U.S. patent application number 15/993357 was filed with the patent office on 2018-12-06 for scope with integral cleaning element for use during a laparoscopic procedure.
The applicant listed for this patent is CareFusion 2200, Inc.. Invention is credited to Jeanny Chung, Jesse Charles Darley, Christopher Alan Harris, Patrick Hubbard, Curtis B. Irwin, Stephen A. Latham, Daniel J. Lee, Joseph Prybell, Douglas Rodenkirch, Joanna L. Rosenbaum, Jeffrey R. Staszak, Corrie Threlkeld, Sara Tillman, Brandon Toth, Andrew P. VanDeWeghe, Thomas Wilschke.
Application Number | 20180344141 15/993357 |
Document ID | / |
Family ID | 62683482 |
Filed Date | 2018-12-06 |
United States Patent
Application |
20180344141 |
Kind Code |
A1 |
Rosenbaum; Joanna L. ; et
al. |
December 6, 2018 |
SCOPE WITH INTEGRAL CLEANING ELEMENT FOR USE DURING A LAPAROSCOPIC
PROCEDURE
Abstract
A scope includes a housing having a distal portion with a distal
end. A lens is at the distal end. A cleaning element is operatively
coupled to the distal portion of the housing, wherein the cleaning
element is movable between a first position and a second position
contacting the distal end.
Inventors: |
Rosenbaum; Joanna L.;
(Evanston, IL) ; Chung; Jeanny; (Deerfield,
IL) ; Hubbard; Patrick; (Vernon Hills, IL) ;
Prybell; Joseph; (Mundelein, IL) ; Threlkeld;
Corrie; (Vernon Hills, IL) ; Tillman; Sara;
(Vernon Hills, IL) ; Toth; Brandon; (Vernon Hills,
IL) ; VanDeWeghe; Andrew P.; (Grayslake, IL) ;
Wilschke; Thomas; (Chicago, IL) ; Darley; Jesse
Charles; (Madison, WI) ; Harris; Christopher
Alan; (Madison, WI) ; Irwin; Curtis B.;
(Madison, WI) ; Latham; Stephen A.; (Sun Prairie,
WI) ; Lee; Daniel J.; (Princeton Junction, NJ)
; Rodenkirch; Douglas; (Sun Prairie, WI) ;
Staszak; Jeffrey R.; (Deerfield, WI) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
CareFusion 2200, Inc. |
San Diego |
CA |
US |
|
|
Family ID: |
62683482 |
Appl. No.: |
15/993357 |
Filed: |
May 30, 2018 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
62513270 |
May 31, 2017 |
|
|
|
62513278 |
May 31, 2017 |
|
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 1/00089 20130101;
A61B 17/3474 20130101; A61B 17/3415 20130101; A61B 1/3132 20130101;
A61B 1/126 20130101; A61B 17/34 20130101; A61B 17/3423 20130101;
A61B 1/00091 20130101; A61B 1/00154 20130101; A61B 2017/3437
20130101; A61B 17/0218 20130101; A61B 1/00135 20130101; A61B
17/3421 20130101; A61B 2090/701 20160201; A61B 90/70 20160201; A61B
2017/00907 20130101; A61B 1/00096 20130101 |
International
Class: |
A61B 1/12 20060101
A61B001/12; A61B 1/00 20060101 A61B001/00; A61B 1/313 20060101
A61B001/313; A61B 17/34 20060101 A61B017/34 |
Claims
1. A scope, comprising: a housing having a distal portion with a
distal end; a lens at the distal end; and a cleaning element
operatively coupled to the distal portion of the housing, wherein
the cleaning element is movable between a first position and a
second position contacting the distal end.
2. The scope of claim 1, wherein the cleaning element is slidably
coupled to a side wall of the housing at the distal portion, and as
the cleaning element is moved toward the first position, the
cleaning element is configured to move across the lens.
3. The scope of claim 2, wherein the cleaning element is made of a
shape memory material.
4. The scope of claim 1, wherein the cleaning element further
comprises: a cover rotatably coupled to the distal portion of the
housing at the distal end, the cover extending over the lens; and a
band extending laterally across the cover, wherein the band is
configured to remain in contact with the cover as the cover
revolves between the first position and the second position.
5. The scope of claim 4, wherein the band has a first end coupled
to the distal portion at a first point and a second end opposite
the first end coupled to the distal portion at a second point
laterally opposing the first point.
6. The scope of claim 1, wherein the cleaning element comprises a
band extending laterally across the lens, the band having a first
segment with a cleaning surface configured to contact the lens as
the lens is rotatable with respect to the housing.
7. The scope of claim 6, wherein the band is movable from the
second position to the first position to allow the lens to move
distally with respect to the distal end of the housing.
8. The scope of claim 6, wherein the band is configured to advance
in a lateral direction such that a second segment adjacent the
first segment contacts the lens.
9. The scope of claim 1, wherein the cleaning element further
comprises: an insert configured to be removably positioned within
an access channel at a distal portion of a trocar assembly, the
insert forming a central opening for receiving the scope and
comprising a first slit formed through a width of the insert on a
first lateral side of the central opening and a second slit formed
through the width of the insert on a second lateral side of the
central opening opposite the first lateral side; and a film movably
positioned within the first slit and the second slit, the film
extending through the first slit in a distal direction, across the
central opening, and through the second slit in a proximal
direction, the film having a first segment including a cleaning
surface configured to contact the lens.
10. The scope of claim 9, wherein the film further comprises a
second segment adjacent the first segment, the second segment
forming an opening aligned with the central opening to allow the
lens to extend through the central opening and the opening.
11. The scope of claim 10, wherein the film is movable to position
one of the first segment and the second segment over the central
opening.
12. The scope of claim 9, wherein the film further comprises a
transparent second segment adjacent the first segment.
13. The scope of claim 1, wherein the cleaning element comprises a
film operatively coupled to the housing at the distal end, wherein
the film extends between a first lateral side of the housing and an
opposing second lateral side of the housing and contacts the lens
with the cleaning element in the second position, and, with the
cleaning element in the first position, the film is configured in a
retracted state on the first lateral side of the housing.
14. The scope of claim 1, wherein the cleaning element comprises an
expandable pad positioned within an opening formed by the housing,
with the cleaning element in the second position, the expandable
pad occludes the opening, the expandable pad including a central
opening formed through the expandable pad, the expandable pad
moveable in a radially outward direction with the lens extending
into the central opening.
15. The scope of claim 1, wherein the cleaning element comprises: a
handle at a proximal portion of the scope; an arm coupled to the
handle and extending along a length of scope between the proximal
portion and the distal portion; and a plurality of blades rotatably
coupled to the arm at the distal end of the scope, the plurality of
blades configured to contact the lens during rotation of the
plurality of blades with respect to the arm.
16. The scope of claim 1, further comprising a shield coupled to
the distal portion of the scope, the shield extending distally with
respect to the distal end of the scope.
17. The scope of claim 16, wherein the shield comprises a
retractable cone, wherein in the first position the shield expands
radially outward from the distal end and in the second position the
shield covers the lens.
18. The scope of claim 1, wherein the cleaning element further
comprises a dispenser configured to express a fluid through an
annular space defined between the housing and the lens.
19. A trocar assembly, comprising: a cannula having a proximal
portion and an opposing distal portion, the distal portion
configured to extend into a patient body, the cannula defining an
access channel between the proximal portion and the distal portion;
a scope movably positioned within the access channel, wherein the
scope can be maneuvered through the access channel to a location
within the patient body; and a cleaning element operatively coupled
to a distal portion of the scope, wherein the cleaning element is
configured to contact at least a lens of the scope.
20. A method for cleaning a distal end of a scope, said method
comprising: coupling a cleaning element at a distal portion of the
scope, the distal portion configured to extend into a patient body
to a location within the patient body; and cleaning at least a
distal end of the scope with the cleaning element by moving the
cleaning element with respect to the distal end of the scope.
Description
RELATED APPLICATIONS
[0001] This application claims the benefit of U.S. Provisional
Application No. 62/513,270, filed May 31, 2017, and U.S.
Provisional Application No. 62/513,278, filed May 31, 2017, each of
which is herein incorporated by reference in its entirety. Further,
each of the following applications, filed on Mar. 7, 2017, is
herein incorporated by reference in its entirety: U.S. patent
application Ser. No. 15/452,169, U.S. patent application Ser. No.
15/452,211, and U.S. patent application Ser. No. 15/452,246.
FIELD OF TECHNOLOGY
[0002] The present disclosure relates generally to scopes, such as
laparoscopes, trocar assemblies, and related devices, and more
specifically, to scopes for use with trocar assemblies, for
example, which can be utilized in laparoscopic medical
procedures.
BACKGROUND
[0003] Laparoscopic surgery is a minimally-invasive surgical
technique typically performed with the assistance of one or more
medical instruments inserted through a small incision in a
patient's body. Laparoscopic surgery is often preferred to
traditional and more invasive surgical procedures because of the
reduced frequency and degree of certain postoperative side effects,
such as postoperative pain, swelling, internal bleeding, and
infection risk. The minimally-invasive nature of laparoscopic
procedures may also result in decreased recovery times and shorter
hospital stays.
[0004] Typical medical devices utilized during laparoscopic
procedures have instruments mounted on an elongated metal or
plastic body that are inserted into the patient's body and
maneuvered to a target area within a body cavity (e.g., the
abdominal, pelvic, thoracic, or chest cavity, where insufflation
may be used to provide additional space in which to maneuver, which
requires a fluid-patient barrier to maintain insufflation pressure
in the cavity). One or more trocar assemblies are typically first
inserted into the patient body at an incision site (for each), and
the instruments access the patient body through the trocar
assembly(ies).
[0005] Often, a medical device including a camera or other
image-transmitting device is inserted through a trocar to transmit
one or more images or a live video feed from within the body cavity
to a medical professional (such as the surgeon). The device may be
referred to as a scope or a laparoscope, and its transmission may
guide the medical professional's actions during the laparoscopic
procedure.
[0006] A problem typically experienced during laparoscopic procures
involves a compromised image or video feed due to an obstructed
lens of the laparoscope. This obstruction may be caused by
condensation (e.g., fog) and/or debris such as bodily fluids or
displaced tissue encountered by the lens during the procedure. Such
obstruction is problematic because the lens of the laparoscope
preferably remains contained in a pressurized and sterile
environment (e.g., insufflated body cavity), and removing the lens
from that environment for cleaning purposes may cause lengthy
interruptions prolonging patient anesthesia and increasing a risk
of compromised sterility.
SUMMARY
[0007] In one aspect, a scope includes a housing having a distal
portion with a distal end. A lens is at the distal end. A cleaning
element is operatively coupled to the distal portion of the
housing, wherein the cleaning element is movable between a first
position and a second position contacting the distal end.
[0008] In another aspect, a trocar assembly includes a cannula
having a proximal portion and an opposing distal portion. The
distal portion is configured to extend into a patient body. The
cannula defines an access channel between the proximal portion and
the distal portion. A scope is movably positioned within the access
channel. The scope can be maneuvered through the access channel to
a location within the patient body. A cleaning element is
operatively coupled to a distal portion of the scope. The cleaning
element is configured to contact at least a lens of the scope.
[0009] In yet another aspect, a method for cleaning a distal end of
a scope includes coupling a cleaning element at a distal portion of
the scope. The distal portion is configured to extend into a
patient body to a location within the patient body. At least a
distal end of the scope is cleaned with the cleaning element by
moving the cleaning element with respect to the distal end of the
scope.
BRIEF DESCRIPTION OF THE DRAWINGS
[0010] FIG. 1 is a perspective view of a distal portion of an
example scope for use during a laparoscopic procedure, the example
scope having a cleaning element in a first position, in accordance
with certain example embodiments;
[0011] FIG. 2 is a perspective view of the distal portion of the
example scope shown in FIG. 1 with the cleaning element in a second
position;
[0012] FIG. 3 is a perspective view of a distal portion of an
example scope for use during a laparoscopic procedure before
cleaning of the distal portion with an integrated cleaning element,
in accordance with certain example embodiments;
[0013] FIG. 4 is a perspective view of the distal portion of the
example scope shown in FIG. 3 as the cleaning element moves across
a cover to clean the cover;
[0014] FIG. 5 is a perspective view of the distal portion of the
example scope shown in FIG. 3 after cleaning of the distal portion
with the integrated cleaning element;
[0015] FIG. 6 is a perspective view of a distal end of the example
scope during cleaning of the distal portion with the integrated
cleaning element;
[0016] FIG. 7 is a perspective view of a distal portion of an
example scope for use during a laparoscopic procedure, the example
scope including a band extending laterally across the distal
portion with the cleaning element in a second position, in
accordance with certain example embodiments;
[0017] FIG. 8 is a sectional view of a portion of the distal
portion of the example scope shown in FIG. 7 with the band
contacting an outer surface of the lens;
[0018] FIG. 9 is a perspective view of the distal portion of the
example scope shown in FIG. 7 with the cleaning element in a first
position after cleaning of the distal portion with the integrated
band;
[0019] FIG. 10 is a perspective view of a distal end of the example
scope including a band extending laterally across the distal
portion as the band is advanced;
[0020] FIG. 11 is a perspective view of a distal portion of an
example scope for use during a laparoscopic procedure, the example
scope including a band extending laterally across the distal
portion with the cleaning element in a second position, in
accordance with certain example embodiments;
[0021] FIG. 12 is a perspective view of a portion of the distal
portion of the example scope shown in FIG. 11 with the cleaning
element in a first position after cleaning of the distal portion
with the integrated band;
[0022] FIG. 13 is a sectional view of the distal portion of the
example scope including a band extending laterally across the
distal portion as the band is advanced;
[0023] FIG. 14 is a perspective view of a distal portion of an
example scope for use during a laparoscopic procedure, the example
scope including a cleaning element having an insert with a film
extending laterally across the distal portion with the cleaning
element in a second position, in accordance with certain example
embodiments;
[0024] FIG. 15 is a plan view of a distal end of the example scope
shown in FIG. 14;
[0025] FIG. 16 is a perspective view of a film suitable for use
with the cleaning element;
[0026] FIG. 17 is a perspective view of the distal portion of the
example scope shown in FIG. 14 with the cleaning element in a first
position;
[0027] FIG. 18 is a perspective view of a distal portion of an
example scope for use during a laparoscopic procedure, the example
scope including a cleaning element having a film extending
laterally across the distal portion with the cleaning element, in
accordance with certain example embodiments;
[0028] FIG. 19 is a perspective view of a film suitable for use
with the cleaning element;
[0029] FIG. 20 is a sectional view of the distal portion of the
example scope shown in FIG. 18;
[0030] FIG. 21 is a perspective view of a distal portion of an
example scope for use during a laparoscopic procedure, the example
scope including a cleaning element having a film extending
laterally across the distal portion with the cleaning element in a
second position, in accordance with certain example
embodiments;
[0031] FIG. 22 is a sectional view of a distal portion of an
example scope with a cleaning element in a second position, in
accordance with certain example embodiments;
[0032] FIG. 23 is a sectional view of the distal portion of the
example scope shown in FIG. 22 as the cleaning element moves from
the second position to a first position;
[0033] FIG. 24 is a sectional view of the distal portion of the
example scope shown in FIG. 22 as the cleaning element moves from
the second position to the first position;
[0034] FIG. 25 is a sectional view of the distal portion of the
example scope shown in FIG. 22 with the cleaning element in the
first position;
[0035] FIG. 26 is a perspective view of a distal portion of an
example scope for use during a laparoscopic procedure, the example
scope including an integral cleaning element, in accordance with
certain example embodiments;
[0036] FIG. 27 is a plan view of a distal portion of an example
scope for use during a laparoscopic procedure, the example scope
including a shield in a second position, in accordance with certain
example embodiments;
[0037] FIG. 28 is a sectional view of the distal portion of the
example scope shown in FIG. 27 with the shield in a first
position;
[0038] FIG. 29 is a perspective view of the distal portion of the
example scope shown in FIG. 27 with the shield in the first
position; and
[0039] FIG. 30 is a perspective view of a distal portion of an
example scope for use during a laparoscopic procedure, in
accordance with certain example embodiments.
DETAILED DESCRIPTION
[0040] Various embodiments are described below with reference to
the drawings in which like elements generally are referred to by
like numerals. The relationship and functioning of the various
elements of the embodiments may better be understood by reference
to the following detailed description. However, embodiments are not
limited to those illustrated in the drawings. It should be
understood that the drawings may or may not be to scale, and in
certain instances details may have been omitted that are not
necessary for an understanding of embodiments disclosed herein,
such as--for example--conventional fabrication and assembly.
[0041] The invention is defined by the claims, may be embodied in
many different forms, and should not be construed as limited to the
embodiments set forth herein; rather, these embodiments are
provided so that this disclosure will be thorough and complete, and
will fully convey enabling disclosure to those skilled in the art.
As used in this specification and the claims, the singular forms
"a," "an," and "the" include plural referents unless the context
clearly dictates otherwise. Reference herein to any industry and/or
governmental standards (e.g., ASTM, ANSI, IEEE, HIPAA, FDA
standards) is defined as complying with the currently published
standards as of the original filing date of this disclosure
concerning the units, measurements, and testing criteria
communicated by those standards unless expressly otherwise defined
herein.
[0042] The terms "proximal" and "distal" are used herein in the
common usage sense where they refer respectively to a
handle/doctor-end of a device or related object and a
tool/patient-end of a device or related object. The terms "about,"
"substantially," "generally," and other terms of degree, when used
with reference to any volume, dimension, proportion, or other
quantitative or qualitative value, are intended to communicate a
definite and identifiable value within the standard parameters that
would be understood by one of skill in the art (equivalent to a
medical device engineer with experience in this field), and should
be interpreted to include at least any legal equivalents, minor but
functionally-insignificant variants, standard manufacturing
tolerances, and including at least mathematically significant
figures (although not required to be as broad as the largest range
thereof).
[0043] In example embodiments, such as described herein, a trocar
assembly includes a proximal portion. A cannula extends between the
proximal portion and a distal portion of the trocar assembly
opposite the proximal portion. The distal portion of the trocar
assembly is configured to extend into a patient body. The cannula
defines or forms an access channel between a first or proximal
opening at the proximal portion and a second or distal opening at
the distal portion. The access channel is configured to receive a
scope, e.g., a laparoscope, such that the scope can be maneuvered
through the access channel to extend distally from the distal
portion of the trocar assembly at a location within the patient
body. The scope includes an integral cleaning element positioned at
or coupled to a distal portion of the scope. The cleaning element
is configured to contact at least a distal end of the scope, e.g.,
with the cleaning element in a second position, to periodically
clean at least the distal end of the scope, e.g., a lens of an
imaging device at the distal end of the scope, to remove
condensation (e.g., fog) and/or debris, such as bodily fluids or
displaced tissue, from the lens during the procedure. In certain
example embodiments, the cleaning element is configured to clean an
entire distally facing surface of the lens, e.g., by temporarily
occluding an opening at or near a distal end of the housing. With
the cleaning element contacting the distally facing surface of the
lens a complete cleaning of the entire lens surface can be
accomplished.
[0044] In example embodiments, the cleaning element is movable
between a first position allowing the scope to freely move in a
proximal direction and/or a distal direction within the access
channel and a second or cleaning position. In the second position,
the cleaning element contacts at least the distal portion of the
scope to clean desired portions of the scope, e.g., the lens. In
certain example embodiments, the cleaning element includes a
plurality of members, e.g., a plurality of brushes, bristles,
fibers, fingers, leaflets, wipers, pads, projections, or any
combination thereof such that the plurality of members contact the
scope. The members may be formed of a compliant or flexible
material such that each member is movable upon contacting the
scope, e.g., to allow the scope to move through a housing of the
scope without undesirable contact with or interference from the
members, while providing sufficient resilience to facilitate
cleaning the distal end of the scope, e.g., the lens.
[0045] Referring to FIGS. 1-30, a scope 40, such as a laparoscope
or another suitable scope, includes an imaging device, e.g., a lens
42, operatively coupled to an external device for processing data
and generating images of a location within the patient body. Lens
42 is configured to generate data signals representative of images
at the location within the patient body and transmit the data
signals to the external device. In example embodiments, scope 40 is
configured to be received within a trocar assembly. More
specifically, scope 40 is movably positionable within an access
channel formed in a cannula of the trocar assembly. The cannula has
a proximal portion and an opposing distal portion. The distal
portion of the cannula is configured to extend into a patient body
to assist with performing minimally-invasive surgical procedures
including, for example, laparoscopic surgical procedures. The inner
wall of the cannula forms or defines at least a portion of the
access channel, which extends between a first or proximal opening
at the proximal portion of the cannula and an opposing second or
distal opening at the distal portion of the cannula. The access
channel is configured to receive scope 40 such that scope 40 can be
maneuvered through the access channel to a location within the
patient body.
[0046] Referring further to FIGS. 1 and 2, scope 40 includes a
cylindrical housing 44 having a proximal portion (not shown in
FIGS. 1 and 2) and an opposing distal portion 46 with a distal end
48. In example embodiments, lens 42 is located at distal end 48
and, in certain embodiments, at least partially set in housing 44.
An integrated cleaning element 50 is operatively coupled to distal
portion 46 of housing 44. In certain example embodiments, cleaning
element 50 is movable between a first position and a second
position contacting at least a portion of distal portion 46, e.g.,
lens 42, to remove condensation and/or debris, such as bodily
fluids or displaced tissue, from distal portion 46, e.g., lens 42,
during a procedure. FIG. 1 shows distal portion 46 of scope 40 with
cleaning element 50 in a first position and FIG. 2 shows distal
portion 46 of scope 40 with cleaning element 50 in a second
position. In the first position, cleaning element 50 allows lens 42
to capture images of the location in the patient body and, in
certain embodiments, extend distally from distal end 48 of housing
44 at the location.
[0047] As shown in FIGS. 1 and 2, in this embodiment, cleaning
element 50 is slidably coupled to a side wall 52 of housing 44 at
distal portion 46. In a particular embodiment, cleaning element 50
is slidably positioned within a slot 54 formed in an outer surface
56 of housing 44. Cleaning element 50 is movable between a first
position, as shown in FIG. 1, toward a second position, as shown in
FIG. 2, substantially contacting an outer surface of lens 42. As
cleaning element 50 is moved between the first position and the
second position, cleaning element 50 is configured to contact and
move across lens 42. Cleaning element 50 is made of or includes a
suitable cleaning material to facilitate cleaning lens 42 to remove
condensation and/or debris, such as bodily fluids or displaced
tissue, from lens 42 and/or other portions of scope 40. Because
cleaning element 50 is made of a suitable compliant, flexible or
bendable material, such as a suitable shape memory material,
cleaning element 50 follows a contour of slot 54 and housing 44 as
cleaning element 50 moves between the first position and the second
position.
[0048] Referring now to FIGS. 3-6, in another example embodiment,
scope 40 includes cleaning element 50 having a cover 60 that is
rotatably coupled to distal portion 46 of housing 44 at or near
distal end 48. FIG. 3 shows distal portion 46 of scope 40 before
cover 60 is cleaned using cleaning element 50. FIG. 4 shows distal
portion 46 of scope 40 as cleaning element 50 moves across cover 60
to clean cover 60. FIG. 5 shows distal portion 46 of scope 40 after
cover 60 is cleaned using cleaning element 50. FIG. 6 shows distal
end 48 of scope 40 as cover 60 is cleaned using cleaning element
50. In this embodiment, cover 60 is configured to substantially
extend over or enclose lens 42. In a particular embodiment, cover
60 has a dome shape as shown in FIGS. 3-6. A band 62 extends
laterally across cover 60. In example embodiments, band 62 has a
first end 64 coupled to distal portion 46 at a first point 66 and a
second end 68 opposite first end 64 coupled to distal portion 46 at
a second point 70 laterally opposing first point 66, as shown in
FIG. 6, for example. Band 62 is configured to remain in contact
with cover 60 as cover 60 rotates or revolves between the first
position and the second position. As cover 60 moves with respect to
band 62, band 62 contacts cover 60 with sufficient frictional force
to remove condensation and/or debris from cover 60, as shown in
FIGS. 3-5.
[0049] Referring now to FIGS. 7-13, in example embodiments,
cleaning element 50 of scope 40 includes a band 72 extending
laterally across lens 42. In these example embodiments, band 72 has
a first segment 74 (extending laterally across lens 42) with a
suitable cleaning surface configured to contact lens 42. Scope 40,
e.g., lens 42, is rotatable with respect to housing 44 such that
first segment 74 contacts lens 42 with sufficient frictional force
to remove condensation and/or debris from lens 42. Scope 40 or lens
42 can be rotated manually by the user, mechanically, or
electronically. FIG. 7 is a perspective view of distal portion 46
of scope 40 including band 72 extending laterally across distal
portion 46 with cleaning element 50 in a second position. FIG. 8 is
a sectional view of a portion of distal portion 46 shown in FIG. 7
with band 72 contacting an outer surface of lens 42. Once lens 42
is cleaned using band 72, cleaning element 50, e.g., band 72, is
movable to a first position to allow lens 42 to move distally with
respect to distal end 48 of housing 44, e.g., to extend distally
from housing 44. As shown in FIG. 9, band 72 is movable to a first
position after cleaning of lens 42 with band 72. Further, after
first segment 74 of band 72 is used to clean lens 42, band 72 is
advanced through housing 44 such that a sterile second segment 76
adjacent used first segment 74 of band 72 is positioned to contact
lens 42 with cleaning element 50 in the second position, as shown
in FIG. 10.
[0050] Referring further to FIG. 10, in example embodiments,
housing 44 includes a first passage 78 on a first lateral side of
housing 44 configured to accommodate band 72. During advancement,
band 72 is fed through first passage 78, laterally across lens 42,
and into a second passage 80 on a second lateral side of housing 44
opposite the first lateral side of housing 44. As band 72 is
advanced in a lateral direction, used first segment 74 enters
second passage 80 as sterile second segment 76 exits first passage
78 to extend over an opening 82 formed by housing 44 in which lens
42 is positioned.
[0051] Similarly, in an example embodiment shown in FIGS. 11-13,
cleaning element 50 includes a band 84 extending laterally across
lens 42. In this example embodiment, band 84 is made of a different
material and/or has different dimensions, e.g., diameter or
circumference, from band 72 shown in FIGS. 7-10, while operating
similarly to band 72. For example, band 84 may include a plurality
of outwardly-extending fibers 85. FIG. 11 is a perspective view of
distal portion 46 of scope 40 including band 84 extending laterally
across distal portion 46 with cleaning element 50 in a second
position. Once lens 42 is cleaned using band 84, cleaning element
50, e.g., band 84, is movable to a first position to allow lens 42
to extend distally from housing 44. FIG. 12 shows distal portion 46
of scope 40 with band 84 in the first position after cleaning lens
42 with band 84. Further, after a first segment 86 of band 84 is
used to clean lens 42, band 84 is advanced through housing 44 such
that a sterile second segment 88 adjacent used first segment 86 of
band 84 is positioned to contact lens 42 with cleaning element 50
in the second position, as shown in FIG. 13.
[0052] In another example embodiment as shown in FIGS. 14-17,
cleaning element 50 of scope 40 includes an insert 90 configured to
be removably positioned within an access channel 92 at a distal
portion of a trocar assembly 94. Insert 90 forms a central opening
96 for receiving scope 40, allowing scope 40 to move through
central opening 96. Insert 90 includes a first passage, such as a
first slit 98, formed through a width of insert 90 (along a
longitudinal direction of scope 40) on a first lateral side 100 of
central opening 96 and a second passage, such as a second slit 102,
formed through the width of insert 90 on a second lateral side 104
of central opening 96 opposite first lateral side 100. A film 106
is movably positioned within first slit 98 and second slit 102. In
example embodiments, film 106 extends through first slit 98 in a
distal direction, across central opening 96, and through second
slit 102 in a proximal direction. Film 106 has a first segment 108,
such as a cleaning pad, sponge, or other suitable material,
including a cleaning surface 110 configured to contact lens 42, as
shown in FIGS. 14 and 15. With cleaning element 50 in a second
position, first segment 108 is positioned over central opening 96
such that cleaning surface 110 contacts lens 42. Lens 42 is
rotatable with respect to housing 44 such that cleaning surface 110
contacts lens 42 with sufficient frictional force to remove
condensation and/or debris from lens 42.
[0053] Film 106 also includes a second segment 112 adjacent first
segment 108. Second segment 112 forms an opening 114 that is
aligned with central opening 96 with cleaning element 50 in a first
position to allow lens 42 to extend through central opening 96 and
co-axially aligned opening 114, as show in FIG. 17, such that lens
42 extends distally from distal end 48 of housing 44. In this
embodiment, after first segment 108 of film 106 is used to clean
lens 42, film 106 is advanced through housing 44 such that second
segment 112 adjacent first segment 108 is positioned over central
opening 96 with opening 114 co-axially aligned with central opening
96. As described above, housing 44 includes first slit 98 formed
through a width of insert 90 on first lateral side 100 of central
opening 96 and second slit 102 formed through a width of insert 90
on second lateral side 104 of central opening 96 configured to
accommodate film 106. During advancement, film 106 is fed through
first slit 98, laterally across central opening 96, and into second
slit 102. As film 106 is advanced in a lateral direction, used
first segment 108 enters second slit 102 as second segment 112
exits first slit 98 to extend over central opening 96 in which lens
42 is positioned.
[0054] Referring to FIGS. 18-20, in another example embodiment,
cleaning element 50 of scope 40 includes a first passage, such as a
first slit 116, formed through housing 44 on a first lateral side
118 of lens 42 and a second passage, such as a second slit 120,
formed through housing 44 on a second lateral side 122 of lens 42
opposite first lateral side 118. A film 124 is movably positioned
within first slit 116 and second slit 120. In example embodiments,
film 124 extends through first slit 116 in a distal direction,
across lens 42, and through second slit 120 in a proximal
direction. Film 124 has a first segment 126, such as a cleaning
pad, sponge, or other suitable material, including a cleaning
surface 128 configured to contact lens 42. With cleaning element 50
in a second position, first segment 126 is positioned over lens 42
such that cleaning surface 128 contacts lens 42. Lens 42 is
rotatable with respect to housing 44 such that cleaning surface 128
contacts lens 42 with sufficient frictional force to remove
condensation and/or debris from lens 42.
[0055] Film 124 also includes a transparent second segment 130
adjacent first segment 126. Second segment 130 is positioned over
lens 42 with cleaning element 50 in a first position. In this
embodiment, after first segment 126 of film 124 is used to clean
lens 42, film 124 is advanced through housing 44 such that second
segment 130 adjacent first segment 126 is positioned over lens 42.
As described above, housing 44 includes first slit 116 formed
through housing 44 on first lateral side 118 of lens 42 and second
slit 120 formed through housing 44 on second lateral side 122 of
lens 42 configured to accommodate film 124. During advancement,
film 124 is fed through first slit 116, laterally across lens 42,
and into second slit 120. As film 124 is advanced in a lateral
direction, used first segment 126 enters second slit 120 as second
segment 130 exits first slit 116 to extend over lens 42.
[0056] In an example embodiment as shown in FIG. 21, cleaning
element 50 includes a film 132 operatively coupled to housing 44 at
distal end 48. Film 132 extends between a first lateral side 134 of
housing 44 and an opposing second lateral side 136 of housing 44
and contacts lens 42 with cleaning element 50 in a second position.
With cleaning element 50 in a first position, film 132 is
configured in a retracted state (not shown in FIG. 21) on first
lateral side 134 or second lateral side 136 of housing 44 to allow
lens 42 to move distally with respect to distal end 48 of housing
44. In this embodiment, film 132 is operatively coupled to housing
44 at distal end 46.
[0057] Referring now to FIGS. 22-25, in example embodiments, scope
40 includes cleaning element 50 having an expandable pad 140
initially positioned within an opening 142 formed by housing 44 to
at least partially occlude opening 142 with cleaning element 50 in
a second position. Expandable pad 140 is displaceable by scope 42.
FIG. 22 shows distal portion 46 of scope 40 with expandable pad 140
positioned in opening 142 and cleaning element 50 in the second
position. FIGS. 23 and 24 show distal portion 46 of scope 40 shown
in FIG. 22 as cleaning element 50 moves from the second position to
a first position. FIG. 25 shows distal portion 46 of scope 40 with
expandable pad 140 displaced by scope 42 and cleaning element 50 in
a first position, allowing scope 42 to move through opening 142 to
extend distally with respect to housing 44. Expandable pad 140 has
a suitable cleaning surface configured to contact scope 40 to
facilitate cleaning lens 42.
[0058] A central opening 144, e.g., a slit, is formed through
expandable pad 140 such that when lens 42 contacts expandable pad
140 with sufficient force, lens 42 passes through central opening
144 to extend distally from housing 44 as shown in FIG. 25. As lens
42 passes through central opening 144, expandable pad 140 removes
condensation and/or debris from lens 42. Expandable pad 140 is
moveable in a radially outward direction with lens 42 extending
into central opening 144. In this embodiment, expandable pad 140 is
made of a suitable resilient material such that expandable pad 140
returns to an initial position substantially covering opening 142
when scope 40 is retracted proximally into housing 44 and cleaning
element 50 is in the second position.
[0059] Referring to FIG. 26, in another example embodiment,
cleaning element 50 of scope 40 includes a handle 150 at a proximal
portion 152 of scope 40. An arm 154 is coupled to handle 150 and
extends along a length of scope 40 between proximal portion 152 and
distal portion 46 of scope 40. One or more blades 156, e.g., a
plurality of blades 156, are rotatably coupled to arm 154 at distal
end 46 of scope 40. Blades 156 are configured to rotate about a
longitudinal axis 158 of arm 154 parallel to a longitudinal axis of
scope 40. As blades 156 rotate about longitudinal axis 158 with
respect to arm 154, each blade 156 contacts lens 42 to remove
condensation and/or debris from lens 42.
[0060] As shown in FIGS. 27-29, in another example embodiment,
cleaning element 50 of scope 40 includes a protective shield 160
coupled to distal portion 46 of scope 40. Shield 160 extends
distally with respect to distal end 48 of scope 40. In a particular
embodiment, shield 160 includes a retractable cone 162. With
cleaning element 50 in a first position, shield 160 expands
radially outward from distal end 48 so as to not obstruct the field
of view of lens 42 while preventing or limiting an amount of
condensation and/or debris forming on lens 42 during the procedure.
With cleaning element 50 in a second position, shield 160 is
retractable to cover or enclose lens 42. FIG. 27 shows distal
portion 46 of scope 40 including shield 160 in the second position,
while FIGS. 28 and 29 show distal portion 46 of scope 40 with
shield 160 in the first position.
[0061] In another example embodiment as shown in FIG. 30, cleaning
element 50 of scope 40 includes a dispenser 164 configured to
express a fluid, e.g., a gas or a liquid such as a saline solution,
through an annular space 166 defined between housing 44 and lens
42.
[0062] In example embodiment as described herein, a trocar assembly
includes a cannula having a proximal portion and an opposing distal
portion. The distal portion of the cannula is configured to extend
into a patient body. The cannula defines an access channel between
the proximal portion and the distal portion, wherein the access
channel is configured to receive a scope such that the scope can be
maneuvered through the access channel to a location within the
patient body. The scope is movably positioned within the access
channel. A cleaning element operatively coupled to a distal portion
of the scope, e.g., integrally coupled to the distal portion of the
scope, is configured to contact at least a lens of the scope to
remove condensation and/or debris from the lens and/or other
portions of the scope during the procedure.
[0063] In example embodiments as described herein, a method for
cleaning a distal end of a scope, e.g., a lens of the scope,
includes coupling a cleaning element at a distal portion of the
scope. The distal portion is configured to extend into a patient
body to a location within the patient body. At least a distal end
of the scope, e.g., the lens, is cleaned with the cleaning element
by moving the cleaning element with respect to the distal end of
the scope.
[0064] In example embodiments, cleaning element 50 includes one or
more surfaces configured to contact the distal end of scope 40 with
cleaning element 50 in a second position. Further, in certain
embodiments, cleaning element 50 is movable between a first
position and a second position via contact of cleaning element 50
with scope 40 or lens 42. In certain example embodiments, cleaning
element 50 may include one or more members, e.g., a plurality of
members, configured to clean lens 42 upon contact with lens 42.
Suitable members include, without limitation, one or more, e.g., a
plurality of, brushes, bristles, fibers, fingers, leaflets, wipers,
bands, pads, projections, or any combination thereof. In certain
example embodiments, each member is made or formed of a suitable
flexible or compliant material to allow each member to move upon
contacting scope 42 to allow scope 42 to freely move with respect
to housing 44 as controlled by the user, e.g., the surgeon. While
each member may be flexible or compliant, each member has
sufficient resilience or rigidity to properly clean lens 42 as well
as other portions of scope 10.
[0065] As described herein, example trocar assemblies for use
during a laparoscopic procedure include a cannula having a distal
end for placement into a patient body during the laparoscopic
procedure. The distal end of the cannula may include a beveled or
sharpened end to facilitate entry of the cannula into the patient
body. An obturator may additionally or alternatively be included.
The cannula may include certain surface characteristics, such as
threads or ridges, to enhance the stability of the trocar assembly
when inserted into a body incision.
[0066] The cannula may include or may be in fluid communication
with a chamber defined by a proximal portion of the trocar
assembly. The chamber may have a proximal opening configured to
receive medical devices used during laparoscopic surgery,
including, without limitation, graspers, dissectors, needles,
scissors, clamps, electrodes, forceps, a camera, and/or a
laparoscope (a "scope"). A valve may be located in the proximal
opening and may form a seal or fluid barrier between the chamber
and an external environment (e.g., the ambient room environment).
Alternatively or in addition, the valve may be located in another
location (such as at a distal opening of the cannula). It may be
advantageous for at least one valve to be located at a the proximal
opening such that a lens of a scope does not have to pass through
the valve prior to cleaning, thereby reducing or eliminating the
chance of materials from the valve dirtying the scope's lens after
cleaning.
[0067] The chamber may be subjected to a continuous sterile and
pressurized environment that extends through the cannula and to the
body cavity (herein referred to as the "internal environment" even
though the continuous region may extend external of the patient
body wall, e.g., within the trocar assembly). This may be
advantageous if maintaining insufflation of the body cavity is
desired during all operation--including cleaning--of a
trans-trocar-located scope or other device. Further, the controlled
environment of the chamber may reduce fogging of a scope by
eliminating or reducing temperature changes and/or changes in
humidity.
[0068] The valve (which may include more than one valve) may
include a particular structure that allows certain medical devices
to pass through the proximal opening and into the chamber while
maintaining the seal or fluid barrier. For example, the valve may
include a duckbill seal, an annular seal structure, or both, but
other suitable structures may additionally or alternatively be
included. The valve may be formed with a compliant material such
that it expands or contracts as necessary for compatibility with
scopes of different sizes. For example, on the Shore Hardness
Scale, the valve may be formed of a material with a hardness
between about Shore A 20 to about Shore A 80, such as from about
Shore A 30 to about Shore A 60.
[0069] An insufflation inlet may communicate with the chamber and
may be configured to control the pressure and other characteristics
(e.g., temperature, composition of the atmosphere), which may be
advantageous for providing precise control of insufflation of a
body cavity during the laparoscopic procedure. The insufflation
inlet may include an insufflation valve, and may be in fluid
communication with a pump or other suitable pressure source.
Advantageously, the flow of gasses or other contents received into
the chamber through the insufflation inlet may be introduced in a
manner such that the effect of the flow across cleaning element is
reduced or eliminated. For example, when the cleaning element
(which is described in detail above) is wetted with a cleaning
fluid, concerns of increased evaporation due to fluid flow over the
cleaning element may be alleviated.
[0070] The trocar assembly may provide an entry or point of access
into the body for a scope. In non-limiting embodiments, the scope
may include a commercially-available rigid laparoscope with a 5
millimeter (mm) or a 10 mm diameter (or any other suitable
diameter) with either a non-angled lens or an angled lens, which
may be angled at 30 degrees, 45 degrees, or 50 degrees, for
example, with respect to the longitudinal axis of the scope. At
least a distal end of the scope may include one or more elements
designed to magnify, reflect, illuminate, and/or capture images of
internal body areas under treatment, and then transmit those images
back to the medical professional controlling the procedure (herein
referred to as a "viewing element"). The scope may be inserted into
the proximal opening of the chamber, may extend through the
chamber, and may extend through into the cannula through a distal
opening in the bottom wall of the chamber, where the distal opening
is in fluid and mechanical communication with the cannula. The
scope may further extend distally to the distal end of the cannula
and into the body cavity. In some embodiments, a sleeve (not shown,
but readily understood as a lining layer) may be located within the
cannula, and the scope may pass through the sleeve. Once deployed,
the scope may be manipulated by the medical professional moving it
distally/proximally, angling it, and/or by rotating it into a
particular orientation. Typically, during laparoscopic procedures,
scopes can become obstructed when debris (e.g., condensation,
displaced tissue, bodily fluids) are encountered and accumulate on
a lens of the scope, which may compromise the image or video feed
provided to the medical professional.
[0071] The surface of the cleaning element may facilitate removal
of obstructions from the scope without necessitating removal of the
scope from the internal environment. Advantageously, lengthy
interruptions (and therefore increased surgical and anesthesia
time) due to removing and/or replacing an obstructed scope may be
reduced or eliminated. Further, the distal end of the scope may
remain in the sterile internal environment during cleaning, which
may advantageously alleviate concerns related to loss of sterility
within the internal environment due to the removal and re-entry of
the scope one or more times for cleaning purposes. Keeping the
scope within the internal environment may also reduce or eliminate
debris in the form of fogging or condensation caused by exposure to
pressure and/or temperature changes when switching between
environments. It should also be understood that certain advantages
of the present embodiments are generally described as relating to a
scope for explanation purposes and may also extend to other types
of instruments used during surgical procedures, and therefore
"scope" should be understood as including any suitable medical
device used during laparoscopic surgery when described in the
context of the present embodiments, unless clearly excluded.
[0072] The cleaning element may incorporate any suitable
structures, materials, and/or cleaning solutions for removing
obstructions from the scope. The cleaning element may have a
unitary construction, or alternatively may have multiple surfaces
or layers with different cleaning characteristics or properties for
facilitating multiple treatments. For example, it is contemplated
that the cleaning element may have a first region with an abrasive
surface for breaking up potential obstructions, a second region
including a liquid, a gel, or other material for dissolving or
washing away the obstructions, and a third region with an absorbent
or adsorbent surface for removing any remaining residue.
[0073] The cleaning element may include any suitable cleaning
structures or materials, such as sponges, foams (e.g., reticulated
or non-reticulated foamed plastic polymers forming open-cell,
semi-open cell, or closed-cell foam structures), fibrous materials
(e.g., materials with natural (e.g., cellulosic) and/or synthetic
fibers), microfiber or wipe materials (e.g., polyethers,
polyamides, polyesters, and/or blends of each in a woven or
non-woven construction with split or non-split fibers), hydrophilic
or hydrophobic materials, fluids, gases, bristles, films, etc. The
structures and/or materials of the cleaning element may include
hydrophobic properties to assist in absorbing and wicking of
various bodily fluids and/or lipophilic characteristics for
increased absorption of oils or fats. The cleaning element may be
capable of absorbing at least 5 times its original weight of
fluids, such as about 15 times its original weight (or more). When
the cleaning element includes pores, consistent or variable pore
sizes may be consistently or randomly dispersed (or layered) in
certain configurations for suitable absorption properties (for
example, a the cleaning element may include a micro-porous foam
with about 4 pores per inch to about 100 pores per inch). The
cleaning element may have a firmness/compliance of about 2 lbs/50
in.sup.2 to about 80 lbs/50 in.sup.2, and preferably about 6 lbs/50
in.sup.2 to about 45 lbs/50 in.sup.2 (when tested at 25% deflection
on a 20 inch by 20 inch by 4 inch specimen). The material(s) of the
cleaning element may be formed of a material suitable for use in a
medical device (e.g., with suitable biocompatibility,
non-linting/no particulate, tear resistance, sterilization or other
chemical/solvent compatibility, and radiation stability).
[0074] The cleaning element may be multi-layered in some
embodiments. For example, a first layer may be configured to absorb
a fluid obstruction located on the scope, and a second layer may be
configured to retain or discard that fluid. In some embodiments,
the first layer may include an open-cell foam with relatively low
density (such as polyurethane or silicone foam) that may be used to
effectively and quickly absorb (or wick, etc.) the obstructing
fluid, and the second layer may include higher-density foam for
effectively retaining the fluid. The second layer may be located
beneath (e.g., covered by) the first layer, for example. Fibrous
materials such as terrycloth and microfiber cloths may additionally
or alternatively be used and may be advantageous for providing a
streak-free lens surface when wiped against the scope. The solid
materials of the cleaning element may be combined or "wetted" with
a cleaning fluid, such as an anti-fog fluid, sterile water, saline,
or a detergent, for example, which may facilitate the removal of
fatty smudges and dried-on debris.
[0075] In the event the medical professional's visibility becomes
compromised due to obstruction of the scope during surgery, the
distal end (or other location) of the scope may then be wiped or
swept by pressing and/or rubbing the distal end of the scope on the
cleaning element to remove obstructions. As explained above, this
cleaning procedure may advantageously be completed without removing
the scope from the internal environment in the trocar assembly. In
certain embodiments, the cannula may be formed of a transparent or
translucent material. When the scope is located in the trocar
assembly, the scope (which often includes a light) may illuminate
the cannula to increase visibility.
[0076] In some embodiments, the cleaning element may be selectable,
removable, and/or replaceable. Thus, the trocar assembly may be
capable of allowing access into the chamber (e.g., in an operating
room prior to a surgery) such that a medical professional can
select an appropriate version of the cleaning element and then use
that cleaning element with the trocar assembly during the
procedure. The cleaning element may additionally or alternatively
be replaced during a medical procedure (e.g., if it becomes
soiled), and/or may be replaced between medical procedures during
reprocessing of the trocar assembly if the trocar assembly is
reusable.
[0077] Those of skill in the art will appreciate that existing
scopes and potential scope designs include at least one
non-longitudinal, distal-end-facing surface of the distal end that
may be generally or exactly perpendicular to the longitudinal axis
of the scope, or which distal-facing surface may be configured at a
non-perpendicular angle relative to the longitudinal axis (e.g., 30
degrees off-perpendicular, 45 degrees off-perpendicular). It is
further contemplated that the distal-facing surface of the scope
may be flat/planar, concave, or convex relative to the major plane
of that face. The term "non-longitudinal, distal-end-facing
surface" is meant to include the operative end face(s) of a scope
in distinction from the longitudinal lateral sides of the scope,
which will generally be columnar or cylindrical. Thus, as described
in more detail below, the surface characteristics of the cleaning
element may be shaped or otherwise configured for compatibility
with a variety of distal-facing surfaces of the scope.
[0078] Those of skill in the art will appreciate that embodiments
not expressly illustrated herein may be practiced within the scope
of the claims, including that features described herein for
different embodiments may be combined with each other and/or with
currently-known or future-developed technologies while remaining
within the scope of the claims. This specifically includes that the
structure, location, and mechanisms of the disclosed cleaning
elements and related structures in the different embodiments
illustrated and described with reference to the drawing figures may
be combined and elements interchanged within the level of skill in
the art as informed by this application, and within the scope of
the present claims, which includes that a variety of disclosed
individual cleaning element components dimensioned for use
encompassed within in laparoscopy trocars may be configured as
separable/replaceable components of a larger trocar assembly.
Although specific terms are employed herein, they are used in a
generic and descriptive sense only and not for purposes of
limitation unless specifically defined by context, usage, or other
explicit designation. It is therefore intended that the foregoing
detailed description be regarded as illustrative rather than
limiting. And, it should be understood that the following claims,
including all equivalents, are intended to define the spirit and
scope of this invention. Furthermore, the advantages described
above are not necessarily the only advantages of the invention, and
it is not necessarily expected that all of the described advantages
will be achieved with every embodiment. In the event of any
inconsistent disclosure or definition from the present application
conflicting with any document incorporated by reference, the
disclosure or definition herein shall be deemed to prevail.
* * * * *