Surgery – Truss – Perineal
Patent
1991-06-28
1992-12-29
Pellegrino, Stephen C.
Surgery
Truss
Perineal
604 95, 604171, 604280, 606 1, 606142, A61B 100
Patent
active
051742764
DESCRIPTION:
BRIEF SUMMARY
The invention relates to surgical devices. Surgical devices according to the invention are especially useful for neurosurgery.
In many surgical techniques it is necessary to introduce instruments into the body, and to operate them at sites within the body to which access is difficult. For example, acces to aneurysms on blood vessels, particularly those at the base of the brain, is often very difficult. Aneurysms are treated by placing clips across their necks to isolate them from the blood vessel on which they have formed. This operation is currently performed by holding a clip open in a pair of specially adapted, rigid, forceps, and then positioning the clip around the neck of the aneurysm, and releasing it from the forceps by manual action. The rigidity of the forceps presents problems in the confined spaces within the brain, as a large arm movement by the surgeon may be required in order to effect a small movement of the tip of the instrument. Inaccuracies in movement and hand tremor can result in accidental damage to tissues and blood vessels. This is clearly especially undesirable when operating close to brain tissue.
According to a first aspect of the invention there is provided a deformable conduit comprising a plurality of conduit elements disposed end to end to form a conduit; at least two elongate tension members anchored to the conduit element at one end of the conduit and passing through each other conduit element successively; means for tensioning the tension members to cause adjacent conduit elements to bear and lock against each other and so render the conduit rigid; and a housing from which the conduit elements extend, the housing having an opening in each of two opposed walls; characterised in that the conduit further comprises a hollow shaft extending in the housing from one opening toward the other, the conduit elements being co-extensive with the shaft and passing through the said other opening; and a brake associated with each tension member which can bear on the tension member and so urge it against the element to hold the member against movement relative to the element.
It is particularly preferred that the deformable conduit is part of a conventional steerable endoscope of the otherwise conventional design, in which case the invention is particularly useful in neurosurgery. The endoscope can be introduced into sites which are normally difficult to gain access to with the minimal exposure of brain tissue, and when in position can be made rigid so that no unwanted movements of the endoscope tube take place.
According to a second aspect of the invention there is provided a remote actuator comprising: a conduit; a shaft axially movable within the conduit; a drive for driving the conduit and the shaft along their axes which can be disengaged from at least one of them; and actuation means for moving axially either the conduit or the shaft, for actuation whereby, in use, the conduit and shaft can be moved as one to position the actuator, and relative to one another for actuation.
Preferred embodiments of the second aspect of the invention provide a surgical device, for introducing a surgical instrument to an operating site in a patient and actuating the instrument, comprising: a conduit; a shaft axially movable within the conduit; a first drive to drive the conduit in an axial direction; a second drive operably connected to the first drive to drive the shaft in an axial direction, at least one of the first and second drives being movable into and out of engagement with the conduit or shaft respectively, so that the shaft and conduit can be driven as one and one another of them can be driven alone. The end of the device distant from the drives being adapted to carry a surgical instrument actuable by relative axial movement of the conduit and the shaft whereby, in use, the distal end of the device can be introduced into a patient and moved by the first and second drives to an operating site where the instrument can be actuated by the relative movement of the conduit and the shaft.
Preferably
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Hillway Surgical Limited
Pellegrino Stephen C.
Schmidt Jeffrey A.
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