting a tissue containment sac having an opening formed therein, through said incision and into said mammalian body;

placing said mass of tissue within said containment sac;

drawing the opening of said containment sac out of said incision while allowing the remainder of said containment sac, with said mass of matter contained therein, to remain within said body, and, wherein;

the insertion of the morcellator device in step b), is accomplished by inserting said morcellator device into said containment sac.

36. The method of claim 35 further comprising:

infusing positive pressure gas into said containment sac to maintain a pressure within said containment sac which is greater than the surrounding pressure within said mammalian body, to thereby prevent said containment sac from collapsing.