U.S. patent application number 16/698073 was filed with the patent office on 2020-04-23 for compact endoscopic surgical blade assembly and method of use thereof.
The applicant listed for this patent is A.M. SURGICAL, INC.. Invention is credited to Ather MIRZA, Romi MIRZA.
Application Number | 20200121347 16/698073 |
Document ID | / |
Family ID | 50188419 |
Filed Date | 2020-04-23 |
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United States Patent
Application |
20200121347 |
Kind Code |
A1 |
MIRZA; Romi ; et
al. |
April 23, 2020 |
COMPACT ENDOSCOPIC SURGICAL BLADE ASSEMBLY AND METHOD OF USE
THEREOF
Abstract
An endoscopic surgical device having a slotted clear cannula, a
blade and a housing, wherein the cannula is attached to the
housing, and wherein the blade is enclosed in the housing and is
slidable into the cannula is disclosed. The blade is enclosed
within the housing and cannula, and has a horizontally-oriented
pushing component and a vertically-oriented cutting component that
protrudes through the slot of the cannula. The device further has a
device for locking a viewing device in place relative to other
components of the device. A method for a performing an operative
procedure on a target tissue in a subject using the endoscopic
surgical device is also described.
Inventors: |
MIRZA; Romi; (Smithtown,
NY) ; MIRZA; Ather; (Smithtown, NY) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
A.M. SURGICAL, INC. |
Smithtown |
NY |
US |
|
|
Family ID: |
50188419 |
Appl. No.: |
16/698073 |
Filed: |
November 27, 2019 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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15661968 |
Jul 27, 2017 |
10548624 |
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16698073 |
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15239557 |
Aug 17, 2016 |
9808274 |
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15661968 |
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14736904 |
Jun 11, 2015 |
9445830 |
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15239557 |
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14013746 |
Aug 29, 2013 |
9066746 |
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14736904 |
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13790016 |
Mar 8, 2013 |
8911470 |
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14013746 |
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13602968 |
Sep 4, 2012 |
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13790016 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 17/320016 20130101;
A61B 1/00128 20130101; A61B 1/00135 20130101; A61B 17/32002
20130101; A61B 17/320036 20130101; A61B 2017/320008 20130101; A61B
1/00087 20130101; A61B 2017/00353 20130101; A61B 2017/320064
20130101; A61B 1/3132 20130101; A61B 1/018 20130101; A61B 17/3205
20130101 |
International
Class: |
A61B 17/32 20060101
A61B017/32; A61B 1/00 20060101 A61B001/00; A61B 1/313 20060101
A61B001/313; A61B 17/3205 20060101 A61B017/3205; A61B 1/018
20060101 A61B001/018 |
Claims
1. An endoscopic surgical device, comprising: (a) a housing having
a proximate end and a distal end; (b) a slotted clear cannula
attached to said distal end of said housing, said slotted clear
cannula comprises a cannula body having a proximate end and a
distal end, and a slot extending from said proximate end of said
cannula to the proximity of said distal end of said cannula; (c) a
revolver assembly located within said housing, comprising: a slide
lock having a proximate end, a distal end and two notches at said
distal end; a scraper; a blade assembly; and a circular revolver
body comprising a selector switch; wherein said scraper and said
blade reside at said two notches of said slide lock in a
pre-deployment position and wherein said selector switch allows
selection of said scraper or said blade for deployment; (d) a tube
assembly having a proximate end and a distal end, said distal end
of said tube assembly is located within said housing and extends
through said revolver, said distal end of the tube assembly is
capable of entering said slotted clear cannula from said proximate
end of said clear cannula; and (e) a scope lock assembly for
holding a viewing device in a stationary position relative to the
tube assembly.
2. The endoscopic surgical device of claim 1, wherein the scope
lock assembly is affixed to the proximate end of the tube
assembly.
3. The endoscopic surgical device of claim 2, wherein the scope
lock assembly is slidable with the tube assembly relative to the
housing of the device.
4. The endoscopic surgical device of claim 2, wherein the scope
lock assembly is lockable to the proximate end of the housing.
5. The endoscopic surgical device of claim 1, wherein the default
condition of the scope lock assembly is immobilization of the
viewing device relative to the tube assembly.
6. The endoscopic surgical device of claim 5, wherein the scope
lock assembly comprises a scope lock button and wherein the scope
lock assembly is in a locked position that immobilizes the viewing
device relative to the tube assembly when the scope lock button is
in an unpressed position.
7. The endoscopic surgical device of claim 5, wherein the scope
lock assembly comprises a scope lock button and wherein the scope
lock assembly is in an unlocked position that allows movement of
the viewing device relative to the tube assembly when the scope
lock button is in pressed position.
8. The endoscopic surgical device of claim 1, wherein the distal
end of the slotted clear cannula is a closed end that is shaped to
serve as an elevator.
9. The endoscopic surgical device of claim 8, wherein the distal
end of the slotted clear cannula forms an angle with the cannula
body, wherein said angle is in the range of 165-145 degrees.
10. An endoscopic surgical kit, comprising the endoscopic surgical
device of claim 1 and a scalpel.
11. The endoscopic surgical kit of claim 8, further comprising an
endoscope.
12. A method for a performing a uniportal endoscopic surgical
procedure on a target tissue using the endoscopic surgical device
of claim 1, comprising: establishing an entry portal in said
subject; inserting into said entry portal said cannula of said
endoscopic surgical device; extending said cannula through said
entry portal to said target tissue; advancing an endoscope into
said cannula visualize a target tissue; and advancing said blade
into said cannula until a desired cut is made on said target
tissue.
13. The method of claim 12, wherein said establishing an entry
portal comprises making an incision.
14. The method of claim 12, wherein said desired cut is division of
said target tissue.
15. The method of claim 12, further comprising: advancing said
scraper into said cannula to remove tenosynovium or ligament
sheath.
16. The method of claim 12, wherein the uniportal endoscopic
surgical procedure is selected from the group consisting of trigger
finger release, Guyon's canal release, carpal tunnel release,
cubital tunnel release, fascia release, lateral release for patella
realignment, release of the extensor tendons, release of the
posterior or other compartments of the leg, fascia release and
blood vessel harvesting.
17. The method of claim 16, wherein the uniportal endoscopic
surgical procedure is fascia release.
18. The method of claim 17, wherein the fascia release is selected
from the group consisting of forearm fasciotomy, plantar
fasciotomy, fasciotomy for compartment syndrome, leg fasciotomy and
fasciotomy of the hand.
19. The method of claim 12, wherein the target tissue is selected
from the group consisting of the A1 pulley, carpal transverse
ligament, cubital tunnel, Guyon's canal, fascia and blood
vessel.
20. The method of claim 19, wherein the blood vessel is a vein or
artery.
21. A slotted clear cannula comprising a cannula body having a
proximal end and a distal end, and a slot extending from the
proximal end of the cannula body to the proximity of the distal end
of the cannula body, wherein the distal end is a closed end.
22. The slotted clear cannula of claim 21, wherein the distal end
of the cannula body is tapered and forms an angle with the cannula
body.
23. The slotted clear cannula of claim 21, wherein the proximal end
of the cannula body is configured to be engaged with another device
and has a diameter that is larger than the diameter of the cannula
body.
24. The slotted clear cannula of claim 21, wherein the distal end
of the cannula body comprises a sharpened edge for tissue
separation.
25. The slotted clear cannula of claim 21, wherein the distal end
of the cannula body forms an angle with the cannula body, wherein
said angle is in the range of 165-145 degrees.
26. A method for a performing a uniportal endoscopic surgical
procedure on a target tissue using the slotted clear cannula of
claim 21, comprising: establishing an entry portal in said subject;
inserting said cannula into said entry portal; extending said
cannula through said entry portal to said target tissue; advancing
an endoscope into said cannula visualize a target tissue; and
advancing a blade into said cannula until a desired cut is made on
said target tissue.
27. The method of claim 26, wherein said establishing an entry
portal comprises making an incision.
28. The method of claim 26, wherein said desired cut is division of
said target tissue.
29. The method of claim 26, wherein the distal end of the cannula
body comprises a sharpened edge for tissue separation.
30. The method of claim 26, further comprising: advancing a scraper
into said cannula to remove tenosynovium or ligament sheath.
31. The method of claim 26, wherein the uniportal endoscopic
surgical procedure is selected from the group consisting of trigger
finger release, Guyon's canal release, carpal tunnel release,
cubital tunnel release, fascia release, lateral release for patella
realignment, release of the extensor tendons, release of the
posterior or other compartments of the leg, fascia release and
blood vessel harvesting.
32. A method for a performing a uniportal endoscopic surgical
procedure on a target tissue using the kit of claim 10, comprising:
establishing an entry portal in said subject; inserting into said
entry portal said cannula of said endoscopic surgical device;
extending said cannula through said entry portal to said target
tissue; advancing an endoscope into said cannula visualize a target
tissue; and advancing said blade into said cannula until a desired
cut is made on said target tissue.
33. The method of claim 32, wherein said establishing an entry
portal comprises making an incision.
34. The method of claim 33, wherein said incision is made with said
scalpel.
35. A method for a performing a uniportal endoscopic surgical
procedure on a target tissue of a hand using the slotted clear
cannula of claim 21, comprising: establishing an entry portal in
said subject; inserting said cannula into said entry portal;
extending said cannula through said entry portal to said target
tissue; advancing an endoscope into said cannula visualize a target
tissue; and advancing a blade into said cannula until a desired cut
is made on said target tissue.
36. The method of claim 35, wherein said establishing an entry
portal comprises making an incision.
37. The method of claim 36, wherein said target tissue is the
flexor tendon sheath.
38. The method of claim 37, wherein said incision is made to the
proximate side of the flexor tendon sheath.
39. The method of claim 37, wherein said incision is made to the
distal side of the flexor tendon sheath.
40. The method of claim 35, wherein said slotted clear cannula is
attached to the distal end of an endoscopic surgical device, the
endoscopic surgical device further comprising: (a) a housing having
a proximate end and a distal end; (b) a revolver assembly located
within said housing, comprising: a slide lock having a proximate
end, a distal end and two notches at said distal end; a scraper; a
blade assembly; and a circular revolver body comprising a selector
switch; wherein said scraper and said blade reside at said two
notches of said slide lock in a pre-deployment position and wherein
said selector switch allows selection of said scraper or said blade
for deployment; (c) a tube assembly having a proximate end and a
distal end, said distal end of said tube assembly is located within
said housing and extends through said revolver, said distal end of
the tube assembly is capable of entering said slotted clear cannula
from said proximate end of said clear cannula; and (d) a scope lock
assembly for holding a viewing device in a stationary position
relative to the tube assembly.
Description
[0001] This application is a Continuation of application Ser. No.
15/661,968, filed on Jul. 27, 2017, which is a Continuation of
application Ser. No. 15/239,557, filed on Aug. 17, 2016, now U.S.
Pat. No. 9,808,274, which is a Continuation of application Ser. No.
14/736,904, filed on Jun. 11, 2015, now a U.S. Pat. No. 9,445,830,
which is a Continuation of application Ser. No. 14/013,746, filed
on Aug. 29, 2013, now U.S. Pat. No. 9,066,746, which is a
Continuation-In-Part of application Ser. No. 13/790,016, filed Mar.
8, 2013, now U.S. Pat. No. 8,911,470, which is a
Continuation-In-Part of application Ser. No. 13/602,968, filed on
Sep. 4, 2012. The entirety of the aforementioned applications is
incorporated herein by reference.
FIELD
[0002] This application generally relates to medical devices. In
particular, the application relates to devices and methods for
endoscopic surgery, e.g., for endoscopic tunnel or pulley release
surgery.
BACKGROUND
[0003] Endoscopic surgery is a minimally invasive surgical
procedure that is performed through small incisions or natural body
openings. An endoscopic procedure typically involves use of
specialized devices and remote-control manipulation of instruments
with indirect observation of the surgical field through an
endoscope or similar device. Comparing to open surgery, endoscopic
surgery may result in shorter hospital stays, or allow outpatient
treatment.
[0004] Trigger finger is characterized by catching, snapping or
locking of the involved finger flexor tendon, associated with
dysfunction and pain. Localized inflammation or nodular swelling of
said flexor tendon causes a disparity in size between the flexor
tendon and the surrounding retinacular pulley system, most commonly
at the level of the first annular (A1) pulley. When the subject
extends the involved finger, the tendon will "catch" on the pulley,
followed by an abrupt popping of the tendon through the pulley.
This results in a difficulty flexing or extending the finger and
the "triggering" phenomenon. Typically, a first course of treatment
for trigger finger is corticosteroid injections into the tendon
sheath to reduce inflammation. When corticosteroid injection is not
or no longer effective, surgical division of the A1 pulley is
indicated.
[0005] Carpal tunnel syndrome is an entrapment median neuropathy
resulting from compression of the median nerve at the wrist in the
carpal tunnel. Symptoms of carpal tunnel syndrome include tingling,
numbness, weakness, or pain felt in the fingers supplied by the
median nerve or in the palm. Repetitive tasks, force, posture, and
vibration have been cited as causative or contributing factors to
carpal tunnel syndrome. Palliative treatments for carpal tunnel
syndrome include direct corticosteroid injections, splinting, oral
corticosteroids and/or behavior modification. Failure of these
methods within a reasonable period of time, and/or the presence of
other contributing factors, indicates a need for surgical division
of the carpal tunnel.
[0006] Other conditions involving the compression of a nerve by a
ligament pulley or tunnel include Guyon's canal (or canal)
syndrome, which is a compression of the ulnar nerve as it passes
through Guyon's canal at the wrist; cubital tunnel syndrome, which
is a compression of the ulnar nerve as it passes through the
cubital tunnel at the elbow; radial tunnel syndrome, which is a
compression of the radial nerve as it travels from the brachial
plexus to the wrist and hand; and pronater teres syndrome, which is
a compression neuropathy of the median nerve in the region of the
elbow.
[0007] Conventional surgical techniques and equipment for pulley or
tunnel release require a fairly large incision over the pulley or
tunnel and spreading of the incision to allow viewing and
instrument access. These techniques can require a longer period of
recovery than endoscopic methods and have greater levels of
post-operative pain due to the incision size and level of
manipulation during the procedure.
[0008] Typically, endoscopic surgery has involved a number of steps
and separate devices for performing pulley or tunnel division.
After making an incision and opening a path to the pulley or tunnel
using a blunt instrument, a cannula is inserted into the path.
Briefly, in order to smoothly insert the cannula, the central lumen
of the cannula must be filled with a device, such as an obturator.
The obturator is then removed and an endoscope, or arthroscope, is
inserted into the cannula to view the pulley or tunnel. The
endoscope is then withdrawn from the cannula, a knife is either
advanced into the cannula for division or a specialized knife
assembly is affixed to the endoscope and the knife/endoscope
assembly is advanced into the cannula for division. The present
application fulfills a need in the art for a compact device for
uniportal endoscopic pulley or tunnel release surgery that
eliminates the need for a separate device, such as an obturator,
for filling the cannula during insertion and eliminates the need to
remove the endoscope in order to insert a blade or blade
assembly.
SUMMARY
[0009] One aspect of the present application relates to an
endoscopic surgical device, comprising: (a) a housing having a
proximate end and a distal end; (b) a slotted clear cannula
attached to said distal end of said housing, said slotted clear
cannula comprises a cannula body having a proximate end and a
distal end, and a slot extending from said proximate end of said
cannula to the proximity of said distal end of said cannula; (c) a
revolver assembly located within said housing, comprising: a slide
lock having a proximate end, a distal end and two notches at said
distal end; a scraper; a blade assembly; and a circular revolver
body comprising a selector switch; wherein said scraper and said
blade reside at said two notches of said slide lock in a
pre-deployment position and wherein said selector switch allows
selection of said scraper or said blade for deployment; (d) a tube
assembly having a proximate end and a distal end, said distal end
of said tube assembly is located within said housing and extends
through said revolver, said distal end of the tube assembly is
capable of entering said slotted clear cannula from said proximate
end of said clear cannula; and (e) a scope lock assembly for
holding a viewing device in a stationary position relative to the
tube assembly.
[0010] Another aspect of the present application relates to an
endoscopic surgical kit, comprising an endoscope and an endoscopic
surgical device, comprising: (a) a housing having a proximate end
and a distal end; (b) a slotted clear cannula attached to said
distal end of said housing, said slotted clear cannula comprises a
cannula body having a proximate end and a distal end, and a slot
extending from said proximate end of said cannula to the proximity
of said distal end of said cannula; (c) a revolver assembly located
within said housing, comprising: a slide lock having a proximate
end, a distal end and two notches at said distal end; a scraper; a
blade assembly; and a circular revolver body comprising a selector
switch; wherein said scraper and said blade reside at said two
notches of said slide lock in a pre-deployment position and wherein
said selector switch allows selection of said scraper or said blade
for deployment; (d) a tube assembly having a proximate end and a
distal end, said distal end of said tube assembly is located within
said housing and extends through said revolver, said distal end of
the tube assembly is capable of entering said slotted clear cannula
from said proximate end of said clear cannula; and (e) a scope lock
assembly for holding a viewing device in a stationary position
relative to the tube assembly, and a scalpel.
[0011] Another aspect of the present application relates to a
method for a performing a uniportal endoscopic surgical procedure
on a target tissue using an endoscopic surgical device, comprising:
(a) a housing having a proximate end and a distal end; (b) a
slotted clear cannula attached to said distal end of said housing,
said slotted clear cannula comprises a cannula body having a
proximate end and a distal end, and a slot extending from said
proximate end of said cannula to the proximity of said distal end
of said cannula; (c) a revolver assembly located within said
housing, comprising: a slide lock having a proximate end, a distal
end and two notches at said distal end; a scraper; a blade
assembly; and a circular revolver body comprising a selector
switch; wherein said scraper and said blade reside at said two
notches of said slide lock in a pre-deployment position and wherein
said selector switch allows selection of said scraper or said blade
for deployment; (d) a tube assembly having a proximate end and a
distal end, said distal end of said tube assembly is located within
said housing and extends through said revolver, said distal end of
the tube assembly is capable of entering said slotted clear cannula
from said proximate end of said clear cannula; and (e) a scope lock
assembly for holding a viewing device in a stationary position
relative to the tube assembly.
[0012] Another aspect of the present application relates to slotted
clear cannula comprising a cannula body having a proximate end and
a distal end, and a slot extending from said proximate end of said
cannula to the proximity of said distal end of said cannula,
wherein the distal end of the cannula is closed.
[0013] Another aspect of the present application relates to a
method for a performing a uniportal endoscopic surgical procedure
on a target tissue using a slotted clear cannula comprising a
cannula body having a proximal end and a distal end, and a slot
extending from the proximal end of the cannula body to the
proximity of the distal end of the cannula body, wherein the distal
end is a closed end, the method comprising: establishing an entry
portal in said subject; inserting said cannula into said entry
portal; extending said cannula through said entry portal to said
target tissue; advancing an endoscope into said cannula visualize a
target tissue; and advancing a blade into said cannula until a
desired cut is made on said target tissue.
[0014] Another aspect of the present application relates to a
method for a performing a uniportal endoscopic surgical procedure
on a target tissue using an endoscopic surgical kit comprising an
endoscopic surgical device comprising: (a) a housing having a
proximate end and a distal end; (b) a slotted clear cannula
attached to said distal end of said housing, said slotted clear
cannula comprises a cannula body having a proximate end and a
distal end, and a slot extending from said proximate end of said
cannula to the proximity of said distal end of said cannula; (c) a
revolver assembly located within said housing, comprising: a slide
lock having a proximate end, a distal end and two notches at said
distal end; a scraper; a blade assembly; and a circular revolver
body comprising a selector switch; wherein said scraper and said
blade reside at said two notches of said slide lock in a
pre-deployment position and wherein said selector switch allows
selection of said scraper or said blade for deployment; (d) a tube
assembly having a proximate end and a distal end, said distal end
of said tube assembly is located within said housing and extends
through said revolver, said distal end of the tube assembly is
capable of entering said slotted clear cannula from said proximate
end of said clear cannula; and (e) a scope lock assembly for
holding a viewing device in a stationary position relative to the
tube assembly, the kit further comprising a scalpel, and the method
comprising: establishing an entry portal in said subject; inserting
into said entry portal said cannula of said endoscopic surgical
device; extending said cannula through said entry portal to said
target tissue; advancing an endoscope into said cannula visualize a
target tissue; and advancing said blade into said cannula until a
desired cut is made on said target tissue.
[0015] Another aspect of the present application relates to a
method for a performing a uniportal endoscopic surgical procedure
on a target tissue of a hand using a slotted clear cannula
comprising a cannula body having a proximal end and a distal end,
and a slot extending from the proximal end of the cannula body to
the proximity of the distal end of the cannula body, wherein the
distal end is a closed end, the method comprising: establishing an
entry portal in said subject; inserting said cannula into said
entry portal; extending said cannula through said entry portal to
said target tissue; advancing an endoscope into said cannula
visualize a target tissue; and advancing a blade into said cannula
until a desired cut is made on said target tissue.
BRIEF DESCRIPTION OF THE DRAWINGS
[0016] The present invention can be better understood by reference
to the following drawings. The drawings are merely exemplary to
illustrate certain features that may be used singularly or in
combination with other features and the present invention should
not be limited to the embodiments shown.
[0017] FIG. 1 is an exploded view of one embodiment of the device
of the present application.
[0018] FIG. 2 is a perspective view of another embodiment of the
device of the present application.
[0019] FIG. 3 is a perspective view of another embodiment of the
device of the present application.
[0020] FIG. 4 is an exploded view of the embodiment of the
embodiment depicted in FIG. 3.
[0021] FIG. 5 shows individual components of the embodiment
depicted in FIG. 3.
[0022] FIG. 6 is a cutaway view of the embodiment of the embodiment
depicted in FIG. 3.
[0023] FIG. 7 is an exploded view of individual components of the
embodiment depicted in FIG. 3.
[0024] FIGS. 8A-F show the orientation of the internal components
in side view (A, C, E) and end view (B, D, F) of the embodiment of
FIG. 3 for the advancement of an endoscope alone (A, B), an
endoscope with a scraper (C, D) or an endoscope with a blade (E,
F).
[0025] FIG. 9 is a perspective view of another embodiment of the
device of the present application.
[0026] FIG. 10 is an exploded view of the embodiment depicted in
FIG. 9.
[0027] FIGS. 11A-E show perspective and cross-sectional views of
the cannula element of the embodiment depicted in FIG. 9.
[0028] FIGS. 12A-F show perspective and cross-sectional views of
the top shell of the housing of the embodiment depicted in FIG.
9.
[0029] FIGS. 13A-F show perspective and cross-sectional views of
the bottom shell of the housing of the embodiment depicted in FIG.
9.
[0030] FIGS. 14A-E show perspective and cross-sectional views of
the revolver element of the embodiment depicted in FIG. 9.
[0031] FIGS. 15A-E show perspective and cross-sectional views of
the slide lock element of the embodiment depicted in FIG. 9.
[0032] FIGS. 16A-E show perspective and cross-sectional views of
the rotary clip element of the embodiment depicted in FIG. 9.
[0033] FIGS. 17A-D show perspective views of the tube assembly
element of the embodiment depicted in FIG. 9.
[0034] FIGS. 18A-C show perspective views of the blade tool element
of the embodiment depicted in FIG. 9.
[0035] FIGS. 19A-E show perspective and cross-sectional views of
the blade of FIGS. 18A-C.
[0036] FIG. 20 shows a perspective view of the blade element of the
embodiment depicted in FIG. 9, as deployed through the slot in the
cannula.
[0037] FIG. 21 shows another perspective view of the blade element
of the embodiment depicted in FIG. 9, as deployed through the slot
in the cannula.
[0038] FIG. 22 shows a side perspective view of the embodiment
depicted in FIG. 9 with the blade deployed through the slot in the
cannula.
[0039] FIGS. 23A-E show perspective views of the scraper element of
the embodiment depicted in FIG. 9.
[0040] FIG. 24 shows a perspective view of the scraper element of
the embodiment depicted in FIG. 9, as deployed through the slot in
the cannula.
[0041] FIG. 25 shows a side perspective view of the embodiment
depicted in FIG. 9 with the scraper deployed through the slot in
the cannula.
[0042] FIG. 26 shows a top perspective view of the embodiment
depicted in FIG. 9 with the scraper deployed through the slot in
the cannula.
[0043] FIG. 27 is a perspective view of another embodiment of the
device of the present application, comprising a scope lock
component.
[0044] FIGS. 28A-D show additional perspective views of the
embodiment depicted in FIG. 27.
[0045] FIG. 29 is an exploded view of the embodiment depicted in
FIG. 27 and FIGS. 28A-D.
[0046] FIGS. 30A-E show perspective and cross-sectional views of
another embodiment of the cannula element of the device.
[0047] FIGS. 31A-F show perspective and cross-sectional views of
the top shell of the housing of the embodiment depicted in FIG.
27.
[0048] FIGS. 32A-F show perspective and cross-sectional views of
the bottom shell of the housing of the embodiment depicted in FIG.
27.
[0049] FIGS. 33A-C show perspective and cross-sectional views of an
embodiment of the blade tool element.
[0050] FIGS. 34A-E show perspective and cross-sectional views of
the blade of FIGS. 28A-C.
[0051] FIGS. 35A-E show perspective and cross-sectional views of an
embodiment of the scraper element of the device.
[0052] FIGS. 36A-E show perspective and cross-sectional views of
the slide lock element of the embodiment depicted in FIG. 27.
[0053] FIGS. 37A-D show perspective views of an embodiment of an
extension spring of the device.
[0054] FIGS. 38A-D show perspective and cross-sectional views of a
tube assembly element of the device as it interfaces with the slide
lock element of the embodiment depicted in FIGS. 31A-E.
[0055] FIG. 39A-D show perspective views of an embodiment of a tool
selector element of the tube assembly.
[0056] FIGS. 40A-E show perspective views of the rotary clip
element of the embodiment depicted in FIG. 27.
[0057] FIGS. 41A-E show perspective and cross-sectional views of
the revolver element of the embodiment depicted in FIG. 27.
[0058] FIGS. 42A-F show perspective and cross-sectional views of
the top portion of an exemplary housing for a scope lock component
of the embodiment of the device depicted in FIG. 27.
[0059] FIGS. 43A-F show perspective and cross-sectional views of
the bottom portion of an exemplary housing for a scope lock
component of the embodiment of the device depicted in FIG. 27.
[0060] FIGS. 44A-E show perspective views of an embodiment of a
scope lock button of the embodiment of the device shown in FIG.
27.
[0061] FIGS. 45A-E show perspective views of an embodiment of a
plate return spring of the device.
[0062] FIGS. 46A-D show perspective views of an embodiment of a
locking plate of the device.
DETAILED DESCRIPTION
[0063] The following detailed description is presented to enable
any person skilled in the art to make and use the invention. For
purposes of explanation, specific nomenclature is set forth to
provide a thorough understanding of the present invention. However,
it will be apparent to one skilled in the art that these specific
details are not required to practice the invention. Descriptions of
specific applications are provided only as representative examples.
The present invention is not intended to be limited to the
embodiments shown, but is to be accorded the widest possible scope
consistent with the principles and features disclosed herein.
[0064] This description is intended to be read in connection with
the accompanying drawings, which are to be considered part of the
entire written description of this application. The drawing figures
are not necessarily to scale and certain features of the
application may be shown exaggerated in scale or in somewhat
schematic form in the interest of clarity and conciseness. In the
description, relative terms such as "front," "back," "up," "down,"
"top," "bottom," "upper," "lower," "distal," and "proximate" as
well as derivatives thereof, should be construed to refer to the
orientation as then described or as shown in the drawing figure
under discussion. These relative terms are for convenience of
description and normally are not intended to require a particular
orientation. Terms concerning attachments, coupling and the like,
such as "connected," "mounted," and "attached," refer to a
relationship wherein structures are secured or attached to one
another either directly or indirectly through intervening
structures, as well as both movable or rigid attachments or
relationships, unless expressly described otherwise.
[0065] The term "trigger finger," as used herein, also refers to
"trigger digit," "trigger thumb," and "stenosing
tendovaginitis."
[0066] As used herein, the terms "horizontal" and "vertical," and
derivatives of those terms, are used in respect to their
relationship to the plane defined by the slot in the cannula of the
present application. "Vertical" refers to the plane that can, for
example, pass through the slot of the cannula and bisect the
cannula into two equal halves, while "horizontal" refers to a plane
that is perpendicular to the vertical plane. The horizontal plane
may be a level plane with respect to the length of the cannula or
housing of the device, or may be at an angle to that level plane,
allowing some upward or downward movement of elements moving along
the horizontal plane with respect to the level plane.
[0067] The present application describes a compact device for
performing endoscopic surgical procedures, comprising a clear
cannula that is attached to a housing. The housing further
comprises a blade that extends into the cannula, and a paddle for
pushing the blade. In some embodiments, the housing further
comprises a ring that secures the paddle to the housing, but allows
the paddle to rotate side-to-side. The present assembly provides a
convenient means for performing endoscopic surgical procedures with
the elimination of the steps of inserting an obturator into the
cannula for introducing the cannula into a portal, removing the
obturator from the cannula, and removing an endoscope from the
cannula so that a blade can be inserted and advanced into the
cannula. The preassembled nature of the device also provides
convenience for the practitioner in that the cannula and blade are
available in a single package that requires no further assembly and
can be used easily in an office setting without the need for some
traditional endoscopic equipment that may be too expensive or
cumbersome to use outside of a hospital. Additionally, the present
device also can be easily transported and used in remote settings,
such as by emergency medical personnel, first responders or
military medical personnel.
[0068] The clear cannula of the present application has a closed
distal end, allowing the cannula to be inserted through a portal
(such as an incision) without the use of a cannula filling
instrument, such as an obturator. The clear cannula allows the
practitioner a 360 degree field of vision around the cannula
through the use of an endoscope (or arthroscope) inserted into the
central lumen of the cannula. This allows the practitioner to
visualize all of the tissues surrounding the cannula from the point
of initial insertion to and beyond the tissue targeted for a
desired endoscopic surgical procedure. Some embodiments of the
clear cannula comprise a blunt leading edge that is designed to
serve as an obturator. The blunt leading edge allows the cannula to
be inserted through an entry point and advanced to and/or beyond
the target tissue without the need to first insert an instrument,
such as an elevator, through the incision to first separate tissues
and make a path for the cannula. An advantage of this design is
that it eliminates a step in the surgical procedure. Another
advantage is that it eliminates a step requiring a blind insertion
of an instrument into a patient, as the insertion and advancement
path of an elevator cannot be easily visualized by the
practitioner. The present clear cannula with a sharpened leading
edge, on the other hand, allows the practitioner to insert an
endoscope into the clear cannula and visually monitor the insertion
of the device and creation of a channel from the point of initial
insertion to, or beyond, the target tissue. This allows the
practitioner to penetrate into the tissue only as far as is
necessary for performing the desired procedure, as well as avoiding
tissues or structures that could be damaged, such as nerves or
blood vessels, by blind insertion of a separating tool, such as an
elevator.
[0069] The use of the present device is exemplified in this
application for, but not limited to, endoscopic surgical division
of a pulley or tunnel. Some other non-limiting uses for the present
device include, for example, other divisions or partial separation
of a tendon or ligament, cutting, dividing, separating or making an
incision in connective tissue, muscle, cartilage, membranes, skin,
other body tissues or organs or any other use of the device that
can be envisioned or carried out by the practitioner. As used
herein, the term "practitioner" refers to one of skill in the art
or any other user of the present device.
[0070] Endoscopic surgical procedures that can be performed with a
cannula or device of the present application include, but are not
limited to, carpal tunnel release, Guyon's canal (or tunnel)
release, cubital tunnel release, plantar fascia release, lateral
release for patella realignment, release of radial tunnel, release
of pronatar teres, release of trigger finger, release of lacertus
fibrosus, release of the extensor tendons for lateral
epicondylitis, release of medial epicondylitis, release of the
posterior and other compartments of the leg, forearm fascia release
for fascial compartment syndrome, release of fascial compartments
in the upper or lower extremities, relieving the compression of a
nerve by a ligament pulley or tunnel, and releasing the travel of a
ligament or tendon through a pulley or tunnel. Additional
endoscopic procedures that can be performed with a cannula or
device of the present application include endoscopic surgical
procedures on the spine, such as endoscopic discectomy for the
treatment of degenerative disc disease, herniated discs, bulging
discs, pinched nerves or sciatica. Endoscopic procedures that can
be performed with a cannula or device of the present application
also include endoscopic procedures on cranial and facial tissues,
as well as fasciotomy release throughout the body. The cannula or
device of the present application can be used for blood vessel,
including vein or artery, harvesting throughout the body, for
example to provide blood vessel graft material in conjunction with
a coronary bypass procedure or for a reconstructive surgical
procedure. Endoscopic procedures that can be performed with a
cannula or device of the present application also include
endoscopic procedures on the wrist and hand, including the palmar
and dorsal sides of the hand. Endoscopic procedures that can be
performed with a cannula or device of the present application on
the hand also include the digits, including the thumb, index
finger, middle finger, ring finger and little (pinky) finger.
[0071] Endoscopic surgical procedures that can be performed with a
cannula or device of the present application, such as, but not
limited to, a tunnel release procedure or trigger finger release,
can be performed by approaching the target tissue through an
incision or body opening on either the proximate or distal side of
the target tissue.
[0072] One aspect of the present application relates to an
endoscopic surgical device, comprising: (a) a housing having a
proximate end and a distal end; (b) a slotted clear cannula
attached to said distal end of said housing, said slotted clear
cannula comprises a cannula body having a proximate end and a
distal end, and a slot extending from said proximate end of said
cannula to the proximity of said distal end of said cannula; (c) a
revolver assembly located within said housing, comprising: a slide
lock having a proximate end, a distal end and two notches at said
distal end; a scraper; a blade assembly; and a circular revolver
body comprising a selector switch; wherein said scraper and said
blade reside at said two notches of said slide lock in a
pre-deployment position and wherein said selector switch allows
selection of said scraper or said blade for deployment; (d) a tube
assembly having a proximate end and a distal end, said distal end
of said tube assembly is located within said housing and extends
through said revolver, said distal end of the tube assembly is
capable of entering said slotted clear cannula from said proximate
end of said clear cannula; and (e) a scope lock assembly for
holding a viewing device in a stationary position relative to the
tube assembly.
[0073] In one embodiment, the scope lock assembly is affixed to the
proximate end of the tube assembly.
[0074] In a further embodiment, the scope lock assembly is slidable
with the tube assembly relative to the housing of the device. In
another further embodiment, the scope lock assembly is lockable to
the proximate end of the housing.
[0075] In another embodiment, the default condition of the scope
lock assembly is immobilization of the viewing device relative to
the tube assembly.
[0076] Another aspect of the present invention relates to an
endoscopic surgical kit, comprising an endoscope and an endoscopic
surgical device, comprising: (a) a housing having a proximate end
and a distal end; (b) a slotted clear cannula attached to said
distal end of said housing, said slotted clear cannula comprises a
cannula body having a proximate end and a distal end, and a slot
extending from said proximate end of said cannula to the proximity
of said distal end of said cannula; (c) a revolver assembly located
within said housing, comprising: a slide lock having a proximate
end, a distal end and two notches at said distal end; a scraper; a
blade assembly; and a circular revolver body comprising a selector
switch; wherein said scraper and said blade reside at said two
notches of said slide lock in a pre-deployment position and wherein
said selector switch allows selection of said scraper or said blade
for deployment; (d) a tube assembly having a proximate end and a
distal end, said distal end of said tube assembly is located within
said housing and extends through said revolver, said distal end of
the tube assembly is capable of entering said slotted clear cannula
from said proximate end of said clear cannula; and (e) a scope lock
assembly for holding a viewing device in a stationary position
relative to the tube assembly.
[0077] In another embodiment, the kit further comprises a
scalpel.
[0078] In yet another embodiment, the kit further comprises an
endoscope.
[0079] Another aspect of the present application relates to a
method for a performing a uniportal endoscopic surgical procedure
on a target tissue using an endoscopic surgical device, the device
comprising: (a) a housing having a proximate end and a distal end;
(b) a slotted clear cannula attached to said distal end of said
housing, said slotted clear cannula comprises a cannula body having
a proximate end and a distal end, and a slot extending from said
proximate end of said cannula to the proximity of said distal end
of said cannula; (c) a revolver assembly located within said
housing, comprising: a slide lock having a proximate end, a distal
end and two notches at said distal end; a scraper; a blade
assembly; and a circular revolver body comprising a selector
switch; wherein said scraper and said blade reside at said two
notches of said slide lock in a pre-deployment position and wherein
said selector switch allows selection of said scraper or said blade
for deployment; (d) a tube assembly having a proximate end and a
distal end, said distal end of said tube assembly is located within
said housing and extends through said revolver, said distal end of
the tube assembly is capable of entering said slotted clear cannula
from said proximate end of said clear cannula; and (e) a scope lock
assembly for holding a viewing device in a stationary position
relative to the tube assembly; the method comprising: establishing
an entry portal in said subject, inserting into said entry portal
said cannula of said endoscopic surgical device; extending said
cannula through said entry portal to said target tissue; advancing
an endoscope into said cannula visualize a target tissue; and
advancing said blade into said cannula until a desired cut is made
on said target tissue.
[0080] In one embodiment, said establishing an entry portal
comprises making an incision.
[0081] In another embodiment, said desired cut is division of said
target tissue.
[0082] In still another embodiment, said method comprises advancing
said scraper into said cannula to remove tenosynovium or ligament
sheath.
[0083] In yet another embodiment, the uniportal endoscopic surgical
procedure is selected from the group consisting of trigger finger
release, Guyon's canal release, carpal tunnel release, cubital
tunnel release, fascia release, lateral release for patella
realignment, release of the extensor tendons, release of the
posterior or other compartments of the leg, fascia release and
blood vessel harvesting. In a further embodiment, the uniportal
endoscopic surgical procedure is fascia release. In a still further
embodiment, the fascia release is selected from the group
consisting of forearm fasciotomy, plantar fasciotomy, fasciotomy
for compartment syndrome, leg fasciotomy and fasciotomy of the
hand.
[0084] In yet still another embodiment, the target tissue is
selected from the group consisting of the A1 pulley, carpal
transverse ligament, cubital tunnel, Guyon's canal, fascia and
blood vessel. In a further embodiment, the blood vessel is a vein
or artery.
[0085] Another aspect of the present application relates to a
slotted clear cannula comprising a cannula body having a proximal
end and a distal end, and a slot extending from the proximal end of
the cannula body to the proximity of the distal end of the cannula
body, wherein the distal end is a closed end.
[0086] In one embodiment, the distal end of the cannula body is
tapered and forms an angle with the cannula body.
[0087] In another embodiment, the proximal end of the cannula body
is configured to be engaged with another device and has a diameter
that is larger than the diameter of the cannula body.
[0088] In still another embodiment, the cannula body is graded
between the proximal end of the cannula body and distal end of the
cannula body.
[0089] In yet another embodiment, the distal end of the cannula
body comprises a sharpened edge for tissue separation.
[0090] Another aspect of the present application relates to a
method for a performing a uniportal endoscopic surgical procedure
on a target tissue using a slotted clear cannula comprising a
cannula body having a proximal end and a distal end, and a slot
extending from the proximal end of the cannula body to the
proximity of the distal end of the cannula body, wherein the distal
end is a closed end, the method comprising: establishing an entry
portal in said subject; inserting said cannula into said entry
portal; extending said cannula through said entry portal to said
target tissue; advancing an endoscope into said cannula visualize a
target tissue; and advancing a blade into said cannula until a
desired cut is made on said target tissue.
[0091] In one embodiment, the method comprises establishing an
entry portal comprises making an incision.
[0092] In another embodiment, the desired cut is division of said
target tissue.
[0093] In still another embodiment, the distal end of the cannula
body comprises a sharpened edge for tissue separation.
[0094] In yet another embodiment, the method further comprises
advancing a scraper into said cannula to remove tenosynovium or
ligament sheath.
[0095] In yet still another embodiment, the uniportal endoscopic
surgical procedure is selected from the group consisting of trigger
finger release, Guyon's canal release, carpal tunnel release,
cubital tunnel release, fascia release, lateral release for patella
realignment, release of the extensor tendons, release of the
posterior or other compartments of the leg, fascia release and
blood vessel harvesting.
[0096] Another aspect of the present application relates to a
method for a performing a uniportal endoscopic surgical procedure
on a target tissue using an endoscopic surgical kit comprising an
endoscopic surgical device comprising: (a) a housing having a
proximate end and a distal end; (b) a slotted clear cannula
attached to said distal end of said housing, said slotted clear
cannula comprises a cannula body having a proximate end and a
distal end, and a slot extending from said proximate end of said
cannula to the proximity of said distal end of said cannula; (c) a
revolver assembly located within said housing, comprising: a slide
lock having a proximate end, a distal end and two notches at said
distal end; a scraper; a blade assembly; and a circular revolver
body comprising a selector switch; wherein said scraper and said
blade reside at said two notches of said slide lock in a
pre-deployment position and wherein said selector switch allows
selection of said scraper or said blade for deployment; (d) a tube
assembly having a proximate end and a distal end, said distal end
of said tube assembly is located within said housing and extends
through said revolver, said distal end of the tube assembly is
capable of entering said slotted clear cannula from said proximate
end of said clear cannula; and (e) a scope lock assembly for
holding a viewing device in a stationary position relative to the
tube assembly, the kit further comprising a scalpel, and the method
comprising: establishing an entry portal in said subject; inserting
into said entry portal said cannula of said endoscopic surgical
device; extending said cannula through said entry portal to said
target tissue; advancing an endoscope into said cannula visualize a
target tissue; and advancing said blade into said cannula until a
desired cut is made on said target tissue.
[0097] In one embodiment, said establishing an entry portal
comprises making an incision. In a further embodiment, said
incision is made with said scalpel.
[0098] Another aspect of the present application relates to a
method for a performing a uniportal endoscopic surgical procedure
on a target tissue of a hand using a slotted clear cannula
comprising a cannula body having a proximal end and a distal end,
and a slot extending from the proximal end of the cannula body to
the proximity of the distal end of the cannula body, wherein the
distal end is a closed end, the method comprising: establishing an
entry portal in said subject; inserting said cannula into said
entry portal; extending said cannula through said entry portal to
said target tissue; advancing an endoscope into said cannula
visualize a target tissue; and advancing a blade into said cannula
until a desired cut is made on said target tissue.
[0099] In one embodiment, said establishing an entry portal
comprises making an incision. In a further embodiment, said target
tissue is the flexor tendon sheath. In a still further embodiment,
said incision is made to the proximate side of the flexor tendon
sheath. In another still further embodiment, said incision is made
to the distal side of the flexor tendon sheath.
[0100] In another embodiment, said slotted clear cannula is
attached to the distal end of an endoscopic surgical device, the
endoscopic surgical device further comprising: (a) a housing having
a proximate end and a distal end; (b) a revolver assembly located
within said housing, comprising: a slide lock having a proximate
end, a distal end and two notches at said distal end; a scraper; a
blade assembly; and a circular revolver body comprising a selector
switch; wherein said scraper and said blade reside at said two
notches of said slide lock in a pre-deployment position and wherein
said selector switch allows selection of said scraper or said blade
for deployment; (c) a tube assembly having a proximate end and a
distal end, said distal end of said tube assembly is located within
said housing and extends through said revolver, said distal end of
the tube assembly is capable of entering said slotted clear cannula
from said proximate end of said clear cannula; and (d) a scope lock
assembly for holding a viewing device in a stationary position
relative to the tube assembly.
Linear Operated Device
[0101] FIG. 1 shows an exemplary device of the present application.
The device comprises a blade 10, a slotted clear cannula 20, and a
housing 30. The device may further include a pusher paddle 40, and
may still further include a retainer ring 50.
[0102] The blade 10 comprises a horizontally-oriented pushing
component 11 and a vertically-oriented cutting component 12. The
cutting component 12 further comprises a sharpened cutting surface
13 at the forward end, which is the end of the blade most proximal
to the cannula 20 of the device. The cutting surface 13 may be
single-beveled or double-beveled.
[0103] In some embodiments, the cutting surface 13 of the blade is
a single cutting surface. In some further embodiments, that single
cutting surface is angled downward such that the upper end of the
cutting surface is forward of the lower end of the cutting surface.
In other further embodiments, that single cutting surface has a
concave curve and is semi-circular or crescent shaped.
[0104] In other embodiments, the cutting surface 13 of the cutting
component 12 is divided into an upper cutting surface and a lower
cutting surface that are at an angle to one another and meet at a
central crotch.
[0105] The design of the present blade 10 is such that it is usable
in endoscopic surgery in a manner that allows the practitioner to
extend the blade 10 through the cannula to the target tissue
without damage to surrounding tissue and/or organs. The cutting
component 12 of blade 10 is made from materials commonly used for
surgical blades or scalpels, such materials include, but are not
limited to, hardened and tempered steel, stainless steel, high
carbon steel, titanium, alloys and ceramic.
[0106] In particular embodiments, the cutting component 12 of the
blade 10 is made from stainless steel. In a further embodiment, the
stainless steel is martensitic stainless steel. An exemplary
martensitic stainless steel is Bohler-Uddeholm AEB-L martensitic
stainless steel. In a still further embodiment, the martensitic
stainless steel is heat-treated. In another further embodiment, the
stainless steel is 440 A stainless steel. In a particular
embodiment, the cutting component 12 of the blade 10 is made from
Hitachi GIN-5 SST-MODIFIED 440-A stainless steel. The cutting
component 12 of the blade 10 is optionally flash electropolished.
The cutting edges are machine finished and must be sharp. In a
particular embodiment, the steel of the cutting component 12 of the
blade 10 is heat-treated to Rockwell C hardness of about 50-72. In
a more particular embodiment, the steel of the cutting component 12
of the blade 10 is heat-treated to Rockwell C hardness of
58-64.
[0107] In particular embodiments, the entire blade 10 is cut from a
single sheet of, or is cast from, a material commonly used for
surgical blades or scalpels. The cutting component 12 is then bent
into a vertical orientation that is perpendicular to the horizontal
orientation of the pushing component 11. In some embodiments, the
bevel(s) of the cutting surface 13 are ground prior to bending. In
other embodiments, the bevel(s) of the cutting surface 13 are
ground after bending.
[0108] In other embodiments, the pushing component 11 and cutting
component 12 of the blade 10 are fabricated separately (by cutting
or casting) and affixed to one another in their respective proper
orientations. In some further embodiments, the pushing component 11
and cutting component 12 are fabricated from the same material. In
other further embodiments, the pushing component 11 and cutting
component 12 are fabricated from different materials, but at least
the cutting component 12 is fabricated from a material commonly
used for surgical blades or scalpels. In such a case, the pushing
component 11 of the blade 10 may be fabricated from any suitable
material providing adequate strength and rigidity for pushing the
cutting component including, but not limited to, plastics,
polycarbonate, hardened and tempered steel, stainless steel, high
carbon steel, titanium, alloys and ceramic. Affixing of the cutting
component 12 to the pushing component 11 may be accomplished by any
means known in the art, such as the use of a suitable adhesive or
by welding, including laser welding. In a particular embodiment,
the strength of the bond between the pushing component 11 and the
cutting component 12 is tested by applying torque to the unit, for
example about 10 in-lbs of torque.
[0109] In particular embodiments, the blade 10 further comprises
tabs 14 at the end of the pushing component 11 distal to the
cutting component 12. In some embodiments, the tabs 14 extend
outward to the sides of the blade 10 in the same horizontal plane
as the pushing component 11, although in some embodiments, the tabs
14 may also be at an angle to that horizontal plane, as appropriate
for the application. As used herein, the term "tabs" refers to
either a single tab structure, two tab structures, or any other
multiple as appropriate.
[0110] The tabs 14 are slidably engaged with the case or housing 30
in a manner to be further described below.
[0111] The cannula 20 is made of a clear plastic material so that
the entirety of the surrounding tissue can be viewed with an
endoscope. The cannula 20 is slotted along its top, with the slot
21 being contiguous with the open end 22 that is proximal to the
housing 30. In some embodiments, the distal end 23 of the cannula
20 is closed, such that the cannula 20 can be inserted into a
channel made through body tissue without the use of an obturator.
In particular embodiments, the closed distal end 23 of the cannula
is tapered, but is sufficiently blunted such that it does not
damage bodily tissues as it is advanced though an incision and
channel through bodily tissue, or through a natural body
opening.
[0112] The cannula 20 engages with the blade 10 of the device such
that the cutting component 12 inserts into and is slidably engaged
with the slot 21.
[0113] In some embodiments, the cannula 20 further internally
comprises horizontal blade guidance tracks 24 perpendicular to the
plane of and below the slot 21. The sides 15 of the pushing
component 11 of the blade 10 slidably engage with the horizontal
blade guidance tracks 24, in order to allow the accurate
advancement of the cutting component 12 of the blade 10 through the
slot 21. In some further embodiments, the height of the horizontal
blade guidance tracks 24 is level with respect to the distance from
the slot 21, such that the distance the cutting surface 13
protrudes through the slot 21 is the same over the entire course of
travel from the proximal end 22 of the cannula 20 to the distal end
23 of the cannula 20. In other further embodiments, the height of
the horizontal blade guidance tracks 24 is at an angle with respect
to the distance from the slot 21, such that the distance the
cutting surface 13 protrudes through the slot 21 is lower at or
near the proximal end 22 of the cannula 20 and higher at or near
the distal end 23 of the cannula 20.
[0114] In some embodiments, the cannula 20 further comprises a
channel 25 for the slidable insertion a viewing device, such as an
endoscope. In some embodiments, the channel 25 is located below the
horizontal blade guidance tracks 24. In some embodiments, the
channel 25 and the horizontal blade guidance tracks 24 form a
single contiguous lumen that is also contiguous with the slot 21.
In other embodiments, there is a layer of material molded as part
of the cannula 20 between the channel 25 and the horizontal blade
guidance tracks 24, such that the lumen of the channel 25 is
physically separate from the lumen contiguous with the slot 21 and
comprising the horizontal blade guidance tracks 24.
[0115] In some embodiments, the proximal end 22 of the cannula 20
is adapted to engage with a connection point 31 on the front end of
the housing 30. The attachment can be by any means known in the
art, such as, but not limited to, adhesives, tabs, welds, laser
welds, locking mechanism, twist-lock, or friction fitting. In order
to provide a stable platform for endoscopic surgical procedures
using the device, the attachment of the cannula 20 to the housing
30 is such that, when assembled, the cannula 20 cannot move in
relation to the housing 30.
[0116] In some embodiments, the housing 30 of the device comprises
two halves 32, 33 that mate to one another to form a single housing
30. In some embodiments, the housing 30 may be formed as a single
piece or comprise three or more pieces.
[0117] The interior of the housing 30 comprises a guidance slot 34
on each side of the housing such that the two guidance slots 34 are
horizontally opposed to one another. The tabs 14 of the blade 10
are slidably engaged with the horizontally opposed guidance slots
34. In some embodiments, the height of the horizontally opposed
guidance slots 34 is parallel to with respect to a horizontal plane
that would bisect the cannula 20 into two equal halves. In other
embodiments, the height of the horizontally opposed guidance slots
34 is at an angle with respect to a horizontal plane that would
bisect the cannula 20 into two equal halves, such that the end of
the horizontally opposed guidance slots 34 distal to the cannula 20
is lower in the device with respect to the end of the horizontally
opposed guidance slots 34 proximal to the cannula 20.
[0118] When the tabs 14 are drawn back in the horizontally opposed
guidance slots 34, the cutting component 12 is contained within the
proximate end 22 of the slot 21 of the cannula 20 and the cutting
surface 13 is not protruded outside the device. As the tabs 14 are
advanced in the horizontally opposed guidance slots 34 toward the
connection point 31 with the cannula 20, the cutting component 12
slides in the proximate direction of the slot 21 of the cannula 20
and moves the cutting surface 13 toward the proximate end 23 of the
cannula 20.
[0119] In some embodiments, the device comprises a paddle 40 that
contacts the blade 10 behind or between the tabs 14. The paddle 40
comprises a grip area 41 that protrudes out of the housing 30
through a slot 35. The blade 10 is slidably advanced along the
horizontally opposed guidance slots 34 by advancing the paddle 40
towards the cannula 20 through the slot 35, causing the contact
area 42 of the paddle 40 to push against the pushing component 11
of the blade 10.
[0120] In some embodiments, the paddle 40 comprises at least one
arm that extends forward of the tabs 14 that allows the paddle 40
to capture the tab 14 and pull the blade 10 back to a withdrawn
position following completion of an endoscopic surgical
procedure.
[0121] In some embodiments, the paddle 40 is secured in the device
by a retaining ring 50. The retaining ring 50 comprises wings 51
that slidably interact with the horizontally opposed guidance slots
34 of the housing 30. The retaining ring 50 further comprises an
attachment ring 52 that connects to the connection region 43 of the
paddle 40. The connection region 43 of the paddle 40 may comprise
any means known in the art for connecting the paddle 40 to the
retaining ring 50. For example, the connection region 43 may
comprise tabs that extend through and entrap the attachment ring
52. In some embodiments, the connection between the connection
region 43 and the attachment ring 52 allows the paddle 40 to rotate
side-to-side in relation to the retaining ring and the blade
10.
[0122] In some embodiments, the paddle 40 can be retained, parked
or locked in a position fully distal to the cannula 20 by rotating
the grip area 41 of the paddle 40 into, for example, a notch 36 in
the housing 30.
[0123] In some embodiments, the housing 30 further comprises an
opening 39 at the end distal to the cannula 20 through which an
endoscope can be inserted. The endoscope is fed through the opening
39 and under the blade 10 to be inserted into the channel 25 of the
catheter 20. This allows direct visualization of the surgical site
and the surrounding tissue before, during and after performing an
endoscopic surgical procedure with the present device.
[0124] Another aspect of the present application relates to a
slotted clear cannula having a closed end such that the cannula can
be inserted into an incision or natural body opening and into a
passage through body tissue without the use of a device, such as an
obturator, filling the lumen of the cannula for insertion. In
particular embodiments, the closed end of the cannula is tapered,
but is sufficiently blunted such that it does not damage bodily
tissues as it is advanced though an incision and channel through
bodily tissue, or through a natural body opening. In another
particular embodiment, the slot is contiguous with the open end of
the cannula opposite the closed end.
Rotationally Operated Devices
[0125] FIGS. 2 and 3 show embodiments of the present application
wherein the device comprises a rotational switch for selecting the
tool to advance into the cannula. FIG. 2 shows an embodiment
comprising selection positions for advancing the endoscope alone
into the cannula and for advancing a blade along the endoscope into
the cannula. FIG. 3 shows an alternate embodiment, wherein the
device further comprises a selectable scraper that can be advanced
along the endoscope into the cannula.
[0126] FIG. 4 depicts an exploded view of the present device of
FIG. 3. The housing 30 is cylindrical in shape and is comprised of
two halves 32,33. The proximal end 22 of the cannula 20 is adapted
to engage with a connection point 31 on the front end of the
housing 30. In some embodiments, the proximal end 22 of the cannula
20 comprises depressions 26 that engage with tabs (or pins) 37 at
the connection point 31 on the front end of the housing 30. As used
herein, the term "depression" is understood to include, but is not
limited to, depressions that do not penetrate completely through
the material of the cannula, as well as holes or slots that
penetrate completely through the material of the cannula.
[0127] The housing 30 further includes an opening 38 that can be
located in either half 32,33 of the housing. In some embodiments,
the opening 38 may span the junction between the halves 32,33 of
the housing 30, being located partially in each half. The opening
38 is located adjacent to an internal revolver 60 that comprises a
selector switch 61 that protrudes through the opening 38.
[0128] Still referring to FIG. 4, the device further comprises an
slide lock 70 (or inner sleeve 70) that encircles a guidance tube
or tube assembly 71. The slide lock 70 comprises notches 72,73 and
a tub 79 separating the notches 72,73, at its distal end that
provide pre-deployment resting places for a blade 80 and a scraper
90. The slide lock 70 works in concert with the revolver 60 in
order to bring the blade 80 or scraper 90 into the proper
orientation for deployment into the slot 21 of the cannula 20. The
tube assembly 71 provides a path for deploying an endoscope through
the device and into the cannula 20. The tube assembly 71 also
provides, at its distal end, a mounting point or tube locator 78
(shown in FIG. 8A) that the blade 80 or scraper 90 is rotated onto
for deployment. At the proximate end of the housing, the tube
assembly passes through a stabilizer ring 74, which mounts into,
and seals, the proximate end of the housing. The tube assembly 71
is advanced along the deployed endoscope into the cannula 20,
thereby deploying the blade 80 or scraper 90 into the slot 21 of
the cannula 20.
[0129] Turning to FIG. 5, a number of components of the device
depicted in FIG. 3 are shown separately from one another. It is
understood that the individual elements of the device are not
limited to the exact configuration depicted in the figures herein.
Any design of particular elements of the device that can be
envisioned by one of ordinary skill in the art to perform the same
function in concert with other elements is included as part of the
present disclosure.
[0130] Also in FIG. 5, the blade 80 comprises a base 81 that allows
the blade 80 to be secure in its pre-deployment notch 72 of the
slide lock 70. When the blade 80 is rotated into deployment
orientation, the notch 82 in the base 81 engages the mounting point
78 (shown in FIG. 8A) on the distal end of the guidance tube 71. As
the blade 80 is distally deployed into the slot 21 of the cannula
20, the base 81 retains the blade 80 in the device by underlapping
the sides of the slot 21 within the channel 25 of the cannula 20.
Additionally, to prevent any unwanted side-to-side motion of the
blade 80 as it is deployed distally through the slot 21 of the
cannula 20, in some embodiments the blade further comprises a ridge
83 that fills the slot side-to-side. Additionally, the engagement
of the notch 82 with the mounting point 78 allows the blade 80 to
be safely retracted back into the housing 30 following usage of the
blade 80 for an endoscopic surgical procedure.
[0131] Still referring to FIG. 5, the scraper 90 comprises a base
91 that allows the scraper 90 to be secure in its pre-deployment
notch 73 of the slide lock 70. When the scraper 90 is rotated into
deployment orientation, the notch 92 in the base 91 engages the
mounting point 78 (shown in FIG. 8A) on the distal end of the
guidance tube 71. As the scraper 90 is distally deployed into the
slot 21 of the cannula 20, the base 91 retains the scraper 90 in
the device by underlapping the sides of the slot 21 within the
channel 25 of the cannula 20. Additionally, the engagement of the
notch 92 with the mounting point 78 allows the scraper 90 to be
safely retracted back into the housing 30 following usage of the
scraper 90 for an endoscopic surgical procedure.
[0132] Turning to FIG. 6, a cutaway drawing is shown that depicts
the passage of the guidance tube or tube assembly 71 through the
slide lock 70 and into the cannula 20.
[0133] FIG. 7 is a cutaway drawing showing an exemplary
relationship of the slide lock 70 to the revolver 60 of the device.
The slide lock 70 extends into the revolver 60 and the
pre-deployment slots 72,73 holding the blade 80 and the scraper 90
are located inside the revolver 60. In an exemplary configuration,
springs 75 are attached to pins 76 located on the revolver 60. The
springs 75 extend to pins 77 that secure the opposite end of the
springs to the slide lock 70. The springs 75 auto center the
revolver 60 within the device. Upon rotation of the revolver 60,
the springs 75 activate detents for the three modes: 1) deployment
of the endoscope, 2) orientation of the scraper 90 in deployment
configuration, and 3) orientation of the blade 80 in deployment
configuration.
[0134] FIGS. 8A-F show the rotation of the slide lock corresponding
to the three modes. FIG. 8A, viewing from above, and 8B, viewing
from a distal position, are a depiction of the first mode, wherein
the endoscope 100 can be advanced through the guidance tube 71 into
the cannula 20, without the deployment of the scraper 90 or the
blade 80. The mounting point 78 is not engaged with either the
blade 80 or the scraper 90, therefore preventing the deployment of
either tool in this mode.
[0135] FIG. 8C, viewing from above, and 8D, viewing from a distal
position, are a depiction of the second mode, wherein the revolver
60 has been turned to select the scraper 90. The slide lock 70 is
rotated in concert with the revolver 60 to bring the scraper 90
into deployment orientation. The slot 92 in the base 91 of the
scraper 90 is rotated to engage the mounting point 78 on the
guiding tube (hidden). The guiding tube is then pushed distally
into the cannula 20 with the scraper 90 protruding through the slot
21. Following use of the scraper 90, the guiding tube is retracted
from the cannula 20 and the revolver 60 is returned to the first
mode, restoring the scraper to its pre-deployment configuration of
FIGS. 8A-B.
[0136] FIG. 8E, viewing from above, and 8F, viewing from a distal
position, are a depiction of the third mode, wherein the revolver
60 has been turned to select the blade 80. The slide lock 70 is
rotated in concert with the revolver 60 to bring the blade 80 into
deployment orientation. The slot 82 in the base 81 of the blade 80
is rotated to engage the mounting point 78 on the guiding tube
(hidden). The guiding tube is then pushed distally into the cannula
20 with the blade 80 protruding through the slot 21. Following use
of the blade 80, the guiding tube is retracted from the cannula 20
and the revolver 60 is returned to the first mode, restoring the
blade 80 to its pre-deployment configuration of FIGS. 8A-B.
[0137] FIG. 9 is a perspective view from above an embodiment of the
device showing, in particular, the cannula 20, housing 30 and tube
assembly 71 as they appear in the assembled device prior to
deployment of the tube assembly 71 into the cannula 20 with the
scraper tool or blade assembly.
[0138] FIG. 10 is an exploded view of the embodiment of the device
shown in FIG. 9. FIG. 10 shows the cannula 20 which joins to the
distal end of top half 32 and bottom half 33 of the housing 30.
Interior to the housing 30 is the revolver 60, having a selector
switch 61 for choosing the "BLADE," "SCOPE," or "SCRAPER" position
of the slide lock 70, which is positioned inside the revolver 60.
The blade 80 and scraper 90 tools are parked in notches 72,73 in
the slide lock 70 and are retained there when not deployed by a
rotary clip 170. The tube assembly 71 passes through the slide lock
70 within the housing 30. The distal end of the tube assembly 71
extends and is deployable into the cannula 20. The tube assembly 71
comprises near its distal end a tube locator 78 that the blade 80
or scraper 90 tool is engaged with for deployment into the cannula
20. The tube assembly 71 further comprises, at its proximate end, a
tube stop 84 that prevents the proximate end of the tube assembly
71 from passing through the stabilizer ring 74 mounted in the rear
of the housing 30. The tube assembly 71 has a longitudinal central
lumen that accommodates the insertion of an endoscope through the
tube assembly 71 and into the clear cannula 20 in order to
visualize the tissue surrounding said cannula 20 and to observe the
surgical procedure performed with the compact endoscopic surgical
device. In some embodiments, the tube stop 84 is gripped by the
practitioner or engaged to a grippable attachment 300 (FIG. 9) to
allow the tube assembly to be operated manually for advancement or
withdrawal of the tube assembly 71. In other embodiments, the tube
stop 84 is engaged to an apparatus or machine for automatic or
remote control of advancement or withdrawal of the tube assembly
71.
[0139] FIGS. 11A-E show details of the clear cannula element of the
device. FIG. 11A shows the cannula 20 from the top, showing the
slot 21 extending longitudinally from the proximity of the proximal
end 22 to the proximity of the distal end 23. Also visible are the
depressions, slots, or holes 26 that engage with tabs or pins on
the front of the housing. In some embodiments, the sides of the
slot 21 comprise texture or tick marks 27 that are at a measured
distance from one another down the length of the slot 21. The tick
marks 27 minimally engage with the carrier of the blade and/or
scraper as it advances, or retreats, along the length of the slot
21 to allow the practitioner to feel, or otherwise determine, how
far the carrier has advanced along the slot. In some embodiments,
the distal end 23 of the cannula 20 is blunted and serves as an
obturator.
[0140] FIG. 11B shows a side view of the cannula 20, showing the
proximate 22 and distal 23 ends, as well as the depressions, slots,
or holes 26 that engage with tabs or pins on the front of the
housing. In some embodiments, the distal end 23 of the cannula is
angled upwards, as an obturator.
[0141] FIG. 11C depicts an angled view of the clear cannula 20 of
the device. In some embodiments, the depressions, slots, or holes
26 that engage with tabs or pins on the front of the housing are
located on the top and bottom of the proximate end 22 of the
cannula. In some embodiments, rather than individual or multiple
depressions, slots, or holes 26 on the top, bottom or sides of the
cannula 20, the depression 26 may be an impression or groove that
runs all the way around the outside of the proximate end 22 of the
cannula 20 and engages with an annular ring that runs around the
inside of the distal end of the housing.
[0142] FIG. 11D shows an end view of the cannula at the proximate
end 22. The view shows the slot, which is contiguous with the
central lumen 28 of the cannula. FIG. 11E is a cross-sectional view
of the cannula 20 at bisecting line E-E in FIG. 11A, looking
towards the proximate end of the cannula 20. The longitudinal slot
21 in the top surface of the cannula 20 can be seen to be
contiguous with the central lumen of the cannula tube 20.
[0143] FIGS. 12A-F show various views of the top half 32 of the
housing 30. FIG. 12A shows the outside of one embodiment of the top
half 32 of the housing 30 at an angle, while FIG. 12B shows the
inside of one embodiment of the top half 32 of the housing 30 at an
angle. FIG. 12C shows the inside of one embodiment of the top half
32 of the housing 30, showing one embodiment of a tab or pin 37
that engages with a depression, slot, or hole located on the
proximate end of the cannula shown in FIGS. 11A-E. In some
embodiments, rather than individual or multiple tabs or pins at the
distal end of the housing, the tab 37 may be an annular ring that
runs around the inside of the distal end of the housing 30 and
engages an impression or groove that runs all the way around the
outside of the proximate end of the cannula. FIG. 12D shows the
upper half 32 of the housing 30 from a side view, while FIG. 12E
shows a view of the top half 32 of the housing 30 from the distal
end and FIG. 12F shows a view of the top half 32 of the housing 30
from the proximate end.
[0144] FIGS. 13A-F show various views of the lower half 33 of the
housing 30. FIG. 13A shows the outside of one embodiment of the
lower half 33 of the housing 30 at an angle, while FIG. 13B shows
the inside of one embodiment of the lower half 33 of the housing 30
at an angle. FIG. 13C shows the inside of one embodiment of the
lower half 33 of the housing 30. FIG. 13D shows the lower half 33
of the housing 30 from a side view, while FIG. 13E shows a view of
the lower half 33 of the housing 30 from the distal end and FIG.
13F shows a cross-sectional view looking towards the distal end of
the lower half 33 of the housing 30 from the line A-A bisecting
FIG. 13C.
[0145] FIGS. 14A-E show detailed views of an embodiment of the
revolver 60 element of the device. FIG. 14A is an exterior
perspective view of the revolver 60, showing a selector switch 61
that protrudes through the opening 38 (FIG. 4) in the housing, as
well as the proximate 63 and distal 64 ends of the revolver 60
element. The selector switch 61 is rotated from side to side by the
user to select the appropriate instrument for a particular step in
an endoscopic surgical procedure. FIG. 14B is a top view of the
rotator 60 with the selector switch 61.
[0146] FIG. 14C is a view of the distal 64 end of the revolver 60.
In some embodiments of the device, the revolver 60 comprises upper
tabs 65 and lower tabs 66 that are used to select the scraper 90 or
blade assembly 190 of the device. For example, when the selector
switch 61 is rotated by the user to the position marked "SCRAPER"
(see FIG. 3, for example), the tabs 65 and 66 engage the scraper 90
and move it to the centerline (here, line E-E in FIG. 14C) of the
device. There, the scraper 90 is engaged by a tab on the tube (71
in FIG. 4, for example) of the device, so that it can be deployed
into the cannula 20 (FIG. 4) and protrude through the longitudinal
slot 21 (FIG. 4) therein. When the selector switch 61 is rotated by
the user to the position marked "BLADE" (see FIG. 2, for example),
the tabs 65 and 66 engage the blade assembly 190 and move it to the
centerline (here, line E-E in FIG. 14C) of the device. There, the
blade assembly 190 is engaged by a tab on the tube (71 in FIG. 4,
for example) of the device, so that it can be deployed into the
cannula 20 (FIG. 4) and protrude through the longitudinal slot 21
(FIG. 4) therein. However, when the selector switch 61 is rotated
by the user to the position marked "SCOPE" (see FIG. 2, for
example), the tabs 65 and 66 retain the scraper 90 and blade
assembly 190 in their parked positions out of the centerline so
that an endoscope, or other device, can be advanced through the
tube 71 (FIG. 4) into the cannula without either the scraper tool
or blade assembly being advanced.
[0147] FIG. 14D is a cross-sectional view of revolver 60 at line
B-B in FIG. 14B and looking in the direction of the proximate end
63 of the revolver 60. FIG. 14E is also a cross-sectional view of
the revolver 60, this time along centerline A-A of FIG. 14C. As can
be seen in this view, in some embodiments of the device, the
revolver 60 comprises a hooked tab 68 that engages the front of the
tab 79 that separates the notches (72, 73 in FIG. 10) in the slide
lock 70 (see FIG. 15) that hold the scraper 90 and blade assembly
190. When the selector switch 61 is in the "SCOPE" position, for
example, the hooked tab 68 helps ensure that neither the scraper
tool nor blade assembly can be deployed into the cannula.
[0148] Turning to FIGS. 15A-E, shown is an embodiment of a slide
lock 70 of the device. FIG. 15A shows the slide lock 70 from an
angled perspective. The slide lock 70 comprises two notches 72,73
that hold the scraper 90 and blade assembly 190 in place when they
are parked, as well as rotate them into the ready position when
they are selected for use by rotation of the revolver 60 (FIGS.
14A-E, for example). The two notches 72,73 are separated from one
another by the tab 79. The front of the tab 79 engages with the
hooked tab 68 (FIG. 14E, for example) of the revolver 60 when the
selector switch 61 is not lined up with the "SCRAPER" or "BLADE"
options, thus preventing the scraper 90 or blade assembly 190 from
being deployed into the cannula when not in use. In some
embodiments, the slide lock 70 comprises retaining tabs 171,172
that hold a rotary clip 170 (FIGS. 16A-E, for example) in place,
preventing the rotary clip from sliding forward or backward on the
slide lock 70. The rotary clip 170 does not rotate with the
revolver 60 and slide lock 70, serving to prevent the scraper 90 or
blade assembly 190 from sliding forward out of their notches 72,73
when they are not selected. Some embodiments of the slide lock 70
further comprise a pair of wings 174,175 that engage with the
revolver 60 (FIGS. 14A-E, for example) for turning the slide lock
70 when a particular tool, such as "SCRAPER," "BLADE" or "SCOPE" is
selected. Some embodiments of the slide lock 70 further comprise a
disc 176 at the proximate end. The outer rim of the disc 176
contacts the inside surface of the housing 30 (FIG. 10) to allow
the slide lock 70 to rotate, but prevents or constrains
side-to-side or up-down movement of the slide lock in the
device.
[0149] Still referring to FIG. 15, FIG. 15B is a side view of the
slide lock 70. In some embodiments, the retaining tabs 171,172 are
matched by identical or similar retaining tabs on the other side of
the slide lock 70. FIG. 15C shows an end view of slide lock 70,
looking from the distal end towards the disc 176 at the proximate
end. The center lumen 173 of the slide lock 70 allows the passage
of the tube assembly 71 through the slide lock 70 and into the
cannula 20 (FIG. 10). FIG. 15D is a perspective view of the slide
lock 70 from the top, while FIG. 15E is a longitudinal
cross-section view at line E-E through FIG. 15D.
[0150] Turning now to FIGS. 16A-E, perspective views of an
embodiment of a rotary clip 170 of the device are presented. FIG.
16A shows the rotary clip 170 from an angle. In some embodiments,
the rotary clip 170 comprises a tab 177 that engages with the
inside of the housing 30 (FIG. 10) to prevent the rotary clip 170
from rotating or sliding. The top of the rotary clip 170 is open
178, so that when the scraper tool or blade assembly is rotated
into the deployment position, it can be deployed through the rotary
clip 170 and into the cannula 20 (FIG. 10). FIG. 16B is a
perspective view of the rotary clip 170 as viewed from the distal
side towards the proximate side. FIG. 16C is a side perspective
view of the rotary clip 170. In some embodiments, a portion of the
distal side of the rotary clip 170 may be notched 179. FIG. 16D is
a perspective view of the rotary clip 170 looking down upon the
top. The rotary clip may be manufactured from any suitable
material, such as plastic, stainless steel, aluminum, or metal
alloys. In some embodiments, the rotary clip 170 may be formed,
cut, stamped, cast or milled as a flat piece, as shown in FIG. 16E,
from a malleable metal such as SS 303 and then formed into the
final shape of being an open-topped ring with a tab at the bottom
as shown in FIG. 16A. In other embodiments, the rotary clip 170 may
be formed, cut, molded, 3D-printed, cast or milled from a suitable
material as an open-topped ring with a tab at the bottom as shown
in FIG. 16A.
[0151] FIGS. 17A-D show an embodiment of a tube assembly 71 of the
device. In some embodiments, the tube assembly is composed of
stainless steel, preferably AISI 304 stainless steel. However, the
tube assembly can be made from any suitable material including, but
not limited to, aluminum, titanium, nitinol or other metal alloys,
or plastic. In some embodiments where the tube assembly 71 is made
of plastic, the plastic may be clear, allowing visualization with
an endoscope of tissues surrounding the cannula 20 through the body
of the tube assembly 71.
[0152] FIG. 17A is a top view of the tube assembly 71. The body of
the tube assembly 71 slides through the center lumen 173 of the
slide lock 70. The tube assembly 71 comprises near its distal end a
tool selector 78. The tool selector 78 is directly on top of the
tube assembly 71. With reference to FIGS. 9 and 10, when the
selector switch 61 of the revolver 60 is positioned at the "SCOPE"
setting, no tools are engaged with the tool selector 78 and the
tube assembly 71 can be advanced into the cannula 20 without the
blade assembly 190 or scraper 90. When the selector switch 61 of
the revolver 60 is mover to the "BLADE" setting, the revolver 60
rotates the slide lock 70 such that the notch 72 holding the blade
assembly 190 is moved to the top of the tube assembly 71 and the
notch in the bottom surface of the blade assembly 190 is positively
engaged with the tool selector 78. Advancement of the tube assembly
71 would cause the advancement of the blade assembly 190 into and
down the length of the cannula 20, protruding through the slot 21.
When the selector switch 61 of the revolver 60 is mover to the
"SCRAPER" setting, the revolver 60 rotates the slide lock 70 such
that the notch 73 holding the scraper 90 is moved to the top of the
tube assembly 71 and the notch in the bottom surface of the scraper
90 is positively engaged with the tool selector 78. Advancement of
the tube assembly 71 would cause the advancement of the scraper 90
into and down the length of the cannula 20, protruding through the
slot 21. In some embodiments, the tool selector 78 is welded,
preferably laser welded, onto the top of the tube element of the
tube assembly 71. In a preferred embodiment, the tool selector 78
is welded all around at its base to the tube element. In particular
embodiments, the strength of the weld should be able to withstand
the application of 5 in-lbs torque to the unit, more particularly
10 in-lbs torque. The tube assembly 71 further comprises a tube
stop 84 at the proximate end of the tube element. The tube stop 84
retains the tube assembly 71 in the housing 30 of the device,
preventing the tube assembly from passing completely through the
stabilizer disc 74 (FIG. 10) at the proximate end of the housing
30. In some embodiments, the tube stop 84 is welded flush with the
proximate end of the tube element of the tube assembly. In
particular embodiments, the weld should be strong enough to
withstand at least 10 lbs normal force to the face, more
particularly 20 lbs normal to the face. In some embodiments, the
proximate portion of the tube assembly.
[0153] The tube assembly 71 can optionally be marked on the top or
side surface with gradations 86,87 as exemplified in FIG. 17A to
show the distance that the tube assembly 71 has been advanced into
the cannula 20. As a non-limiting example, major gradations 86 can
be made to show each centimeter in distance that the tube assembly
71 has been advanced into the cannula 20, with minor gradations 87
between them to show, for example, each 1, 2, 2.5 or 5 millimeters.
While the gradations can be applied to the tube assembly 71 by any
means known in the art, it is preferable to lasermark the
gradations on the tube assembly 71 for accuracy and permanence. In
some embodiments, the distance between the major or minor
gradations 86,87 corresponds to the distance between the tick marks
27 (FIG. 11A) in the sides of the slot 21 in the cannula 20.
[0154] FIG. 17B shows a cross-section of the tube assembly 71 at
the line bisecting FIG. 17A at A-A and looking in the direction of
the tube stop 84 at the proximate end. The tube assembly 71 has a
central lumen 85 that accommodates the insertion and free passage
of an endoscope or other viewing device or tool, for example. FIG.
17C is a side view of the tube assembly 71 and FIG. 17D is a
perspective view of the tube assembly 71 from an angle.
[0155] FIGS. 18A-C show an embodiment of the blade assembly 190,
comprising a pusher base 191 and a cutting blade 200. The blade
assembly 190 is compatible with the embodiment of the device shown
in FIGS. 9-10, as well as with the embodiment of the device shown
in FIG. 27. FIG. 18A is a side perspective view of the blade
assembly 190. The pusher base 191 comprises a notch 192 that
positively engages with the tool selector 78 of the tube assembly
(FIGS. 17A, C and D). When the selector switch 61 of the revolver
60 (FIG. 10) is rotated to the "BLADE" position, the blade assembly
190 is rotated upward by the slide lock 70 so that the notch 192 in
the base of the blade assembly 190 slides onto and engages the tool
selector 78. The tool selector 78 then firmly holds the blade
assembly 190 on the surface of the tube assembly 71. Advancing the
tube assembly 71 also advances the blade assembly 190 into the
cannula 20 (FIG. 10). The blade assembly 190 protrudes through the
longitudinal slot 21 in the cannula 20 and advancement of the blade
assembly 190 with the tube assembly 71 moves the blade 200 into
contact with the target tissue. Further advancement of the blade
assembly allows the blade 200 to separate the target tissue. In
preferable embodiments, the bottom surface 210 of the blade 200 is
at least slightly above the bottom surface 193 of the pusher base
191 so that the blade 200 does not directly contact the body of the
tube assembly 71, which may affect rotation of the blade assembly
190 into place for deployment. In particular embodiments, the end
of the pusher base opposite the blade 200 is angled so that it does
not catch tissues as it is being withdrawn through the slot 21 of
the cannula 20. FIG. 18B is an end view of the blade assembly 190.
The width of the pusher base 191 is such that it securely contacts
the side walls of the slot 21 in the cannula 20 (FIG. 10) but is
still able to be advanced or withdrawn through the slot without an
amount of friction that would impede its progress. The sides of the
blade 200 do not contact the walls of the slot 21. In particular
embodiments, the bottom surface 193 of the pusher base is curved to
match the curvature of the tube assembly, thus inhibiting or
preventing side to side motion, or wobble, of the blade assembly
190 during deployment. FIG. 18C is an angled perspective view of
the blade assembly 190. The view is clear so that the attachment of
the blade 200 to the pusher base 191 can be seen. In particular
embodiments, the blade 200 comprises a tab 215 that embeds into the
pusher base 191. In particular embodiments there is a hole 220 in
the tab 215 that allows the material of the pusher base 191 to flow
through it when the pusher base 191 is cast, thereby securing the
tab 215 into the pusher base 191. In some embodiments, the tab 215
is secured into the pusher base 191 using a pin or screw. In such
an embodiment, the blade 200 may be replaceable in the blade
assembly, allowing the use of blades with different profiles
particularly suited for a specific surgical procedure. For example,
it may be desirable to use a hook blade in some situations, where
the cutting surface faces back towards the housing 30 of the
device, allowing the practitioner to move the blade past the target
tissue and separate the target tissue by pulling the blade
backwards, rather than separating the target tissue upon advancing
the blade. The pusher base 191 of the blade assembly 190 can be
formed of any medically acceptable material, such as a plastic, as
it does come in contact with body tissues. In a particular
embodiment, the pusher base 191 is formed of polycarbonate. In some
embodiments, the blade assembly 190 may be replaced in the device
with any other suitable blade tool that engages with the tool
selector, such as, but not limited to, the blade 80 shown in FIG. 4
or a hooked endoscopic blade tool.
[0156] FIGS. 19A-E show a particular embodiment of the blade 200.
FIG. 19A shows a side view of the blade 200 embodiment. In a
particular embodiment, the blade 200 as shown in FIG. 19A comprises
an upper cutting surface 1 on the leading end of the blade, which
is at an angle 2 with respect to the horizontal orientation of the
blade 200, as defined by the bottom surface 210 of the blade 200.
The angle 2 is such that the top of cutting surface 1 is forward of
the bottom of the cutting surface. In one embodiment the angle 2 is
between about 30 and about 45 degrees. In a particular embodiment,
the angle 2 is between about 30 and about 40 degrees. In another
particular embodiment, the angle 2 is between about 33 and about 39
degrees. In a more particular embodiment, the angle 2 is about 36
degrees.
[0157] In some embodiments, the upper end 3 of the cutting surface
1 is radiused. The radiused upper end 3 of the cutting surface 1 is
about 90 degrees of a circle and has a radius measurement between
about 0.50 mm and 1.50 mm. In a particular embodiment, the radius
is about 0.94 mm.
[0158] In a particular embodiment, the blade 200 as shown in FIG.
19A comprises a lower cutting surface 4 on the leading end of the
blade, which is at an angle 5 with respect to the horizontal
orientation of the blade 200, as defined by the bottom surface 210
of the blade 200. The angle 5 is such that the bottom of the lower
cutting surface 4 is forward of the top of the lower cutting
surface. In one embodiment the angle 5 is between about 45 and
about 65 degrees. In a particular embodiment, the angle 5 is
between about 50 and about 60 degrees. In a more particular
embodiment, the angle 5 is about 54 degrees. In some embodiments,
the bottom of the lower cutting surface 4 is not radiused, as the
bottom of the lower cutting surface 4 remains within the slot 21 of
the cannula 20 (FIG. 10) during deployment.
[0159] In a particular embodiment, the blade 200 as shown in FIG.
19A comprises upper cutting surface 1 and lower cutting surface 4
on the leading end of the blade 200, which are at an angle 6 to one
another and meet at a central crotch 7. In one embodiment the angle
6 is between about 80 and about 100 degrees. In a further
embodiment, the angle 6 is between about 85 and about 95 degrees.
In a still further embodiment, the angle 6 is about 90 degrees.
[0160] Still referring to FIG. 19A, in some embodiments, the plane
where the upper and lower cutting surfaces meet is angled downward
8 towards the crotch 7. In some embodiments, the angle 8, as it
relates to the plane defined by the bottom surface 210 of the
blade, is between about 0 and 20 degrees. In further embodiments,
the angle 8, as it relates to the plane defined by the bottom
surface 210 of the blade, is between about 5 and 15 degrees. In a
particular embodiment, the angle 8, as it relates to the plane
defined by the bottom surface 210 of the blade, is about 9 degrees.
In particular embodiments, the crotch 7 is ground to have a maximum
radius of between about 0.18 mm and about 0.58 mm, more
particularly between about 0.28 mm and about 0.48 mm. In a still
more particular embodiment, the crotch 7 is ground to have a
maximum radius of about 0.381 mm.
[0161] In some embodiments, in order to prevent the blade 200 from
catching on tissues when the blade 200 is drawn backwards through
the cannula 20, the top surface 211 of the blade 200 is angled
downward and may comprise a further stepped angle 212, before fully
descending 213 to meet the top edge 214 of the tab 215 that secures
the blade 200 into the pusher base 191. In a particular embodiment,
the vertical height of the radius 3 at the top end of the upper
cutting surface 1 above the top edge 214 of the tab 215 is between
about 0.75 mm and about 1.75 mm, more particularly between about
1.0 mm and about 1.50 mm. In a more particular embodiment, the
vertical height 229 of the radius 3 at the top end of the upper
cutting surface 1 above the top edge 214 of the tab 215 is about
1.26 mm.
[0162] Additionally, in some embodiments, the trailing end 216 of
the bottom surface 210 of the blade 200 may be angled up to the
bottom edge 217 of the tab 215. In a particular embodiment, the
vertical height between the bottom surface 210 of the blade 200 and
the bottom edge 217 of the tab 215 is between about 0.1 mm and
about 1.0 mm, more particularly between about 0.3 mm and about 0.7
mm. In a more particular embodiment, the vertical height between
the bottom surface 210 of the blade 200 and the bottom edge 217 of
the tab 215 is about 0.5 mm.
[0163] Still referring to FIG. 19A, in some embodiments, the tab
215 is between about 1.5 mm and about 2.0 mm high between the top
edge 214 and bottom edge 217 of the tab 215, more particularly
between about 1.65 mm and about 1.85 mm. In a still more particular
embodiment, the tab 215 is about 1.75 mm high between the top edge
214 and bottom edge 217 of the tab 215. Additionally, in some
embodiments, the tab 215 is between about 2.0 mm and about 3.0 mm
long between where it meets the top surface 211 of the blade 200
(at 213) and the trailing edge 218 of the tab 215, more
particularly between about 2.25 mm and about 2.75 mm. In a still
more particular embodiment, the tab 215 is about 2.5 mm long
between where it meets the top surface 211 of the blade 200 (at
213) and the trailing edge 218 of the tab 215. The hole 220 in the
tab 215 that serves to secure the blade 200 into the pusher base
191 (FIG. 18C) is generally centered horizontally and vertically in
the tab 215 in order to provide maximum adhesion of the tab 215 to,
and stability within, the pusher base 191. The diameter of the hole
220 is between about 0.5 mm and about 1.5 mm, more particularly
between about 0.75 mm and about 1.25 mm. In a more particular
embodiment, the diameter of the hole 220 is about 1.0 mm.
[0164] In some embodiments, the crotch 7 of the blade 200 is
between about 3.0 mm and about 7.5 mm forward of the trailing edge
218 of the tab 215, more particularly between about 4.0 mm and
about 6.5 mm. In a still more particular embodiment, the crotch 7
of the blade 200 is about 5.25 mm forward of the trailing edge 218
of the tab 215.
[0165] In particular embodiments, the blade 200 is made from
stainless steel. In a further embodiment, the stainless steel is
martensitic stainless steel. An exemplary martensitic stainless
steel is Bohler-Uddeholm AEB-L martensitic stainless steel. In a
still further embodiment, the martensitic stainless steel is
heat-treated. In another further embodiment, the stainless steel is
440 A stainless steel. In a particular embodiment, the blade is
made from Hitachi GIN-5 SST-MODIFIED 440-A stainless steel. The
blade is optionally flash electropolished or passivated per ASTM
A967, or by any other method that delivers a similar finish. The
cutting edges are machine finished and must be sharp. In a
particular embodiment, the steel of the blade is heat-treated to
Rockwell C hardness of about 50-72. In a more particular
embodiment, the steel of the blade is heat-treated to R30N
75.7-77.5 (Rockwell C hardness of 58-60).
[0166] Referring now to FIG. 19B, the lower cutting surface 4 is a
single beveled cutting surface and the angle 9 is between about 30
degrees and about 50 degrees. In some embodiments, the angle 9 is
between about 35 degrees and about 45 degrees. In a particular
embodiment, the angle 9 is about 40 degrees. While not shown in the
figure, the upper cutting surface 1 is a similarly a single beveled
cutting surface and the angle is between about 30 degrees and about
50 degrees. In some embodiments, the angle is between about 35
degrees and about 45 degrees. In a particular embodiment, the angle
is about 40 degrees.
[0167] Also referring to FIG. 19B, in some embodiments, the depth
of the grind 225 of lower cutting surface 4, as well as for upper
cutting surface 1, is between about 0.6 mm and about 1.1 mm. In
other embodiment, the depth of the grind 225 is between about 0.7
mm and about 1.0 mm. In a further embodiment, the depth of the
grind 225 is about 0.86 mm.
[0168] Referring now to FIG. 19C, in a particular embodiment, the
overall height 226 of the body of the blade 200 is between about
3.0 mm and about 4.0 mm. In another embodiment, the height 226 of
the body of the blade 200 is between about 3.25 mm and about 3.75
mm. In a more particular embodiment, the height 226 of the body of
the blade 200 is about 3.5 mm. Again referring to FIG. 1C, in a
particular embodiment, the width 227 of the body of the blade 200
is between about 0.3 mm and about 0.9 mm. In another embodiment,
the width 227 of the body of the blade 200 is between about 0.45 mm
and about 0.75 mm. In a particular embodiment, the width 227 the
body of the blade 200 is about 0.635+/-0.025 mm.
[0169] Referring to FIG. 19D, the total length 228 of the blade 200
from the leading point of the upper cutting surface 1 to the
trailing end 218 of the tab 215 is between about 4 mm and about 10
mm. In another particular embodiment, the total length 228 of the
blade 200 from the leading point of the upper cutting surface 1 to
the trailing end 218 of the tab 215 is between about 5.5 mm and
about 8.5 mm. In a more particular embodiment the total length 228
of the blade 200 is about 7.153 mm. FIG. 19E presents an angled
perspective view of an embodiment of the blade 200.
[0170] FIGS. 20 and 21 show perspective views of the blade assembly
190 deployed into the cannula 20 of the device. Tube assembly 71
can be seen within the lumen of the cannula 20 with an endoscope
extended through the tube assembly 71. The tool selector 78 is
positively engaged with the pusher base 191 of the blade assembly
190. The pusher base 191 and blade 200 are seen partially
protruding from the slot 21 in the cannula 20, but are securely
held in the slot 21 by the tool selector 78 of the tube assembly
71.
[0171] FIG. 22 is another perspective view showing the assembled
compact endoscopic surgical device of FIG. 9 with the blade
assembly 190 deployed.
[0172] FIGS. 23A-E show an embodiment of the scraper 90 of the
compact endoscopic surgical device. As seen in FIG. 23A, the base
91 of the scraper 90 comprises a notch 92 that positively engages
with the tool selector 78 of the tube assembly (FIGS. 17A, C and
D). When the selector switch 61 of the revolver 60 (FIG. 10) is
rotated to the "SCRAPER" position, the scraper 90 is rotated upward
by the slide lock 70 so that the notch 92 in the base 91 of the
scraper 90 slides onto and engages the tool selector 78. The tool
selector 78 then firmly holds the scraper 90 on the surface of the
tube assembly 71. Advancing the tube assembly 71 also advances the
scraper 90 into the cannula 20 (FIG. 10). The teeth 93 of the
scraper 90 protrude through the longitudinal slot 21 in the cannula
20 and advancement of the scraper 90 with the tube assembly 71
moves the teeth 93 into contact with the target tissue. Further
advancement of the blade assembly allows the teeth 93 to rake
across the target tissue. In particular embodiments, the distal end
94 and proximate end 95 of the base 91 are rounded and angled
downwards so that they do not catch tissues as the scraper 90 is
being advanced or withdrawn through the slot 21 of the cannula
20.
[0173] FIG. 23B is an end view of the scraper tool 90. The width of
the base 91 is such that it securely contacts the side walls of the
slot 21 in the cannula 20 (FIG. 10) but is still able to be
advanced or withdrawn through the slot without an amount of
friction that would impede its progress. In particular embodiments,
the bottom surface of the base 91 is curved to match the curvature
of the tube assembly, thus inhibiting or preventing side to side
motion, or wobble, of the scraper 90 during deployment.
[0174] FIG. 23C is a perspective view of the top of the scraper 90
showing the linear arrangement of the teeth 93. FIG. 23D is a
cross-sectional view of the scraper 90 at the line D-D through FIG.
23C. In some embodiments, the teeth are angled 96 to each other at
between about 45 degrees and 75 degrees, more particularly between
about 55 degrees and about 65 degrees. In a still more particular
embodiment, the teeth 93 are angled 96 to each other at about 60
degrees. In some embodiments the teeth 93 are between about 1.0 mm
and about 6.0 mm in height, more particularly between about 2.0 mm
and about 4.0 mm. In a still more particular embodiment, the teeth
93 are about 3.23 mm in height. FIG. 23E is a perspective view of
the scraper 90 from an angle. The scraper 90 can be formed of any
medically acceptable material, such as a plastic, ceramic,
stainless steel, or nitinol, as it does come in contact with body
tissues. In a particular embodiment, scraper 90 is formed of
polycarbonate.
[0175] FIG. 24 shows a perspective views of the scraper 90 deployed
into the cannula 20 of the device. Tube assembly 71 can be seen
within the lumen of the cannula 20 with an endoscope extended
through the tube assembly 71. The tool selector 78 is positively
engaged with the scraper 90. The base 91 of the scraper 90 is seen
partially protruding from the slot 21 in the cannula 20, but is
securely held in the slot 21 by the tool selector 78 of the tube
assembly 71. The teeth 93 are fully exposed to the environment
outside the cannula 20 when deployed.
[0176] FIG. 25 is a side perspective view showing the assembled
compact endoscopic surgical device of FIG. 9 with the scraper 90
deployed.
[0177] FIG. 26 is a top perspective view showing the assembled
compact endoscopic surgical device of FIG. 9 with the scraper 90
deployed.
Rotationally Operated Devices with Scope Lock Assembly
[0178] FIGS. 27 and 28A-D show embodiments of the present device
wherein the device comprises a rotational switch for selecting the
tool to advance into the cannula, as well as a latch for locking an
endoscope in position during a procedure. FIG. 27 shows a view of
the device depicting the cannula 20, the main housing 30 holding
the rotational tool selector and storage for the tools, and the
scope lock assembly 30A. As described in more detail below, the
scope lock assembly 30A comprises a scope lock housing 130 having a
top shell 132 (FIGS. 36A-F) and a bottom shell 133 (FIGS. 37A-F)
and a scope lock piece 150 (FIGS. 47A-E).
[0179] FIG. 28A shows a view of the device depicted in FIG. 27,
wherein the tube assembly 71 can be seen extended into the cannula
20. The selector switch 61 is set for "SCOPE" and neither the blade
tool nor the scraper is attached to the tool selector 78. FIG. 28B
shows a top view of the device and FIG. 28C shows a side view. FIG.
28D is a distal end view of the device.
[0180] FIG. 29 shows an exploded view of the embodiment of the
device shown in FIGS. 27 and 28. One particular feature of this
embodiment is the addition of a scope lock assembly 130, which can
also serve as a handle for advancing or withdrawing the tube
assembly 71 into/from the slotted clear cannula 20 of the device.
In such an embodiment, the tube stop 84 element of the tube
assembly 71 is retained within the neck 134 of the scope lock
assembly 130. The tube stop 84 can freely rotate within the neck
134 so that the scope lock assembly 130 can be twisted to lock into
the back of the main housing 30. In some embodiments, the scope
lock assembly 130 comprises a four part locking mechanism
comprising a scope lock button 150, a plate return spring 152 and a
pair of locking plates 156. When the scope lock button 150 is
depressed, the plate return spring 152 brings the locking plates
156 towards a parallel configuration, allowing a scope to be freely
moved through the holes in the locking plates 156 into or out of
the lumen of the tube assembly 71. When the scope lock button 150
is released, the plate return spring 152 allows the locking plates
156 to return to their default configuration and the scope is
immobilized within the holes, thereby locking the position of the
scope in, or extending through, the tube assembly. This embodiment
of a scope lock mechanism is an exemplary embodiment and is not
limiting on the device. Any scope lock device that can be
envisioned to function with the present device is within the scope
of the present application.
[0181] FIGS. 30A-E show details of the clear cannula element of the
embodiment of the device shown in FIGS. 27 and 28A-D. FIG. 30A
shows the cannula 20 from the top, showing the slot 21 extending
longitudinally from the proximity of the proximal end 22 to the
proximity of the distal end 23. Also visible are the depressions,
slots, or holes 26 that engage with tabs or pins on the front of
the housing. In some embodiments, the sides of the slot 21 comprise
texture or tick marks 27 that are at a measured distance from one
another down the length of the slot 21. The tick marks 27 minimally
engage with the carrier of the blade and/or scraper as it advances,
or retreats, along the length of the slot 21 to allow the
practitioner to feel, or otherwise determine, how far the carrier
has advanced along the slot. In some embodiments, the distal end 23
of the cannula 20 is a blunted and closed to eliminate the need of
an obturator. Since the cannula 20 is made from a transparent
material, the closed distal end 23 would still allow observation of
the surrounding tissue with an endoscope. In some embodiments, the
closed distal end 23 is turned up and has a sharpened edge that
allows the cannula to separate tissues without the need to first
use an elevator. In some embodiments, the distal end 23 is a
tapered, tongue-shaped protrusion that forms an angle with the body
of the cannula 20 that may serve as an elevator. In some
embodiments, the cannula 20 has a total length in the range of
25-200 mm, 25-150 mm, 25-100 mm, 25-75 mm, 25-50 mm, 50-200 mm,
50-150 mm, 50-100 mm, 50-75 mm, 75-200 mm, 75-150 mm, 75-100 mm,
100-200 mm, 100-150 mm or 150-200 mm. In other embodiment, the
cannula 20 has a total length of about 50 mm, about 60 mm, about 70
mm, about 75 mm, about 80 mm, about 90 mm or about 100 mm. In one
embodiment, the cannula 20 has a total length of about 76.2 mm. In
another embodiment, the cannula 20 has a total length of about 71
mm.
[0182] FIG. 30B shows a side view of the cannula 20, showing the
proximal 22 and distal 23 ends, as well as the depressions, slots,
or holes 26 that engage with tabs or pins on the front of the
housing. In this embodiment, the distal end 23 of the cannula is
closed and angled upwards to serve as an elevator. In some
embodiments, the angle 29 is in the range of about 180-135 degrees,
about 170-140 degrees, about 165-145 or about 160-150 degrees. In
some embodiments, the distal end 23 has a blunted edge. In other
embodiments, the distal end 23 has a sharpened edge. As used
herein, the term "sharpened," as it related to the cannula, refers
to an edge or portion of the cannula that has a angle and/or shape
that allows the cannula to push through/between or to separate
tissues, without cutting a tissue. The closed distal end 23 of the
cannula allows the cannula to be used without the need of inserting
a separate obturator into the lumen of the cannula, thereby
providing the advantage of eliminating the steps of inserting and
removing an obturator into/from the cannula during an endoscopic
surgical procedure. The sharpened edge of the distal end 23 allows
the cannula to be inserted into an entry portal and create a plane
to and/or beyond the target tissue without the need for first
inserting an instrument, such an elevator, through the entry portal
for creating the plane. This provides the advantage of eliminating
the steps of inserting and removing an elevator (or similar
instrument) through the entry portal prior to the insertion of the
cannula.
[0183] FIG. 30C depicts an angled view of the clear cannula 20 of
the device. The proximal end 22 is configured to be engaged with
another device, such as the housing 30. In some embodiments, the
depressions, slots, or holes 26 that engage with tabs or pins on
the front of the housing 30 are located on the top and bottom of
the proximal end 22 of the cannula. In some embodiments, rather
than individual or multiple depressions, slots, or holes 26 on the
top, bottom or sides of the cannula 20, the depression 26 may be an
impression or groove that runs all the way around the outside of
the proximal end 22 of the cannula 20 and engages with an annular
ring that runs around the inside of the distal end of the
housing.
[0184] FIG. 30D shows an end view of the cannula at the proximal
end 22. The view shows the slot 21, which is contiguous with the
central lumen 28 of the cannula. In some embodiments, the central
lumen 28 has a diameter in the range of 2-10 mm, 2-8 mm, 2-6 mm,
2-4 mm, 4-10 mm, 4-8 mm, 4-6 mm, 6-10 mm, 6-8 mm or 8-10 mm. In
certain embodiments, the central lumen 28 has a diameter of about 2
mm, about 3 mm, about 4 mm, about 5 mm, about 6 mm, about 7 mm,
about 8 mm, about 9 mm or about 10 mm. The width of the slot 21 may
vary to adapt to the diameter of the central lumen 28 and the width
of the blade assembly 190. In a particular embodiment, the central
lumen 28 has a diameter of about 4.8 mm and the slot 21 has a width
of about 2.3 mm. In this embodiment, the proximal end 22 has a
diameter that is larger than the diameter of the cannula body.
[0185] FIG. 30E is a cross-sectional view of the cannula 20 at
bisecting line A-A in FIG. 30A, looking towards the proximal end 22
of the cannula 20. The longitudinal slot 21 in the top surface of
the cannula 20 can be seen to be contiguous with the central lumen
of the cannula tube 20.
[0186] FIGS. 31A-F show various views of an embodiment the top half
32 of the main housing 30 of the device, more particularly of the
device shown in FIGS. 27 and 28, wherein the device further
comprises a scope lock. FIG. 31A shows the outside of one
embodiment of the top half 32 of the housing 30 at an angle, while
FIG. 31B shows the inside of one embodiment of the top half 32 of
the housing 30 at an angle. FIG. 31C shows the inside of one
embodiment of the top half 32 of the housing 30, showing one
embodiment of a tab or pin 37 that engages with a depression, slot,
or hole 26 located on the proximate end of the cannula shown in
FIGS. 30A-E. In some embodiments, rather than individual or
multiple tabs or pins at the distal end of the housing, the tab 37
may be an annular ring that runs around the inside of the distal
end of the housing 30 and engages an impression or groove that runs
all the way around the outside of the proximate end of the cannula.
FIG. 31C also shows one embodiment of a locking mechanism 139 on
the proximal end that engages with the locking mechanism 135
located on the neck 134 on the distal end of the scope lock housing
130 (see FIG. 29). FIG. 31D shows the upper half 32 of the housing
30 from a side view, while FIG. 31E shows a view of the top half 32
of the housing 30 from the distal end and FIG. 31F shows a
cross-section view of the top half 32 of the housing 30 looking
towards the distal end from the line bisecting FIG. 31C at D-D.
[0187] FIGS. 32A-F show various views of the lower half 33 of the
main housing 30 of the device, more particularly of the device
shown in FIGS. 27 and 28A-D, wherein the device further comprises a
scope lock. FIG. 32A shows the outside of one embodiment of the
lower half 33 of the housing 30 at an angle, while FIG. 32B shows
the inside of one embodiment of the lower half 33 of the housing 30
at an angle. FIG. 32C shows the inside of one embodiment of the
lower half 33 of the housing 30. FIG. 32C also shows one embodiment
of a locking mechanism 139 on the proximal end that engages with
the locking mechanism 135 located on the neck 134 on the distal end
of the scope lock housing 130. FIG. 32D shows the lower half 33 of
the housing 30 from a side view, while FIG. 32E shows a view of the
lower half 33 of the housing 30 from the distal end and FIG. 32F
shows a cross-sectional view looking towards the distal end of the
lower half 33 of the housing 30 from the line A-A bisecting FIG.
32C.
[0188] FIGS. 33A-C show another embodiment of the blade assembly
190, comprising a pusher base 191 and a cutting blade 200. The
blade assembly 190 is compatible with the embodiment of the device
shown in FIG. 27, as well as with the embodiment of the device
shown in FIGS. 9-10. FIG. 33A is a side perspective view of the
blade assembly 190. The pusher base 191 comprises a notch 192 that
positively engages with the tool selector 78 of the tube assembly
(FIGS. 17A, C and D; FIGS. 28A, B). When the selector switch 61 of
the revolver 60 (FIG. 10, FIGS. 28A, B) is rotated to the "BLADE"
position, the blade assembly 190 is rotated upward by the slide
lock 70 so that the notch 192 in the base of the blade assembly 190
slides onto and engages the tool selector 78. The tool selector 78
then firmly holds the blade assembly 190 on the surface of the tube
assembly 71. Advancing the tube assembly 71 also advances the blade
assembly 190 into the cannula 20 (FIG. 10; FIGS. 28A, B). The blade
assembly 190 protrudes through the longitudinal slot 21 in the
cannula 20 and advancement of the blade assembly 190 with the tube
assembly 71 moves the blade 200 into contact with the target
tissue. Further advancement of the blade assembly allows the blade
200 to separate the target tissue. In preferable embodiments, the
bottom surface 210 of the blade 200 is at least slightly above the
bottom surface 193 of the pusher base 191 so that the blade 200
does not directly contact the body of the tube assembly 71, which
may affect rotation of the blade assembly 190 into place for
deployment. In particular embodiments, the end of the pusher base
opposite the blade 200 is angled 194 so that it does not catch
tissues as it is being withdrawn through the slot 21 of the cannula
20. FIG. 33B is an end view of the blade assembly 190. The width of
the pusher base 191 is such that it securely contacts the side
walls of the slot 21 in the cannula 20 (FIG. 10; FIGS. 28A, B) but
is still able to be advanced or withdrawn through the slot without
an amount of friction that would impede its progress. The sides of
the blade 200 do not contact the walls of the slot 21. In
particular embodiments, the bottom surface 193 of the pusher base
is curved to match the curvature of the tube assembly, thus
inhibiting or preventing side to side motion, or wobble, of the
blade assembly 190 during deployment. FIG. 33C is an angled
perspective view of the blade assembly 190. The view is clear so
that the attachment of the blade 200 to the pusher base 191 can be
seen. In particular embodiments, the blade 200 comprises a tab 215
that embeds into the pusher base 191. In some embodiments the top
surface of tab 215 is extended and is flush with the top surface of
the pusher base 191. In particular embodiments there is a hole 220
in the tab 215 that allows the material of the pusher base 191 to
flow through it when the pusher base 191 is cast, thereby securing
the tab 215 into the pusher base 191. In some embodiments, the tab
215 is secured into the pusher base 191 using a pin or screw. In
such an embodiment, the blade 200 may be replaceable in the blade
assembly, allowing the use of blades with different profiles
particularly suited for a specific surgical procedure. For example,
it may be desirable to use a hook blade in some situations, where
the cutting surface faces back towards the housing 30 of the
device, allowing the practitioner to move the blade past the target
tissue and separate the target tissue by pulling the blade
backwards, rather than separating the target tissue upon advancing
the blade. The pusher base 191 of the blade assembly 190 can be
formed of any medically acceptable material, such as a plastic or
ceramic, as it does come in contact with body tissues. In a
particular embodiment, the pusher base 191 is formed of
polycarbonate. In some embodiments, the blade assembly 190 may be
replaced in the device with any other suitable blade tool that
engages with the tool selector, such as, but not limited to, the
blade 80 shown in FIG. 4 or a hooked endoscopic blade tool.
[0189] FIGS. 34A-E show a particular embodiment of the blade 200 as
shown in FIGS. 28A-C. FIG. 34A shows a side view of the blade 200
embodiment. In a particular embodiment, the blade 200 as shown in
FIG. 34A comprises an upper cutting surface 1 on the leading end of
the blade, which is at an angle 2 with respect to the horizontal
orientation of the blade 200, as defined by the bottom surface 210
of the blade 200. The angle 2 is such that the top of cutting
surface 1 is forward of the bottom of the cutting surface. In one
embodiment the angle 2 is between about 30 and about 45 degrees. In
a particular embodiment, the angle 2 is between about 30 and about
40 degrees. In another particular embodiment, the angle 2 is
between about 33 and about 39 degrees. In a more particular
embodiment, the angle 2 is about 36 degrees.
[0190] In some embodiments, the upper end 3 of the cutting surface
1 is radiused. The radiused upper end 3 of the cutting surface 1 is
about 90 degrees of a circle and has a radius measurement between
about 0.50 mm and 1.50 mm. In a particular embodiment, the radius
is about 0.94 mm.
[0191] In a particular embodiment, the blade 200 as shown in FIG.
34A comprises a lower cutting surface 4 on the leading end of the
blade, which is at an angle 5 with respect to the horizontal
orientation of the blade 200, as defined by the bottom surface 210
of the blade 200. The angle 5 is such that the bottom of the lower
cutting surface 4 is forward of the top of the lower cutting
surface. In one embodiment the angle 5 is between about 45 and
about 65 degrees. In a particular embodiment, the angle 5 is
between about 50 and about 60 degrees. In a more particular
embodiment, the angle 5 is about 54 degrees. In some embodiments,
the bottom of the lower cutting surface 4 is not radiused, as the
bottom of the lower cutting surface 4 remains within the slot 21 of
the cannula 20 (FIG. 28A, B) during deployment.
[0192] In a particular embodiment, the blade 200 as shown in FIG.
34A comprises upper cutting surface 1 and lower cutting surface 4
on the leading end of the blade 200, which are at an angle 6 to one
another and meet at a central crotch 7. In one embodiment the angle
6 is between about 80 and about 100 degrees. In a further
embodiment, the angle 6 is between about 85 and about 95 degrees.
In a still further embodiment, the angle 6 is about 90 degrees.
[0193] Still referring to FIG. 34A, in some embodiments, the plane
where the upper and lower cutting surfaces meet is angled downward
8 towards the crotch 7. In some embodiments, the angle 8, as it
relates to the plane defined by the bottom surface 210 of the
blade, is between about 0 and 20 degrees. In further embodiments,
the angle 8, as it relates to the plane defined by the bottom
surface 210 of the blade, is between about 5 and 15 degrees. In a
particular embodiment, the angle 8, as it relates to the plane
defined by the bottom surface 210 of the blade, is about 9 degrees.
In particular embodiments, the crotch 7 is ground to have a maximum
radius of between about 0.18 mm and about 0.58 mm, more
particularly between about 0.28 mm and about 0.48 mm. In a still
more particular embodiment, the crotch 7 is ground to have a
maximum radius of about 0.381 mm.
[0194] In some embodiments, in order to prevent the blade 200 from
catching on tissues when the blade 200 is drawn backwards through
the cannula 20, the top surface 211 of the blade 200 is angled
downward and meets the top 214 of the tab 215 which embeds into the
pusher base 191 of the blade assembly 190 (FIGS. 33A-C). In a
particular embodiment, the vertical height of the radius 3 at the
top end of the upper cutting surface 1 above the top edge 214 of
the tab 215 is between about 0.25 mm and about 0.75 mm, more
particularly between about 0.35 mm and about 0.65 mm. In a more
particular embodiment, the vertical height 229 of the radius 3 at
the top end of the upper cutting surface 1 above the top edge 214
of the tab 215 is about 0.51 mm.
[0195] Additionally, in some embodiments, the trailing end 216 of
the bottom surface 210 of the blade 200 may be angled up to the
bottom edge 217 of the tab 215. In a particular embodiment, the tab
215 is notched 219, so that the extended end of the tab is able to
clear the notch 192 in the pusher base 191. In a particular
embodiment, the vertical height between the bottom surface 210 of
the blade 200 and the bottom edge 217 of the tab 215 is between
about 0.1 mm and about 1.0 mm, more particularly between about 0.3
mm and about 0.7 mm. In a more particular embodiment, the vertical
height between the bottom surface 210 of the blade 200 and the
bottom edge 217 of the tab 215 is about 0.5 mm.
[0196] Still referring to FIG. 34A, in some embodiments, the tab
215 is between about 2.0 mm and about 3.0 mm high between the top
edge 214 and bottom edge 217 of the tab 215, more particularly
between about 2.15 mm and about 2.85 mm. In a still more particular
embodiment, the tab 215 is about 2.5 mm high between the top edge
214 and bottom edge 217 of the tab 215. Additionally, in some
embodiments, the center of hole 220 is between about 6.0 mm and
about 9.0 mm long from the trailing edge 218 of the tab 215, more
particularly between about 7.0 mm and about 8.0 mm. In a still more
particular embodiment, the center of hole 220 is about 7.5 mm from
the trailing edge 218 of the tab 215. The hole 220 in the tab 215
that serves to secure the blade 200 into the pusher base 191 (FIG.
33C) is generally centered in the tab 215 in order to provide
maximum adhesion of the tab 215 to, and stability within, the
pusher base 191. The diameter of the hole 220 is between about 0.5
mm and about 2.0 mm, more particularly between about 1.0 mm and
about 1.5 mm. In a more particular embodiment, the diameter of the
hole 220 is about 1.25 mm.
[0197] In some embodiments, the crotch 7 of the blade 200 is
between about 8.0 mm and about 12.0 mm forward of the trailing edge
218 of the tab 215, more particularly between about 9.0 mm and
about 11.0 mm. In a still more particular embodiment, the crotch 7
of the blade 200 is about 10.25 mm forward of the trailing edge 218
of the tab 215. In some embodiments, the total length of the
cutting surface 221 of the blade 200 from the leading point of the
upper cutting surface 1 to the trailing point 222 of the grind
forming the crotch 7 is between about 1.5 mm and about 4.5 mm. In
another particular embodiment, the total length of the cutting
surface 221 of the blade 200 from the leading point of the upper
cutting surface 1 to the t trailing point 222 of the grind forming
the crotch 7 is between about 2.25 mm and about 3.75 mm. In a more
particular embodiment the total length of the cutting surface 221
of the blade 200 is about 3.107 mm.
[0198] In particular embodiments, the blade 200 is made from
stainless steel. In a further embodiment, the stainless steel is
martensitic stainless steel. An exemplary martensitic stainless
steel is Bohler-Uddeholm AEB-L martensitic stainless steel. In a
still further embodiment, the martensitic stainless steel is
heat-treated. In another further embodiment, the stainless steel is
440 A stainless steel. In a particular embodiment, the blade is
made from Hitachi GIN-5 SST-MODIFIED 440-A stainless steel. The
blade is optionally flash electropolished or passivated per ASTM
A967, or by any other method that delivers a similar finish. The
cutting edges are machine finished and must be sharp. In a
particular embodiment, the steel of the blade is heat-treated to
Rockwell C hardness of about 50-72. In a more particular
embodiment, the steel of the blade is heat-treated to R30N
75.7-77.5 (Rockwell C hardness of 58-60).
[0199] Referring now to FIG. 34B, the lower cutting surface 4 is a
single beveled cutting surface and the angle 9 is between about 30
degrees and about 50 degrees. In some embodiments, the angle 9 is
between about 35 degrees and about 45 degrees. In a particular
embodiment, the angle 9 is about 40 degrees. While not shown in the
figure, the upper cutting surface 1 is a similarly a single beveled
cutting surface and the angle is between about 30 degrees and about
50 degrees. In some embodiments, the angle is between about 35
degrees and about 45 degrees. In a particular embodiment, the angle
is about 40 degrees. In some embodiments, the total depth 223 of
the sharp surface of the blade 200 is between about 0.5 mm and
about 1.2 mm. In another particular embodiment, the total depth 223
of the sharp surface of the blade 200 is between about 0.75 mm and
about 0.95 mm. In a more particular embodiment the total depth 223
of the sharp surface of the blade 200 is about 0.864 mm.
[0200] Also referring to FIG. 34B, in some embodiments, the depth
of the grind 225 of lower cutting surface 4, as well as for upper
cutting surface 1, is between about 0.6 mm and about 1.1 mm. In
other embodiment, the depth of the grind 225 is between about 0.7
mm and about 1.0 mm. In a further embodiment, the depth of the
grind 225 is about 0.86 mm.
[0201] Referring now to FIG. 34C, in a particular embodiment, the
overall height 226 of the body of the blade 200 is between about
3.0 mm and about 4.0 mm. In another embodiment, the height 226 of
the body of the blade 200 is between about 3.25 mm and about 3.75
mm. In a more particular embodiment, the height 226 of the body of
the blade 200 is about 3.5 mm. Again referring to FIG. 34C, in a
particular embodiment, the width 227 of the body of the blade 200
is between about 0.3 mm and about 0.9 mm. In another embodiment,
the width 227 of the body of the blade 200 is between about 0.45 mm
and about 0.75 mm. In a particular embodiment, the width 227 the
body of the blade 200 is about 0.635+/-0.025 mm.
[0202] Referring to FIG. 34D, the total length 228 of the blade 200
from the leading point of the upper cutting surface 1 to the
trailing end 218 of the tab 215 is between about 8.0 mm and about
16.0 mm. In another particular embodiment, the total length 228 of
the blade 200 from the leading point of the upper cutting surface 1
to the trailing end 218 of the tab 215 is between about 10.0 mm and
about 14.0 mm. In a more particular embodiment the total length 228
of the blade 200 is about 12.151 mm. FIG. 34E presents an angled
perspective view of an embodiment of the blade 200.
[0203] FIGS. 35A-E show an embodiment of the scraper 90 of the
compact endoscopic surgical device depicted in FIGS. 27 and 28A-D.
As seen in FIG. 35A, the base 91 of the scraper 90 comprises a
notch 92 that positively engages with the tool selector 78 of the
tube assembly (FIG. 38). When the selector switch 61 of the
revolver 60 (FIG. 28) is rotated to the "SCRAPER" position, the
scraper 90 is rotated upward by the slide lock 70 so that the notch
92 in the base 91 of the scraper 90 slides onto and engages the
tool selector 78. The tool selector 78 then firmly holds the
scraper 90 on the surface of the tube assembly 71. Advancing the
tube assembly 71 also advances the scraper 90 into the cannula 20
(FIG. 28). The teeth 93 of the scraper 90 protrude through the
longitudinal slot 21 in the cannula 20 and advancement of the
scraper 90 with the tube assembly 71 moves the teeth 93 into
contact with the target tissue. Further advancement of the blade
assembly allows the teeth 93 to rake across the target tissue. In
particular embodiments, the distal end 94 and proximate end 95 of
the base 91 are rounded and angled downwards so that they do not
catch tissues as the scraper 90 is being advanced or withdrawn
through the slot 21 of the cannula 20.
[0204] FIG. 35B is an end view of the scraper tool 90. The width of
the base 91 is such that it securely contacts the side walls of the
slot 21 in the cannula 20 (FIG. 28) but is still able to be
advanced or withdrawn through the slot without an amount of
friction that would impede its progress. In particular embodiments,
the bottom surface of the base 91 is curved to match the curvature
of the tube assembly, thus inhibiting or preventing side to side
motion, or wobble, of the scraper 90 during deployment.
[0205] FIG. 35C is a perspective view of the top of the scraper 90
showing the linear arrangement of the teeth 93. FIG. 35D is a
cross-sectional view of the scraper 90 at the line A-A through FIG.
35C. In some embodiments, the teeth 93 are angled 96 to each other
at between about 45 degrees and 75 degrees, more particularly
between about 55 degrees and about 65 degrees. In a still more
particular embodiment, the teeth 93 are angled 96 to each other at
about 60 degrees. In some embodiments the teeth 93 are between
about 1.0 mm and about 6.0 mm in height, more particularly between
about 2.0 mm and about 4.0 mm. In a still more particular
embodiment, the teeth 93 are about 3.24 mm in height from where the
base 91 contacts the tube assembly 71. FIG. 35E is a perspective
view of the scraper 90 from an angle. The scraper 90 can be formed
of any medically acceptable material, such as a plastic, ceramic,
stainless steel, or nitinol, as it does come in contact with body
tissues. In a particular embodiment, scraper 90 is formed of
polycarbonate.
[0206] Turning to FIGS. 36A-E, shown is another embodiment of a
slide lock 70 of the device. FIG. 36A shows the slide lock 70 from
an angled perspective. The slide lock 70 comprises two notches
72,73 that hold the scraper 90 and blade assembly 190 in place when
they are parked, as well as rotate them into the ready position
when they are selected for use by rotation of the revolver 60
(FIGS. 28A, B, for example). The two notches 72,73 are separated
from one another by the tab 79. The front of the tab 79 engages
with the tab 68 (FIG. 42D, for example) of the revolver 60 when the
selector switch 61 is not lined up with the "SCRAPER" or "BLADE"
options, thus preventing the scraper 90 or blade assembly 190 from
being deployed into the cannula when not in use. In some
embodiments, the slide lock 70 comprises a retaining groove 177
that holds a rotary clip 170 (FIGS. 41A-E, for example) in place,
preventing the rotary clip from sliding forward or backward on the
slide lock 70. The rotary clip 170 does not rotate with the
revolver 60 and slide lock 70, serving to prevent the scraper 90 or
blade assembly 190 from sliding forward out of their notches 72,73
when they are not selected. Some embodiments of the slide lock 70
further comprise a pair of wings 174,175 that engage with the
revolver 60 (FIGS. 42A-E, for example) for turning the slide lock
70 when a particular tool, such as "SCRAPER," "BLADE" or "SCOPE" is
selected. Some embodiments of the slide lock 70 further comprise a
disc 176 at the proximate end. The outer rim of the disc 176
contacts the inside surface of the housing 30 (FIG. 29) to allow
the slide lock 70 to rotate, but prevents or constrains
side-to-side or up-down movement of the slide lock in the device.
In some embodiments, the sides of the disc 176 are notched inwards
towards the body of the slide lock 70.
[0207] Still referring to FIG. 36, FIG. 36B is a side view of the
slide lock 70, showing the position of the retaining grove 177.
FIG. 36C shows an end view of slide lock 70, looking from the
distal end towards the disc 176 at the proximate end. The center
lumen 173 of the slide lock 70 allows the passage of the tube
assembly 71 through the slide lock 70 and into the cannula 20 (FIG.
28A, B). FIG. 36D is a perspective view of the slide lock 70 from
the top, while FIG. 36E is a longitudinal cross-section view at
line E-E through FIG. 36D.
[0208] FIGS. 37A-D show perspective views of an embodiment of an
extension spring 158 of the device, more particularly of the device
shown in FIGS. 27 and 28A-D. Two extension springs 158 are mounted
at one end on the disc 176 at the proximate end of the slide lock,
opposite one another in relation to the lumen for the tube assembly
71 (See FIG. 29, for example). The opposite ends of extension
springs 158 are mounted on attachment points 159 (FIG. 29 and FIGS.
32B, D-F) on the main housing 30. The extension springs 158 retain
the slide lock 70 in the "SCOPE" (safe or no tools) position as a
default and control the rotation of the slide lock 70 when the
revolver 60 is turned. The extension springs 158 also assist in
returning the slide lock 70 and revolver 60 back to the "SCOPE"
position when a tool is withdrawn from the cannula 20 back into its
notch 72,73 in the slide lock 70.
[0209] FIGS. 38A-D show an embodiment of a tube assembly 71 of the
device, as it interacts with an embodiment of the slide lock 70. In
some embodiments, the tube assembly is composed of stainless steel,
preferably AISI 304 stainless steel. However, the tube assembly can
be made from any suitable material including, but not limited to,
aluminum, titanium, nitinol or other metal alloys, or plastic. In
some embodiments where the tube assembly 71 is made of plastic, the
plastic may be clear, allowing visualization with an endoscope of
tissues surrounding the cannula 20 through the body of the tube
assembly 71.
[0210] FIG. 38A is a top view of the tube assembly 71. The body of
the tube assembly 71 slides through the center lumen 173 of the
slide lock 70. The tube assembly 71 comprises near its distal end a
tool selector 78. The tool selector 78 is directly on top of the
tube assembly 71. With reference to FIGS. 28A and B, when the
selector switch 61 of the revolver 60 is positioned at the "SCOPE"
setting, no tools are engaged with the tool selector 78 and the
tube assembly 71 can be advanced into the cannula 20 without the
blade assembly 190 or scraper 90. When the selector switch 61 of
the revolver 60 is mover to the "BLADE" setting, the revolver 60
rotates the slide lock 70 such that the notch 72 holding the blade
assembly 190 is moved to the top of the tube assembly 71 and the
notch in the bottom surface of the blade assembly 190 is positively
engaged with the tool selector 78. Advancement of the tube assembly
71 would cause the advancement of the blade assembly 190 into and
down the length of the cannula 20, protruding through the slot 21.
When the selector switch 61 of the revolver 60 is mover to the
"SCRAPER" setting, the revolver 60 rotates the slide lock 70 such
that the notch 73 holding the scraper 90 is moved to the top of the
tube assembly 71 and the notch in the bottom surface of the scraper
90 is positively engaged with the tool selector 78. Advancement of
the tube assembly 71 would cause the advancement of the scraper 90
into and down the length of the cannula 20, protruding through the
slot 21. In some embodiments, the tool selector 78 is welded,
preferably laser welded, onto the top of the tube element of the
tube assembly 71. In a preferred embodiment, the tool selector 78
is welded all around at its base to the tube element. In particular
embodiments, the strength of the weld should be able to withstand
the application of 5 in-lbs. torque to the unit, more particularly
10 in-lbs. torque. The tube assembly 71 further comprises a tube
stop 84 at the proximate end of the tube element. The tube stop 84
retains the tube assembly 71 in the housing of the device,
preventing the tube assembly from passing forward completely
through the proximate end of the scope lock housing 130. In some
embodiments, the tube stop 84 is welded flush with the proximate
end of the tube element of the tube assembly. In particular
embodiments, the weld should be strong enough to withstand at least
10 lbs. normal force to the face, more particularly 20 lbs. normal
to the face.
[0211] The tube assembly 71 can optionally be marked on the top or
side surface with gradations 86,87 as exemplified in FIG. 38A to
show the distance that the tube assembly 71 has been advanced into
the cannula 20. As a non-limiting example, major gradations 86 can
be made to show each centimeter in distance that the tube assembly
71 has been advanced into the cannula 20, with minor gradations 87
between them to show, for example, each 1, 2, 2.5 or 5 millimeters.
While the gradations can be applied to the tube assembly 71 by any
means known in the art, it is preferable to lasermark the
gradations on the tube assembly 71 for accuracy and permanence. In
some embodiments, the distance between the major or minor
gradations 86,87 corresponds to the distance between the tick marks
27 (FIG. 30A) in the sides of the slot 21 in the cannula 20.
[0212] FIG. 38B shows a cross-section of the tube assembly 71 at
the line bisecting FIG. 38A at A-A and looking in the direction of
the tool selector towards the distal end. The tube assembly 71 has
a central lumen 85 that accommodates the insertion and free passage
of an endoscope or other viewing device or tool, for example. FIG.
38C is a side view of the tube assembly 71 and FIG. 38D is a
perspective view of the tube assembly 71 from an angle.
[0213] FIGS. 39A-D are perspective views of the tool selector 78
tab of the tube assembly 71. In some embodiments, the edges of the
tool selector 78 are rounded in order to insure that sliding the
notch 192 of the knife assembly 190 (FIGS. 18A and 30A, for
example) or the notch 92 of the scraper 90 (FIGS. 23A and 35A, for
example) occurs smoothly. The base 278 of the tool selector 78 can
be rounded in order to assure solid mating of the tool selector 78
onto the tube assembly 71.
[0214] In some embodiments, the tube stop 84 of the tube assembly
71 is trapped within the neck 134 of the scope lock assembly (FIG.
29, for example), allowing the scope lock assembly 130 to be used
as a handle for advancing/withdrawing the tube assembly 71 through
the main housing 30 of the device and into/from the clear cannula
20 (FIG. 29, for example). The tube stop 84 can rotate within the
neck 134 of the scope lock assembly 130 so that, in some
embodiments, the scope lock assembly 130 can be twisted to
lock/unlock it to/from the main housing 30, for example to keep the
scope in a locked position within the clear cannula 20 during
insertion or withdrawal of the cannula through a body opening or a
channel between/through a body tissue during an endoscopic surgical
procedure.
[0215] Turning now to FIGS. 40A-E, perspective views of an
embodiment of a rotary clip 170 of the device are presented. In
some embodiments, the rotary clip 170 is of a width that allows it
to fit securely within the groove 177 of the slide lock 70 (FIGS.
36A, B, for example). FIG. 40A shows the rotary clip 170 from an
angle. In some embodiments, the rotary clip 170 comprises a tab 177
that engages with the inside of the housing 30 to prevent the
rotary clip 170 from rotating or sliding. The top of the rotary
clip 170 is open 178, so that when the scraper tool or blade
assembly is rotated into the deployment position, it can be
deployed through the rotary clip 170 and into the cannula 20 (FIG.
28). FIG. 40B is a perspective view of the rotary clip 170 as
viewed from the distal side towards the proximate side. FIG. 40C is
a side perspective view of the rotary clip 170. In some
embodiments, a portion of the distal side of the rotary clip 170
may be notched 179. FIG. 40D is a perspective view of the rotary
clip 170 looking down upon the top. The rotary clip may be
manufactured from any suitable material, such as plastic, stainless
steel, aluminum, or metal alloys. In some embodiments, the rotary
clip 170 may be formed, cut, stamped, cast or milled as a flat
piece, as shown in FIG. 40E, from a malleable metal such as SS 303
and then formed into the final shape of being an open-topped ring
with a tab at the bottom as shown in FIG. 40A. In other
embodiments, the rotary clip 170 may be formed, cut, molded,
3D-printed, cast or milled from a suitable material as an
open-topped ring with a tab at the bottom as shown in FIG. 40A.
[0216] FIGS. 41A-E show detailed views of an embodiment of the
revolver 60 element of the device depicted in FIGS. 27-28, for
example. FIG. 41A is an exterior perspective view of the revolver
60, showing a selector switch 61 that protrudes through the opening
38 (FIGS. 28A-B, for example) in the housing, as well as the
proximate 63 and distal 64 ends of the revolver 60 element. The
selector switch 61 is rotated from side to side by the user to
select the appropriate instrument for a particular step in an
endoscopic surgical procedure. FIG. 41B is a top view of the
rotator 60 with the selector switch 61.
[0217] FIG. 41C is a view of the distal 64 end of the revolver 60.
In some embodiments of the device, the revolver 60 comprises upper
tabs 65 and lower tabs 66 that are used to select the scraper 90 or
blade assembly 190 of the device. For example, when the selector
switch 61 is rotated by the user to the position marked "SCRAPER"
(see FIG. 28B, for example), the tabs 65 and 66 engage the scraper
90 and move it to the centerline (i.e., in line with the
longitudinal slot 21 in FIG. 28B) of the device. There, the scraper
90 is engaged by the tool selector 78 on the tube assembly 71 (FIG.
38, for example) of the device, so that it can be deployed into the
cannula 20 (FIG. 28, for example) and protrude through the
longitudinal slot 21 (FIG. 28, for example) therein. When the
selector switch 61 is rotated by the user to the position marked
"BLADE" (see FIG. 28, for example), the tabs 65 and 66 engage the
blade assembly 190 and move it to the centerline (i.e., in line
with the longitudinal slot 21 in FIG. 28B) of the device. There,
the blade assembly 190 is engaged by the tool selector 78 on the
tube assembly 71 (FIG. 38, for example) of the device, so that it
can be deployed into the cannula 20 (FIG. 28A) and protrude through
the longitudinal slot 21 (FIG. 28A) therein. However, when the
selector switch 61 is rotated by the user to the position marked
"SCOPE" (see FIG. 28A, for example), the tabs 65 and 66 retain the
scraper 90 and blade assembly 190 in their parked positions out of
the centerline so that an endoscope, or other device, can be
advanced through the tube 71 (FIG. 28A) into the cannula without
either the scraper tool or blade assembly being advanced.
[0218] FIG. 41D is a cross-sectional view of revolver 60 at line
D-D in FIG. 41B and looking in the direction of the proximate end
63 of the revolver 60. FIG. 41E is also a cross-sectional view of
the revolver 60, this time along centerline E-E of FIG. 41C. As can
be seen in this view, in some embodiments of the device, the
revolver 60 comprises a hooked tab 68 that engages the front of the
tab 79 that separates the notches (72, 73 in FIG. 36D, for example)
in the slide lock 70 (see FIG. 36) that hold the scraper 90 and
blade assembly 190. When the selector switch 61 is in the "SCOPE"
position, for example, the hooked tab 68 helps ensure that neither
the scraper tool nor blade assembly can be deployed into the
cannula.
[0219] FIGS. 42A-F are views of the top shell 132 portion of the
housing for an embodiment of a scope lock assembly 130 (see also
FIG. 29) of some embodiments of the present device. In some
embodiments, the assembly 130 comprises a neck 134 on the distal
end of the housing that inserts into the main housing 30 (FIG. 28,
for example) of the device. In other embodiments, the neck 134 is
part of the housing 30 and inserts into the scope lock housing. In
some embodiments, the neck 134 comprises a locking mechanism 135
that interacts with a counterpart mechanism on the housing 30. In
particular embodiments, the proximate end of the scope lock housing
130 comprises a hole 136 for passing a viewing device (such as an
endoscope or arthroscope) through. In particular embodiments, the
diameter of the hole securely supports the viewing device without
allowing it significant lateral motion, however, does not impede,
for example by friction, the proximate or distal motion of the
viewing device through the device. In some embodiments, the neck
134 comprises a corresponding supporting hole 137 in the distal
end. In some embodiments, the supporting hole 137 in the distal end
of the neck 134 comprises a hole large enough for the tube assembly
71 to pass through the hole, allowing the tube stop 84 to be
retained in the lumen of the neck 134. By retaining the tube stop
84 within the neck 134 of the scope lock assembly 130, the scope
lock assembly can be used as a handle for manipulation of the tube
assembly 71. FIGS. 42A-B are perspective views of the top shell 132
of the housing of the scope lock assembly 130. FIG. 42C is a view
of an exemplary inside of the top shell 132 of the housing of the
scope lock assembly 130 and FIG. 42D is an end view of the distal
end of the top shell 132 of the housing of the scope lock assembly
130. In some embodiments, the inside of the housing may comprise
ridges or protrusions in order to support or retain the individual
elements of the scope lock mechanism. FIG. 42E is a cross section
of the top shell 132 of the housing of the scope lock assembly 130
as depicted in FIG. 42C at line A-A and looking in the proximal
direction. FIG. 42F is a longitudinal section of the top shell 132
of the housing of the scope lock assembly 130 as depicted in FIG.
42C at line B-B.
[0220] FIGS. 43A-F are views of the bottom shell 133 of an
embodiment of a housing of the scope lock assembly 130 of some
embodiments of the present device. In some embodiments, the housing
of the scope lock assembly 130 comprises a neck 134 on its distal
end that inserts into the housing 30 (FIG. 28A-B, for example) of
the device. In other embodiments, the neck 134 is part of the main
housing 30 and inserts into the scope lock housing. In some
embodiments, the neck 134 comprises a locking mechanism 135 that
interacts with a counterpart mechanism on the main housing 30. In
particular embodiments, the proximate end of the scope lock housing
130 comprises a hole 136 for passing a viewing device (such as an
endoscope or arthroscope) through. In particular embodiments, the
diameter of the hole securely supports the viewing device without
allowing it significant lateral motion, however, does not impede,
for example by friction, the proximate or distal motion of the
viewing device through the device. In some embodiments, the neck
134 comprises a corresponding supporting hole 137 in the distal
end. In some embodiments, the supporting hole 137 in the distal end
of the neck 134 comprises a hole large enough for the tube assembly
71 to pass through the hole, allowing the tube stop 84 to be
retained in the lumen of the neck 134. By retaining the tube stop
84 within the neck 134 of the scope lock assembly 130, the scope
lock assembly can be used as a handle for manipulation of the tube
assembly 71. FIGS. 43A-B are perspective views outside and inside,
respectively, of the bottom shell 133 of the housing of the scope
lock assembly 130. FIG. 43C is a view of an exemplary inside of the
bottom shell 133 of the housing of the scope lock assembly 130 and
FIG. 43D is an end view of the distal end of the bottom shell 133
of the housing of the scope lock assembly 130. In some embodiments,
the inside of the housing may comprise ridges or protrusions in
order to support or retain the individual elements of the scope
lock mechanism. FIG. 43E is a cross section of the bottom shell 133
of the housing of the scope lock assembly 130 as depicted in FIG.
43C at line A-A and looking in the proximal direction. FIG. 43F is
a longitudinal section of the bottom shell 133 of the housing of
the scope lock assembly 130 as depicted in FIG. 43C at line
B-B.
[0221] While a neck 134 with a locking mechanism 135 has been
exemplified here, any suitable mechanism for joining the housing of
the scope lock assembly 130 to the device housing 30 is envisioned
in this application and is included within the scope of the present
application. In some embodiments, the scope lock housing is
integral with the main housing of the device. In such an
embodiment, the device may comprise another element for advancing
and withdrawing the tube assembly 71 through the device, for
example including, but not limited to, a slot and tab mechanism
that may be similar to that depicted in the embodiment of FIG. 1.
In some embodiments, the top and bottom shells of the housing of
the scope lock assembly are molded as a single piece with the top
and bottom shells, respectively, of the main device housing and the
lumen of the scope lock housing is separated from the lumen of the
main device housing by a partition having a hole for the scope to
pass through. In other embodiments, there is no partition between
the lumens.
[0222] FIGS. 44A-E show an embodiment of a scope lock button 150 of
the device, more particularly of the device shown in FIGS. 27 and
28A-D. In this exemplary, but non-limiting, embodiment, the scope
lock button 150 protrudes through the opening 138 in the upper
shell 132 of the housing of the scope lock assembly 130. Pressing
down on the scope lock button 150 engages a plate return spring 152
(FIGS. 29 and 45) that, in turn, engages a pair of locking plates
154 (FIGS. 29 and 46). This engagement presses the tops of the
locking plates 154 towards one another, allowing a viewing device,
such as an endoscope or arthroscope, to freely pass through the
holes 155 in the locking plates 154. Releasing the scope lock
button 150 allows it to return to its default, raised, position,
locking the viewing device in place.
[0223] FIGS. 45A-E show an exemplary, non-limiting, embodiment of a
plate return spring 152 element of an embodiment of a scope lock
assembly 130 of