Surgery – Instruments – Forceps
Reexamination Certificate
2000-01-24
2002-04-16
Reip, David O. (Department: 3731)
Surgery
Instruments
Forceps
C600S439000
Reexamination Certificate
active
06371973
ABSTRACT:
FIELD AND BACKGROUND OF THE INVENTION
The present invention relates to forceps which are asymmetric along the length thereof and as such can be attached to various medical instruments so as to enable positioning and/or anchoring of said instruments within the body. More particularly, the present invention relates to a forceps which is attachable to an endovaginal ultrasound transducer and which is utilizable for positioning and/or anchoring said ultrasound transducer against the cervix.
The use of manipulative instruments in the course of examination of a patient, or in the course of a surgical procedure, are well known in the art.
Various forceps and retention devices have been developed which, in one way or another, conform to the physiology of a person. Specific amongst these prior art devices are retention, seizing and holding tools and forceps conformed for particular aspects of the patient's anatomy.
Amongst these are tenaculums which also serve as uterine cervical holders and as such are conformed or adapted for intra-vaginal use. Such cervical holders can be utilized, for example, to position endovaginal ultrasound transducers against the uterine cervix so as to enable monitoring obstetric and gynecological procedures.
For example, WO 99/03399 describes an apparatus which includes a cervical holder for holding the patient's cervix and an attached connector for interconnecting an ultrasound transducer to the cervical holder. The apparatus described in WO 99/03399 can be used to guide and monitor, in real time, intra uterine, cervical and tubal procedures such as, for example, curettage or evacuation of the uterine cavity for diagnostic and/or therapeutic purposes, and the like.
Although this apparatus provides several advantages over similar prior art devices, which advantages significantly improve the precision with which an intra uterine, cervical and tubal procedures can be performed, several limitations are still inherent to this apparatus, which limitations, in part, arise from the configuration of the cervical holder utilized thereby.
As is shown in
FIGS. 1
a-b
, when in use, the apparatus described in WO 99/03399, is positioned within the vagina and is attached via a cervical holder or grasper onto cervical tissue, as is shown by arrow A. As a result, the ultrasound transducer, connected thereto, contacts a tissue region adjacent to the site of attachment, as shown by arrow B.
Since the finger holding portions (arrow C) of the cervical holder are positioned such that the transducer cannot be positioned directly over the cervical holder, shifting of the transducer to the side of the cervical holder is necessary. This severely limits the accuracy with which the transducer assembly is positioned since such an assembly is oftentimes placed blindly and offline, and as such a physician relies on the cervical holder to guide the transducer to the desired position. Thus, when the cervical holder and the transducer are not in the same plane, the chances or inaccurate positioning or orientation are increased. In addition, this configuration of the finger holding portions severely limits the accessibility of these portions, since they are partially blocked by the transducer, thus severely limiting the ability of a physician to operate such a cervical holder while positioning the transducer.
There is thus a widely recognized need for, and it would be highly advantageous to have, forceps which can be used to guide and anchor in position an intrabody medical instrument such as endovaginal ultrasound transducer devoid of the above limitations.
SUMMARY OF THE INVENTION
According to one aspect of the present invention there is provided a forceps useful in intrabody or surface positioning of a medical instrument or a device, the forceps comprising (a) a first arm including a first finger holding portion, a first pivot portion and a first tissue holding portion; and (b) a second arm including a second finger holding portion, a second pivot portion and a second tissue holding portion; wherein the first pivot portion is attached to the second pivot portion so as to form a pivot point about which the first and the second arms co-rotate in a scissor-like motion from a grasping position to an open position and wise versa, whereas the first and the second finger holding portions are positioned on one side of a plane defined by a length of the first arm, the plane is perpendicular to the scissor-like motion.
According to further features of the invention, in the grasping position of the forceps, (i) the tissue holding portion of the second arm on one side of the pivot point is substantially parallel to the tissue holding portion of the first arm on the corresponding side of the pivot point; (ii) the finger holding portion of the second arm on the other side of the pivot point forms an obtuse angle with respect to the tissue holding portion of the second arm; and (iii) the finger holding portions of the first and second arms terminate in finger-receiving elements which are both located on one side of the first arm and are aligned with each other in the direction of the scissor-like motion.
According to another aspect of the present invention there is provided an apparatus for guidance and monitoring of intra-uterine, cervical and tubal procedures, the apparatus comprising an assembly, including (a) an endovaginal ultrasound transducer being adapted for insertion into a portion of a patient's vagina so as to be positionable against a cervix of the patient; (b) a forceps including (i) a first arm including a first finger holding portion, a first pivot portion and a first tissue holding portion; and (ii) a second arm including a second finger holding portion, a second pivot portion and a second tissue holding portion; wherein the first pivot portion is attached to the second pivot portion so as to form a pivot point about which the first and the second arms co-rotate in a scissor-like motion from a grasping position to an open position and wise versa, whereas the first and the second finger holding portions are positioned on one side of a plane defined by a length of the first arm, the plane is perpendicular to the scissor-like motion; and (c) a connector for interconnecting the ultrasound transducer and the forceps, the connector being constructed so as to enable counter resisted movement of the ultrasound transducer relative to the forceps, the counter resisted movement being in a direction away from the cervix.
According to yet another aspect of the present invention there is provided a system for guidance and monitoring of a medical instrument utilized in intra-uterine, cervical and tubal procedures, the system comprising (a) an endovaginal ultrasound transducer being adapted for insertion into a portion of a patient's vagina; (b) a forceps including (i) a first arm including a first finger holding portion, a first pivot portion and a first tissue holding portion; and (ii) a second arm including a second finger holding portion, a second pivot portion and a second tissue holding portion; wherein the first pivot portion is attached to the second pivot portion so as to form a pivot point about which the first and the second arms co-rotate in a scissor-like motion from a grasping position to an open position and wise versa, whereas the first and the second finger holding portions are positioned on one side of a plane defined by a length of the first arm, the plane is perpendicular to the scissor-like motion; (c) a connector for interconnecting the ultrasound transducer and the forceps, the connector being constructed so as to enable counter resisted movement of the ultrasound transducer relative to the forceps, the movement being in a direction away from the cervix of the patient; and (d) a device for monitoring an alignment of a medical instrument with respect to an ultrasonic beam produced by the endovaginal ultrasound transducer.
According to still further features in the described preferred embodiments the first and the second tissue holding portions are adapted for
Bui Vy Q.
Reip David O.
Ron-Tech Medical Ltd.
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