Surgery – Instruments – Means for removing tonsils – adenoids or polyps
Patent
1998-09-22
2000-11-28
Coggins, Wynn Wood
Surgery
Instruments
Means for removing tonsils, adenoids or polyps
606127, 606113, A61B 1724
Patent
active
06152932&
DESCRIPTION:
BRIEF SUMMARY
TECHNICAL FIELD
The present invention relates to a surgical instrument to be used in certain endoscopic surgical operations, such as in laparoscopic surgery, in order to extract a specimen, such as an organ or tissue.
BACKGROUND
Laparoscopic surgery, also known as keyhole surgery, has gained increasing importance within general surgery and gynaecological surgery, The advantages obtained compared with conventional surgery are considerable to the patient and society alike, In laparoscopic surgery small puncture orifices are made in the abdominal wall through which trocars (tubular sleeves) are inserted, said trocars serving as a means for introduction of the laparoscopic instrument as well as one or several working instruments. The abdomen is inflated by gas, which increases the abdominal volume considerably, allowing survey and accessibility. The image of the surgical area is transmitted to a monitor and the disordered organ is isolated and separated from surrounding tissue with the aid of the operational instrument. The surgical technique, instrument and other equipment used for this purpose are well known and highly developed, The specimen (organ, surgically removed tissue) is then to be removed from the abdomen. When the specimen is small-sized it may be extracted through a trocar directly but when the specimen is large it is either necessary to open the abdomen by making an incision therein (thus reducing the advantages gained by the laparoscopic surgical operation) or to fragmentize (morcellate) the specimen. Instruments for this purpose (morcellators) have been known for several decades (for example the instrument known as Serrated Edge Macro Morcellator "SEMM" manufactured by Wisarp in Germany) and in recent years several models have been developed. A morcellator of this kind is described for instance in U.S. Pat. No. 5,443,472 comprising two rods which are carried down into the abdomen and one of which comprises a net which may be gathered together and which is positioned in such a manner as to extend around the other rod and the specimen, The second rod comprises an outer tube having an opening therein and an inner tube having a cutting edge. When the net is gathered together a part of the specimen is forced to enter through the opening, whereupon the inner tube is forced downwards and cuts off the protruding part of the specimen, the inner tube is withdrawn, and the procedure may be repeated.
The problem connected with this and other morcellators are, however, considerable. This is due essentially to the fact that by a retaining device;
The consequences are several: from the specimen in a planned and optimum manner. if the specimen is very large. directions and consequently limp and difficult to handle. assess the specimen microscopically, since the specimen is presented to him in fragments that cannot be orientated relative to one another, and one consequence thereof is that the laparoscopic surgical technique is unsuitable for example for certain types of cancer surgery. blood vessels) during the morcellation since there is no safe barrier between on the one hand the morcellator and the specimen and on the other the abdominal cavity. abdominal wall (infected specimen, caner cells).
Also when the specimen, such as an organ or tissue, is small and should not need to be fragmentized extraction thereof could nonetheless be difficult using prior art equipment. Prior art equipment often comprises a bag or sack of some kind which is introduced into the abdomen through the trocar. When the specimen is entrapped and the equipment is pulled upwards it may, however, be deformed in an unfavourable manner or assume an oblique position, making it impossible to extract it through the trocar.
These and other problems are complicating features of the laparoscopic surgery and restrict its use and application. Under corresponding conditions the above is applicable also to the operative thorascopy (keyhole surgery in the thoracic cavity).
OBJECT OF THE INVENTION
The object of the present invention is to prov
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Coggins Wynn Wood
Maynard Jennifer
Safe Conduct AB
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