Helical Tissue Cutter and Trocars Attachable to Common Handle for Mesh Sling Deployment and Myomectomy

Abstract

A helical tissue cutter, used for safely and speedily resecting biological tissues and spiraling out the resected tissues and any biological debris, having an enclosed, exposable, retractable cutter with a helical blade that is continued further as a helical fin; a tubular curved trocar having a capability and means to intravaginally carry, deploy and mechanistically release a mesh sling attached to an anchor using a retropubic approach to treat stress urinary incontinence; a turnable trocar that can be used on the right or left side of the groin to deploy a mesh sling by applying a transobturator approach to treat women's stress urinary incontinence; and a handle having a motorized capability and means to couple, attach, handle, operate, and retract the helical tissue cutter while having an aspiration connection for a vacuumized tissue collector, or to couple, attach, handle, and operate the tubular curved trocar or the turnable trocar.

Claims

1. A helical tissue cutter, to be used for resecting biological tissues and for spiraling out the resected tissues and any biological debris, having an enclosed, exposable, retractable, protective cutter with a helical blade that is continued further as a helical fin, said cutter comprising: an elongated shaft longitudinally having said helical blade continued further a as said helical fin on the cylindrical surface around the neutral axis of said shaft, said blade having a sharp edge, said fin having a flat edge, said shaft having a flattened end, and said end having a rounded boss on both flat sides of said end to perform a coupling function by engaging; an elongated hollow cylinder for enclosing said cutter, said cylinder longitudinally having at least two opposing elongated through slots for exposing said blade on the sides of said cylinder when in use, said cylinder having one end open, said end having bent and rounded edge, and said cylinder containing at the other end a receptacle luer lock to perform an attachment function.

2. A tubular curved trocar having a capability and means to intravaginally carry, deploy and release a mesh sling using a retropubic approach to treat stress urinary incontinence, said trocar comprising: a curved tube having on one end a cross hole and a slit, and said tube having at the other end said receptacle luer lock; a shaft being conformable to and residing within said curved tube, said shaft having a flattened end, and said end having a rounded boss on both flat sides of said end to perform a coupling function by engaging; a rod functioning as an anchor for a mesh sling, said anchor having at one end a pointed shape and at the other end a deep crescent slot and a stud, said anchor having one end of the mesh sling bonded into said slot, said stud having orthogonally at least one rounded boss, and said boss engaging into said cross hole of said tube.

3. A turnable trocar that can be used on the right or left side of the groin to deploy a mesh sling with a transobturator approach to treat women's stress urinary incontinence, said turnable trocar comprising: a curved trocar wire having a planar stem, said stem having a groove, said groove having at one edge two notches, and said notches being 180° apart; a receptacle stud having a cross hole at one end, said receptacle stud having axially on the other end a blind hole and a larger concentric threaded hole, and said blind hole intersecting said cross hole; a plunger residing in said blind hole, and said plunger engaging with said groove and said notches; a compression spring residing in said blind hole, and said spring mating with said plunger; a trocar shaft having threads on one end and said receptacle luer lock on the other end.

4. A handle having a motorized capability and means to couple, attach, handle and operate, slide and retract said cutter while having an aspiration connection for a vacuumized tissue collector, or to couple, attach, handle and operate said tubular curved trocar or said turnable trocar, said handle comprising: a top part and a bottom part, said top part having a shallow-trough shape with alignment bosses and a semicircular channel on the wall edges and an elongated slot on the planar surface, said bottom part having a matching deep-trough shape with matching alignment blind holes and a matching semicircular channel on the wall edges, and said bottom part on the back wall having a large hole and a small hole; a slider knob orthogonally having a cylindrical stem, said stem having on the end a flat yoke, said knob being contained in said slot of said top part, and said yoke captivating said knob in said top part when said knob turned to a 90° angle; an elongated motor drive gear having a D-hole; a boxed spring-wound motor having a small hole on the top and having a D-shape motor drive shaft on the front and a D-shape crank shaft on the back, said drive shaft having a cross hole, said drive shaft having said drive gear and a press-fit pin in said cross hole, said pin retaining said drive gear, said crank shaft passing through said large hole of said bottom part, and said boxed motor being bonded internally to the floor of said bottom part; an elastomeric plug having a step, and said plug having a through sealing hole; a Y-branched tube having a straight tube and a joined angled tube, said branched tube functioning as an aspiration channel, said straight tube being bonded to said semicircular channel of said bottom part and said angled tube passing through and bonded to said small hole of said bottom part, said straight tube on one end having said plug bonded and on the other end having a plug luer lock for attaching said cutter or said tubular curved trocar or said turnable trocar via said receptacle luer lock, said angled tube at the end having said receptacle luer lock, and said receptacle luer lock connecting to a standard or conventional aspiration tubing attached to a conventional or standard vacuumized tissue collector; an elongated extension spring having a hook on either end; a cutter drive gear having a D-hole, said cutter gear having a hub, and said hub having a concentric circular flange; a coupler shaft at the front end having prongs, said prongs having through holes for performing a coupling function by engaging with said rounded bosses of said cutter or said trocar, said coupler at the back end having a D-shape shaft, said D-shape shaft having a cross hole, said coupler going through said straight tube and extending out of said plug luer lock at said front end and also extending out of said sealing hole of said plug at said back end, said coupler having said cutter gear on said D-shape shaft, said D-shape shaft having said hook of said extension spring in said cross hole, said hook retaining said cutter gear, said boxed motor having the other said hook of said extension spring in said hole of said boxed motor; a crank knob having a cylindrical stem, said stem having a blind D-hole, and said crank knob being on and bonded to said crank shaft of said boxed motor while said stem going through said large hole of said bottom part.

Description

BRIEF DESCRIPTION OF THE VIEWS IN THE DRAWING

[0023] FIG. 1A, FIG. 1B, FIG. 1C, and FIG. 1D respectively show left-side, top, right-side, and cut-away section views of the helical tissue cutter with the receptacle luer lock and the cutter's coupling feature while FIG. 1E, FIG. 1F, FIG. 1G, FIG. 1H, and FIG. 1J show enlarged broken views of the details of the helical tissue cutter with the receptacle luer lock and the cutter's coupling feature.

[0024] FIG. 2A, FIG. 2B, and FIG. 2C respectively show left-side, top and front views of the assembled handle while FIG. 2D and FIG. 2G respectively show a cut-away section of the left-side view and a top view of the opened handle and FIG. 2H, FIG. 2J and FIG. 2K show their enlarged broken views of the details containing the boxed spring-wound motor, the gears, coupler shaft, sliding mechanism, extension spring, the shaft's coupling feature, the plug luer lock, the aspiration channel with the receptacle luer lock, and the slider and crank knobs; and FIG. 2E and FIG. 2F show enlarged broken views of the details of the shaft's coupling feature.

[0025] FIG. 3A shows a top view of the assembled handle with the helical tissue cutter attached to the handle via the plug luer lock on the Y-branched aspiration channel and coupled to the coupler shaft while FIG. 3B shows an enlarged broken view of the details of the coupling; FIG. 3C shows a top view of the assembled handle with the helical tissue cutter attached and coupled and in the retracted state; FIG. 3D shows a top view of the opened handle with the helical tissue cutter attached and coupled and in the retracted state; and FIG. 3E and FIG. 3F respectively show enlarged broken top views of the details of the retracted helical tissue cutter and the opened handle.

[0026] FIG. 4A, FIG. 4B, and FIG. 4C respectively show left-side, top, and right-side views of the hollow cylinder.

[0027] FIG. 5A and FIG. 5B respectively show a top view of the helical tissue cutter and an enlarged broken view of the details of the helical tissue cutter.

[0028] FIG. 6A and FIG. 6B respectively show top and front views of the coupler shaft for the helical tissue cutters while FIG. 6C and FIG. 6D respectively show enlarged broken views of the details of the coupling feature.

[0029] FIG. 7A, FIG. 7B, and FIG. 7C respectively show left-side, front, and right-side views of the cutter gear.

[0030] FIG. 8A and FIG. 8B respectively show left-side and front views of the elongated motor drive gear.

[0031] FIG. 9A and FIG. 9B respectively show left-side and top views of the boxed spring-wound motor only showing the motor's extended drive shaft and crank shaft.

[0032] FIG. 10A and FIG. 10B respectively show top and front views of the elastomeric seal plug.

[0033] FIG. 11A and FIG. 11B respectively show front and bottom views of the crank knob.

[0034] FIG. 12A, FIG. 12B, FIG. 12C, and FIG. 12D respectively show front, left-side, bottom, and right-side views of the slider knob.

[0035] FIG. 13 shows a top view of the Y-branched aspiration channel.

[0036] FIG. 14A, FIG. 14B, and FIG. 14C respectively show top, right-side and backside views of the bottom part of the handle.

[0037] FIG. 15A and FIG. 15B respectively show top and right-side views of the top part of the handle.

[0038] FIG. 16 shows a front view of the mesh sling with the anchors glued to either end of the mesh sling.

[0039] FIG. 17A and FIG. 17B respectively show front and right-side views of the anchor while FIG. 17C shows an enlarged broken view of the details of the anchor.

[0040] FIG. 18 shows a top view of the assembled handle with the slider knob that is slid to a certain distance.

[0041] FIG. 19 shows a top view of the tubular curved trocar.

[0042] FIG. 20A shows a top view of the tubular curved trocar that is attached to the assembled handle and coupled to the sliding mechanism via the coupler shaft contained inside the handle, while FIG. 20B shows an enlarged broken view with a cut-away section of the details of the installed anchor containing the mesh sling.

[0043] FIG. 21A shows a top view of the curved tube while FIG. 21B shows an enlarged broken view of the details of the distal end of the curved tube.

[0044] FIG. 22 shows a top view of the slidable shaft in a straight position, which shaft goes into the curved tube and conforms to the curve of the curved tube.

[0045] FIG. 23A and FIG. 23B respectively show front and top views of the turnable trocar.

[0046] FIG. 24 shows a top view of the turnable trocar attached to the assembled handle.

[0047] FIG. 25A shows a top view of the turnable trocar's shaft while FIG. 25B shows an enlarged broken view with a cut-away section of the details of the turn-lock mechanism installed at the distal end of the turnable trocar's shaft.

[0048] FIG. 26A shows a front view of the curved trocar wire having the stem while FIG. 26B shows an enlarged broken view with a cut-away section and FIG. 26C and FIG. 26D show enlarged broken views of the details of the stem of the curved trocar wire.

[0049] FIG. 27 shows a top view of the shaft of the turnable trocar.

[0050] FIG. 28A, FIG. 28B, and FIG. 28C respectively show left-side, front and right-side views of the receptacle stud that houses the turn-lock mechanism.

DETAILED DESCRIPTION OF THE INVENTION

[0051] Now, referring to FIG. 1A, FIG. 1B, FIG. 1C, FIG. 1D, FIG. 1E, FIG. 1F, FIG. 1G, FIG. 1H, FIG. 1J, FIG. 4A, FIG. 4B, FIG. 4C, FIG. 5A, FIG. 5B, FIG. 6A, FIG. 6B, FIG. 6C, and FIG. 6D in accordance with the present invention, a helical tissue cutter 1X consists of a cutter shaft 1, and a hollow cylinder 2. For resecting biological tissues and spiraling out the resected tissues and any biological debris, the cutter shaft 1 distally has a sharp-edged helical blade 1A, which blade is longitudinally spiraled around and integral to the cutter shaft 1 and has continuously another matching flat-edged helical fin 1B, which fin is also longitudinally spiraled around and integral to the cutter shaft 1. The cutter shaft 1 proximally has a flattened end 1C and on either side of the flattened end 1C has a rounded boss 1D, which boss performs a coupling function by engaging. The hollow cylinder 2 encloses the cutter shaft 1 containing the sharp-edged helical blade 1A and the flat-edged helical fin 1B. The hollow cylinder 2 is also used for aspiration of the resected tissues and/or biological debris. To expose the sharp-edged helical blade 1A, the hollow cylinder 2 has at least two elongated slots 2A longitudinally, one on either aspect of the hollow cylinder 2, which slots are located 180° apart. For an attachment purpose, the hollow cylinder 2 integrally contains on one end a receptacle luer lock 3A. The other end of the hollow cylinder 2 is open and has a bent and rounded edge.

[0052] Referring to FIG. 2A, FIG. 2B, FIG. 2C, FIG. 2D, FIG. 2G, FIG. 2E, FIG. 2F, FIG. 2H, FIG. 2J, FIG. 2K, FIG. 7A, FIG. 7B, FIG. 7C, FIG. 8A, FIG. 8B, FIG. 9A, FIG. 9B, FIG. 10A, FIG. 10B, FIG. 11A, FIG. 11B, FIG. 12A, FIG. 12B, FIG. 12A, FIG. 12A, FIG. 12B, FIG. 12C, FIG. 12D, FIG. 13, FIG. 14A, FIG. 14B, FIG. 14C, FIG. 15A, and FIG. 15B in accordance with the present invention, there is a bottom-part handle 6 and there is a top-part handle 7. The bottom-part handle 6 has on its wall edges blind holes 6D while the top-part handle 7 has on its wall edges matching bosses 7C, which bosses go into the blind holes 6D of the bottom-part handle 6 for aligning and assembling the bottom-part handle 6 and top-part handle 7. The bottom-part handle 6 has on the front end a semicircular channel 6A and has on the back end a large hole 6B and a small hole 6C, while the top-part handle 7 has on the front end a matching semicircular channel 7B and has on the planar surface an elongated slot 7A.

[0053] The bottom-part handle 6 contains a boxed spring-wound motor 14, which motor has on one end, a motor drive shaft 14A with an extended motor drive D-shape shaft 14B, which shaft contains a cross hole 14C. The boxed spring-wound motor 14 on the opposite end has a motor crank shaft 14E with an extended motor crank D-shape shaft 14F and on the top has a small hole 14D. A motor drive gear 12 has a D-hole 12A and is installed via the D-hole 12A on the extended motor drive D-shape shaft 14B. A press-fit pin 15 is fitted into the cross hole 14C to retain the motor drive gear 12. The boxed spring-wound motor 14 with the installed motor drive gear 12 is placed and adhered inside to the floor of the bottom-part handle 6 while internally inserting the extended motor crank D-shape shaft 14F into the large hole 6B of the bottom-part handle 6.

[0054] A Y-branched tubular aspiration channel 5, which channel has a straight leg and an integral angled leg, integrally contains a plug luer lock 3B at the front end of the straight leg and contains at the back end 5A of the straight leg an elastomeric seal plug 10, which plug has a step 10A and a sealing hole 10B, while the step 10A is glued into the back end 5A. The straight leg of the Y-branched tubular aspiration channel 5 further contains a coupler shaft 4, which shaft at the front end has prongs 4A, which prongs have through holes 4B. The coupler shaft 4, at the front end, extends out of the plug luer lock 3B. The prongs 4A and the holes 4B together perform a coupling function by engaging. The coupler shaft 4 at the back end extends out of the sealing hole 10B of the seal plug 10 and has at the back end an extended D-shape shaft 4C, which D-shape shaft has a cross hole 4D. The extended D-shape shaft 4C contains a cutter gear 11, which gear has a D-hole 11A for the extended D-shape shaft 4C. The cutter gear 11 has a hub 11B and a concentric circular flange 11C. The coupler shaft 4 at the back end also contains an extension spring 13, which spring has a front hook 13A and a back hook 13B, while the front hook 13A is in the cross hole 4D to retain the cutter gear 11.

[0055] The straight leg of the Y-branched tubular aspiration channel 5 containing the integral plug luer lock 3B, the glued elastomeric seal plug 10, the coupler shaft 4, the cutter gear 11 and the extension spring 13 is placed on and adhered to the semicircular channel 6A of the bottom-part handle 6 while inserting the angled leg of the Y-branched tubular aspiration channel 5 into the small hole 6C of the bottom-part handle 6 and gluing the angled leg of the Y-branched tubular aspiration channel 5 to the small hole 6C of the bottom-part handle 6 and while making sure that the cutter gear 11 and motor drive gear 12 are meshed. Another receptacle luer lock 3A that functions as an aspiration tubing connection is adhered to the back end of the angled leg of the Y-branched tubular aspiration channel 5. The back hook 13B of the extension spring 13 is inserted into the small hole 14D of the boxed spring-wound motor 14. The extended motor crank D-shape shaft 14F contains a motor crank knob 9, which knob has a cylindrical feature 9A with a D-hole 9B for the extended motor crank D-shape shaft 14F. The motor crank knob 9 is fixed by placing an adhesive 16 on the extended motor crank D-shape shaft 14F while inserting the motor crank knob 9 from the cylindrical feature 9A into the large hole 6B located on the back of the bottom-part handle 6.

[0056] The top-part handle 7 contains a slider knob 8 in the elongated slot 7A, which knob has a cylindrical stem 8A with a yoke 8B. The slider knob 8 is captivated by the yoke 8B by turning the slider knob 8 to a 90° angle after inserting the slider knob 8 into the elongated slot 7A.

[0057] The bosses 7C, the semicircular channel 7B of the top-part handle 7 containing the slider knob 8 with the yoke 8B are, respectively, aligned and joined together with the blind holes 6D and the semicircular channel 6A of the bottom-part handle 6 containing all the parts mentioned above while making sure that the yoke 8B of the slider knob 8 is aligned with the hub 11B of the cutter gear 11 and is also in contact with the back of the concentric circular flange 11C. The joined top-part handle 7 and the bottom-part handle 6 are externally glued together, becoming an assembled handle 2X.

[0058] Referring to FIG. 3A, FIG. 3B, FIG. 3C, FIG. 3D, FIG. 3E, and FIG. 2F in accordance with the present invention, before starting a surgical procedure that involves resecting biological tissues and aspirating the resected tissues and any biological debris, the coupler shaft 4 is fully exposed by sliding the slider knob 8 on the assembled handle 2X all the way toward the front; and while holding the slider knob 8 at that position, the cutter shaft 1 of the helical tissue cutter 1X is coupled with the coupler shaft 4 by engaging the flattened end 1C and the rounded bosses 1D of the cutter shaft 1, respectively, with the prongs 4A and the holes 4B of the coupler shaft 4; and then the hollow cylinder 2 of the helical tissue cutter 1X is attached to the assembled handle 2X by interconnecting the plug luer lock 3B and the receptacle luer lock 3A. After removing the hold, the slider knob 8 retracts the cutter shaft 1, which shaft is coupled. This retraction allows the sharp-edged helical blade 1A to move away from the slots 2A of the hollow cylinder 2 of the helical tissue cutter 1X so as to keep the sharp-edged helical blade 1A unexposed, hence providing protection to the user and/or patient while the helical tissue cutter 1X is not in use. Now, a standard vacuumized tissue collector (not shown) containing a standard aspiration tubing (not shown) is attached to the assembled handle 2X by connecting the aspiration tubing to the receptacle luer lock 3A located at the back of the assembled handle 2X.

[0059] To resect biological tissues and aspirate the resected tissues and any biological debris, the vacuum system (not shown) of the tissue collector (not shown) is turned on and the motor crank knob 9 located at the back of the assembled handle 2X is fully turned to power the boxed spring-wound motor 14, which speedily rotates the cutter shaft 1 containing the sharp-edged helical blade 1A and the flat-edged helical fin 1B of the helical tissue cutter 1X. While it is running, the helical tissue cutter 1X is placed on a targeted surgical site (not shown) while making sure that at least one of the slots 2A of the hollow cylinder 2 is intimately in contact with the tissues of the targeted surgical site (not shown) and that the slider knob 8 on the assembled handle 2X is slid all the way toward the front and held at that position, which act exposes the rotating sharp-edged helical blade 1A through the slot 2A of the hollow cylinder 2 of the helical tissue cutter 1X in order to start resecting the tissues while spiraling out and aspirating the resected tissues and any biological debris. After resecting the tissues, the hold on the slider knob 8 is removed which causes the slider knob 8 to retract, which, in turn, moves the rotating sharp-edged helical blade 1A away from the slot 2A for safety.

[0060] Referring to FIG. 16, FIG. 17A, FIG. 17B, FIG. 17C, FIG. 18, FIG. 19, FIG. 20A, FIG. 20B, FIG. 21A, FIG. 21B, and FIG. 22 in accordance with the present invention, for a treatment of stress urinary incontinence, a mesh sling 17 has an anchor 18 glued on the either end of the mesh sling 17 while the anchor 18 on one end has a crescent slot 18A, which slot has the glued end of the mesh sling 17. The anchor 18 on the same end also has a stud 18B, which stud has two rounded bosses 18C, one on each side of the stud 18B. A tubular curved trocar 1Y has a curved tube 19, which tube internally contains a slidable shaft that is the same as the cutter shaft 1, and hence this is now a slidable shaft 1 in this case, which shaft conforms to the curved tube 19 while being inside the curved tube 19 and which shaft has at the back the flattened end 1C and on either side of the flattened end 1C is a rounded boss 1D, which boss performs a coupling function by engaging. At the front end, the curved tube 19 has a cross holes 19A and a slit and compliant tip 19B and at the back end, the curved tube 19 contains yet another receptacle luer lock 3A. The anchor 18 with the mesh sling 17 is installed on the curved tube 19 by inserting the stud 18B with the round bosses 18C into the tip 19B of the curved tube 19 all the way until the round bosses 18C of the anchor 18 fully engage with the cross holes 19A of the curved tube 19.

[0061] As before, the coupler shaft 4 is fully exposed by sliding the slider knob 8 on the assembled handle 2X all the way toward the front; and while holding the slider knob 8 at that position, the slidable shaft 1 of the tubular curved trocar 1Y is coupled with the coupler shaft 4 by engaging the flattened end 1C and the rounded bosses 1D, respectively, with the prongs 4A and the holes 4B of the coupler shaft 4; and then the tubular curved trocar 1Y is attached to the assembled handle 2X by interconnecting the plug luer lock 3B and the receptacle luer lock 3A.

[0062] Using the retropubic approach, after creating periurethral tunnels with the helical tissue cutter 1X, the mesh sling 17 with the anchor 18 installed on the tubular curved trocar 1Y is deployed intravaginally and then the installed anchor 18 is released from the tubular curved trocar 1Y by sliding the slider knob 8 on the assembled handle 2X all the way toward the front, which dislodges the anchor 18 with the mesh sling 17.

[0063] Referring to FIG. 23A, FIG. 23B, FIG. 24, FIG. 25A, FIG. 25B, FIG. 26A, FIG. 26B, FIG. 26C, FIG. 26D, FIG. 27, FIG. 28A, FIG. 28B, and FIG. 28C in accordance with the present invention, a turnable trocar 1Z contains a curved trocar wire 20, which wire forms on one end a planar stem 20A, which stem has a groove 20B. On one edge of the groove 20B are two notches 20C, which notches are located 180° apart. A receptacle stud 21 has at one end a cross hole 21B, which hole contains the stem 20A of the curved trocar wire 20. The receptacle stud 21 has on the other end a blind axial hole 21C and a larger concentric threaded hole 21A. The blind axial hole 21C, which intersects the cross hole 21B, houses a plunger 23 and a compression spring 24, both of which are parts of a turn-lock mechanism for the turnable trocar 1Z. The plunger 23 captivates the curved trocar wire 20 via the engagement of the plunger 23 with the groove 20B and the notches 20C on the stem 20A. The larger concentric threaded hole 21A contains a trocar shaft 22 with threads on one end 22A, which end is inserted into the threaded hole 21A. The trocar shaft 22 on the other end has still another receptacle luer lock 3A.

[0064] The curved trocar wire 20 can freely and fully turn when the plunger 23 is in the groove 20B on the stem 20A while the curved trocar wire 20 is lifted, but to lock its turn, the curved trocar wire 20 is pushed down to feelingly find and engage the plunger 23 with one of the two notches 20C, resulting a lockingly turnable trocar 1Z. As before, the turnable trocar 1Z is attached to the assembled handle 2X by interconnecting the plug luer lock 3B and the receptacle luer lock 3A.

[0065] With a transobturator approach and after creating any needed periurethral tunnels with the helical tissue cutter 1X, the turnable trocar 1Z is used for a right or left side of the groin as a single tool to treat stress urinary incontinence.