Rectal manipulation devices

• US 8,734,478 B2
• Filed: 07/13/2011
• Issued: 05/27/2014
• Est. Priority Date: 03/14/2011
• Status: Active Grant

• Current Assignee: Cilag Gmbh International (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Widenhouse, Tamara, Shelton, Frederick E. IV, Yoo, Andrew, Baxter, Chester O. III, Worrell, Barry C., Janszen, James R., Beckman, Andrew T., Vendely, Michael J., Young, Joseph E., Schall, Christopher J.
• Primary Examiner(s): Severson, Ryan
• Assistant Examiner(s): MILES, JONATHAN WADE
• Application Number:
  US13/181,842
• Publication Number:
  US 20120239075A1
• Time in Patent Office: 1,049 Days
• Field of Search: 600/184, 600/201, 600/202, 600/203, 600/204, 600/205, 600/206, 604/104, 604/105, 604/106, 604/109, 606/159, 606/191, 606/197, 606/198
• US Class Current: 606/197
• 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 17/0218 for minimally invasive surgery A61B17/0281, 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 17/068 Surgical staplers , e.g. containing multiple staples or clampsstaplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105; for performing anastomosis A61B17/115; staplers in general B25C5/00
• CPC Class Codes: A61B 17/072 for applying a row of staples in a single action , e.g. the staples being applied simultaneously
• CPC Class Codes: A61B 17/07207 the staples being applied sequentially
• CPC Class Codes: A61B 17/1155 Circular staplers comprising a plurality of staples
• 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 2017/00287 Bags for minimally invasive surgery
• CPC Class Codes: A61B 2017/00353 one mechanical instrument performing multiple functions, e.g. cutting and grasping channel for multiple instruments A61B2017/3445; instrument channel A61B2017/22072; replaceable heads A61B2017/2931; suction A61M1/00
• CPC Class Codes: A61B 2017/00477 Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61B 2017/0225 flexible, e.g. fabrics, meshes, or membranes
• CPC Class Codes: A61B 2017/0287 with elastic retracting members connectable to a frame, e.g. hooked elastic wires
• CPC Class Codes: A61B 2017/07257 characterised by its anvil
• CPC Class Codes: A61B 2560/0443 Modular apparatus
• CPC Class Codes: F04C 2270/0421 Controlled or regulated

Abstract

Tissue manipulation devices are disclosed. In various forms, the devices include tissue manipulation arms that are arranged in a position suitable to enable the device to be inserted into the colon then, upon application of at least one actuation motion thereto, at least some of the tissue manipulation arms are moved to deployed positions wherein they contact corresponding portions of the colon to thereby expand the colon. Various devices are actuatable by various forms of actuation forces. In various embodiments, the tissue manipulation arms may be movable along corresponding axes that are transverse to an insertion axis and may also be rotated about the insertion axis as well as be moved in directions that are substantially parallel to the insertion axis.

Claims

1. A rectal manipulation device, comprising:

a shaft assembly defining an insertion axis, wherein at least a portion of said shaft assembly is configured to be inserted into a patient'"'"'s rectum; and

a plurality of tissue manipulation arms each having a tissue manipulation end, each said tissue manipulation arm operably supported by said shaft assembly, wherein at least some of said tissue manipulation arms are selectively movable from a first insertion position wherein all of said tissue manipulation ends are substantially aligned relative to each other and, upon application of an actuation motion thereto, said at least some of said tissue manipulation arms move to other deployed positions about said insertion axis such that said tissue manipulation ends of said plurality of tissue manipulation arms are not all substantially aligned relative to each other and wherein one of said at least some of said tissue manipulation arms is constrained to move along a corresponding transverse axis that is substantially transverse to said insertion axis from said first insertion position to one of said other deployed positions upon application of said actuation motion thereto and wherein another one of said at least some of said tissue manipulation arms is constrained to move along another corresponding transverse axis that is substantially transverse to said insertion axis and parallel to said corresponding transverse axis from said first insertion position to another one of said other deployed positions upon application of said actuation motion thereto.

2. The rectal manipulation device of claim 1 further comprising an expandable sheath extending over at least some of said plurality of tissue manipulation arms, said expandable sheath configured to retain said at least some of said plurality of tissue manipulation arms in said first insertion position and expand as said at least some of said plurality of tissue manipulation arms are moved to said other deployed positions.

3. The rectal manipulation device of claim 1 wherein, upon application of said actuation motion to said one of said at least some of said tissue manipulation arms, said one of said at least some of said tissue manipulation arms moves to said one of said other deployed positions wherein said tissue manipulation end thereof is located on one lateral side of said insertion axis and, upon application of said actuation motion to said another one of said at least some of said tissue manipulation arms causes said another one of said at least some of said tissue manipulation arms to move to said another said other deployed position wherein said tissue manipulation end thereof is located on another lateral side of said insertion axis.

4. The rectal manipulation device of claim 1 wherein said actuation motion is applied to said at least some of said tissue manipulation arms by a tension member operably engaging a deployment portion thereof such that, upon application of tension to said tension member, said at least some of said tissue manipulation arms are moved to at least some of said other deployed positions.

5. The rectal manipulation device of claim 4 wherein each said deployment portion of said at least some of said tissue manipulation arms is configured to return said at least some of said tissue manipulation arms from said at least some other deployed positions to said insertion position upon removal of said application of tension to said tension member.

6. The rectal manipulation device of claim 1 wherein said plurality of said tissue manipulation arms is equally spaced along a portion of said shaft assembly.

7. The rectal manipulation device of claim 1 wherein said at least some of said tissue manipulation arms that are selectively movable are configured to move axially along said insertion axis upon application of said actuation motion thereto.

8. A rectum manipulation device, comprising:

a shaft assembly defining an insertion axis;

a first tissue manipulation arm movably supported on said shaft assembly and is movable relative thereto along a first axis that is substantially transverse to said insertion axis;

a second tissue manipulation arm movably supported on said shaft assembly and is movable relative thereto along a second axis that is substantially transverse to said insertion axis;

a third tissue manipulation arm movably supported on said shaft assembly and is movable relative thereto along a third axis that is substantially transverse to said insertion axis;

a fourth tissue manipulation arm movably supported on said shaft assembly and is movable relative thereto along a fourth axis that is substantially transverse to said insertion axis; and

an actuation member comprising a tension member operably interfacing with each of said first, second, third, and fourth tissue manipulation arms such that, upon application of an actuation motion to said tension member, said tension member applies deployment motions to said first, second, third and fourth tissue manipulation arms.

9. The rectum manipulation device of claim 8 further comprising

a first biasing member biasing said first tissue manipulation arm to a first insertion position upon discontinuing said application of said deployment motion thereto;

a second biasing member biasing said second tissue manipulation arm to a second insertion position upon discontinuing said application of said deployment motion thereto;

a third biasing member biasing said third tissue manipulation arm to a third insertion position upon discontinuing said application of said deployment motion thereto; and

a fourth biasing member biasing said fourth tissue manipulation arm to a fourth insertion position upon discontinuing said application of said deployment motion thereto.

10. The rectum manipulation device of claim 8 wherein said actuation member is configured to operably engage corresponding portions of each of said first, second, third, and fourth tissue manipulation arms when said actuation motion is applied thereto in a first direction, said actuation member configured to disengage said corresponding portions of each of said first, second, third, and fourth tissue manipulation arms when said actuation motion is applied thereto in a second direction that is opposite to said first direction.

11. A rectal manipulation device, comprising:

a shaft assembly defining an insertion axis, wherein at least a portion of said shaft assembly is configured to be inserted into a patient'"'"'s rectum; and

a plurality of tissue manipulation arms each having a tissue manipulation end, each said tissue manipulation arm operably supported by said shaft assembly, wherein at least some of said tissue manipulation arms are selectively movable from a first insertion position wherein all of said tissue manipulation ends are substantially aligned relative to each other and, upon application of an actuation motion thereto, said at least some of said tissue manipulation arms move to other deployed positions about said insertion axis such that said tissue manipulation ends of said plurality of tissue manipulation arms are not all substantially aligned relative to each other and wherein said actuation motion is applied to said at least some of said tissue manipulation arms by a tension member operably engaging a deployment portion thereof such that, upon application of tension to said tension member, said at least some of said tissue manipulation arms are moved to at least some of said other deployed positions.

12. The rectal manipulation device of claim 11 further comprising an expandable sheath extending over at least some of said plurality of tissue manipulation arms, said expandable sheath configured to retain said at least some of said plurality of tissue manipulation arms in said first insertion position and expand as said at least some of said plurality of tissue manipulation arms are moved to said other deployed positions.

13. The rectal manipulation device of claim 11 wherein, upon application of said actuation motion to one of said at least some of said tissue manipulation arms, said one of said at least some of said tissue manipulation arms moves to one of said other deployed positions wherein said tissue manipulation end thereof is located on one lateral side of said insertion axis and, upon application of said actuation motion to another one of said at least some of said tissue manipulation arms causes said another one of said at least some of said tissue manipulation arms to move to another said other deployed position wherein said tissue manipulation end thereof is located on another lateral side of said insertion axis.

14. The rectal manipulation device of claim 11 wherein one of said at least some of said tissue manipulation arms is constrained to move along a corresponding transverse axis that is substantially transverse to said insertion axis from said first insertion position to one of said other deployed positions upon application of said actuation motion thereto and wherein another one of said at least some of said tissue manipulation arms is constrained to move along another corresponding transverse axis that is substantially transverse to said insertion axis from said first insertion position to another one of said other deployed positions upon application of said actuation motion thereto.

15. The rectal manipulation device of claim 14 wherein said corresponding transverse axis is substantially parallel to said corresponding transverse axis.

16. The rectal manipulation device of claim 11 wherein each deployment portion of said at least some of said tissue manipulation arms is configured to return said at least some of said tissue manipulation arms from said at least some other deployed positions to said insertion position upon removal of said application of tension to said tension member.

17. The rectal manipulation device of claim 11 wherein said plurality of said tissue manipulation arms are equally spaced along a portion of said shaft assembly.

18. A rectal manipulation device, comprising:

a shaft assembly defining an insertion axis, wherein at least a portion of said shaft assembly is configured to be inserted into a patient'"'"'s rectum; and

a plurality of tissue manipulation arms each having a tissue manipulation end, each said tissue manipulation arm operably supported by said shaft assembly, wherein at least some of said tissue manipulation arms are selectively movable from a first insertion position wherein all of said tissue manipulation ends are substantially aligned relative to each other and, upon application of an actuation motion thereto, said at least some of said tissue manipulation arms move to other deployed positions about said insertion axis such that said tissue manipulation ends of said plurality of tissue manipulation arms are not all substantially aligned relative to each other and wherein one of said at least some of said tissue manipulation arms is constrained to move along a corresponding transverse axis that is substantially transverse to said insertion axis from said first insertion position to one of said other deployed positions upon application of said actuation motion thereto and wherein another one of said at least some of said tissue manipulation arms is constrained to move along another corresponding transverse axis that is substantially transverse to said insertion axis and axially spaced from said corresponding transverse axis from said first insertion position to another one of said other deployed positions upon application of said actuation motion thereto.

19. The rectal manipulation device of claim 18 further comprising an expandable sheath extending over at least some of said plurality of tissue manipulation arms, said expandable sheath configured to retain said at least some of said plurality of tissue manipulation arms in said first insertion position and expand as said at least some of said plurality of tissue manipulation arms are moved to said other deployed positions.

20. The rectal manipulation device of claim 18 wherein, upon application of said actuation motion to said one of said at least some of said tissue manipulation arms, said one of said at least some of said tissue manipulation arms moves to one of said other deployed positions wherein said tissue manipulation end thereof is located on one lateral side of said insertion axis and, upon application of said actuation motion to another one of said at least some of said tissue manipulation arms causes said another one of said at least some of said tissue manipulation arms to move to another said other deployed position wherein said tissue manipulation end thereof is located on another lateral side of said insertion axis.

21. The rectal manipulation device of claim 18 wherein said one of said at least some of said tissue manipulation arms is constrained to move along a corresponding transverse axis that is substantially transverse to said insertion axis from said first insertion position to said one of said other deployed positions upon application of said actuation motion thereto and wherein said another one of said at least some of said tissue manipulation arms is constrained to move along another corresponding transverse axis that is substantially transverse to said insertion axis from said first insertion position to said another one of said other deployed positions upon application of said actuation motion thereto.

22. The rectal manipulation device of claim 21 wherein said corresponding transverse axis is substantially parallel to said another corresponding transverse axis.

23. The rectal manipulation device of claim 18 wherein said actuation motion is applied to said at least some of said tissue manipulation arms by a tension member operably engaging a deployment portion thereof such that, upon application of tension to said tension member, said at least some of said tissue manipulation arms are moved to at least some of said other deployed positions.

24. The rectal manipulation device of claim 23 wherein each said deployment portion of said at least some of said tissue manipulation arms is configured to return said at least some of said tissue manipulation arms from said at least some other deployed positions to said insertion position upon removal of said application of tension to said tension member.

25. A rectal manipulation device, comprising:

a shaft assembly defining an insertion axis, wherein at least a portion of said shaft assembly is configured to be inserted into a patient'"'"'s rectum; and

a plurality of tissue manipulation arms each having a tissue manipulation end, each said tissue manipulation arm operably supported by said shaft assembly, wherein at least some of said tissue manipulation arms are selectively movable from a first insertion position wherein all of said tissue manipulation ends are substantially aligned relative to each other and, upon application of an actuation motion thereto, said at least some of said tissue manipulation arms move to other deployed positions about said insertion axis such that said tissue manipulation ends of said plurality of tissue manipulation arms are not all substantially aligned relative to each other and wherein one of said at least some of said tissue manipulation arms is constrained to move along a corresponding transverse plane that is substantially transverse to said insertion axis from said first insertion position to one of said other deployed positions upon application of said actuation motion thereto and wherein another one of said at least some of said tissue manipulation arms is constrained to move along another corresponding transverse plane that is substantially transverse to said insertion axis and parallel to said corresponding transverse plane from said first insertion position to another one of said other deployed positions upon application of said actuation motion thereto.

26. The rectal manipulation device of claim 25 further comprising an expandable sheath extending over at least some of said plurality of tissue manipulation arms, said expandable sheath configured to retain said at least some of said plurality of tissue manipulation arms in said first insertion position and expand as said at least some of said plurality of tissue manipulation arms are moved to said other deployed positions.

27. The rectal manipulation device of claim 25 wherein, upon application of said actuation motion to said one of said at least some of said tissue manipulation arms, said one of said at least some of said tissue manipulation arms moves to one of said other deployed positions wherein said tissue manipulation end thereof is located on one lateral side of said insertion axis and, upon application of said actuation motion to said another one of said at least some of said tissue manipulation arms causes said another one of said at least some of said tissue manipulation arms to move to another said other deployed position wherein said tissue manipulation end thereof is located on another lateral side of said insertion axis.

28. The rectal manipulation device of claim 25 wherein said actuation motion is applied to said at least some of said tissue manipulation arms by a tension member operably engaging a deployment portion thereof such that, upon application of tension to said tension member, said at least some of said tissue manipulation arms are moved to at least some of said other deployed positions.