Clear view cannula
There is disclosed a clear view cannula for use in surgical procedures having a tubular body, a cylindrical sleeve mounted about and slidably secured to the tubular body, and a plurality of shield members secured to the cylindrical sleeve. The cylindrical sleeve is slidably movable relative to the tubular body causing the shield members to expand and deploy such that the shield members retain torn and fragmented soft tissue within an anatomical cavity. Means are provided on the tubular body to co-act with means on the cylindrical sleeve to lock the expanded and deployed shield members and secure the tubular body within an anatomical body.
This invention relates to a clear view cannula for use in surgical procedures. More particularly, this invention relates to a clear view cannula that permits an operator to insert the cannula through a body wall into an anatomical cavity, maintain the cannula in its inserted position, and introduce an auxiliary surgical instrument into the anatomical cavity through the cannula without visual or mechanical obstruction within the body wall.
BACKGROUND OF THE INVENTIONThe use of surgical instruments such as cannulas to introduce an auxiliary surgical instrument into a body such as a joint, abdominal cavity, or the like is well known and widely used. A typical procedure can include making a small incision in the desired portion of the body wall, inserting a cannula into and through the incision and introducing an auxiliary surgical instrument through the cannula into the body to perform a further procedure.
In order to be thoroughly effective and minimize trauma to a patient, it is desirable in such procedures that the cannula be capable of being anchored or secured and not slip out of the anatomical cavity thereby preventing its reinsertion and that fragmented or torn soft tissue not have to be removed from the area surrounding the insertion point of the cannula in order to ensure that the auxiliary instrument can be used without visual or mechanical obstruction.
Several attempts have been proposed to overcome these problems and deficiencies. For example, U.S. Pat. No. 5,217,451 to Freitas discloses a trocar assembly having first and second cylindrical members secured to one another at the distal end of the assembly and a sleeve portion having a series of radially extending flexible members. This device has many small parts and is operable through the use of an interacting gear mechanism. Since the radially extending members, when fully deployed, form an acute angle substantially less than 90 degrees with respect to the longitudinal axis of the cylindrical members, they are not capable of effectively retaining or retracting torn or fragmented soft tissue within a body cavity; that is, the spaces between the fully deployed members permit torn or fragmented soft tissue to visually and mechanically obstruct the use of an instrument such as a camera that is typically introduced through a cannula prior to performing a surgical procedure.
U.S. Pat. No. 5,632,761 to Smith, et.al. discloses a device used to dissect and retract layers of tissue while a portion of the device is retained in a patient. The device utilizes two balloons, the first of which is inserted between layers of tissue and inflated to dissect the tissue layers after which the balloon is deflated. The second balloon is then positioned between the tissue layers and inflated to retract the tissue layers. The device includes a tube coaxially mounted to a delivery portion. The tube has a contracting portion and is provided with a number of deformable, longitudinally exterding segments. This device also has many small moving parts and, due to the spherical shape of the second balloon, is not capable of fully retracting torn or fragmented soft tissue. Consequently, the device would have to be inserted deeper into a patient in order to be fully effective.
U.S. Pat. No. 5,637,097 to Yoon discloses an instrument used to penetrate an anatomical cavity having a fixed or retractable penetrating member, the distal end of which is used for penetration, and a portal sleeve having an expandable portion fixed relative to the penetrating member. This instrument, as with the devices described above, comprises many components and functions primarily to anchor the instrument within an anatomical cavity. The anchoring component is not designed to effectively retract or retain torn or fragmented soft tissue within the anatomical cavity.
These illustrative devices typically comprise many parts requiring costly and time consuming assembly. Since they are of relatively complex construction, subsequent cleaning and sterilization would also be costly and time consuming. In addition, these devices are not designed to effectively retract and retain torn or fragmented tissue within an anatomical cavity while, at the same time, anchoring the device within the cavity so that only a minimal portion of the device is retained in the cavity. Due to their complex structures, these devices are cumbersome to handle and manipulate by an operator. Furthermore, these illustrative devices are typically designed to function within a relatively large body cavity such as the abdomen where maneuverability is relatively unrestricted.
SUMMARY OF THE INVENTIONIt has now been found that the shortcomings of such prior art devices are overcome by the clear view cannula of this invention. In general, the clear view cannula of the invention comprises: a tubular body having a proximate end and a distal end; a plurality of closely spaced teeth members formed on the outer surface and extending parallel to the longitudinal axis of said tubular body intermediate its proximate and distal ends; a cylindrical sleeve having a proximate end and a distal end concentrically mounted about and slidably secured to said tubular body; means at the proximate end of said cylindrical sleeve to engage said teeth members; and, a plurality of spaced apart shield members circumferentially disposed about and longitudinally co-extensive with said tubular body secured to the distal end of said cylindrical sleeve such that when said cylindrical sleeve is slidably urged along said tubular body toward the distal end of said tubular body, said shield members are caused to expand and deploy enabling said shield members to retract and retain torn or fragmented soft tissue within an anatomical cavity and anchor said clear view cannula within an anatomical cavity with a minimum of penetration of said clear view cannula into an anatomical cavity.
The means to secure the cylindrical sleeve to the teeth members as the cylindrical sleeve is slidably moved along the tubular body is readily provided by a detent depending from a raised shoulder at the proximate end of the cylindrical sleeve.
The shield members at the distal end of the cylindrical sleeve and are manufactured so as to be capable of being flexed intermediate their ends enabling them to be fully deployed and expanded within an anatomical cavity.
In one embodiment, the shield members are provided with an expandable web member so that when the shield members are fully deployed, the expandable web member fills the spaces between them thereby further assuring that any torn or fragmented tissue is completely retracted and retained within the body of a cavity.
Although the clear view cannula of the invention can readily be used in large body cavities such as the abdomen, it is particularly useful in smaller cavities such as joints; i.e., knees, shoulders, elbows, ankles, and the like. During arthroscopic surgery of a joint, the joint is typically inflated with water as opposed to a gas which is typically used in abdominal surgical procedures as the surgical procedures performed within a joint are significantly different from those performed within an abdominal cavity.
For example, the inside of a joint such as the knee is lined with a layer of a friable tissue called the synovium which is about ½ cm. thick. In patients about to undergo arthroscopic surgery, the synovial tissue is often inflamed and is also frequently torn and fragmented. In addition, there is present in the anterior portion of the knee joint a patella fat pad (or blob of fat tissue) which generally measures about 3×5 cm. square. Thus, inflamed and/or torn and fragmented synovial tissue and the patella fat pad in the knee joint serve to restrict and impede visualization of the joint cavity by the surgeon. However, this restricted vision is completely overcome when using the clear view cannula of the invention.
BRIEF DESCRIPTION OF THE DRAWINGThe clear view cannula of the invention will become more apparent from the ensuing description when considered together with the accompanying drawing wherein:
Turning now to the drawing wherein like reference numerals and letters identify like parts, there is shown in
A cylindrical sleeve 15 is concentrically mounted about and slidably secured to the cannula body 11 in a close fitting relationship. The cylindrical sleeve 15 extends from adjacent the proximate end 12 of cannula body 11 toward the distal end 13 of cannula body 11 a distance of from about ½ to about ¾ the length of the cannula body 11. Cylindrical sleeve 15 is provided with a raised shoulder 16 at its proximate end and a plurality of spaced apart shield members 17 secured to its distal end. The shield members 17, shown partially deployed in
As can be best seen in
The proximate end 12 of cannula body 11 is provided with a handle 21 which can be in any geometrical form that will enable a user to readily grasp the handle 21 with the fingers one hand and concurrently manipulate the cylindrical sleeve 15 toward and away from the distal end 13 of the cannula body 11 with another finger of the same hand. For example, the geometric form of handle 21 can be oblong, spherical, round, square or rectangular as such forms will readily enable a user to comfortably and easily grasp the handle 21 and manipulate the cylindrical sleeve 15 with the fingers of one hand while retaining complete control of the cannula 10.
A pair valve members 22 and 22a (
To further prevent leakage or seepage of fluid from a body cavity, a gasket such as a rubber or latex O-ring 24 is seated between the outer circumferential surface of cannula body 11 and the inner circumferential surface of cylindrical sleeve 15 intermediate the proximate end 12 and the distal end 13 of cannula 10 as shown in
As illustrated in
After the cannula body 11 has been inserted through the body wall 26 as shown in
As the operator withdraws the cannula body 11 outwardly, the shield members 17 are maintained in their partially expanded and deployed condition by annular detent 16a firmly and securely engaging the perpendicular face 19 of a tooth member 18.
Urging of the cylindrical sleeve 15 to slide along the cannula body 11 is facilitated by the sloping rear portions 20 of the teeth members 18.
Typically, an operator will continue to slidably urge the cylindrical sleeve 15 along the annular body 11 and withdraw the cannula body 11 through the body wall 26 in this manner until the shield members 17 are fully expanded and deployed retaining the torn and fragmented tissue 27 against the inner surface of the body wall 26 with only a small portion of the distal end 13 of the cannula body 11 retained and locked in place within the body wall 26 as illustrated in
In
Since the flexible members 30 (
By contrast, the structure and operation of the clear view cannula of the invention permits its shield members 17 to be deployed at an angle that is substantially coincidental to 90 degrees with respect to the longitudinal axis of the cannula body as is illustrated in
The materials used to fabricate the clear view cannula of the invention are not critical provided they are suitable for use in surgical procedures. For ease of fabrication, assembly and use, all components of the clear view cannula of the invention; i.e., the cannula body 11 carrying teeth members 18, cylindrical sleeve 15 with annular collar 16 and detent 16a, and shield members 17 are preferably fabricated from well known and commercially available plastic materials that are suitable for use in surgical procedures.
Although the clear view cannula of the invention has been described in detail and with particularity, it will be appreciated by those skilled in this art that changes and modifications can be made therein without departing from the scope and spirit of the invention.
Claims
1-13. (Canceled)
14. A method using a clear view cannula in anthroscopic surgery comprising the steps of:
- a. Providing a clear view cannula suitable for providing visibility within a joint cavity of a patient, the clear view cannula having a tubular body and a cylindical sleeve defining a longitudinal axis, the clear view cannula defining a through hole aligned with the longitudinal axis and having shield members configured for expanding substantially perpendicular to the longitudinal axis of the cannula while creating only a minimal penetration into a body of a patient, the clear view cannula including a single piece handle and a shoulder being adapted for use by one hand of a surgeon, the complete control of the clear view cannula being done by the one hand of the surgeon, the tubular body including and the shoulder being configured to engage the teeth and lock the cylindrical sleeve in position relative to the tubular body;
- b. making an arthroscopic penetration of a body wall of a patient using a distal end of the clear view cannula in a first position and positioning the shield members inside a body wall of the patient;
- c. moving the cylindrical sleeve distally relative to the tubular body using finger pressure of the one hand of the surgeon to expand the shield members from the first position aligned with the longitudinal axis of the clear view cannula to the second position wherein the shield members are approximately perpendicular to the longitudinal axis of the clear view cannula, positioning the proximal side of the shield members against the inside of the body wall, the clear view cannula being configured to minimized the distance of penetration of the distal end of the cannula into the patient in the second position, the shield members being configured for securing the torn or fragmented tissue associated with the arthroscopic penetration against the inner surface of the body wall, using the clear view cannula to visualize a joint cavity of the patient; and
- d. returning the clear view cannula to the first position by repositioning the shoulder of the cylindrical sleeve proximally relative to the tubular body so as to return the shield members to the first position using only the one hand of the surgeon, withdrawing the clear view cannula from the body of the patient.
15. The method of claim 14, wherein the step of making a penetration includes using the clear view cannula for the initial penetrating of the body on a joint of a patient.
16. The method of claim 14, wherein the step of making a penetration includes inserting the clear view cannula in an incision.
17. The method of claim 15, wherein the step of making a penetration includes using a trocar positioned in the through hole of the clear view cannula to penetrate the tissue of a patient.
18. The method of claim 14, wherein the step of moving further includes the surgeon applying a proximally directed pull on the handle relative to the cylindrical sleeve to move the shield members from the first position to the second position.
19. The method of claim 14, wherein the step of moving further includes a surgeon applying finger pressure on the shoulder relative to the tubular body to move the shield members from the first position to the second position.
20. The method of claim 14, wherein the step of moving further includes positioning a camera through the clear view cannula, the camera being adapted to visualize a joint cavity of the patient, the shield members in the second position being configured to improve the internal visibility of the camera through the arthroscopic portal by retracting and retaining the torn or fragmented tissue associated with the arthroscopic portal against the inner surface of the body wall.
Type: Application
Filed: Jul 25, 2003
Publication Date: Apr 7, 2005
Inventor: Thomas Lyon (Bronx, NY)
Application Number: 10/627,315