Surgery – Means for introducing or removing material from body for... – Gas application
Utility Patent
1999-01-25
2001-01-02
Bockelman, Mark (Department: 3763)
Surgery
Means for introducing or removing material from body for...
Gas application
C604S024000, C604S250000
Utility Patent
active
06168577
ABSTRACT:
FIELD OF THE INVENTION
The present invention relates generally to surgical instruments, and more particularly to a surgical apparatus for providing a directed stream of gas and/or fluid to a surgical site to improve visibility.
BACKGROUND OF THE INVENTION
A difficult aspect of many surgical procedures is obtaining and maintaining clear and unobstructed visibility at the surgical site. Accordingly, the instruments and fixtures used in a surgical setting are meticulously designed and selected to ensure that the surgeons have optimum visual access to the surgical site. In most instances, irrigation and suction are used in one form or another to wash away and remove unwanted or undesirable material, fluids, or other particulate. In prolonged surgical procedures, irrigation is also useful in preventing the deleterious effects of tissue desiccation.
Visibility requirements are particularly acute when the surgery involves particularly delicate or small structures, such as those routinely encountered in vascular or neurological surgery. In a vascular anastomosis procedure, for example, even small amounts of fluid or other material can significantly effect the surgeons view of the anastomotic site. Blood flow from the surrounding tissues or from the vessels themselves is particularly problematic for visualization of the surgical site during an anastomosis. In such procedures, standard liquid irrigation alone is often ineffective for clearing the surgical site.
Devices using a directed gas or fluid stream to obtain a clear view of the surgical site are known. For example, U.S. Pat. No. 5,336,170 to Salerno et al. discloses a surgical site visualization wand which has a fluid delivery conduit having a fan shaped tip for delivering a pressurized gas to a target site. The visualization wand may also have a humidification or moisturizing conduit for the selective introduction of a sterile liquid in the form of a mist carried by and intermixed with the gas stream to the target site. Such arrangements tend to have the improved ability to blow away fluid or debris without desiccating tissue.
One problem with the directed stream visualization devices known in the art, however, is that they are cumbersome to operate, offering inadequate gas and liquid flow control. If the flow rate of the gas supply is too low, it will not adequately clear the targeted site of undesired material. If the gas stream is delivered at an excessive flow rate or pressure it tends to cause a certain amount of spattering of the cleared material and may displace or damage the delicate tissue structures under operation. If the flow rate of the liquid is too high it may over-irrigate the site; too low and the surrounding tissue may become desiccated.
Typically, such visualization devices offer flow control only in the form of separate mechanical clamps at the liquid supply line and at the gas supply line. To adjust the flow rate of either the gas or the liquid, the user is required to distract their attention from the surgical site, locate the appropriate clamp along the supply tubing, manipulate the clamp to effectuate a change in flow rate, observe whether the adjustment has had the desired effect on the characteristics of the flow emanating from the device, and then return the device, and their attention, to the surgical site.
In fact, the process of closing or adjusting the flow rates of such devices is, in many cases, so cumbersome that it has become common to simply leave the device on and flowing for the duration of the procedure. This results in an unacceptable waste of both pressurized gas and sterile liquid. Moreover, the continuous flow of gas and liquid throughout the duration of the surgical procedure may cause the supply of gas or liquid to run out to the detriment of the surgeon, and ultimately the patient. While members of the surgical team are distracted with the task of locating and connecting a new supply, the surgeon must endure diminished visibility at the surgical site.
In view of the foregoing, it would be desirable to have a directed stream blower device for improving surgical site visualization having a convenient flow control for single-handed, undistracted operation. Most desirably, the flow control would not only allow in-use flow rate adjustment, but would also allow the fluid and gas flow to be substantially stopped and started as desired during a surgical procedure. It would be further desirable to have these features in a directed stream blower which is of simple construction and preferably disposable.
SUMMARY OF THE INVENTION
The present invention involves a directed stream surgical blower for removing unwanted fluid and other materials from a surgical site. Preferably, the blower provides an intermixed stream of gas and fluid which may be directed to the surgical site to remove blood, debris, particulate, or other undesirable material from a target surgical site.
In one aspect of the present invention, the directed stream blower is provided with a distally located flow control mechanism configured for convenient one-handed operation of the flow control while the blower is being used to actively clear a surgical site. This allows the stream directed at a target surgical site to be adjusted or interrupted by the user during use without distraction. Preferably, the directed stream blower or the flow control mechanism or both have a construction suitable for disposable use.
In one embodiment, the invention involves a directed stream blower having an elongated flexible tube having a first lumen and a separate and independent second lumen and a handle. The handle has an interior passage for receiving a length of the flexible tube, a surface adapted to support at least a portion of the length of the tube, and a roller which is positionable in relation to the surface. A portion of the length of the flexible tube is positioned within the handle passage between the surface and the roller such that movement of the roller closer to the surface at least partially clamps the flexible tube. Such clamping effectively reduces the cross-sectional flow area or either the first lumen or the second lumen, or both. In one embodiment, the first lumen and the second lumen are coaxial.
In a preferred embodiment, the flexible tube includes an outer tube and an inner tube. The outer tube has an inside diameter and a central lumen therein and the inner tube has an outside diameter. The inner tube is positioned within the central lumen of the outer tube. In this configuration, the second lumen of the flexible tubing is simply the lumen within the inner tube and the first lumen of the flexible tubing is the space between the inside diameter of the outer tube and the outside diameter of the inner tube. The outer tube and the inner tube may be made from different materials having different properties.
In one aspect of the present invention, the roller is substantially cylindrical having a central axis and a central hub shaft generally concentric with the central axis. The handle may comprise at least one slot oriented at an angle to the surface. The hub shaft of the roller may be constrained within the slot or slots. In a preferred embodiment, the hub shaft has a first end and a second end and the handle has a first slot and a second slot parallel to the first slot. The first end of the hub shaft may be constrained within the first slot and the second end within the second slot. The slots provide support for the roller on both sides as well as constraining the roller to movement in accordance with the shape or path of the slot.
In one embodiment, the angle between the surface supporting the flexible tube and the slot in which the roller rides is preferably in the range from about 4° to about 20°, more preferably between about 4° to about 8°. At one end of the slot the roller will be at a first distance from the surface and at the other end the roller is spaced at a second distance from the surface.
Preferably, the proximal end of the first lumen is connected to a source of pressurized gas and the proximal end of the seco
Green, II Harry L.
Niederjohn James W.
Reis Eugene E.
Bockelman Mark
Cardiothoracic Systems, Inc.
Hayes Michael J
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