Multi-fit suction irrigation hand piece

Details Multi-fit suction irrigation hand piece Multi-fit suction irrigation hand piece

1999-09-09

2001-08-28

Seidel, Richard K. (Department: 3763)

Surgery

Means for introducing or removing material from body for...

Infrared, visible light, ultraviolet, x-ray or electrical...

C604S035000, C606S049000, C600S121000, C600S156000

Reexamination Certificate

active

06282442

ABSTRACT:

FIELD OF THE INVENTION
The present invention relates to a surgical hand piece that can be adaptably used in conjunction with different vendors' endoscopes. The hand piece provides irrigation to a surgical field and aspiration from the surgical field. Also described are enhancements to the invention, comprising mechanical, laser, electrosurgical, drug delivery and real-time imaging capabilities.
BACKGROUND OF THE INVENTION
Surgeons have traditionally operated on the internal organs and other internal structures of the human body by laying the body open to provide access for the operation. In recent decades, however, some surgeons have employed devices and techniques by which such access can be provided without laying open the body. Such means have been described variously. Two such descriptions are “minimally invasive surgery” and “endoscopy”.
The first description, “minimally invasive surgery”, alludes to the fact that the access to the site can be gained by small incisions made by trocars and cannulas.
The second description, “endoscopy”, alludes to the fact that a surgeon uses an endoscope to view the surgical field and tissue effects produced by instrumentation, as for example devices which cut or coagulate tissue. In certain contexts, “endoscopy” is used to refer to non-invasive surgery using the body's own lumens and cavities for access, whereas in other contexts the term is also used to refer to invasive surgery where small incisions are made in the body by trocars and such access is further secured by cannulas. Here, the term “endoscopy” is meant to include both non-invasive and invasive approaches. The term “endoscope” is meant to incorporate a host of viewing devices that provide visibility to a surgeon in minimally invasive surgery. Among such endoscopes, for example, are arthroscopes, bronchoscopes, cystoscopes, hysteroscopes, laparoscopes, laryngoscopes, nephrescopes, resectoscopes and sinuscopes.
Ancillary to many surgical operations are irrigation and aspiration of the surgical field. Irrigant can broadly serve to wash and cleanse the tissue and to clear the field of view of such interference as blood or tissue debris. Irrigant can also, depending upon its temperature, pressure, volume and composition, serve a narrower specific therapeutic purpose, as for example it may selectively dissect tissue, or it may effect vasoconstriction of certain tissues.
Aspiration may serve a broad role in evacuating irrigant, blood and tissue debris from the surgical field. Aspiration may also serve a narrower role in keeping the optics of an endoscope free from interference.
Necessarily, it is beneficial in endoscopy to maximize the surgical capabilities that can enter a corporal orifice or slip down a single cannula and thus minimize the time and effort in removing and inserting surgical instruments into and from such orifices or cannulas. It becomes desirable for a single orifice or cannula to accommodate multiple surgical instrumentalities simultaneously. Thus, a single endoscopic device that can both cut tissue mechanically and provide laser or electrosurgical coagulation can save significant time in the operating room and thus reduce the time during which a patient is at surgical risk. In similar fashion, an endoscopic device that provides visibility of the surgical field and also provides irrigation and aspiration, in both their broad and narrower roles, can likewise save time and reduce risk. Properly designed, such an endoscopic device can also provide electrosurgical or laser coagulating capability.
Among the leading vendors of endoscopes are such manufacturers as Karl Storz of Tuttlingen, Germany; Richard Wolf of Knittlingen, Germany; Circon ACMI of Santa Barbara, California; and Olympus Optical of Tokyo, Japan. Naturally, the endoscopes of the various manufacturers will have differing structural and operating characteristics, and naturally some surgeons will have decided preferences for one endoscope over another. A single hospital may have a sinuscope by Karl Storz in one operating room, and a sinuscope by Richard Wolf in a different operating room.
However, the leading endoscopes have one primary feature in common: they all have a tubular shafts that can enter directly a corporal orifice or slip down a cannula. Many endoscopes addressing the same surgical function also have tubular shafts of similar lengths. This is, for example, the case for many sinuscopes, which have tubular shafts of approximately 4 mm in outer diameter and 170 mm in length. It is desirable, therefore, to provide a device by which ancillary irrigation and aspiration can supplement any of the leading endoscopes. A hospital would thereby not be obliged to carry multiple irrigation/aspiration devices for various endoscopes.
Significant concern exists nowadays over the spread of disease within nosocomial institutions. The HIV virus and autoimmune deficiency syndrome (AIDS) have heightened this concern. Also, it can be problematic to clean and sterilize an irrigation/aspiration hand piece after use and possible exposure to disease, having as it does intricate valves and passageways blocked from ready view. A valve system, moreover, is susceptible to wear and deterioration in such components as O-rings and other seals. It is desirable that a device providing ancillary irrigation and aspiration should be inexpensively produced and therefore economical to be used in a single procedure and then disposed of in accordance with proper disposal procedures. Such a product, called a disposable, allays concerns that resterilization may be effective against infection from certain communicable diseases.
U.S. Pat. No. 4,149,315 to Page, Jr. et al. describes a suction/irrigation device for dental surgery. The hand grip of the device is shaped like a pistol. An elongated tube includes a pair of concentric tubes. The inner tube supplies irrigant; the outer tube provides suction. Two trumpet valves regulate the irrigant and aspirant. To similar effect is U.S. Pat. No. 4,776,840 to Freitas et al., where the described device entails an internal pump to supply the irrigant and also a separate flexible tube for additional suction of the surgical site.
U.S. Pat. No. 4,744,360 to Bath discloses a suction/irrigation device for use in ophthalmic surgery. Surrounding an optical fiber for laser surgery are an irrigation sleeve and a separate aspiration sleeve which provide irrigation and suction capability, respectively.
U.S. Pat. No. 5,170,774 to Heckele discloses an endoscope with lateral viewing capability and with separate channels for gentle irrigation, high pressure irrigation and aspiration. The irrigant exits its channel at such an angle that it will impact the tissue being treated within the field of view of the endoscope. A nozzle on the end of the high-pressure channel may be changed to vary the pressure. Thus a surgeon may immediately observe whether the irrigant is having the effect that is desired.
U.S. Pat. No. 5,195,958 to Phillips discloses a device for minimally invasive surgery which provides irrigation, suction and evacuation of the surgical site. Various attachments may be attached to and detached from a hand piece.
U.S. Pat. No. 5,197,963 to Parins discloses a device which provides irrigation, aspiration and electrosurgery. A sheath encloses a cylindrical rod. Within the rod are at least one electrosurgical electrode and a lumen for irrigation and aspiration. The sheath protects the electrode from breakage during insertion or withdrawal from the surgical site. The sheath may be retracted, and thus expose the electrode for use. If the sheath is extended beyond the electrode, the sheath effectively provides an extended path for the irrigant or aspirant.
Various patents describe suction/irrigation devices which can receive, through a special port, other instrumentation to be used at the surgical site. U.S. Pat. No. 5,310,406 to Sharpe et al. discloses a large diameter tube which has a port concentric with the tube through which a grasping tool may be inserted. U.S. Pat. No. 5,312,332 to Bales et al.

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