Method and devices for performing minimally invasive surgery

• US 8,225,798 B2
• Filed: 05/18/2010
• Issued: 07/24/2012
• Est. Priority Date: 05/18/2009
• Status: Active Grant

• Current Assignee: Teleflex Medical Incorporated (Teleflex Incorporated)
• Original Assignee: LOMA Linda University
• Inventors: Baldwin, Dalton D., Richards, Gideon
• Primary Examiner(s): PEFFLEY, MICHAEL F
• Application Number:
  US12/937,705
• Publication Number:
  US 20110213366A1
• Time in Patent Office: 798 Days
• Field of Search: 606/1, 606/41, 606 45- 50, 600/104, 128/898, 604/43
• US Class Current: 128/898
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/2909 Handles
• CPC Class Codes: A61B 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• 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 18/1482 having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
• CPC Class Codes: A61B 2017/292 connection of actuating rod to handle, e.g. ball end in recess
• CPC Class Codes: A61B 2017/2931 with releasable head
• CPC Class Codes: A61B 2017/2936 Pins in guiding slots
• CPC Class Codes: A61B 2017/294 Connection of actuating rod to jaw, e.g. releasable
• CPC Class Codes: A61B 2018/00083 low, i.e. electrically insulating
• CPC Class Codes: A61B 2018/00107 Coatings on the energy applicator
• CPC Class Codes: A61B 2018/00595 Cauterization
• CPC Class Codes: A61B 2018/1422 Hook
• CPC Class Codes: A61B 2217/005 with suction drainage system
• CPC Class Codes: A61M 1/84 Drainage tubes; Aspiration tips for negative pressure wound therapy A61M1/90; for surgical cutting instruments A61B17/32

Abstract

A device for use in performing minimally invasive surgery. A system for performing minimally invasive surgery comprising the device according to the present invention. A method for performing minimally invasive surgery.

Claims

1. A method for performing a form of minimally invasive surgery, referred to as “

scarless microport augmented restoration of triangulation surgery”

(SMART surgery), in a body cavity within a living body, where the body cavity is separated from a space outside of the body by a body wall, the method comprising;

a) providing a first device comprising a first part and a second part;

b) making two or more than two openings into the body wall, where the two or more than two openings comprise a first opening and a second opening;

where the first opening has a maximum transverse dimension that permits introduction of the first part of the first device from the space outside of the body through the first opening and into the body cavity, where the first part of the first device has a maximum external transverse dimension greater than 3 mm;

where the second opening has a maximum transverse dimension between 0.1 mm and 3 mm and permits introduction of a second part of the first device from the space outside of the body through the second opening and into the body cavity, where the second part of the first device has a maximum external transverse dimension of between 0.1 mm and 3 mm;

c) introducing the second part of the first device from the space outside of the body through the second opening into the body cavity;

d) passing the second part of the first device from inside of the body cavity through the first opening into the space outside of the body;

e) coupling the first part of the first device to the second part of the first device in the space outside of the body to make an assembled first device;

f) passing the first part of the first device coupled to the second part of the first device back into the body cavity through the first opening; and

g) using the first device to perform a procedure within the body cavity.

2. The method of claim 1, further comprising:

a) introducing a second device into the body cavity through the first opening; and

b) using the first device and the second device to perform a procedure within the body cavity allowing for triangulation of the first device with respect to the second device.

3. The method of claim 1, further comprising:

a) providing a second device comprising a first part and a second part;

b) making a third opening through the body wall and into the body cavity, and where the third opening has a maximum transverse dimension between 0.1 mm and 3 mm and permits introduction of the second part of the second device from the space outside of the body through the third opening and into the body cavity;

c) introducing the second part of the second device from the space outside of the body through the third opening into the body cavity;

d) passing the second part of the second device from inside of the body cavity through the first opening into the space outside of the body;

e) coupling the first part of the second device to the second part of the second device in the space outside of the body to make an assembled second device;

f) passing the first part of the second device coupled to the second part of the second device back into the body cavity through the first opening; and

g) using the second device to perform a procedure within the body cavity.

4. The method of claim 3, further comprising:

a) introducing a third device into the body cavity through the first opening; and

b) using the first device, the second device and the third device to perform a procedure within the body cavity allowing for triangulation of the first device with respect to the second device and with respect to the third device.

5. The method of claim 3, further comprising introducing a third port into the third opening, where the third port extends from the space outside of the body through the body wall and into the body cavity, and where the third port has a maximum transverse dimension between 0.1 mm and 3 mm that permits introduction of a second part of the second device from a space outside of the body through the third opening and into the body cavity.

6. The method of claim 3, where the third opening is made using a surgical scalpel, a no-scalpel technique or a trocar.

7. The method of claim 3, where the third opening has a maximum transverse dimension of between 1 mm and 3 mm.

8. The method of claim 3, where the third opening has a maximum transverse dimension of between 2 mm and 3 mm.

9. The method of claim 3, where the third opening has a maximum transverse dimension of 2.5 mm.

10. The method of claim 1, where the body cavity is selected from the group consisting of an abdominal cavity, a pelvic cavity and a thoracic cavity.

11. The method of claim 1, where the body wall is selected from the group consisting of an abdominal wall, a colonic wall, an esophageal wall, a thoracic wall, a tracheal wall, an oral wall and a vaginal wall.

12. The method of claim 1, where the living body is a living human body.

13. The method of claim 1, where the two or more than two openings consist of between two openings and fifty openings into the body wall.

14. The method of claim 1, where the two or more than two openings consist of between two openings and twenty openings into the body wall.

15. The method of claim 1, where the two or more than two openings consist of between two openings and ten openings into the body wall.

16. The method of claim 1, where the two or more than two openings consist of between two openings and five openings into the body wall.

17. The method of claim 1, where the two or more than two openings consist of four openings into the body wall.

18. The method of claim 1, where the two or more than two openings consist of three openings into the body wall.

19. The method of claim 1, where the two or more than two openings consist of two openings into the body wall.

20. The method of claim 1, further comprising introducing a first port into the first opening, where the first port extends from the space outside of the body through the body wall and into the body cavity, where the first port has a maximum transverse dimension that permits introduction of the first part of a first device from a space outside of the body through the first port and into the body cavity, and where the first part of the first device has a maximum external transverse dimension greater than 3 mm.

21. The method of claim 20, where the first port has a maximum transverse dimension of between 3 mm and 80 mm.

22. The method of claim 20, where the first port has a maximum transverse dimension of between 3 mm and 50 mm.

23. The method of claim 20, where the first port has a maximum transverse dimension of between 5 mm and 50 mm.

24. The method of claim 20, where the first port has a maximum transverse dimension of between 3 mm and 20 mm.

25. The method of claim 20, where the first port has a maximum transverse dimension of between 3 mm and 12 mm.

26. The method of claim 20, where the first port has a maximum transverse dimension of between 5 mm and 10 mm.

27. The method of claim 20, where the first port has a maximum transverse dimension of between 20 mm and 30 mm.

28. The method of claim 1, further comprising introducing a second port into the second opening, where the second port extends from the space outside of the body through the body wall and into the body cavity, and where the second port has a maximum transverse dimension between 0.1 mm and 3 mm that permits introduction of a second part of the first device from a space outside of the body through the second opening and into the body cavity.

29. The method of claim 28, where the second port has a maximum transverse dimension of between 1 mm and 3 mm.

30. The method of claim 28, where the second port has a maximum transverse dimension of between 2 mm and 3 mm.

31. The method of claim 28, where the second port has a maximum transverse dimension of 2.5 mm.

32. The method of claim 1, further comprising passing the first part of the first device and second part of the first device from the body cavity back through the first opening and into the space outside of the body, uncoupling and removing the first part of the first device from the second part of the first device.

33. The method of claim 32, further comprising passing the second part of the first device back through the first opening and into the body cavity, and then back through the second opening thereby removing the first part of the first device from the body.

34. The method of claim 32, where the first part of the first device is a first, first part of the first device, and where the method further comprises coupling a second, first part of the first device to the second part of the first device in the space outside of the body to make a second, first device, passing the second, first part of the first device coupled to the second part of the first device back into the body cavity through the first opening and using the second, first device to perform a procedure within the body cavity.

35. The method of claim 1, where the method comprises using a surgical robot to control the first device.

36. The method of claim 1, further comprising removing all devices from within the body cavity and removing all ports, and closing any openings greater than 5 mm.

37. The method of claim 1, where the first part of the first device is a working end and the second part of the first device is an intermediate portion of a user interface.

38. The method of claim 1, where the first device is a suction, and the first part of the first device is a suction head, and the second part of the first device is a suction shaft.

39. The method of claim 1, where the first device is an electrocautery assembly, and the first part of the first device is the electrocautery assembly head, and the second part of the first device is the electrocautery assembly shaft.

40. The method of claim 1, where the first device or the second device is selected from the group consisting of a canulator, a clip applied, a cutter, a grasper, an image recorder, an image viewer, a retractor, a sealer and a suction.

41. The method of claim 1, where the first opening is made using a surgical scalpel, a no-scalpel technique or a trocar.

42. The method of claim 1, where the body wall is an abdominal wall and the first opening is made through an umbilicus or through an umbilical crease.

43. The method of claim 1, where the second opening is made using a surgical scalpel, a no-scalpel technique or a trocar.

44. The method of claim 1, where the first opening has a maximum transverse dimension of between 3 mm and 80 mm.

45. The method of claim 1, where the first opening has a maximum transverse dimension of between 3 mm and 50 mm.

46. The method of claim 1, where the first opening has a maximum transverse dimension of between 5 mm and 50 mm.

47. The method of claim 1, where the first opening has a maximum transverse dimension of between 3 mm and 20 mm.

48. The method of claim 1, where the first opening has a maximum transverse dimension of between 3 mm and 12 mm.

49. The method of claim 1, where the first opening has a maximum transverse dimension of between 5 mm and 10 mm.

50. The method of claim 1, where the first opening has a maximum transverse dimension of between 20 mm and 30 mm.

51. The method of claim 1, where the second opening has a maximum transverse dimension of between 1 mm and 3 mm.

52. The method of claim 1, where the second opening has a maximum transverse dimension of between 2 mm and 3 mm.

53. The method of claim 1, where the second opening has a maximum transverse dimension of 2.5 mm.

54. The method of claim 1, where the first part of the first device has a maximum external transverse dimension of between 3 mm and 50 mm.

55. The method of claim 1, where the first part of the first device has a maximum external transverse dimension of between 3 mm and 50 mm.

56. The method of claim 1, where the first part of the first device has a maximum external transverse dimension of between 5 mm and 50 mm.

57. The method of claim 1, where the first part of the first device has a maximum external transverse dimension of between 3 mm and 20 mm.

58. The method of claim 1, where the first part of the first device has a maximum external transverse dimension of between 3 mm and 12 mm.

59. The method of claim 1, where the first part of the first device has a maximum external transverse dimension of between 5 mm and 10 mm.

60. The method of claim 1, where the first part of the first device has a maximum external transverse dimension of between 20 mm and 30 mm.

61. The method of claim 1, where the second part of the first device has a maximum external transverse dimension between 0.1 mm and 3 mm.

62. The method of claim 1, where the second part of the first device has a maximum external transverse dimension between 1 mm and 3 mm.

63. The method of claim 1, where the second part of the first device has a maximum external transverse dimension between 2 mm and 3 mm.

64. The method of claim 1, where the second part of the first device has a maximum external transverse dimension of 2.5 mm.

65. The method of claim 1, where the second part of the second device has a maximum external transverse dimension between 0.1 mm and 3 mm.

66. The method of claim 1, where the second part of the second device has a maximum external transverse dimension between 1 mm and 3 mm.

67. The method of claim 1, where the second part of the second device has a maximum external transverse dimension between 2 mm and 3 mm.

68. The method of claim 1, where the second part of the second device has a maximum external transverse dimension of 2.5 mm.

69. The method of claim 5, where the third port has a maximum transverse dimension of between 1 mm and 3 mm.

70. The method of claim 5, where the third port has a maximum transverse dimension of between 2 mm and 3 mm.

71. The method of claim 5, where the third port has a maximum transverse dimension of 2.5 mm.