Finger mounting for surgical instruments particularly useful in open and endoscopic surgery
A finger mounting for a surgical instrument includes a sleeve dimensioned to be received on the outer end of a finger of a user. The sleeve has an open proximal end for application to the outer end of the user's finger, an open distal end for exposing the outer tip of the user's finger when mounted thereon, and an inner diameter which decreases from the proximal end to the distal end for facilitating the application of the sleeve to the user's finger. The sleeve is formed of an elastic material and with a longitudinal split along its length to permit its diameter to be increased in order to accommodate fingers of different thicknesses. The longitudinal split is defined by two opposed edges having interengaging ribs and recesses of a length in the circumferential direction to accommodate a wide range of finger thicknesses without pinching The sleeve is also integrally formed at one side with a socket for receiving a surgical instrument, such as retractor or probe having a shank received within the socket, or a pair of forceps having one arm received in the socket.
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The present invention relates to finger-mountings for surgical instruments for use in both open and endoscopic surgery. The invention also relates to such finger-mountable surgical instruments.
In an open surgery procedure, an incision is made through the skin, and the tissues overlying the surgical site are retracted in order to expose an area large enough to allow for access and orientation by direct vision. The surgeon may use a wide range of instruments to perform the specific procedure, and may also use the surgeon's fingers to touch organs and receive tactile feedback. However, fingers lack the delicacy to pick up fine tissue; they require making larger divisions when dissecting tissues; and they are subject to injury when holding tissue if sharp instruments or energy modalities, such as ultrasound or RF, are used in the treatment at the surgical site.
In recent years, more and more procedures are being performed endoscopically. Endoscopy is a minimal invasive surgical procedure in which illumination, cameras and surgical tools are inserted into the patient's body via small incisions through the skin, and are manipulated externally, guided by the image displayed on a TV monitor. For the patient, trauma is minimized, and healing time and length of stay in hospital are shortened. Particularly, laparoscopy—endoscopy in the abdominal cavity—is being widely used both for diagnosis and for performing full surgical procedures.
However, several difficulties are inherent in this technique. Thus, considerable skill and experience are required to position the instruments spatially relative to internal organs while viewed in a two-dimensional monitor. Also, the field of vision displayable on the monitor is narrow making orientation even more difficult. In addition, it is hard to control the instruments because of their length, which is typically about 350 mm from the handles outside the body to the tip that actually performs the operations within the body cavity; this length is needed to reach the organs within the abdomen when the cavity is insufflated as required by the technique. Moreover, direct contact between the organs and the surgeon's hand is not possible, so that tactile feedback is lost.
Recently, a modified laparoscopic technique has evolved which is referred to as Hand-Assisted Laparoscopic Surgery (HALS), in which one hand of the surgeon has access to the body cavity while maintaining insufflation. This technique, as described for example in U.S. Pat. No. 5,640,977 to Patrick Leahy et al, is now an alternative procedure of choice. As only a relatively small additional incision is required, just sufficient for admitting the surgeon's hand, the advantages of minimal invasiveness are preserved. For the surgeon, less training is required because the presence of his/her hand in the body cavity allows palpation of internal organs, biophysical feedback, and easier manipulation of various instruments within the body cavity while viewing the TV monitor.
With the advancement of the HALS technique, a need arose for instruments which could be mounted directly onto the fingers of the hand within the body cavity, i.e, the “ported” hand. Miniature forceps, graspers, scissors, dissectors, probes, retractors, etc., modeled on existing instruments used in open surgery and mounted on the surgeon's finger, could perform delicate surgical tasks and aid the laparoscopic instruments introduced through the “keyhole” incisions. Obviously it would be advantageous to provide such instruments for use in open procedures as well as in “keyhole” procedures.
Several such instruments were suggested in U.S. Pat. No. 5,925,065 to Meyers et al, and US Application 20040193211 to Voegele et al. However, all the instruments described therein must be fixed to the finger outside of the body. Therefore, in HALS procedures the hand must be withdrawn through the port for changing instruments, which limits the advantages possible by this procedure.
OBJECT AND BRIEF SUMMARY OF THE PRESENT INVENTIONAn object of the present invention is to provide a finger mounting for a surgical instrument which enables the surgical instrument to be mounted on the surgeon's finger by other fingers in the same hand to carry the surgical instrument, thereby eliminating the need for withdrawing the hand from the body cavity for purposes of mounting or changing surgical instruments. Another object of the invention is to provide such finger-mountable surgical instruments.
According to a broad aspect of the present invention, there is provided a finger mounting for surgical instruments, comprising: a sleeve dimensioned to be received on the outer end of a finger of a user; the sleeve having an open proximal end for application to the outer end of the user's finger, an open distal end for exposing the outer tip of the user's finger when mounted thereon, and an inner diameter which decreases from the proximal end to the distal end for facilitating the application of the sleeve to the user's finger; the sleeve being formed of an elastic material and with a longitudinal split along its length to permit its diameter to be increased in order to accommodate fingers of different thicknesses.
According to further features in the described preferred embodiments, the longitudinal split is defined by two opposed edges having interengaging ribs and recesses of a length in the circumferential direction to accommodate a wide range of finger thicknesses without pinching. Such inter-engaging ribs and recesses not only assure firm gripping of the (gloved) fingers around the complete circumference of the sleeve, but also facilitate the manipulation of the instrument onto the user's finger without pinching the user's finger. In addition, the inner surface of the sleeve is formed with circumferentially-extending ribs to firmly grip the user's finger when the sleeve is applied thereto. In the described embodiments, the sleeve is made of an elastic plastic material.
According to further features in the described preferred embodiments, the sleeve is integrally formed at one side with a socket for receiving a surgical instrument. Various types of surgical instrument are described for purposes of example, including retractors, probes, and forceps.
According to another aspect of the present invention, there is provided a finger-mountable surgical instrument, comprising: a sleeve dimensioned to be received on the outer end of a finger of a user; and a pair of arms integrally formed at one side of the sleeve which arms are displaceable towards and away from each other to closed and open positions, respectively, for grasping and releasing objects.
According to yet another aspect of the present invention, there is provided a finger-mountable surgical instrument comprising: a sleeve dimensioned to be received in the outer end of a finger of a user, the sleeve being formed at one side with a socket; and a surgical instrument received in the socket.
As will be described more particularly below, the invention enables one or more finger-mountable surgical instruments to be enclosed within the surgeon's fist and introduced with the surgeon's fist through the port into the body cavity in the above-described HALS procedures. The instruments, when so introduced into the patient's body, can be easily applied to and removed from the finger of the ported hand of the surgeon by merely manipulating the fingers of the ported hand, as will be described below.
An additional advantage of the described preferred embodiments is that the finger-mountable sleeves, and also the instruments affixed thereto, can be produced in volume and at low cost, thereby permitting one-time use.
Further features and advantages of the invention will be apparent from the description below.
The invention is herein described, by way of example only, with reference to the accompanying drawings, wherein:
It is to be understood that the foregoing drawings, and the description below, are provided primarily for purposes of facilitating understanding the conceptual aspects of the invention and possible embodiments thereof, including what is presently considered to be a preferred embodiment. In the interest of clarity and brevity, no attempt is made to provide more details than necessary to enable one skilled in the art, using routine skill and design, to understand and practice the described invention. It is to be further understood that the embodiments described are for purposes of example only, and that the invention is capable of being embodied in other forms and applications than described herein.
DESCRIPTION OF PREFERRED EMBODIMENTSThe finger-mountable surgical instrument illustrated in
As further seen in
As further shown in
Sleeve 20 illustrated in
As shown in
Another modification illustrated in
Thus, the construction illustrated in
All the components of the finger-mountable instruments described above can be made of a suitable biocompatible material according to conventional techniques, such as machining, forming, molding, riveting, etc.
While the invention has been described with respect to several preferred embodiments, it will be appreciated that these are set forth merely for purposes of example, and that many other variations, modifications and applications of the invention may be made.
Claims
1. A finger mounting for a surgical instrument, comprising:
- a sleeve dimensioned to be received on the outer end of a finger of a user;
- said sleeve having an open proximal end for application to the outer end of the user's finger, an open distal end for exposing the outer tip of the user's finger when mounted thereon, and an inner diameter which decreases from said proximal end to said distal end for facilitating the application of the sleeve to the user's finger;
- said sleeve being formed of an elastic material and with a longitudinal split along its length to permit its diameter to be increased in order to accommodate fingers of different thicknesses.
2. The finger mounting according to claim 1, wherein said longitudinal split is defined by two opposed edges having interengaging ribs and recesses of a length in the circumferential direction to accommodate a wide range of fingers thicknesses without pinching.
3. The finger mounting according to claim 1, wherein the inner surface of said sleeve is formed with circumferentially-extending ribs to firmly grip the user's finger when the sleeve is applied thereto.
4. The finger mounting according to claim 1, wherein said sleeve is made of an elastic plastic material.
5. The finger mounting according to claim 1, wherein said sleeve is integrally formed at one side with a socket for receiving a surgical instrument.
6. The finger mounting according to claim 5, wherein said socket includes a retainer element engageable with a retainer element on the surgical instrument for releasably retaining the surgical instrument within said socket.
7. The finger mounting according to claim 6, wherein one of said retainer elements is a projection releasably engageable with an elastic tongue constituting the other retainer element.
8. The finger mounting according to claim 5, wherein said sleeve in integrally formed at one side also with a pair of arms displaceable towards and away from each other to closed and open positions, respectively, for grasping and releasing objects.
9. The finger mounting according to claim 8, wherein said pair of arms are spring-urged to a closed position but are manually displaceable to an open position.
10. The finger mounting according to claim 9, further comprising a cam element located between the pair of arms and manually depressible to cam the two arms apart to their open positions.
11. The finger mounting according to claim 1, wherein said sleeve is further formed with a hole therethrough for the attachment of a suture strand.
12. A finger-mountable surgical instrument, including a finger mounting in accordance with claim 5, and a surgical instrument received in said socket formed in one side of said sleeve.
13. The finger-mountable surgical instrument according to claim 12, wherein said surgical instrument is a retractor having a shank received in said socket.
14. The finger-mountable surgical instrument according to claim 12, wherein said surgical instrument is a probe having a shank received in said socket.
15. The finger-mountable surgical instrument according to claim 12, wherein said surgical instrument is a forceps having pair of arms, one of said arms being received in said socket, and the other of said arms being spaced away from said one arm but manually displaceable towards said one arm to a closed position with respect thereto for grasping an object.
16. A finger-mountable surgical instrument, comprising:
- a sleeve dimensioned to be received on the outer end of a finger of a user;
- and a pair of arms integrally formed at one side of said sleeve which arms are displaceable towards and away from each other to closed and open positions, respectively, for grasping and releasing objects.
17. A finger-mountable surgical instrument according to claim 16, wherein said pair of arms are spring-urged to a closed position, but are manually displaceable to an open position by a cam element located between said pair of arms and is manually depressible to cam the two arms apart to their open positions.
18. A finger-mountable surgical instrument, comprising:
- a sleeve dimensioned to be received in the outer end of a finger of a user, said sleeve being formed at one side with a socket;
- and a surgical instrument received in said socket.
19. The finger-mountable surgical instrument according to claim 18, wherein said surgical instrument is a retractor or probe having a shank received within said socket.
20. The finger-mountable surgical instrument according to claim 18, wherein said surgical instrument is a forceps having a pair of arms, one of which is received in said socket, and the other of which is manually displaceable to closed and open positions with respect to said one arm for grasping and releasing objects.
Type: Application
Filed: Mar 30, 2007
Publication Date: Oct 2, 2008
Applicant: T.A.G. Medical Products a Limited Partnership (Doar-Na Oshrat)
Inventors: Ran Oren (Kibbutz Gaaton), Eran Zakai (Moshav Yodfat), Dan Moor (Kibbutz Gaaton)
Application Number: 11/729,939