Devices and methods for percutaneous surgery

• US 7,198,598 B2
• Filed: 01/20/2004
• Issued: 04/03/2007
• Est. Priority Date: 03/22/1996
• Status: Expired due to Term

• Current Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Original Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Inventors: Null, William Barry, Foley, Kevin T., Smith, Maurice M., Roehm, Thomas E. III
• Primary Examiner(s): Leubecker; John P.
• Application Number:
  US10/760,817
• Publication Number:
  US 20040186346A1
• Time in Patent Office: 1,169 Days
• Field of Search: 600/102, 600/114, 600/101, 600/125, 600/136, 604/164.01, 604/164.07, 604/264
• US Class Current: 600/114
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/3417 Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating syringe needles A61M5/32; dilators A61M29/00
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 2017/00261 Discectomy
• CPC Class Codes: A61B 2017/00296 mounted on an endoscope
• CPC Class Codes: A61B 2017/0046 with a releasable handle; with handle and operating part separable for prosthetic joint-implanting tools A61F2/4603
• CPC Class Codes: A61B 2017/00469 for insertion of instruments, e.g. guide wire, optical fibre
• CPC Class Codes: A61B 2017/3445 used as instrument channel for multiple instruments catheters A61B2017/22072
• CPC Class Codes: A61B 2017/347 Locking means, e.g. for locking instrument in cannula
• CPC Class Codes: A61B 2090/306 using optical fibres
• CPC Class Codes: A61B 2090/3614 using optical fibre
• CPC Class Codes: A61B 2090/373 using light, e.g. by using optical scanners
• CPC Class Codes: A61B 90/37 Surgical systems with images on a monitor during operation
• CPC Class Codes: A61B 90/50 Supports for surgical instruments, e.g. articulated arms
• CPC Class Codes: A61M 29/00 Dilators with or without means for introducing media, e.g. remedies instruments for performing visual medical inspections of cavities or tubes of the body A61B1/00

Abstract

Methods and devices for performing surgery in a patient are provided. A cannula provides a working channel for access to a location in the patient. A clamp assembly is removably engaged to the cannula. The clamp assembly allows use of an endoscopic viewing system or can be removed to allow use of a microscopic viewing system in order to view the surgical site in the patient through the working channel. The clamp assembly includes a viewing element mounting portion having a length along which an endoscopic viewing element can be selectively positioned.

Claims

1. A device for use in spinal surgery, comprising:

a cannula sized for introduction into a patient, said cannula defining a working channel extending between a distal end and an opposite proximal end, said cannula further defining a length between said distal end and said proximal end, said proximal end including a ring extending radially outwardly therefrom about a perimeter of said cannula and forming a lip about an outer surface of said cannula;

a clamp assembly including a viewing element mounting portion extending proximally from said cannula, said clamp assembly further comprising a foot with a channel to receive said ring when said clamp assembly is engaged to said cannula, said foot occupying a first portion of the perimeter of said cannula with the remaining portion of the perimeter unoccupied by said foot; and

a viewing element engageable to said viewing element mounting portion.

2. The device of claim 1, wherein said clamp assembly contacts an inner surface and an outer surface of said cannula when engaged thereto.

3. The device of claim 1, wherein said perimeter is circular.

4. The device of claim 3, wherein said foot includes an inner lip positionable along an inner surface of said cannula and an outer lip positionable along an outer surface of said ring.

5. The device of claim 4, wherein said inner lip includes a concave profile along a concave profile of said inner surface of said cannula.

6. The device of claim 1, wherein said clamp assembly includes a lever arm pivotally coupled to said foot.

7. The device of claim 6, wherein said lever arm includes a handle and a clamping member, said clamping member including a clamping surface positionable against said outer surface of said cannula to secure said foot about said ring.

8. The device of claim 7, wherein said ring is positioned between said foot and said lever arm when said clamping surface is positioned against said outer surface of said cannula.

9. The device of claim 8, wherein said clamping member includes a ramped surface oriented toward said ring structured to facilitate passage of said clamping member below said ring.

10. The device of claim 9, wherein said clamping member includes an upper surface adjacent said ramped surface positionable against a lower surface of said lip when said clamping surface is positioned against said outer surface of said cannula.

11. The device of claim 7, wherein said foot includes an inner lip positionable along an inner surface of said cannula, said inner lip clamping against said inner surface when said clamping surface is positioned against said outer surface of said cannula.

12. The device of claim 1, wherein said viewing element includes an optics cannula positionable in said working channel of said cannula when said viewing element is engaged to said viewing element mounting portion.

13. The device of claim 1, wherein said ring is engageable to a flexible arm to secure a position of said cannula during spinal surgery.

14. The device of claim 13, wherein said ring includes a bracket extending therefrom for engagement with the flexible arm.

15. The device of claim 1, wherein said viewing element is adjustably positionable along a length of said viewing element mounting portion to reposition a distal end of said viewing element relative to said distal end of said cannula.

16. A device for use in spinal surgery, comprising:

a cannula sized for introduction into a patient, said cannula defining a working channel extending between a distal end and an opposite proximal end, said cannula further defining a first length between said distal end and said proximal end;

a viewing element including an optics cannula extending into said working channel; and

a clamp assembly including a viewing element mounting portion extending proximally from said cannula, said viewing element being mountable to said mounting portion, wherein said clamp assembly is engageable at a plurality of locations about said proximal end of said cannula to reposition said optics cannula in said working channel and said clamp assembly contacts an inner surface and an outer surface of said cannula when engaged thereto.

17. The device of claim 16, wherein said clamp assembly further comprises a foot with a channel to receive a ring extending radially outwardly about said proximal end of said cannula.

18. The device of claim 17, wherein said ring is engageable to a flexible arm to secure a position of said cannula during spinal surgery.

19. The device of claim 17, wherein when said clamp assembly is engaged to said cannula, said foot occupies a first portion of the perimeter of said cannula with the remaining portion of the perimeter unoccupied by said foot.

20. The device of claim 16, wherein said viewing element is adjustably positionable along a length of said viewing element mounting portion to reposition a distal end of said optics cannula relative to said distal end of said cannula.

21. The device of claim 16, wherein said perimeter is circular.

22. A device for use in spinal surgery on a patient, comprising:

a cannula sized for introduction into a patient, said cannula defining a working channel extending between a distal end and an opposite proximal end, said cannula further defining a length between said distal end and said proximal end and a perimeter extending around said working channel; and

a viewing element engageable at a first location along said perimeter with a clamp assembly and said clamp assembly and said viewing element are movable about said perimeter for engagement at a second location about said perimeter remote from said first location, wherein said clamp assembly is configured to occupy a portion of said perimeter when engaged to said cannula with a remaining portion of said perimeter unoccupied by said clamp assembly.

23. The device of claim 22, further comprising a flexible arm removably coupled to a proximal end ring extending about said proximal end of said cannula, said flexible arm maintaining an orientation of said cannula in the patient.

24. The device of claim 22, wherein said cannula includes a bracket extending laterally from said ring, said flexible arm being engageable with said bracket.

25. The device of claim 22, further comprising:

said clamp assembly including a viewing element mounting portion extending proximally from said cannula, said clamp assembly further comprising a foot with a channel to receive said proximal end of said cannula when said clamp assembly is engaged to said cannula, said foot extending about a first portion of the perimeter of said cannula with the remaining portion of the perimeter remaining substantially unobstructed; and

said viewing element includes an optics cannula mountable to said viewing element mounting portion with said optics cannula extending into said working channel.

26. The device of claim 25, wherein said clamp assembly is engageable to an inner surface and an outer surface of said cannula.