U.S. patent number 3,834,392 [Application Number 05/328,513] was granted by the patent office on 1974-09-10 for laparoscopy system.
This patent grant is currently assigned to KLI, Inc.. Invention is credited to William R. Knepshield, Russell A. Lampman.
United States Patent |
3,834,392 |
Lampman , et al. |
September 10, 1974 |
LAPAROSCOPY SYSTEM
Abstract
A laparoscopy system for female sterilization whereby a single
unit contains the power source to provide illumination, oscillatory
electrical power and CO.sub.2 for a laparoscopy. CO.sub.2 gas,
under pressure, is first passed into the body through a needle into
the peritoneal cavity. The fallopian tubes are identified and then
the laparoscope, which contains a telescope connected to a source
of illumination, is inserted into the body cavity. A flexible
forceps is, thereafter, inserted through the laparoscope into the
body cavity. The forceps is manipulated to successively close the
passage through each fallopian tube, either by means of sending
electrical oscillations through the forceps to simultaneously cut,
seal and cauterize each tube in turn, or by means of a specific
clamp which clamps the passage shut.
Inventors: |
Lampman; Russell A. (Yardley,
PA), Knepshield; William R. (Malvern, PA) |
Assignee: |
KLI, Inc. (Ivyland,
PA)
|
Family
ID: |
23281289 |
Appl.
No.: |
05/328,513 |
Filed: |
February 1, 1973 |
Current U.S.
Class: |
606/52; 600/126;
600/104 |
Current CPC
Class: |
A61B
17/42 (20130101); A61B 18/12 (20130101); A61B
18/1206 (20130101); A61M 13/00 (20130101); A61B
2018/0066 (20130101) |
Current International
Class: |
A61B
18/12 (20060101); A61B 17/42 (20060101); A61M
13/00 (20060101); A61b 017/36 () |
Field of
Search: |
;128/303.13,303.14,303.15,303.17,303.18,303.1,4,347,6 |
References Cited
[Referenced By]
U.S. Patent Documents
Other References
Fiber Optic Laparoscope-American Cystoscope Makers, Inc., D-183,
Feb. 1972. .
The Lancet - Vol. II of 1959, No. 7104, pages 650-651..
|
Primary Examiner: Laudenslager; Lucie H.
Attorney, Agent or Firm: Jacobs; Arthur A.
Claims
The invention claimed is:
1. In a laparoscopy system comprising a housing, a gas tank in said
housing, conduit means connecting said tank to a source of gas
under pressure, penetrating means constructed and arranged to
penetrate into a body cavity through the abdominal wall, said
penetrating means being in selective gaseous fluid connection with
said tank and being constructed and arranged to project said gas
into said body cavity, and a piercing means constructed and
arranged to pierce the abdominal wall and pass between muscle
layers under the skin to form a passage into a body cavity, said
piercing means being in selective gaseous fluid connection with
said tank, the improvement comprising a laparoscope selectively
insertable through said passage into said body cavity, said
laparoscope comprising an elongated casing containing a telescope
and a forceps guide tube, said telescope and forceps guide tube
extending longitudinally of said elongated casing in substantial
parallelism with each other, said telescope being in selective
operative connection with a source of illumination in said housing,
an elongated flexible forceps adapted to grasp a fallopian tube,
said forceps being selectively positioned in said forceps guide
tube and extending therefrom in a position to grasp said fallopian
tube while said telescope is illuminated by connection with said
source of illumination, whereby said forceps may be manipulated
while said telescope provides an illuminated view to the operator
through the same passage into said body cavity, means connected to
said forceps for closing the passage of said fallopian tube, said
laparoscope having means to substantially prevent escape of gas
from said body cavity when said forceps is not positioned in said
forceps guide tube, and said forceps being constructed and arranged
to substantially prevent escape of said gas from said body cavity
when it is positioned in said forceps guide tube.
2. The system of claim 1 wherein said means for closing the passage
of the fallopian tube is an oscillatory electrical current, said
current being supplied by an electrical oscillation circuit in said
housing, a source of electrical energy operatively and selectively
connected to said oscillation circuit, said forceps being
constructed and arranged to receive and transmit said oscillatory
current from said oscillation circuit to said fallopian tube, said
forceps being in selective operative connection with said
oscillation circuit, and means to selectively actuate said
oscillation circuit.
3. The system of claim 2 wherein adjusting means are provided in
said oscillation circuit to vary the power output thereof.
4. The system of claim 1 wherein said means for closing the passage
of the fallopian tube is a clip means.
Description
This invention relates to a laparoscopy system for female
sterilization, and it particularly relates to a system of this type
which is embodied in a single unitary assembly.
A laparoscopy system is used for female sterilization by minor
surgical means wherein the fallopian tubes are separated, cut and
sealed.
Heretofore, in laparoscopy, it was necessary for the operator to
use a variety of different surgical instruments as well as separate
heat sealing means or clamps in order to complete the process. The
assembling of the various instruments and their separate use was
not only time-consuming, but their proper use depended largely on
the skill and experience of the operator. It was also often
necessary to use a variety of make-shift instruments and apparatus
which were never designed for this specific task so that much time
and effort were wasted and much skill was needed to obtain the
exact correlation of steps and the exact results desired.
It is one object of the present invention to overcome the aforesaid
disadvantages by providing a unitary laparoscopy assembly wherein
all the elements are correlated and coactive with each other for
the specific purpose required and wherein the proper metering and
indicating devices co-act with each other to obtain a rapid, highly
coordinated and effective result with a minimum of skill and
experience.
Another object of the present invention is to provide an assembly
of the aforesaid type that is relatively simple and inexpensive in
construction and which requires a minimum of maintenance.
Another object of the present invention is to provide an assembly
of the aforesaid type which is compact and relatively portable.
Other objects and many of the attendant advantages of this
invention will be readily appreciated as the same becomes better
understood by reference to the following description when read in
conjunction with the accompanying drawings wherein:
FIG. 1 is a view, partly in elevation and partly in perspective of
the various components constituting a laparoscopy device embodying
the present invention.
FIG. 2 is an enlarged end view taken on line 2--2 of FIG. 1, in the
present invention.
FIG. 3 is a schematic view of the electronic circuit utilized in
the present invention.
Referring now in greater detail to the various figures of the
drawings wherein similar reference characters refer to similar
parts, there is shown a housing 10 having a pair of fluidic
indicators, 12 and 14, each of which consists of a small
spring-pressed piston. These indicators are of the type
manufactured by the Micro Switch Company, Freeport, Ill., a
division of Honeywell. These indicators are operatively connected
between an internal tank and the patient output. The indicator 12
shows red when the pressure is below a predetermined level and the
indicator 14 shows red when there is no flow of CO.sub.2 gas.
Below the indicators 12 and 14 is a lamp 16 which indicates the
CO.sub.2 input, being adapted to glow when the pressure in the
supply (external tank) is below a predetermined level.
Below the lamp 16 are two dials, the dial 18 indicating the
CO.sub.2 volume in the internal tank, and the dial 20 indicating
the CO.sub.2 pressure in the body cavity of the patient being
treated.
Below the dials 18 and 20 are three mechanical switch means
indicated at 22, 24 and 26 respectively. The switch 22 is a
push-button device which mechanically activates a fill valve for
the CO.sub.2 flowing from the primary (external) supply to the
internal tank when it is pushed in; the toggle switch 24
mechanically activates or deactivates an "on-off" valve to allow
flow of CO.sub.2 from the internal tank to the patient; the toggle
switch 26 is a "high-low" pressure selector which selects flow from
either a high or low pressure second stage regulator of standard
construction.
The electrocoagulation activator system comprises a push-button,
"on-off" electrical switch 28 to activate or deactivate the
electronic network, a push-button, "on-off" electrical switch 30
for the illuminator system, and a glow lamp 32 to indicate
activation of the electrocoagulation means, this lamp being adapted
to glow when the foot-pedal, hereinafter described, is depressed.
The push-buttons 28 and 30 also contain glow lamps which will be
hereinafter described.
Below the aforementioned switches is a selector switch 34 which is
used to regulate the high frequency oscillator to set the range of
electrocoagulation, and a fitting or adaptor 36 which is provided
for the purpose of providing illumination to the telescope through
a fiberoptic cable hereinafter described. Behind the fitting 36 is
contained a projection bulb, hereinafter described, which is
electrically connected to the push-button 30 which turns it on and
off.
A groundplate 38 is adapted to be strapped to the patient by a
rubber band or the like, indicated at 39, and this groundplate is
connected at 40 to the electronic network. A cable-type forceps 42
is provided with a jack 44 that is connected by a cable to a
connector 46 connected into the oscillator circuit of the
electronic network. A footpedal 48 is connected by a cable to the
plug 50 connected to the oscillator circuit. A CO.sub.2 outlet 52
is connected to a valve 54 which has an outlet 56 that is
selectively connected to either the housing 58 of a Verees needle
60 or a trocar sleeve 62. The sleeve 62 is adapted to hold a trocar
64 which is insertable through the sleeve and held in place by a
spring-pressed plunger 66. The sleeve 62 is also provided with an
inlet tube 68 which is adapted to receive the outlet 56 of the
valve housing 54.
The laparoscope is indicated generally at 70, and comprises a
tubular housing 72 having a neck portion 74 and a connector portion
76 which is connected through an optionally provided knurled
focusing knob 78 to an eyepiece 80. A tubular inlet 82 extends
outwardly from the interior of neck portion 74 and is adapted to
receive the forceps 42. The inlet 84 is provided with a shut-off
valve 85 similar to the valve 54. A tubular extension 84 projects
outwardly from the interior of connector portion 76. This extension
84 comprises a bundle of fiberoptic strands and is adapted to be
connected to a light-transmitting cable 86 which is also a bundle
of fiberoptic strands encased in a flexible sheathing. This cable
86 is connected to the adaptor 36.
The housing 72, as best seen in FIG. 2, contains an elongated tube
88, adapted to receive a telescope 89 (shown in FIG. 1), and an
elongated tube 90 integral and continuous with the inlet 82 and
adapted to receive the forceps 42 which is inserted through inlet
82. The interior of the housing 72 is filled with fiberoptic
material 92 around the two tubes 88 and 90. The cable 86 is adapted
to transmit light from the projection bulb behind the adaptor 36
through the extension 84 into the housing 72 to provide light for
the telescope.
In operation, the valve 54 is attached to the housing 58 of the
Verees needle 60 and the valve 54 is connected by a flexible tube
to the CO.sub.2 supply outlet 52. The supply outlet 52 is connected
to an internal tank in the housing 10 by a low pressure hose. The
internal tank is filled with CO.sub.2 from an external supply tank
(not shown) by means of the push-button switch 22 which
mechanically operates a valve in the connection between the
external and internal tank after going through a primary stage
regulator of standard construction.
The needle 60 is then injected into the peritoneal cavity of the
patient and the select switch 26 is set to "high", which is about
30 mm. of mercury as set by the factory. The switch 24 is then
activated to cause a flow of CO.sub.2 into the patient's peritoneal
cavity at the area selected by the operator. The needle 60 is
adapted to pass through the tissue into the desired cavity where
the fallopian tubes should be situated. If the pressure reading is
then maintained, at 9-12 mm. Hg pressure, as shown by dial 20, the
gas flow is within the correct cavity. If it is not the correct
cavity, the gas pressure rapidly increases and flow is slowed. In
this case, the needle is then reinjected and the gas flow repeated
until the correct cavity is found. The selector valve, operated by
the select switch 26, is then set to "low" (about 10 mm. of
mercury) after approximately 2 liters of CO.sub.2 is passed into
the peritoneal cavity.
When the pressure reading indicates that the gas is flowing into
the correct cavity, the gas flow is halted and the needle is
withdrawn. A slight incision is then made with a scalpel just below
the umbilicus, and through this incision is inserted the trocar 64
which is telescopically positioned within the sleeve 62. The valve
device 54, which has been disassembled from the needle housing 58,
is then coupled to the inlet 68 and the CO.sub.2 pressure is
maintained at a constant 10 mm. of mercury. The trocar is
manipulated to push between the tissue and into the peritoneal
cavity.
The trocar is then pulled out and the laparoscope 70 is inserted in
its place. With the laparoscope in position, the fiberoptic cable
86 is connected between the extension 84 and the adaptor 36 behind
which is contained the light source. The ground plate 38 is also
attached to the patient at this time.
With the laparoscope in position, the valve 85, which is normally
closed to prevent escape of the gas, is opened and the forceps 42
is inserted through the inlet 82 and the tube 90 into the body
cavity. The forceps itself then substantially prevents escape of
the gas. The pushbutton 30 is pushed in to turn on the lamp behind
adaptor 36. At this time the CO.sub.2 is maintained at a constant
10 mm. mercury pressure which equalizes the pressure of the gas in
the cavity, so that there is effectively no flow. The operator then
peers through the eyepiece 80 and, while doing so, uses the forceps
to grip a fallopian tube. With the forceps in the proper position
around the fallopian tube, the operator steps on the footpedal 48
which activates the oscillator circuit, the power output of the
oscillator having been set by adjustment of the selector switch 34
to a predetermined value. The oscillator sends its pulses through
the cable 94, leading from connector 46, through the forceps 42.
This results in a simultaneous cutting, sealing and cauterizing of
the fallopian tube by electrocoagulation. The same procedure is
then repeated with the other fallopian tube.
Although an electrocoagulation process has been described above, it
is also possible to substitute a clip means which can be inserted
by a special forceps and manipulated thereby to clamp the fallopian
tube, closing the passage therethrough.
The electronic control and actuating network is shown in FIG. 3.
The AC input is comprised of power input lines 102 and 104 and a
ground line 106. The ground line 106 is tied to the housing to
prevent shock hazard. The lines 102 and 104 are placed into and out
of the circuit with the primary winding 108 of a transformer 110 by
means of a double pole double throw maintained contact illuminated
pushbutton switch 112 operated by button 28. A fuse 114 is provided
in the power line 102 to prevent undesirable power surges.
The primary 108 coacts with three secondary windings designated
116, 118 and 120 respectively. The secondary 116 is in circuit with
a lamp 122 inside button 28 and a lamp 124 inside button 30. A
double throw double pole maintained contact illuminated pushbutton
switch is operated by button 30, one of the switch blade contacts
being shown at 126 and the other at 128. When the button 30 is
pushed in, it simultaneously closes both contacts 126 and 128 to
cause both the lamp 124 and a projection lamp 130 to glow. The
projection lamp 130 is positioned within the unit and provides the
illumination for the telescope in the laparoscope at its output
connector 36.
The light circuit also includes a pressure-operated switch 132,
single pole double throw momentary contact press to test switch 134
and lamp 16. The switch 134 is normally held in engagement with a
contact 136 but may be passed into engagement with contact 138 for
a purpose to be hereinafter described.
When the button 28 is pushed in to close switch 112, it activates a
blower 140 to keep the equipment cool and activates the transformer
110. This also causes the lamp 122 to glow. When the button 30 is
pushed in, it closes switch contacts 126 and 128 causing lamps 124
and 130 to glow. Normally, the switch 132 is open and the lamp 16
does not glow. However, when the primary (external) pressure falls
below a predetermined minimum value, the switch 132 closes and the
lamp 16 glows indicating low primary gas pressure. If it is desired
to test the circuit to determine if the lamp 16 is operative, the
switch 134 is moved from contact 136 by pressing pushbutton 32 to
contact 138, thereby by-passing the switch 132 and causing lamp 16
to glow.
The secondary winding 118 is in circuit with a rectifier bridge 142
for changing AC to DC current. The bridge 142 is in circuit with a
relay solenoid 146 which is operated by a foot-pedal switch 148.
When the foot-pedal switch 148 is closed, it causes the relay
solenoid 146 to energize which, thereupon, acts to close the
solenoid switch 150. This energizes the primary winding 152 of a
transformer 154 thereby actuating the electrocoagulatory
oscillator.
The transformer 154 has two secondary windings 156 and 158.
Energization of secondary 156 causes lamp 32 to glow, indicating
activation of the electrocoagulator oscillator. Energization of
secondary 158 sends current through the high voltage rectifier
bridge 160 to actuate the high frequency oscillator partially
comprised of pentodes 162 and 164, whose filaments are in circuit
with secondary 120 of transformer 110. The resultant high frequency
oscillations pass through transformer 166 and through the pre-set
range selector switch 34 to the forceps connector 46 and in turn to
the forceps 42. The circuit from transformer 166 is completed
through the shield connector 40. The shield 38 is attached to the
patient and by means of the shield cable is connected to shield
connector 40.
When the operator releases the foot-pedal 48, it opens the switch
148 and this inactivates the oscillator circuit. Generally only a
momentary or very short activation time is required.
* * * * *