Surgical instrument and method for use in hand-assisted laparoscopy

• US 6,149,642 A
• Filed: 01/16/1998
• Issued: 11/21/2000
• Est. Priority Date: 01/16/1998
• Status: Expired due to Fees

• Current Assignee: vMedical Creative Technologies, Inc.
• Original Assignee: vMedical Creative Technologies, Inc.
• Inventors: Gerhart, Clark D., Rambo, Robert D.
• Primary Examiner(s): Thaler, Michael H.
• Application Number:
  US09/008,135
• Time in Patent Office: 1,040 Days
• Field of Search: 606/1, 606/210, 128/897
• US Class Current: 606/1
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0293 with ring member to support retractor elements
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/30 Surgical pincettes without pivotal connectionsfor holding suture needles or materials A61B17/0483; wound clamps A61B17/08 ; hand-held gripping tools without pivotal connections in general B25B9/02
• CPC Class Codes: A61B 17/3423 Access ports, e.g. toroid shape introducers for instruments or hands access sites for liquids A61M39/0247
• CPC Class Codes: A61B 2017/00265 Hand assisted surgery, i.e. minimally invasive surgery with at least part of an assisting hand inside the body

Abstract

A surgical instrument and the method for delivering and withdrawing surgical tools through a cannula in an abdominal cavity during hand-assisted minimally invasive surgery. A tube slidably extends through a cannula with a slender surgical tool such as a suture needle holder, secured in a snap-in gripper at the insertion end of the tube. The thumb and fingers of one hand of the surgeon or an assistant'"'"'s cause the tube to move axially from a fully retracted position in the cannula to a position where the tool projects from a snap-in socket in the tube a length sufficient for a surgeon'"'"'s hand to grip a knurled surface around the tool. A detent bead around the periphery of the tool snaps into a complementary groove within the gripper. Insufflating gas may be introduced or vented as needed through a port which communicates through the interior of the tube with the abdominal cavity. The procedure is reversed for withdrawing the tool.

Claims

1. Apparatus for use in hand-assisted laparoscopy in which one hand of a surgeon is inserted in an insufflated abdominal cavity, comprising:

a cannula having a distal end portion insertable through a puncture wound into the cavity, and a proximal end portion with a finger grip affixed thereto;

a tube slidable lengthwise in said cannula having a thumb grip sealing one end of said tube adjacent to said proximal end portion, and a gripper formed in said tube near an opposite end thereof;

a surgical tool having members insertable in said gripper when said members are squeezed together; and

limit means connected between said cannula and said tube for limiting travel of the tool between a retracted position within said distal end portion and a partially extended position sufficient for the one hand to grasp and release said tool from said gripper for use by the surgeon within the cavity.

2. Apparatus according to claim 1 further comprising:

detent means operatively connected to said gripper and said tool for producing a snap-in fitting.

3. Apparatus according to claim 2 wherein said detent means further comprises:

a circumferential groove within said gripper providing a socket; and

a circumferential bead around said tool mating with said groove in an interference fit.

4. Apparatus according to claim 1 wherein said limit means comprises:

a slot along the external surface of said tube adjacent to said proximal end, the length of said slot being equal to said selected exposure length; and

a pin projecting from said cannula into said slot, said pin positioned in said cannula to limit travel of said tube in said slot.

6. Apparatus according to claim 1 further comprising:

a circumfrential groove in said gripper; and

a circumferential bead around said tool mating with said groove for producing an interference fit.

7. Apparatus according to claim 1 further comprising:

a knurled surface around said members for enabling positive finger gripping of the tool.

8. Apparatus according to claim 1 further comprising:

alignment means operatively connected between said jaw members for aligning the said members when squeezed together.

5. Apparatus according to claim 5 wherein said limit means further comprises:

force-exerting means for urging said pin into said slot.

9. A method for delivering a surgical tool to a surgeon'"'"'s hand within an insufflated abdominal cavity comprising the steps of:

inserting one end of a slender surgical tool axially into a snap-in gripper at a distal end of an elongate tube;

sliding the tube in a cannula until the tool is completely withdrawn in a distal end of the cannula;

inserting the distal end of the cannula through a wound in the abdomen to within easy reach of the surgeon'"'"'s hand;

sliding the tool forwardly through the cannula until the tool is sufficiently exposed for the surgeon'"'"'s hand to grasp; and

removing the tool from the gripper within the cavity for executing a surgical procedure.

10. A method according to claim 9 further comprising to steps of:

reinserting the tool in the gripper;

retracting the tube in said cannula until the tool is completely inside the cannula; and

withdrawing the cannula from the cavity.

11. In a surgical instrument for hand-assisted minimally invasive surgery within a body cavity under conditions of pneumoperitoneum, the combination comprising:

an elongate outer tube having a forward end and a rearward end, a first handle at the rearward end formed to be gripped by the fingers of one hand;

an inner tube slidable in said outer tube having a forward end and a rearward formed to be gripped by the thumb of the one hand;

tool means operably and removably carried at the inner tube forward end, said tool means including opposed first and second ends, said first end having a cross sectional area slidable into said forward end of said inner tube and a second end retractable into said outer tube; and

interference fitting means operatively connecting said first end of said tool means to said inner tube forward end, including a circumferential bead around said tool means mating with a circumferential groove around the interior of said inner tube.

12. An instrument according to claim 11 wherein said tool means comprises a bifurcated shaft having normally open jaws compressed together to fit in the forward end of said inner member.

13. An instrument according to claim 11 including a reclosable port in said cannula.

14. A method for withdrawing a surgical tool from a surbon'"'"'s hand within an insufflated abdominal cavity comprising the steps of:

inserting the distal end of a cannula through a wound in the abdomen to within easy reach of the surgeon'"'"'s hand;

inserting one end of the surgical tool into a snap-in gripper at a distal end of an elongate tube;

retracting the tube in the cannula until the tool is completely withdrawn into the cannula; and

withdrawing the cannula and hence the tool from the abdominal cavity.

15. A method for delivering a surgical tool to a surgeon'"'"'s hand within an insufflated abdominal cavity, comprising the steps of:

inserting one end of a tool axially into a snap-in gripper at a distal end of a tube sidable within a cannula with the tool contained within a distal end portion of the cannula;

inserting the distal end portion of the cannula with the distal end of the tube through a wound in the abdomen within easy reach of the surgeon'"'"'s hand; and

sliding the tube toward the distal end of the cannula to expose a distal portion of the tool for grasping by the surgeon.