Surgery – Instruments – Suture – ligature – elastic band or clip applier
Reexamination Certificate
1999-08-12
2001-12-25
Thaler, Michael H. (Department: 3731)
Surgery
Instruments
Suture, ligature, elastic band or clip applier
C606S167000, C606S174000, C606S185000, C606S205000, C030S298000, C294S025000, C081S177300
Reexamination Certificate
active
06332888
ABSTRACT:
FIELD AND BACKGROUND OF THE INVENTION
The present invention relates to surgical instruments, and more particularly, to finger-guided surgical instruments, for performing extra as well as intrabody surgical tasks, such as, but not limited to, cutting, grasping, suturing, sample collection by capillary forces or aspiration, placement of anchors and the like, especially in body locations of limited minimal-invasive accessibility. The present invention further relates to surgical procedures in which one or more finger-guided surgical instrument of the present invention are used to cut, grasp, suture, collect a sample, place anchors and the like, especially in body locations of limited minimal-invasive accessibility.
For years, there has been a discernible, clear tendency in surgery and invasive diagnosis, especially, but not exclusively, in abdominal, joint, vaginal, in-utero and brain, surgeries or diagnoses, to develop procedures that would reduce the need for major access-providing incisions with their concomitant requirements of general anesthesia, extended hospitalization and increased infection hazard. One step in this direction was the introduction of endoscopy and laparoscopy, which, through provision of minimal incision in, e.g., the abdominal wall of joint covering skin, permits the introduction into the abdominal cavity or joint of a miniature television camera including a light source, as well as of various surgical instruments.
PCT/U.S. Pat. No. 97/11494 teaches a number of surgical instruments which can be mounted directly on a surgeon's fingertips in a way that the surgeon can insert his or her hand into the patient through a minimal incision to perform surgical procedures, and also to use his or her fingers to manipulate tissues, thus enabling the surgeon to perform the procedures with the benefits of minimally invasive surgery, but with much greater tactile sense, control; and ease of manipulation. However, these surgical instruments (i) are carried by a finger and operated by the thumb, thereby are not applicable for procedures in which a single finger is employed for tactile sensing an operated intrabody location; (ii) include an operating head which permanently extends far beyond the fingertip on which the surgical instrument is mounted, which limits the tactile sensing of the surgeon; and/or (iii) prevent tactile sensing by the instrument carrying fingertip altogether.
Several surgical procedures are performed while the surgeon uses tactile information collected by a single fingertip for tactile sensing the intrabody site to be surgically operated prior to the actual surgical operation. Several non-limiting examples of such procedures are described in detail in the sections that follow. However, once the surgeon has collected the tactile information, surgical instruments are to be blindly operated intrabodily. Such instruments, in most part, engage both the hands of the surgeon. Evidently, blindly operating surgical instruments intrabodily based on finger tip tactile information collected earlier may prove inconvenient, inaccurate and may increase the chance of inadvertently harming the patient.
There is thus a widely recognized need for, and it would be highly advantageous to have, finger-guided surgical instruments devoid of the limitations associated with the prior art instruments and which enable a surgeon to use a single finger to both collect tactile information from an intrabody location to be surgically operated and to surgically operate that intrabody location with a finger-guided surgical instrument.
SUMMARY OF THE INVENTION
According to one aspect of the present invention there is provided a finger-mounted device for guiding a surgical instrument, the device comprising a thimble-like element being adapted to surround at least a portion of a surgeon's finger while at least partially exposing the ventral tactile portions of the distal phalanx thereof, so as to enable the surgeon to tactile sense a body location to be treated, the thimble-like element being formed with at lest one longitudinal guiding tunnel formed within a wall thereof, the at least one longitudinal guiding tunnel being for guiding the surgical instrument therethrough, so as to enable the surgeon to operate the body location.
According to another aspect of the present invention there is provided a finger-guided surgical instrument, comprising (a) a thimble-like element being adapted to surround at least a portion of a surgeon's finger while at least partially exposing the ventral tactile portions of the distal phalanx thereof, so as to enable the surgeon to tactile sense a body location to be treated; (b) an ejectable surgical tool being engaged within a housing being formed within, or connected to, a wall of the thimble-like element; and (c) a mechanism for ejecting the surgical tool from the thimble-like element, so as to enable the surgeon to operate the body location.
According to further features in preferred embodiments of the invention described below, the finger-mounted device for guiding a surgical instrument and/or the finger-guided surgical instrument of claim
1
, further comprising an adapter insertable between the thimble-like element and the surgeon's finger, so as to adapt the guided surgical instrument to fingers of different size.
According to still further features in the described preferred embodiments the mechanism includes a first portion engaged within the housing and which is in contact with the ejectable surgical tool and a second, remote, portion extending out of the patient's body and which is operable by a free hand of the surgeon so as to eject the surgical tool from the thimble-like element.
According to still further features in the described preferred embodiments the mechanism includes a ratchet member disposed between the thimble-like element and the surgeon's finger so as to eject the surgical tool from the thimble-like element by twisting back and forth the surgeon's finger.
According to still further features in the described preferred embodiments the mechanism further serves for withdrawing the ejectable surgical tool back into the housing.
According to still further features in the described preferred embodiments the wall is a side wall of the thimble-like element.
According to still further features in the described preferred embodiments the wall is a front wall of the thimble-like element.
According to still further features in the described preferred embodiments the thimble-like element is constructed so as to be mounted over a dorsal side of the distal phalanx of the surgeon's finger, thereby exposing the entire ventral tactile portions of the distal phalanx. According to still further features in the described preferred embodiments the thimble-like element is constructed so as to fully surround the distal phalanx and expose the tip of the ventral tactile portion of the distal phalanx.
According to still further features in the described preferred embodiments the thimble-like element is constructed so as to be mounted over a ventral side of the distal phalanx of the surgeon's finger and expose the tip of the ventral tactile portion of the distal phalanx.
According to still further features in the described preferred embodiments the surgical tool is ejectable in a direction generally in extension of a longitudinal axis of the thimble like element.
According to still further features in the described preferred embodiments the surgical tool is ejectable in a circular path.
According to still further features in the described preferred embodiments the circular path on a plane which substantially parallels a plane traversing the surgeon's finger from top to bottom.
According to still further features in the described preferred embodiments the circular path on a plane which substantially parallels a plane traversing the surgeon's finger from side to side.
According to still further features in the described preferred embodiments the circular path on a plane which is substantially perpendicular
Levy Gil
Maroko Moshe
Thaler Michael H.
Urogyn Ltd.
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