SINGLE PORTAL, SURGICAL APPARATUS
20230404617 ยท 2023-12-21
Inventors
Cpc classification
A61B2017/0046
HUMAN NECESSITIES
A61B17/1606
HUMAN NECESSITIES
A61B2017/2902
HUMAN NECESSITIES
A61B17/3423
HUMAN NECESSITIES
A61B2017/320032
HUMAN NECESSITIES
A61B17/1608
HUMAN NECESSITIES
A61B2017/00367
HUMAN NECESSITIES
A61B2017/320024
HUMAN NECESSITIES
International classification
Abstract
Some implementations of the disclosure are directed to single portal surgical systems. In one implementation, an apparatus includes first, second, and third cannulas. Fluid flows through a proximal opening of the first cannula. The second cannula couples within the first cannula such that an outer wall of the second cannula contacts an inner wall of the first cannula. The second cannula includes a first distal opening and a first slot longitudinally extending along the second cannula. Fluid entering the proximal opening flows through the first slot and exits at a distal end of the. The third cannula couples within the second cannula such that an outer wall of the third cannula is in touching relation with an inner wall of the second cannula. The third cannula includes a second distal opening that rotationally interacts with the first distal opening during tissue debridement.
Claims
1. An apparatus, comprising: a first cannula to couple to a fluid receptacle such that fluid flows from the fluid receptacle through a proximal opening of the first cannula; a second cannula to couple within the first cannula such that an outer wall of the second cannula is in touching relation with an inner wall of the first cannula, the second cannula including a first distal opening and a first slot longitudinally extending along a length of the second cannula, wherein the fluid entering the proximal opening of the first cannula is to flow through the first slot and exit at a distal end of the apparatus; and a third cannula to couple within the second cannula such that an outer wall of the third cannula is in touching relation with an inner wall of the second cannula, the third cannula including a second distal opening that rotationally interacts with the first distal opening during debridement of tissue.
2. The apparatus of claim 1, wherein: the second cannula further includes a second slot longitudinally extending along the length of the second cannula; and the fluid entering the proximal opening of the first cannula is to flow through the first slot and the second slot, and exit at the distal end of the apparatus.
3. The apparatus of claim 2, wherein: the second cannula further includes a third slot longitudinally extending along the length of the second cannula; and the first slot, second slot, and third slot are circumferentially spaced along the second cannula.
4. The apparatus of claim 1, wherein: the fluid entering the proximal opening of the first cannula is to flow through a channel defined by an opening between a first boundary and a second boundary, the opening including the first slot, the first boundary including a longitudinal portion of the inner wall of the first cannula, and the second boundary including a longitudinal portion of the outer wall of the third cannula.
5. The apparatus of claim 1, wherein the first slot is substantially linear along the length of the second cannula.
6. The apparatus of claim 1, wherein the first slot spirals along the length of the second cannula.
7. The apparatus of claim 1, wherein a thickness of the channel is substantially the same as a thickness of the second cannula between the outer wall of the second cannula and the inner wall of the second cannula.
8. The apparatus of claim 1, wherein the outer wall of the second cannula is flush against the inner wall of the first cannula along a longitudinal length of the first cannula.
9. The apparatus of claim 1, further comprising: a housing coupled to a proximal end of the third cannula, the housing comprising a port configured to couple to a suction line that suctions the tissue after debridement or the fluid after exiting at the distal end of the apparatus.
10. The apparatus of claim 1, wherein an edge of the third cannula along the second distal opening is sharpened.
11. The apparatus of claim 1, further comprising: a light source to transmit light to a location of the tissue during debridement; and an image sensor to image the location during debridement.
12. The apparatus of claim 11, wherein the first cannula comprises a channel via which the light transmitted by the light source travels.
13. The apparatus of claim 1, further comprising: the fluid receptacle, wherein the fluid receptacle is configured to fluidically couple to a fluid source, and the fluid receptacle is longitudinally rotatable.
14. The apparatus of claim 1, wherein the third cannula is to removably couple within the second cannula.
15. The apparatus of claim 1, wherein the third cannula is integrated within the second cannula; or the second cannula is integrated within the first cannula.
16. The apparatus of claim 1, wherein a length of the apparatus is between 5 cm and 25 cm, an outer diameter of the first cannula is between 2.2 mm and 8 mm, and an inner diameter of the third cannula is between 2.0 mm and 7.5 mm.
17. An apparatus, comprising: a first cannula to couple to a fluid receptacle such that fluid flows from the fluid receptacle through a proximal opening of the first cannula; a second cannula to couple within the first cannula such that an outer wall of the second cannula is in touching relation with an inner wall of the first cannula, the second cannula including a first distal opening and at least one slot longitudinally extending along a length of the second cannula, wherein the fluid entering the proximal opening of the first cannula is to flow through the at least one slot and exit at a distal end of the apparatus; and an instrument shaft to couple within the second cannula such that an outer wall of the instrument shaft is in touching relation with an inner wall of the second cannula.
18. A single portal surgical apparatus, comprising: a first cannula to couple to a fluid source such that fluid flows from the fluid source through a proximal opening of the first cannula; an instrument shaft longitudinally extending within the first cannula, an outer surface of the instrument shaft comprising circumferentially spaced first and second structures longitudinally extending along a distal portion of the instrument shaft, the first structure in continuous, touching relation with a first surface of an inner wall of the first cannula along a first location, and the second structure in continuous, touching relation with a second surface of the inner wall along a second location such that an interior of the first cannula is partitioned into at least two fluid channels having boundaries defined by at least the first location and the second location; and a first tool distally extending from the instrument shaft.
19. The single portal surgical apparatus of claim 18, wherein: an interior of the instrument shaft comprises a first instrument channel longitudinally extending along the instrument shaft; and the first tool distally extends from a distal end of the first instrument channel.
20. The single portal apparatus of claim 19, further comprising: a cable wire coupled to the proximal end of the first tool, the cable wire running through the first instrument channel to a proximal end of the single portal surgical apparatus.
21. The single portal surgical apparatus of claim 19, further comprising a second tool distally extending from the instrument shaft, wherein: an interior of the instrument shaft further comprises a second instrument channel separate from the first instrument channel; and the second tool distally extends from a distal end of the second instrument channel.
22. The single portal surgical apparatus of claim 18, wherein the first and second structures circumferentially spiral about the instrument shaft along its longitudinal length.
23. The single portal surgical apparatus of claim 22, wherein the first and second structures are winged structures.
24. The single portal surgical apparatus of claim 18, wherein: the at least two fluid channels comprise a first fluid channel and a second fluid channel; the fluid entering the proximal opening of the first cannula is to flow through the first fluid channel and exit at a distal end of the first cannula; and the second fluid channel is configured to suction the fluid or tissue.
25. The single portal surgical apparatus of claim 24, wherein: the second fluid channel is coupled to a suction line proximal to the first cannula.
26. The single portal surgical apparatus of claim 18, wherein: the outer surface of the instrument shaft further comprises a third structure longitudinally extending along the distal portion of the instrument shaft, the third structure in continuous, touching relation with a third surface of the inner wall along a third location, and the third structure circumferentially spaced with the first and second structures; the at least two fluid channels comprise three or more fluid channels; and the interior of the first cannula is partitioned into the three or more fluid channels having boundaries defined by at least the first location, the second location, and the third location.
27. The single portal surgical apparatus of claim 18, further comprising: a light source to transmit light to an anatomical site during surgery; and an image sensor to image the anatomical site during surgery.
28. The single portal surgical apparatus of claim 27, wherein: the image sensor is integrated into the first cannula; and the first cannula comprises a channel via which the light transmitted by the light source travels; or a distal end of the first cannula comprises the light source.
29. The single portal surgical apparatus of claim 18, further comprising: a handle proximal to and coupled to the first cannula and the instrument shaft, the handle comprising a control configured to be actuated to move the first instrument.
30. The single portal surgical apparatus of 18, further comprising: a connector distal to the handle, the connector configured to removably couple a proximal end of the instrument shaft to the handle.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0037] The present disclosure, in accordance with one or more implementations, is described in detail with reference to the following figures. The figures are provided for purposes of illustration only and merely depict example implementations. Furthermore, it should be noted that for clarity and ease of illustration, the elements in the figures have not necessarily been drawn to scale.
[0038] Some of the figures included herein illustrate various implementations of the disclosed technology from different viewing angles. Although the accompanying descriptive text may refer to such views as top, bottom or side views, such references are merely descriptive and do not imply or require that the disclosed technology be implemented or used in a particular spatial orientation unless explicitly stated otherwise.
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[0064] The figures are not exhaustive and do not limit the present disclosure to the precise form disclosed.
DETAILED DESCRIPTION
[0065]
[0066] The optical component 100 includes a fluid port 105, a fluid receptacle 110, and a cannula 120. The optical component 100 may also include an endoscopic light source and image sensor (not shown). The light source and/or image sensor may be positioned on a distal end of cannula 120 or in a housing (not shown) at a proximal end of optical component 100. For example, during endoscopic operation of optical component 100, light emitted from a light source (e.g., LED light source) contained within an endoscope housing may transmit light that travels through cannula 120 via an illumination channel that terminates at the distal end of cannula 120. The illumination channel may be a molded illumination pipe. Alternatively, in other implementations the light source may be integrated, internally and/or externally, into the cannula 120. In such implementations, the light source may be positioned near the distal end of cannula 120 (e.g., near the camera sensor, in a different channel such that the light emitted by the light source does not interfere with the operation of the camera sensor), or in some other segment of the cannula 120.
[0067]
[0068] The microdebrider outer component 200 includes head 210, a cannula 220, and distal end or cannula tip 230 that has an opening 230a.
[0069] The microdebrider inner component 300 includes a head 310, cannula 320, and distal end or cannula tip 330 that has an opening 330a.
[0070] During operation, inner component 300 may rotate or oscillate within the outer component 200 to facilitate debriding of tissue by apparatus 10. Multiple options for length of the cannula apparatus 10, diameter of the outer cannula 120, and diameter of the inner cannula/channel 320 are envisioned. Cannula apparatus lengths could range between 5 cm and outer diameters between 2.2 mm and 8 mm, and inner diameters between 2.0 mm and 7.5 mm, respectively.
[0071] In this example, apparatus 10 is assembled by moving the microdebrider inner component 300 through the microdebrider outer component 200 (e.g., starting at an opening at a proximal end of head 210 of outer component 200) such that cannula 320 moves through cannula 220, and by moving optical component 100 over cannula 220 (e.g., starting at the distal end of microdebrider outer component 200) such that cannula 120 moves over cannula 220. Manners of assembly in which the integral parts are not detachable or manufactured as one piece are also envisioned, but it should be appreciated that the apparatus 10 incorporates an optical component 100 having a cannula 130 containing a cannula 220 of an outer component 200, which contains a cannula 320 of an inner component 300.
[0072] In some implementations, head 210 and head 310 can be implemented as a single housing. In some implementations, head 210 and head 310 can be omitted from outer component 200 and inner component 300, respectively. For example, each of cannula 220 and cannula 320 can couple to (removably or non-removably) to the same proximal housing. In such implementations, optical component 100 could also couple to the same proximal housing.
[0073]
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[0075] The foregoing design enables irrigation fluid or other fluid to be delivered through the optical component 100 in a joint space between cannula 120 and cannula 220 in a manner that both maximizes the microdebrider outer diameter (e.g., 2 times r.sub.2 in
[0076] In the foregoing arrangement, the outer wall of the cannula 320 of microdebrider inner component 300 may fit flush within the inner wall 220a of the cannula 220 of microdebrider outer component 200. The microdebrider inner component 300 thereby creates a floor to the one or more slots 225 placed into to microdebrider outer component 200. In a similar manner, the inner wall 120a of the working channel of the cannula 120 of optical component 100 provides a roof or ceiling to the slot 225. The slot 225 may therefore confine the irrigation channel to the material thickness of the cannula 220 of outer microdebrider component 200 as well as the width of the slot 225.
[0077] In some implementations, multiple slots 225 (e.g., 2, 3, 4, 5, 6, or more) may be spaced circumferentially and running longitudinally along the outer cannula 220. For example,
[0078] In some implementations, the slots are envisioned to be linear in shape, however in other implementations, the slots may be non-linear in shape and width. Such embodiments may include spiral or mixed horizontal and longitudinal slot configurations. For instance, a spiral slot configuration may allow for tortional closure of the slot in certain applications whereby altering the size and therefore fluid carrying capacity of the slots would be beneficial. By way of example,
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[0081] Cannulas 120, 220, and 320 may be made out of metal and/or rigid or flexible polymer such as PEBA, PEEK or LCP. Disposable and reusable cannulas are also envisioned. In some implementations, the optical cannula shaft 120 may be articulating, flexible, malleable, or otherwise non-linear or curved in configuration. Optical cannula shafts that relay anatomical tip positioning information to an image guidance computer are also envisioned. Inner cannula 220 and 320 may also be flexible and/or articulating thereby allowing them to passively or actively move in relation to an outer flexible or articulating optical cannula.
[0082] In some implementations, a powered rotating shafted instrument could be inserted through the second cannula 220 instead of a rotating hollow cannula 320. For example, a shafted burr could be inserted instead of a rotating hollow cannula 320 through the second cannula 220 such that the suction could still occur around the burr tip.
[0083] The delivery of irrigation fluid via the cannula and slot configurations described herein are not limited to arthroscopic microdebriders. Similar applications are envisioned for shafted instrumentation passed through an outer cannula in instances whereby slots or indentations/grooves incorporated into the outer diameter of an instrument shaft are required for fluid delivery. It should also be noted that the outer contour of an instrument shaft may be circular or of some other geometric outer contour and that cannulas may also have outer or inner contours that are not necessarily circular in configuration.
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[0086] The instrument shaft 1250 includes a winged portion 1252 and connector portion 1253 to connect the instrument shaft 1250 to the handle 1210. The connector portion 1253 mechanically couples a proximal end of the instrument shaft 1250 to the instrument shaft connector 1220 distally extending from handle 1210. A housing containing or extending from the instrument shaft connector 1220 can also incorporate irrigation and suction mechanisms that attach to suction and irrigation lines running to apparatus 1200. Connector portion 1253 can be rigid or semi-rigid, and the coupling mechanism of instrument shaft connector 1220 can enable a removable coupling mechanism such as snap fit, press fit, friction fit, magnetic attachment, and/or some other attachment mechanism. One embodiment may include a longitudinal slot in housing 1220 that rotates around shaft connector portion 1253 after 1253 is positioned within the slot (not shown). In alternative implementations, the instrument shaft is integrated and not removable.
[0087] Extending proximal to connector portion 1253 is a cable/wire 1254 configured to drive tool tip 1255. The cable/wire 1254 can be configured to run through the instrument shaft 1250 to the tool tip 1255. Instrument handle 1210, housing 1220 and actuating control 1205 can be configured to removably secure instrument shaft segment 1253 in relation to the proximal end of cable wire 1254 so that cable wire 1254, once engaged, can move back and forth within shaft 1252 when engaged and actuated by control 1205. As depicted in this example, the tool tip 1255 includes forceps. However, as further described below, various other instrument tools are envisioned for use with the single portal surgical apparatus 1200, or variants thereof. During operation, control 1205 can be actuated to drive distal tool 1255 via cable 1254. The control 1205 is illustrated as having finger grips that can be grasped to actuate the distal tool 1255. Other controls are envisioned, including, for example, a trigger, a button, a dial, a slide, etc.
[0088] The winged portion 1252 of the instrument shaft 1250 includes circumferentially spaced apart wings/structures 1252a and 1252b that protrude from and longitudinally extend along a length of the instrument shaft. When apparatus 1200 is assembled, the shaft 1252 can be inserted through an outer/optical cannula 1280 shown in
[0089] The instrument shaft and outer cannula can be assembled together by inserting a distal end of the instrument shaft 1250 through a proximal end of the outer cannula until the distal end of the instrument shaft 1250 reaches or extends through a distal end of the outer cannula 1280. In such implementations, the instrument shaft 1250 can first couple to the instrument shaft connector 1220 via connector portion 1253, followed by the outer cannula. Alternatively, a proximal end of the instrument shaft 1250 can be inserted or pushed through a distal end of the optical cannula and then coupled to the handle 1210 and/or connector 1220. The latter form of assembly may be preferable in cases where the distal tool is too large to fit through the outer cannula.
[0090] Although two circumferentially spaced apart wings/structures 1252a and 1252b are illustrated for dividing the inside of the outer cannula 1280 into two fluid channels, it should be appreciated that additional, circumferentially spaced apart structures can be included to divide the inside of the outer cannula 1280 into more than two fluid channels. Additionally, although the wings 1252a and 1252b are circumferentially spaced apart about 180 degrees along the instrument shaft to enable the formation of two fluid channels that are substantially equal in size, it should be appreciated that other spacing configurations can be implemented, and the formed fluid channels need not be substantially equal in size.
[0091] The material properties of winged portion 1252 (and particularly wings 1252a and 1252b), including stiffness, flexibility, malleability, and/or roughness can be selected to enable each wing to continuously remain in contact with a surface of the inner wall along its longitudinal length. The material properties of the inner wall of the outer cannula 1280 can also be taken into consideration when making this selection. For instance, there may me longitudinal or spiral grooves incorporated into the inner surface wall of the cannula to engage the wings thereby securing position and creating a tighter fluid or suction seal.
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[0094] Although described above in terms of various example implementations and implementations, it should be understood that the various features, aspects and functionality described in one or more of the individual implementations are not limited in their applicability to the particular implementation with which they are described, but instead can be applied, alone or in various combinations, to one or more of the other implementations of the application, whether or not such implementations are described and whether or not such features are presented as being a part of a described implementation. Thus, the breadth and scope of the present application should not be limited by any of the above-described example implementations.
[0095] It should be appreciated that all combinations of the foregoing concepts (provided such concepts are not mutually inconsistent) are contemplated as being part of the inventive subject matter disclosed herein. In particular, all combinations of claimed subject matter appearing at the end of this disclosure are contemplated as being part of the inventive subject matter disclosed herein.
[0096] The terms substantially and about used throughout this disclosure, including the claims, are used to describe and account for small fluctuations, such as due to variations in manufacturing tolerances. For example, they can refer to less than or equal to 5%, such as less than or equal to 2%, such as less than or equal to 1%, such as less than or equal to 0.5%, such as less than or equal to 0.2%, such as less than or equal to 0.1%, such as less than or equal to 0.05%.
[0097] To the extent applicable, the terms first, second, third, etc. herein are merely employed to show the respective objects described by these terms as separate entities and are not meant to connote a sense of chronological order, unless stated explicitly otherwise herein.
[0098] Terms and phrases used in this document, and variations thereof, unless otherwise expressly stated, should be construed as open ended as opposed to limiting. As examples of the foregoing: the term including should be read as meaning including, without limitation or the like; the term example is used to provide some instances of the item in discussion, not an exhaustive or limiting list thereof; the terms a or an should be read as meaning at least one, one or more or the like; and adjectives such as conventional, traditional, normal, standard, known and terms of similar meaning should not be construed as limiting the item described to a given time period or to an item available as of a given time, but instead should be read to encompass conventional, traditional, normal, or standard technologies that may be available or known now or at any time in the future. Likewise, where this document refers to technologies that would be apparent or known to one of ordinary skill in the art, such technologies encompass those apparent or known to the skilled artisan now or at any time in the future.
[0099] The presence of broadening words and phrases such as one or more, at least, but not limited to or other like phrases in some instances shall not be read to mean that the narrower case is intended or required in instances where such broadening phrases may be absent. The use of the term module does not imply that the components or functionality described or claimed as part of the module are all configured in a common package. Indeed, any or all of the various components of a module, whether control logic or other components, can be combined in a single package or separately maintained and can further be distributed in multiple groupings or packages or across multiple locations.
[0100] Additionally, the various implementations set forth herein are described in terms of example block diagrams, flow charts and other illustrations. As will become apparent to one of ordinary skill in the art after reading this document, the illustrated implementations and their various alternatives can be implemented without confinement to the illustrated examples. For example, block diagrams and their accompanying description should not be construed as mandating a particular architecture or configuration.
[0101] While various implementations of the present disclosure have been described above, it should be understood that they have been presented by way of example only, and not of limitation. Likewise, the various diagrams may depict an example architectural or other configuration for the disclosure, which is done to aid in understanding the features and functionality that can be included in the disclosure. The disclosure is not restricted to the illustrated example architectures or configurations, but the desired features can be implemented using a variety of alternative architectures and configurations. Indeed, it will be apparent to one of skill in the art how alternative functional, logical or physical partitioning and configurations can be implemented to implement the desired features of the present disclosure. Also, a multitude of different constituent module names other than those depicted herein can be applied to the various partitions. Additionally, with regard to flow diagrams, operational descriptions and method claims, the order in which the steps are presented herein shall not mandate that various implementations be implemented to perform the recited functionality in the same order unless the context dictates otherwise.