Surgical instrument including viewing optics and an atraumatic probe

• US 5,735,792 A
• Filed: 04/29/1996
• Issued: 04/07/1998
• Est. Priority Date: 11/25/1992
• Status: Expired due to Term

• Current Assignee: Clarus Medical LLC
• Original Assignee: Clarus Medical Systems, Inc.
• Inventors: Brown, Mark Francis, Blackledge, Victor Roy, Shockey, Richard L., Finn, Miles A., Vanden Hoek, John C., Barthel, Thomas C.
• Primary Examiner(s): FLANAGAN, BEVERLY MEINDL
• Application Number:
  US08/638,680
• Time in Patent Office: 708 Days
• Field of Search: 600/104, 600/109, 600/114, 600/115, 600/116, 600/117, 600/129, 600/138, 600/245, 600/204, 600/210, 606/7, 606/13, 606/14, 606/15, 606/16, 606/17, 606/160, 606/161, 607/88, 607/89
• US Class Current: 600/138
• CPC Class Codes: A61B 1/00087 Tools A61B17/00234 takes precedence
• CPC Class Codes: A61B 1/00089 Hoods
• CPC Class Codes: A61B 1/00101 the distal tip features being detachable
• CPC Class Codes: A61B 1/00135 Oversleeves mounted on the endoscope prior to insertion
• CPC Class Codes: A61B 1/00165 with light-conductive means, e.g. fibre optics A61B1/07 takes precedence
• CPC Class Codes: A61B 1/00174 characterised by the viewing angles
• CPC Class Codes: A61B 1/042 characterised by a proximal camera, e.g. a CCD camera
• CPC Class Codes: A61B 1/127 with means for preventing fogging A61B1/253 takes precedence
• CPC Class Codes: A61B 1/3135 for examination of the epidural or the spinal space

Abstract

A surgical instrument incorporating visualizing optics is disclosed. The instrument comprises a handle supporting a rigid hollow shaft, an expanded tip is located on the distal end of the shaft providing a surface that will not tear or easily penetrate tissue. A fiber-optic assembly, containing at least one illumination transmitting fiber, a plurality of image-carrying fibers and an objective lens mounted near the distal end of the image fibers runs the length of the shaft. The objective lens is positioned relative to an opening in the tip allowing viewing. Light for illuminating the surgical site passes through one or more illumination fibers and through the opening in the tip of the probe. Light reflected from the tissue at the tip of the probe is focused onto the distal face of the image bundle by an objective lens and is then transmitted to the proximal end of the image bundle. Connectors on the proximal ends of the illumination fibers and image fibers facilitate their being coupled to an illumination source and a viewing device.

Claims

1. A surgical instrument for examining tissue comprising:

(a) an elongated substantially rigid shaft having a proximal end, a distal end and a lumen extending between the ends;

(b) a handle connected to the proximal end of the shaft, the handle including a longitudinal bore communicating with the lumen;

(c) an expanded rigid atraumatic tip on the distal end of the shaft, the tip defining a surface opening that communicates with the lumen; and

(d) a fiber-optic viewing assembly including a plurality of optical image fibers and having an objective lens mounted within the lumen for creating an optical image of tissue proximal to the opening, the assembly being mounted to extend and terminate within the lumen such that the tissue can be examined.

2. The surgical instrument of claim 1 wherein the expanded tip forms an elevator.

3. The surgical instrument of claim 1 wherein the expanded tip is a blade that arches from the shaft.

4. The surgical instrument of claim 3 wherein the blade has an arcuate distal end.

5. The surgical instrument of claim 1 wherein the expanded tip is bulbous.

6. The surgical instrument of claim 5 wherein the expanded tip and the shaft are formed from a single tube.

7. The surgical instrument of claim 5 wherein the proximal end of the shaft has an outer diameter and the expanded tip has an outer diameter which is less than the outer diameter of the shaft.

8. The surgical instrument of claim 1 wherein the handle is detachably coupled to an endoscope connector, the connector including a passage in fluid communication with the bore of the handle.

9. The surgical instrument of claim 1 wherein the handle is detachably coupled to a Y-connector forming a passage, the Y-connector attached to a hose including a lumen, the passage and lumen in fluid communication with the bore of the handle.

10. The surgical instrument of claim 1 wherein the lumen and fiber-optic assembly define a space between them that is in fluid communication with the opening to allow a flushing fluid to be sent through the lumen and out the opening.

11. The surgical instrument of claim 10 wherein the fluid enters the lumen about the objective lens.

12. The surgical instrument of claim 1 wherein the fiber-optic viewing assembly extends from an endoscope connector, the endoscope connector being detachably connected to the handle.

13. The surgical probe of claim 1 wherein the tip is generally spherical and symmetrically joined on the shaft and has a diameter about twice that of the shaft to permit tissue to close about the shaft and open in front of the opening.

14. The surgical instrument of claim 1 wherein the objective lens is recessed a predetermined distance from the opening such that tissue at the opening is in focus.

15. The surgical instrument of claim 1 wherein the shaft includes an arcuate bend proximal of the atraumatic tip.

16. The surgical instrument of claim 1 wherein the axis of the fiber-optic assembly is eccentric to the axis of the lumen.

17. The surgical instrument of claim 1 further including at least one illumination fiber extending through the longitudinal bore and the lumen for transmitting light energy from an external source proximal of the handle and through the opening.

18. The surgical instrument of claim 1 wherein the fiber-optic assembly is removably mounted on the handle.

19. The surgical instrument of claim 18 including the cooperating connectors on the fiber-optic assembly and handle and wherein a distal portion of fiber optic assembly has a predetermined length to extend through the bore and lumen with the fiber-optic assembly terminating within the lumen spaced from the opening.

20. The surgical instrument of claim 1 including a camera mounted on the handle operably associated with the fiber-optic assembly.

21. The surgical instrument of claim 1 wherein the opening in the tip is generally coaxial with the lumen.

22. The surgical instrument of claim 1 wherein the opening is located at an angle to a longitudinal axis of the lumen.

23. The surgical instrument of claim 1 wherein at least a portion of the shaft is malleable by a user.

24. A surgical instrument comprising:

(a) an elongated rigid shaft having a proximal end, a distal end and a lumen extending between the ends;

(b) a handle affixed to the proximal end of the shaft, the handle including a longitudinal bore communicating with the lumen;

(c) a rigid expanded tip on the distal end of the shaft and projecting from the diameter of the shaft, the tip defining an opening communicating with the lumen;

(d) an optic harness assembly removably mounted on the handle with a fiber-optic assembly extending into the lumen for creating, at a remote location, a viewable image of tissue located proximal and exterior to the tip; and

(e) an endoscope connector attached to the fiber-optic viewing assembly and detachably coupled to the handle, the fiber-optic viewing assembly extending a predetermined length from the endoscope connector such that the fiber-optic assembly terminates within the lumen.

25. The surgical instrument of claim 24 wherein the expanded tip is joined to the distal end of the shaft and forms an elevator.

26. The surgical instrument of claim 24 wherein the expanded tip has a generally dovetailed shape and is joined to the distal end of the shaft, the tip arcing from the shaft and having a tapered terminal end.

27. The surgical instrument of claim 24 wherein the endoscope connector includes a longitudinal port in fluid communication with the bore of the handle.

28. The surgical instrument of claim 24 wherein the fiber-optic assembly has a proximal end and a distal end and including at least one illumination fiber, a plurality of image fibers and an objective lens affixed to the distal end, the objective lens mounted in the tip to receive light traversing the illumination fiber and reflected from an object being viewed.

29. The surgical instrument of claim 28 further including flushing means for injecting a flushing liquid through the lumen for maintaining the objective lens clean of blood and debris.

30. The surgical instrument of claim 25 wherein the shaft is malleable by a user.

31. The surgical instrument of claim 25 wherein an annular space is defined between the shaft, the tip and the fiber-optic assembly within the lumen and bore to provide flushing liquid to the tip.

32. The surgical instrument of claim 25 wherein the shaft includes a flush lumen therein parallel to the fiber-optic assembly to provide liquid to the opening.

33. A surgical instrument for elevating and viewing tissue comprising:

(a) an elongated rigid shaft having a proximal end, a distal end and a lumen extending between the ends;

(b) a handle connected to the proximal end of the shaft, the handle including a longitudinal bore communicating with the lumen;

(c) a rigid spread atraumatic tip associated with the distal end of the shaft, the tip defining an opening that communicates with the lumen; and

(d) a fiber-optic viewing assembly including a plurality of optical image fibers having a planar face at the distal end thereof, the assembly extending through the shaft and including an objective lens for creating an optical image of tissue proximal to the opening onto the fact of the image fibers, the assembly terminating within the lumen such that the tissue can be positioned and viewed simultaneously,

the lumen being in fluid communication with the opening to allow a fluid to be sent through the lumen, about the objective lens and out the opening.

34. The surgical instrument of claim 33 wherein the fiber-optic viewing assembly is disposed in the lumen.

35. The surgical instrument of claim 33 further including an endoscope connector attached to the fiber-optic viewing assembly and detachably coupled to the handle.