U.S. patent application number 16/105384 was filed with the patent office on 2018-12-20 for device and methods for lifting patient tissue during laparoscopic surgery.
The applicant listed for this patent is Lapovations, LLC. Invention is credited to Kinan Alhallak, Jill Goodrich, Jared Greer, Mason Harper, Patrick O'Brien, Christopher Oldfield, Terry Oquin, Byron Smith, Chris Taylor, Abby Terluow.
Application Number | 20180361081 16/105384 |
Document ID | / |
Family ID | 60326604 |
Filed Date | 2018-12-20 |
United States Patent
Application |
20180361081 |
Kind Code |
A1 |
Taylor; Chris ; et
al. |
December 20, 2018 |
DEVICE AND METHODS FOR LIFTING PATIENT TISSUE DURING LAPAROSCOPIC
SURGERY
Abstract
A method of manipulating patient tissue with a surgical device
that provides a suction force against a patient's body. The device
includes a handle and a suction head pivotally attached to the
handle. The suction head includes an open-ended suction chamber
having a rim positioned to engage the patient's skin. An actuator
on the handle operates a pump to draw a negative pressure in the
suction chamber, causing the rim to seal against the patient's skin
via the suction force. Once the suction force is initiated, the
user may lift the handle away from the patient's body to lift
tissue. The lifted tissue provides a site for insertion of a trocar
or Veress needle for a laparoscopic procedure in some embodiments.
A gimbal disposed between the handle and the suction head provides
at least two degrees of freedom such that the handle can be rotated
and pivoted to optimize the direction of applied lifting force.
Inventors: |
Taylor; Chris; (Harrison,
AR) ; Greer; Jared; (Fayetteville, AR) ;
Terluow; Abby; (Fayetteville, AR) ; Alhallak;
Kinan; (Paragould, AR) ; Oldfield; Christopher;
(Benton, AR) ; Harper; Mason; (Fayetteville,
AR) ; O'Brien; Patrick; (Fayetteville, AR) ;
Goodrich; Jill; (Fayetteville, AR) ; Oquin;
Terry; (Fairhope, AL) ; Smith; Byron;
(Nashville, TN) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Lapovations, LLC |
Fayetteville |
AR |
US |
|
|
Family ID: |
60326604 |
Appl. No.: |
16/105384 |
Filed: |
August 20, 2018 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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15800412 |
Nov 1, 2017 |
10052440 |
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16105384 |
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15601941 |
May 22, 2017 |
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15800412 |
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62339424 |
May 20, 2016 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 2017/306 20130101;
A61M 5/425 20130101; A61B 17/3498 20130101; A61B 17/34 20130101;
A61B 17/0281 20130101; A61M 2205/3331 20130101; A61M 1/0092
20140204; A61M 1/0068 20140204 |
International
Class: |
A61M 5/42 20060101
A61M005/42; A61B 17/02 20060101 A61B017/02; A61M 1/00 20060101
A61M001/00; A61B 17/34 20060101 A61B017/34 |
Claims
1. A surgical device apparatus, comprising: a handle; a pump
disposed in the handle, the pump configured for drawing a negative
pressure; an actuator disposed on the handle, the actuator linked
to the pump; a suction head attached to the handle at an
articulating joint, the suction head defining a suction chamber in
fluid communication with the pump, wherein the pump is operable to
communicate the negative pressure to the suction chamber; and a
gimbal forming the articulating joint between the handle and the
suction head, wherein the joint includes at least two angular
degrees of freedom between the handle and the suction head.
2. The apparatus of claim 1, further comprising an actuator travel
slot defined in the handle, wherein the actuator travels along the
actuator travel slot when the pump is operated.
3. The apparatus of claim 2, further comprising a pump spring
disposed in the handle.
4. The apparatus of claim 3, further comprising a pump piston
disposed in the handle.
5. The apparatus of claim 4, wherein the pump spring biases the
piston toward the suction head.
6. The apparatus of claim 5, wherein the interior of the handle
forms a pump piston cylinder along which the pump piston may
travel.
7. The apparatus of claim 6, wherein the actuator is linked to the
pump piston and the pump piston moves in a direction away from the
suction head when the actuator is moved in the same direction away
from the suction head.
8. The apparatus of claim 7, further comprising a sliding pump
piston seal between the pump piston and the pump piston cylinder in
the handle.
9. The apparatus of claim 8, wherein the pump piston applies a
negative pressure on the suction head when the actuator is moved in
the direction away from the suction head.
10. The apparatus of claim 9, wherein the joint includes a second
angular degree of freedom between the handle and the suction
head.
11. The apparatus of claim 1, further comprising a suction valve
disposed in the suction head.
12. The apparatus of claim 11, further comprising a gimbal forming
the joint between the handle and the suction head.
13. The apparatus of claim 12, wherein the handle is pivotable
relative to the gimbal about the horizontal reference axis.
14. The apparatus of claim 13, wherein the handle is pivotable
relative to the gimbal about the vertical reference axis.
15. The apparatus of claim 14, further comprising a vacuum gauge
disposed on the gimbal, the vacuum gauge including indicia
representative of a predetermined pressure.
16. A surgical device apparatus for lifting a patient tissue for
placement of a surgical instrument for a laparoscopic procedure,
the apparatus comprising: a handle forming a cylinder, the handle
including an actuator and a pump, the pump including a piston
housed inside the cylinder in the handle, the actuator attached to
the piston, wherein the actuator is moveable relative to the handle
and wherein movement of the actuator relative to the handle causes
the piston to travel in a corresponding motion inside the cylinder;
a gimbal pivotally disposed on the handle, the gimbal including a
first angular degree of freedom wherein the handle may be rotated
relative to the gimbal about a horizontal reference axis; a suction
head disposed on the gimbal, the suction head including a suction
chamber having a rim positioned for engagement with the patient's
skin, the gimbal including a second angular degree of freedom
wherein the gimbal may be rotated relative to the suction head
about a vertical reference axis; and a pressure release disposed on
the suction head.
17. The apparatus of claim 16, further comprising a travel slot
defined in the handle, wherein the actuator is moveable along the
travel slot.
18. The apparatus of claim 17, further comprising a suction valve
disposed in the suction head.
19. The apparatus of claim 18, wherein the pressure release
includes a pressure release port passing through the suction
head.
20. The apparatus of claim 19, further comprising a vacuum gauge
disposed on the gimbal, the vacuum gauge including indicia
representative of a predetermined pressure.
Description
CROSS-REFERENCES TO RELATED APPLICATIONS
[0001] This application claims priority to and benefit of
co-pending U.S. patent application Ser. No. 15/800,412 entitled
"Device and Methods for Lifting Patient Tissue During Laparoscopic
Surgery", which is a continuation of U.S. patent application Ser.
No. 15/601,941 entitled "Device and Methods for Lifting Patient
Tissue During Laparoscopic Surgery," which claims priority to
Provisional Patent Application No. 62/339,424 entitled "Surgical
Device," all of which are hereby incorporated by reference in their
entireties.
[0002] A portion of the disclosure of this patent document contains
material that is subject to copyright protection. The copyright
owner has no objection to the reproduction of the patent document
or the patent disclosure, as it appears in the U.S. Patent and
Trademark Office patent file or records, but otherwise reserves all
copyright rights whatsoever.
STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT
[0003] Not Applicable.
REFERENCE TO SEQUENCE LISTING OR COMPUTER PROGRAM LISTING
APPENDIX
[0004] Not Applicable.
BACKGROUND
[0005] The present disclosure relates generally to surgical devices
and more particularly to a device and methods for lifting tissue of
a patient prior to insertion of a surgical instrument such as a
trocar or Veress needle.
[0006] During various surgical procedures, including laparoscopy,
surgical instruments such as a trocar, Veress needle or access port
may be inserted into the tissue of a human or animal. In some
procedures, the instrument is inserted in a position to access the
abdominal cavity. The initial surgical instrument or trocar is
preferably placed through the umbilicus because the abdominal wall
is at its thinnest in this region. A laparoscopic camera is then
placed through this initial trocar to aid in visualizing the
intraabdominal cavity and the structures therein. Carbon dioxide
gas is then used to insufflate the abdominal cavity, thereby
creating a pneumoperitoneum or space to operate. Once the
pneumoperitoneum is created, secondary trocars can be placed under
direct visualization utilizing the laparoscopic camera thus
reducing the risk of injury.
[0007] Patient injuries most often occur during initial placement
of the trocar or Veress needle, which is generally considered to be
the most dangerous portion of a laparoscopic surgery. Currently,
there are two common methods for the placement of the primary
umbilical trocar: the blind technique and the open (Hasson)
technique.
[0008] The blind technique can be accomplished either before or
after the creation of the pneumoperitoneum. Some surgeons prefer
insufflating the abdominal cavity prior to the placement of the
initial trocar. This is accomplished with the use of a Veress
needle. The needle is blindly introduced through an umbilical
incision. Carbon dioxide gas is introduced through the Veress
needle, elevating the abdominal wall away from the underlying
structures. The Veress needle is then removed, and the primary
trocar placed.
[0009] Other surgeons prefer placing the primary trocar prior to
insufflating the abdomen. This is the direct entry method and is
performed using a technique called a "controlled jab." The trocar
is placed through an umbilical incision under controlled force
using a stabbing motion with care not to penetrate beyond the
abdominal wall. Most surgeons elevate the abdominal wall during
blind insertion of either the primary trocar or the Veress needle.
This reduces the risk of injury to underlying structures.
[0010] The most common type of injury is to vascular structures,
bowel, or to other visceral organs. Multiple studies have shown
that complication rates are similar between the Veress needle and
direct entry as well as between the blind technique and the open
Hasson technique. Various techniques and inventions have been
described to assist with elevation of the abdominal wall to
facilitate blind trocar or Veress needle placement. This includes
rarely used devices such as retractors and lifting rods used to
mechanically elevate the abdominal wall thereby creating negative
pressure within the abdomen allowing a space for initial trocar
placement or room to operate without the need for creating a
pneumoperitoneum.
[0011] More commonly, two conventional manual techniques for
lifting the abdominal wall are utilized. The first method involves
grasping and lifting the abdominal wall below or on either side of
the umbilicus with one's hand. The second method utilizes
perforating towel clips placed in a similar location to provide a
handle on which to lift and elevate the abdominal wall. Each of
these techniques require that sufficient elevation of the abdominal
wall is maintained in opposition to the downward force generated
during primary trocar or Veress needle placement. Although
providing a more secure grasp of the abdominal wall, towel clips
pierce the abdominal skin and therefore risk injury and trauma to
vessels and tissue. This is also a source of postoperative
discomfort to what is intended to be a minimally invasive
procedure. Grasping and lifting the abdominal wall by hand poses
its own challenges. Whether the surgeon is lifting the abdomen
below the umbilicus or the surgeon and his assistant are lifting on
either side of the umbilicus, it can be difficult to maintain a
grip and the proper elevation to insure inadvertent injury does not
occur to the underlying structures. The shape, elasticity and
overall thickness of the abdominal wall can also prohibit one from
adequately grasping the abdomen by hand. Also, lifting the full
thickness of the abdominal wall by hand risks inadvertently
grasping and elevating the omentum and other underlying structures
together with the abdominal wall bringing these structures into the
path of the trocar or Veress needle.
[0012] In an effort to improve on current tools and techniques, a
number of devices have been developed. One recent apparatus,
marketed under the name of LapDome by Narbitas, utilizes a dome
shaped device and negative pressure generated from external
operating room suction to raise the abdominal wall within the dome
thereby creating intraabdominal space. A Veress needle is then
introduced through the dome and into the elevated abdominal cavity.
The abdominal cavity is then insufflated with carbon dioxide gas,
and the surgery can commence as usual.
[0013] There are several drawbacks to using the LapDome and similar
devices. First, it is a bulky apparatus fixated over the abdomen
and umbilicus and requires external suction to create lift within
the device. Second, the LapDome can be used only with the Veress
needle technique and therefore limits a surgeon to a technique that
he or she may not be comfortable with performing.
[0014] What is needed then are improvements to devices and methods
for laparoscopic surgery, and particularly for manipulating and
lifting patient tissue for insertion and placement of a surgical
device during a surgical procedure, such as but not limited to a
trocar or Veress needle.
BRIEF SUMMARY
[0015] This Brief Summary is provided to introduce a selection of
concepts in a simplified form that are further described below in
the Detailed Description. This Summary is not intended to identify
key features or essential features of the claimed subject matter,
nor is it intended to be used as an aid in determining the scope of
the claimed subject matter.
[0016] One aspect of some embodiments of the present disclosure is
a surgical device including a handle and a suction head attached to
the handle at a pivotable joint. The joint allows relative angular
motion between the suction head and the handle in at least one
angular degree of freedom. A manual pump is disposed on the handle,
and an actuator is coupled to the pump. A user may manipulate the
actuator to operate the pump, thereby creating a suction force
between the suction head and the skin of a patient. Once a suction
force is established between the suction head and the patient, the
user may then lift the surgical device away from the patient's body
to lift tissue for trocar insertion.
[0017] Another aspect of some embodiments of the present disclosure
provides a surgical device including a handle and a suction head
attached to the handle at an articulating joint. A gimbal device is
positioned at the joint between the suction head and the handle in
some embodiments. The gimbal provides a first angular degree of
freedom between the gimbal and the handle, and a second angular
degree of freedom between the gimbal and the suction head. Thus,
the gimbal operates as an intermediate structure between the handle
and the suction head to allow relative angular movement between the
handle and the suction head in at least two degrees of freedom.
[0018] A further aspect of some embodiments of the present
disclosure provides a surgical device including a handle and a
suction head, wherein a negative pressure suction force may be
easily released by manual operation of a pressure release on the
suction head.
[0019] Another object of some embodiments of the present disclosure
is to provide a device and associated methods to lift tissue prior
to trocar or Veress needle insertion to allow surgeons to utilize
either trocar insertion method.
[0020] Another object of some embodiments of the present disclosure
is to provide a surgical device for lifting a patient's tissue for
insertion of a surgical instrument such as a trocar, wherein the
device allows the user to move an actuator in the same direction as
the axial pull force for lifting the tissue.
[0021] Numerous other objects, advantages and features of the
present disclosure will be readily apparent to those of skill in
the art upon a review of the following drawings and description of
a preferred embodiment.
BRIEF DESCRIPTION OF THE DRAWINGS
[0022] FIG. 1 is a perspective view of an embodiment of a surgical
device in accordance with the present disclosure.
[0023] FIG. 2 is a perspective view of an embodiment of a surgical
device in accordance with the present disclosure.
[0024] FIG. 3 is a perspective view of an embodiment of a surgical
device in accordance with the present disclosure.
[0025] FIG. 4 is a perspective partial cross-sectional view of an
embodiment of a surgical device in accordance with the present
disclosure.
[0026] FIG. 5 is a perspective view of an alternative embodiment of
a surgical device in accordance with the present disclosure.
[0027] FIG. 6 is a perspective view of an alternative embodiment of
a surgical device in accordance with the present disclosure.
[0028] FIG. 7 is a perspective view of an alternative embodiment of
a surgical device in accordance with the present disclosure.
[0029] FIG. 8 is a perspective view of an alternative embodiment of
a surgical device in accordance with the present disclosure.
[0030] FIG. 9 is a front elevation view of an alternative
embodiment of a surgical device in accordance with the present
disclosure.
[0031] FIG. 10 is a side elevation view of an alternative
embodiment of a surgical device in accordance with the present
disclosure.
[0032] FIG. 11 is an exploded perspective view of an alternative
embodiment of a surgical device in accordance with the present
disclosure.
[0033] FIG. 12 is an exploded cross-sectional elevation view of an
alternative embodiment of a surgical device in accordance with the
present disclosure.
DETAILED DESCRIPTION
[0034] While the making and using of various embodiments of the
present invention are discussed in detail below, it should be
appreciated that the present invention provides many applicable
inventive concepts that are embodied in a wide variety of specific
contexts. The specific embodiments discussed herein are merely
illustrative of specific ways to make and use the invention and do
not delimit the scope of the invention. Those of ordinary skill in
the art will recognize numerous equivalents to the specific
apparatus and methods described herein. Such equivalents are
considered to be within the scope of this invention and are covered
by the claims.
[0035] In the drawings, not all reference numbers are included in
each drawing, for the sake of clarity. In addition, positional
terms such as "upper," "lower," "side," "top," "bottom," etc. refer
to the apparatus when in the orientation shown in the drawing, or
as otherwise described. A person of skill in the art will recognize
that the apparatus can assume different orientations when in
use.
[0036] Referring to FIG. 1, an embodiment of a surgical device 10
is shown in a perspective view. Device 10 includes a handle 12 and
a suction head 14. Handle 12 is attached to suction head 14 at a
moveable joint 16. During use, a user may grasp handle 12 while
suction head 14 engages a patient's body. Suction head 14 includes
a suction cup 24 having an open suction chamber 22. A rim 28 is
positioned to engage a patient's body. An actuator 18 on handle 12
is coupled to a pump mechanism housed within the device. When rim
28 is positioned against a patient's body, actuator 18 is
manipulated to cause the pump mechanism to draw a negative pressure
between the patient's body and the suction head 14. Rim 28 operates
as a seal between the patient's skin and the suction head 14. Once
a negative pressure suction force is established between the device
10 and the patient via the suction head 14, the user may then use
handle 12 to manually lift the patient's tissue while maintaining a
negative pressure seal between the patient's body and the rim 28.
Once the tissue is lifted, the user may then insert a trocar or
Veress needle using any suitable insertion technique.
[0037] After the surgical instrument is inserted, the negative
pressure suction force is released by operation of a pressure
release 32 on the device 10. One or more pressure release ports 34,
shown in FIG. 3, are defined in suction head 14 in some
embodiments. Each pressure release port 34 passes through the
suction head 14 to allow gas transfer across suction head 14. When
a negative pressure is pulled in suction chamber 22, pressure
release 32 is held down against the exterior of suction head 14,
thereby blocking entry of gas into the suction chamber. In such
embodiments, the pressure release 32 is closed. An upturned edge
around the perimeter of pressure release 32 provides a location for
a user to manually lift the pressure release 32. When pressure
release 32 is lifted away from suction head 14, one or more
pressure release ports 34 are opened and the suction force created
in suction chamber 22 is released as air enters suction chamber 22
quickly through the pressure release ports 34. The pressure release
32 provides a convenient way for a user to quickly release the
suction of the device against a patient during an operation.
[0038] Referring to FIG. 1 and FIG. 2, in some embodiments, device
10 includes a joint 16 between handle 12 and suction head 14. Joint
16 provides a first angular degree of freedom about a reference
horizontal axis 17. This first angular degree of freedom allows
handle 12 to pivot toward and away from the patient's body when in
use. The first angular degree of freedom also allows a user to
angle the handle relative to suction head 14 for applying a pulling
force in various directions away from the patient's body. Notably,
the degree of freedom offered by joint 16 in some embodiments, and
the at least two degrees of freedom offered by joint 16 in
additional embodiments, provide a user with the ability to lift the
patient tissue at various angles of application of lifting force.
This further allows a user to properly position the user's hands
out of the way of the trocar insertion or Veress needle insertion
during the laparoscopic surgical procedure using device 10.
[0039] As further seen in FIG. 2, in additional embodiments, device
10 includes a joint 16 between handle 12 and suction head 14 that
provides a second angular degree of freedom about a reference
vertical axis 19. The second angular degree of freedom allows a
user to pivot the handle relative to the suction head 14 when the
suction head 14 is engaged with the patient's body. For example,
during use, a user may press suction head 14 against a patient's
body. Then, the user may manipulate actuator 18 along travel slot
54 to draw a negative pressure suction force between suction head
14 and the patient's body. Once the suction force is established,
the user may then pivot handle 12 relative to suction head 14 about
vertical axis 19 via joint 16. In such embodiments, joint 16 may be
referred to as having two degrees of freedom--a first degree of
freedom about reference axis 17, shown in FIG. 1, and a second
degree of freedom about reference axis 19, shown in FIG. 2.
[0040] Alternatively, in some embodiments, joint 16 includes only
the first degree of freedom about reference axis 17. In further
embodiments, joint 16 includes only the second degree of freedom
about reference axis 19.
[0041] During use, a negative pressure suction force is established
in suction head 14 using a pump mechanism. Negative pressure is
established in suction head 14 using a suction port 48 in fluid
communication with the pump mechanism. Suction port 48, shown in
FIG. 3, provides one or more orifices in suction head 14 that are
open on one side to suction chamber 22 and are open on the other
side to the pump mechanism 90, shown in FIG. 4.
[0042] A suction valve 44 is disposed in suction head 14 to seal
suction chamber 22 with a negative applied pressure in some
embodiments. Suction valve 44 includes any suitable valve for
drawing and holding a reduced pressure in suction chamber 22 via
suction port 48. For example, as seen in FIG. 4, an embodiment of a
suction valve 44 in suction head 14 includes an umbrella valve
positioned above suction port 48. The valve operates as a check
valve, allowing negative pressure to be drawn from suction chamber
22 while preventing the flow of gas back into suction chamber 22
when rim 28 is sealed against a patient's body.
[0043] Suction valve 44 is seated in a stem 40 on suction head 14
in some embodiments, as seen in FIG. 4. Stem 40 includes a
protruding structure extending upwardly from the suction head 14
allowing attachment to joint 16. Stem 40 includes a hollow interior
stem channel 50, and a stem wall 52 spanning the stem channel 50.
Stem wall 52 forms a separation between suction chamber 22 and stem
channel 50. One or more suction ports 48 are defined in stem wall
52, and suction valve 44 is seated in stem channel 50 on stem wall
52 in some embodiments. During use, when a negative pressure is
drawn on suction head 14 via stem channel 50, suction valve 44
opens slightly to allow the negative pressure to act on suction
chamber 22 via suction ports 48, thereby drawing a corresponding
negative pressure on suction chamber 22. When the desired negative
pressure is reached, suction valve 44 presses back down against
stem wall 52 thereby blocking suction ports 48 and maintaining the
reduced pressure in suction chamber 22.
[0044] In some embodiments, a gimbal 60 provides joint 16 between
handle 12 and suction head 14. Gimbal 60 includes an intermediate
structure located between handle 12 and suction head 14 to provide
two angular degrees of freedom between handle 12 and suction head
14. Gimbal 60 includes a first pivoting gimbal joint 62 between
gimbal 60 and handle 12, shown in FIG. 2. First gimbal joint 62
allows handle 12 to pivot about a reference horizontal axis 17, as
seen in FIG. 1. First gimbal joint 62 includes a first gimbal joint
seal between gimbal 60 and handle 12. The first gimbal joint seal
may include any suitable seal for maintaining a pressure-tight seal
along first gimbal joint 62 during articulation between handle 12
and gimbal 60 when suction is pulled on handle 12 using the pump
mechanism. First gimbal joint seal includes an O-ring or gasket in
some embodiments. First gimbal joint seal ensures that that any
applied negative pressure from the pump mechanism in handle 12 is
communicated and maintained through the interior port in gimbal 60
to suction head 14. Gimbal 60 may be secured to handle 12 using any
suitable connection for allowing relative rotation between handle
12 and gimbal 60 about reference horizontal axis 17, and while
preventing axial movement between handle 12 and gimbal 60 along
reference horizontal axis. In some embodiments, handle 12 is
attached to gimbal 60 using one or more mechanical fasteners such
as bolts, set screws, clips or other suitable fasteners.
[0045] A second gimbal joint 64, shown in FIG. 2, provides a second
angular degree of freedom, providing a pivoting joint between
gimbal 60 and suction head 14. A second gimbal joint seal is
disposed in second gimbal joint 64 to maintain a suction seal
during rotation of gimbal 60 and handle 12 relative to suction head
14 while suction head 14 is engaged with a patient's skin. Thus,
second gimbal joint 64 allows handle 12 to be rotated relative to
suction head 14 about a reference vertical axis 19. Second gimbal
joint seal may include any suitable seal such as but not limited to
an O-ring or a gasket. Second gimbal joint seal maintains a sealing
engagement between gimbal 60 and suction head 14 during rotation of
handle 12 relative to suction head 14 and during application of
suction force to the patient's tissue using suction head 14.
Suction head 14 may be secured to gimbal 60 at second gimbal joint
64 in a number of different ways to provide relative sealed
rotation between the structures about reference vertical axis 19.
For example, in some embodiments, a horizontal U-shaped retaining
pin may be installed in gimbal 60 to engage a corresponding stem
groove in stem 40 on suction head 14. When the retaining pin is
installed in the stem groove, the suction head 14 is secured in
axial position relative to gimbal 60, thereby allowing gimbal 60 to
rotate about reference vertical axis 19 relative to suction head
14, but preventing axial movement between suction head 14 and
gimbal 60.
[0046] A vacuum gauge, or suction gauge 70, shown in FIG. 1, is
disposed on gimbal 60 in some embodiments. Vacuum gauge 70 extends
from gimbal along reference horizontal axis 17 in some embodiments.
Vacuum gauge 70 is maintained in position along a gimbal port 66,
shown in FIG. 4. Gimbal port 66 provides a passage through the
gimbal for communicating pressure from pump 90 to suction head 14.
Vacuum gauge 70 is disposed in an opening in communication with
gimbal port 66, and a gauge spring 74 provides a spring force to
maintain vacuum gauge 70 at an equilibrium position. When a reduced
pressure is applied on suction head 14 through gimbal port 66, the
pressure reduction causes vacuum gauge 70 to translate against
gauge spring 74, retracting partially into the gimbal 60. One or
more indicia 72 on vacuum gauge 70 provides information about a
desired applied pressure level. For example, in some embodiments,
indicia 72 includes a color band or a line indicating an acceptable
applied pressure range for achieving a desired suction force on
suction head 14. The pressure range corresponding to the indicia is
a predetermined pressure range in some embodiments that has been
calibrated to be a sufficient pressure to achieve a desirable
suction force for lifting patient tissue using the device 10. When
a corresponding pressure drop across gimbal port 66 is achieved,
vacuum gauge 70 will retract such that the indicia 72 of a color
band or line is aligned with vacuum gauge keeper 76, shown in FIG.
3. Alternatively, indicia 72 may be measured against another point
of reference including any suitable structure on gimbal 60. The
vacuum gauge 70 allows a user to visually determine when a desired
negative pressure is achieved in suction head 14. Once the desired
suction pressure is confirmed by visual observation of vacuum gauge
70, the user may then pull on handle 12 to lift the patient's
tissue for insertion of a surgical instrument such as a trocar or
Veress needle.
[0047] Referring further to FIG. 4, a pump 90 is disposed in handle
12 in some embodiments. Pump 90 includes a pump piston 80 that is
moveable along the interior of handle 12. Handle 12 forms a pump
piston cylinder 84 in some embodiments. During use, pump piston 80
translates along the pump piston cylinder 84 on the interior of
handle 12. A pump piston seal 86 is positioned between pump piston
80 and pump piston cylinder 84. Pump piston seal 86 is a slidable
seal such as an o-ring in some embodiments. Actuator 18 is linked
to pump piston 80 such that translation of actuator 18 along travel
slot 54 results in a corresponding motion of pump piston 80 along
pump piston cylinder 84. Pump spring 82 presses against pump piston
80 and biases pump piston 80 in a position at the lower end of
handle 12 toward suction head 14.
[0048] A spring stop 92 is installed on pump 90 inside handle 12.
Spring stop 92 provides an axial stop for pump spring 82, which is
a compression spring in some embodiments. Spring stop 92 also forms
an end wall for pump piston cylinder 84. Spring stop 92 may be
threaded into handle, secured in place using one or more fasteners,
or fixed relative to handle 12 using any suitable fastening means
such as but not including an adhesive or integrally molded into
handle 12. Spring stop 92 also includes a spring pilot rod 94
extending axially downwardly toward suction head 14 in some
embodiments. Spring pilot rod 94 includes a projecting rod
positioned on the interior of pump spring 82, as shown in FIG. 4.
Spring pilot rod 94 in some embodiments prevents pump spring 82
from buckling or becoming misaligned during spring compression that
occurs during a stroke of pump 90.
[0049] During a procedure, a surgeon or assistant may grasp handle
12 and use a finger or thumb to move actuator 18 away from suction
head 14, thereby causing pump piston 80 to translate away from
suction head 14 along pump piston cylinder 84 inside handle 12.
Such motion of pump piston 80 away from suction head 14 draws a
negative pressure inside the pump piston cylinder 84. The negative
pressure is maintained by pump piston seal 86. A corresponding
negative pressure is also drawn through gimbal port 66, and through
suction port 48 in suction head 14, causing a pressure drop in
suction chamber 22. The negative pressure created by movement of
actuator 18 creates a suction force on a patient's skin in suction
chamber 22, thereby allowing a user to lift the patient's tissue
for insertion of a surgical instrument such as a trocar or Veress
needle.
[0050] In some applications, it may be necessary to initiate
multiple pump strokes to achieve a desired suction pressure. For
example, when actuator 18 is pulled to the end of its travel range,
the pump spring 82 is operable to force the actuator and piston
back toward the suction head 14. A pump valve 88 is included on
pump piston 80 in some embodiments. Pump valve 88 is a check valve
in some embodiments that is closed when pump piston 80 is drawn
away from suction head 14, but is opened when pump piston 80
returns back toward suction head 14 to its starting position. The
pump valve 88 allows the gas in pump piston cylinder 84 to vent out
of the cylinder as the pump piston 80 returns via the pump spring
82.
[0051] In various alternative embodiments, different configurations
of joint 16 and actuator 18 may be provided. Such alternative
embodiments include a handle 12 and a suction head 14 configured
for applying a suction force against a patient's skin. An example
of an alternative embodiment of a surgical device 10 is shown in
FIG. 5. The device 10 shown in FIG. 5 includes a center gimbal
allowing for rotation about a reference horizontal reference axis
17 only. In this embodiment, the joint 16 includes only one angular
degree of freedom. A spring stop 92 includes an adjustable end cap
that may be axially adjusted relative to handle 12 by rotating the
end cap in some embodiments. This allows a user to modify the axial
grip length of the handle 12 for ergonomic purposes by adjusting
the distance between the axial end cap and the actuator 18. The
spring stop 92 including an adjustable end cap may also include an
ergonomic shape such as an oval or hemisphere to comfortably fit in
the palm of the user's hand. In some embodiments, the adjustable
end cap is separate from the spring stop 92 housed within handle
12. In other embodiments, the adjustable end cap is integrally
formed with the spring stop 92 as a single piece. Also shown in
FIG. 5, an alternative embodiment of actuator 18 includes a single
piece with opposing finger grips. The actuator 18 is inserted
completely through handle 12 such that each opposing finger grip
extends from an opposing side of handle 12. In other embodiments,
each finger grip is a separate individual piece, as shown in FIG.
4.
[0052] Referring to FIG. 6, an alternative embodiment of a surgical
device 10 is shown with a side gimbal design. In this embodiment,
actuator 18 includes a continuous finger holder extending in a ring
around handle 12. As shown in FIG. 6, this embodiment may also
include a spring stop 92 forming an adjustable end cap that may be
axially adjusted relative to handle 12 by rotating the end cap.
Also shown in FIG. 5, pressure release 32 may take numerous forms
to allow a release of negative pressure held inside suction chamber
22. In some alternative embodiments, as shown in FIG. 6, pressure
release 32 includes a knob that may be released by turning,
pressing or bending to open a seal on pressure release 32 to
quickly release the suction drawn in suction chamber 22 against a
patient's tissue.
[0053] Referring to FIG. 7, an alternative embodiment of a surgical
device 10 includes a joint 16 having a bevel configuration. This
configuration allows the handle 12 to be rotated relative to
suction head 14 by turning about the beveled joint to achieve a
desired orientation of handle relative to suction head 14.
[0054] Referring to FIG. 8, an alternative embodiment of a surgical
device 10 includes an actuator 18 having a pivotable lever on
handle 12. When a user depresses the lever on actuator 18, the pump
housed within handle 12 is stroked. Another feature shown in FIG. 8
is the use of a flexible medical tubing for the joint 16 between
handle 12 and suction head 14. Flexible medical tubing may take the
place of gimbal 60 in forming joint 16. The tubing allows at least
two angular degrees of freedom between handle 12 and suction head
14, allowing handle to be pivoted relative to suction head 14 about
reference horizontal axis 17 and also pivoted about reference
vertical axis 19.
[0055] Referring to FIGS. 9-12, an alternative embodiment of a
surgical device 10 is shown in a front view. The device 10 includes
a handle 12 and a suction head 14. Handle 12 is secured to suction
head 14 at an articulating joint 16. In some embodiments, joint 16
includes a ball and socket joint, including a ball on suction head
14 and a socket attached to handle 12. As shown in the alternative
embodiment, a suction force may be applied in suction head 14 by
using an axial stroking action of actuator 18 on handle 12. During
use, an operator may grasp the actuator portion 18 on handle 12.
Actuator 18 is moved up and down relative to handle 12 to actuate a
pump housed on the interior of handle 12 and actuator 18. The
upstroke motion of actuator 18 causes the pump to draw a vacuum
inside suction chamber 22, shown in FIG. 12. A manual release 32,
shown in FIG. 11, is positioned on actuator 18 to allow a user to
quickly release the vacuum from suction chamber 22. First and
second piston springs 82 provide an axial force to bias actuator 18
at its upward position. During use, the user presses actuator 18
down against piston springs 82, thereby moving a piston 80 on
actuator 18 through a corresponding pump piston cylinder 84 defined
in handle 12. When the actuator 18 is reversed and moved upward
away from the suction head 14, a negative pressure is drawn as the
actuator 18 moves the piston 80 upwardly through its pump piston
cylinder 84 away from suction head 14. A suction valve 44 in the
form of a check valve, shown in FIG. 11 and FIG. 12, maintains the
negative pressure inside suction chamber 22 held in place by a seal
between rim 28 and a patient's skin. Suction port 48, shown in FIG.
12, communicates the pressure drop associated with the motion of
piston 80 from handle 12 to suction chamber 22 on suction head
14.
[0056] A pump valve 88 is included on handle 12 in some
embodiments. Pump valve 88 is a check valve in some embodiments
that is closed during the upstroke motion of actuator 18, but is
opened when pump piston 80 is pressed downward through piston
cylinder 84 toward suction head 14. The pump valve 88 allows the
gas in pump piston cylinder 84 to vent out of the cylinder as it is
pressed downward through piston cylinder 84 toward suction head
14.
[0057] The articulating joint 16 shown in some embodiments, such as
the ball joint shown in FIGS. 9-12, provides at least two angular
degrees of freedom between handle 12 and suction head 14. The ball
and socket joint allows angular movement of handle 12 relative to
suction head 14 about both a horizontal axis and a vertical
axis.
[0058] Thus, although there have been described particular
embodiments of the present invention of a new and useful device and
method for lifting a patient's tissue for insertion of a surgical
instrument such as but not limited to a trocar or Veress needle, it
is not intended that such references to particular embodiments be
construed as limitations upon the scope of this invention.
* * * * *