Tissue manipulation devices

• US 8,858,590 B2
• Filed: 07/13/2011
• Issued: 10/14/2014
• 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: Shelton, Frederick E. IV, Knight, Gary W.
• Primary Examiner(s): MILES, JONATHAN WADE
• Application Number:
  US13/181,831
• Publication Number:
  US 20120239082A1
• Time in Patent Office: 1,189 Days
• Field of Search: 128/897, 128/898, 606/1, 606/108, 606/110, 606/113, 606/114, 606/127, 606/128, 606/185, 606/205, 606/206, 606/207, 606/208, 606/130, 600/37, 600/106, 600/146, 600/147, 600/184, 600/197, 600/214, 600/226, 604/95.04, 604/164.01, 604/164.02, 604/164.03, 604/164.04, 604/523, 604/528
• US Class Current: 606/206
• 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 and retraction devices. In various forms, the manipulation devices include a cannula that is insertable through the abdominal wall. A plurality of independently controllable manipulation members extend through the cannula and are attachable to various forms of surgical tools. The surgical tools may be manipulated and controlled by a surgeon from a position outside of the patient.

Claims

1. A tissue manipulation device, comprising:

a hollow cannula having a distal end and a proximal end;

a plurality of manipulation members, each said manipulation member having a manipulation distal end;

an adjustment assembly coupled to said proximal end of said hollow cannula and operably interfacing with each of said plurality of manipulation members to selectively apply separate actuation motions to each of said plurality of manipulation members, wherein each of said plurality of manipulation members is moveable independently from others of said plurality of manipulation members in response to said separate actuation motions, wherein each of said plurality of manipulation members is extendable beyond said distal end of said hollow cannula;

at least one surgical tool removably coupled to at least one of said plurality of manipulation members, wherein each said surgical tool is at least initially configured to pass through said cannula, wherein said adjustment assembly is operably supported on a body coupled to said proximal end of said hollow cannula and wherein said adjustment assembly comprises;

a plurality of actuator members operably supported on said body, wherein each of said actuator members comprises a rotatable wheel, wherein each of said rotatable wheels operably interfaces with a corresponding one of said plurality of manipulation members; and

locking means interfacing with said plurality of actuator members for selectively locking said actuator members in unactuatable positions.

2. The tissue manipulation device of claim 1 wherein each of said plurality of manipulation members comprises a substantially ductile manipulation cable.

3. The tissue manipulation device of claim 1 further comprising a locking assembly interfacing with said adjustment assembly to selectively prevent actuation of said adjustment assembly.

4. The tissue manipulation device of claim 1 further comprising a removable sheath supported on said distal end of said hollow cannula and configured to pierce through tissue, wherein said removable sheath is removably couplable to said hollow cannula.

5. The tissue manipulation device of claim 1 wherein at least one of said plurality of manipulation members has a distal end configured to be removably attached to said surgical tool.

6. The tissue manipulation device of claim 5 wherein said at least one said manipulation member comprises a manipulation cable having an attachment member on said distal end thereof and wherein said surgical tool comprises a pair of movable jaws selectively movable between an open position and a closed position.

7. The tissue manipulation device of claim 6 wherein said pair of movable jaws further comprises:

a first jaw;

a second jaw;

a biasing member interacting with said first and second jaws to bias said first and second jaws to said open position; and

an attachment portion movably supporting said first and second jaws and configured to interact with said attachment member such that upon application of an actuation motion thereto by said attachment member, said first and second jaws move toward each other.

8. The tissue manipulation device of claim 7 wherein said application of said actuation motion comprises applying a tension force to a portion of said manipulation cable.

9. The tissue manipulation device of claim 8 wherein said first and second jaws apply a closure force to tissue received therebetween during said application of said tension force to said manipulation cable and wherein said attachment portion is configured such that said closure force increases as said tension force increases.

10. The tissue manipulation device of claim 5 wherein said surgical tool comprises a flexible tissue-retaining net structure.

11. A tissue manipulation device, comprising:

a hollow cannula having a distal end and a proximal end;

a plurality of manipulation members, each said manipulation member having a manipulation distal end;

an adjustment assembly coupled to said proximal end of said hollow cannula and operably interfacing with each of said plurality of manipulation members to selectively apply separate actuation motions thereto; and

at least one surgical tool removably coupled to at least one of said plurality of manipulation members, wherein each said surgical tool is at least initially configured to pass through said cannula, wherein said adjustment assembly is operably supported on a body coupled to said proximal end of said hollow cannula, wherein said adjustment assembly comprises;

a plurality of actuator members operably supported on said body, wherein each of said actuator members comprises a rotatable wheel, wherein each of said rotatable wheels operably interfaces with a corresponding one of said plurality of manipulation members; and

locking means interfacing with said plurality of actuator members for selectively locking said actuator members in unactuatable positions, wherein each of said plurality of manipulation members comprises a manipulation cable and wherein each of said rotatable wheels is configured to selectively windup and pay out said corresponding manipulation cable attached thereto, and wherein said locking means comprises a movable locking switch associated with each said rotatable wheel for selectively immobilizing said rotatable wheel independently from other of said rotatable wheels.

12. A tissue manipulation device, comprising:

a hollow cannula having a distal end and a proximal end;

a plurality of manipulation members, each said manipulation member having a manipulation distal end;

an adjustment assembly coupled to said proximal end of said hollow cannula and operably interfacing with each of said plurality of manipulation members to selectively apply separate actuation motions thereto; and

at least one surgical tool removably coupled to at least one of said plurality of manipulation members, wherein each said surgical tool is at least initially configured to pass through said cannula, wherein at least one of said plurality of manipulation members has a distal end configured to be removably attached to the at least one surgical tool, wherein said at least one said manipulation member comprises a manipulation cable having an attachment member on said distal end thereof and wherein said surgical tool comprises a pair of movable jaws selectively movable between an open position and a closed position, wherein said movable jaws are each configurable from a rolled up orientation to a substantially planar orientation.

13. The tissue manipulation device of claim 12 further comprising a selectively rupturable member extending around at least a portion of said movable jaws to temporarily retain said movable jaws in said rolled up orientation.

14. A tissue manipulation device comprising:

a body portion;

a hollow cannula coupled to said body portion and having a distal end configured to puncture tissue;

a first manipulation cable extending through said hollow cannula, said first manipulation cable coupled to a first rotatable disc assembly operably supported by said body portion such that by rotating said first rotatable disc assembly in a first deployment direction, a first portion of said first manipulation cable is deployed in a first distal direction relative to said distal end of said hollow cannula and by rotating said first rotatable disc assembly in a first actuation direction, said first portion of said first manipulation cable is moved in a first proximal direction relative to said distal end of said cannula;

a first releasable lock member interfacing with said first rotatable disc assembly to selectively prevent rotation of said first rotatable disc assembly;

a second manipulation cable extending through said hollow cannula, said second manipulation cable coupled to a second rotatable disc assembly operably supported by said body portion such that by rotating said second rotatable disc assembly in a second deployment direction, a second portion of said second manipulation cable is moved in a second distal direction relative to said distal end of said hollow cannula and by rotating said second rotatable disc assembly in a second actuation direction, said second portion of said second manipulation cable is moved in a second proximal direction toward said distal end of said cannula;

a second releasable lock member interfacing with said second rotatable disc assembly to selectively prevent rotation of said second rotatable disc assembly;

a third manipulation cable extending through said hollow cannula, said third manipulation cable coupled to a third rotatable disc assembly operably supported by said body portion such that by rotating said third rotatable disc assembly in a third deployment direction, a third portion of said third manipulation cable is moved in a third distal direction relative to said distal end of said hollow cannula and by rotating said third rotatable disc assembly in a third actuation direction, said third portion of said third manipulation cable is moved in a third proximal direction toward said distal end of said cannula;

a third releasable lock member interfacing with said third rotatable disc assembly to selectively prevent rotation of said third rotatable disc assembly; and

at least one surgical tool removably couplable to a distal end of at least one of said first, second and third manipulation cables, said at least one surgical tool selected from a group of surgical tools comprising;

a grasping device; and

a substantially flexible tissue-retaining net.

15. The tissue manipulation device of claim 14 wherein at least a portion of at least one of said first, second and third manipulation cables is substantially ductile.

16. The tissue manipulation device of claim 14 wherein said grasping device comprises:

a first jaw;

a second jaw;

a biasing member interacting with said first and second jaws to bias said first and second jaws to an open position; and

an attachment portion movably supporting said first and second jaws and configured to interact with said one of said first, second and third manipulation cables such that upon application of an actuation motion thereto, said first and second jaws move toward each other.

17. The tissue manipulation device of claim 15 wherein said application of said actuation motion comprises applying a tension force to said one of said first, second and third manipulation cables attached to said attachment portion.

18. The tissue manipulation device of claim 17 wherein said first and second jaws apply a closure force to tissue received therebetween during said application of said tension force to said one of said first, second and third manipulation cables and wherein said attachment portion is configured such that said closure force increases as said tension force increases.