Surgery – Instruments – Means for removing tonsils – adenoids or polyps
Reexamination Certificate
2001-09-28
2004-01-20
Woo, Julian W. (Department: 3731)
Surgery
Instruments
Means for removing tonsils, adenoids or polyps
C606S139000, C606S144000
Reexamination Certificate
active
06679892
ABSTRACT:
BACKGROUND OF THE INVENTION
1. Field of the Invention
The present invention relates generally to surgical devices, and more particularly, to a surgical device for ligating, and severing vessels.
2. Prior Art
Methods for ligating and transecting vessels via endoscopic means are known in the art. One method involves use of scissors and ligating clips. Two tools are required for this approach, thus complicating the procedure by excess tool exchanges. Furthermore, the placed clips can hinder subsequent movement of instruments. Finally, foreign bodies (clips) are left in the patient's body.
Another approach involves the use of a knife placed between two wire guides that are capable of applying a current across a vessel. This design can potentially result in the spread of thermal energy to unintended portions of the vessel to be transected, potentially compromising its utility. Still yet another approach involves the use of scissor-like clamping jaws that open around a vessel, and then must be closed, whereby a current is applied to the vessel from within the jaws. However, these types of instruments are difficult to use in confined spaces because of the upward opening movement of at least one of the jaws often causes an interference with objects in the field. Further, the upward opening jaw obscures the vision of the surgeon using the device, particularly in endoscopic procedures.
Both saphenous veins and radial arteries are used as conduits in coronary artery bypass surgery. Conventional techniques for harvesting these vessels involve an incision length approximately equal to the length of the vessel being harvested. Recently, various bipolar endoscopic vessel-harvesting devices have been developed as a means of removing saphenous veins or radial arteries in a minimally invasive manner.
Users of these devices frequently struggle to separate side branches of the veins or arteries when said side branches run beneath or above the main trunk of the vessel. In addition, the visualization of the vessel may be lost in excess adipose tissue. Finally, the user friendliness of these devices is subject to question since the steps involved in identifying, securing, and dissection/ligation of side branches is not always intuitive, i.e., the user frequently has to concentrate on what his or her hands are doing and not the vessel at hand. Current bipolar devices also fail to complete the terminal ligation required to excise the vein or artery.
SUMMARY OF THE INVENTION
Therefore it is an object of the present invention to provide a surgical device for ligating and severing a vessel, which is friendlier to use than the devices of the prior art.
It is another object of the present invention to provide a surgical device for ligating and severing a vessel, which eliminates the need for ligating clips to ligate the vessel.
It is yet another object of the present invention to provide a surgical device for ligating and severing a vessel, which eliminates the use of thermal energy so as not to compromise the utility of the vessel.
It is yet another object of the present invention to provide a surgical device for ligating and severing a vessel, which eliminates the necessity of opening and closing scissor-like jaws.
It is still yet another object of the present invention to provide a surgical device for ligating and severing a vessel, which minimizes the need for multiple instrument exchanges.
Accordingly, a surgical device for ligating and severing a vessel is provided. The surgical device comprising: a housing; a flexible suture having a looped portion extending from a distal end of the housing for capturing a periphery of the vessel; ligating means for tightening the looped portion around the periphery of the vessel; and cutting means for cutting the vessel.
Preferably, the flexible suture further comprises an extended portion disposed in the housing and proximal to the looped portion. The housing preferably comprises at least a first tube, the extended portion of the suture being disposed in the first tube, the looped portion being extended from a distal end of the first tube. Preferably a transition between the looped and extended portions of the flexible suture comprises a slipknot.
The ligating means preferably comprises a first handle disposed on the first tube, the first handle being connected to a proximal end of the extended portion of the flexible suture such that a proximal movement of the first handle extends the extended portion of the flexible suture and decreases a loop size of the looped portion of the flexible suture to ligate the vessel captured therein. Preferably, the first handle is connected to a proximal end of the first tube by a breakaway joint.
The cutting means preferably comprises: a flexible cutting material having a looped portion extending from the distal end of the housing for capturing a periphery of the vessel, the flexible cutting material further having an extended portion; and cutting material actuation means disposed in the housing for tightening the looped portion of the flexible cutting material around the periphery of the vessel and for drawing the vessel against a cutting surface. The housing preferably comprises at least a second tube, the extended portion of the flexible cutting material being disposed in the second tube, the looped portion being extended from a distal end of the second tube.
The cutting material actuation means preferably comprises a second handle disposed on the second tube, the second handle being connected to a proximal end of the extended portion of the cutting material such that a proximal movement of the second handle decreases a loop size of the looped portion of the flexible cutting material and draws the vessel against the cutting surface to sever the vessel captured therein. The second handle is preferably connected to a proximal end of the second tube by a breakaway joint.
Preferably, the cutting surface is a cutting edge of a knife blade, the knife blade being disposed in the distal end of the second tube. The knife blade is preferably movably disposed in the second tube and further comprising knife blade actuation means for moving the knife blade in the second tube between an extended position and a retracted position, in which case, the knife cooperates with the cutting material to sever the vessel when in the extended position. The knife blade actuation means preferably comprises a third handle slidingly disposed on the second tube and operatively connected to the cutting blade by a control rod disposed in an internal lumen of the second tube, wherein movement of the third handle in the distal direction moves the knife blade into the extended position and movement of the third handle in the proximal direction moves the knife blade into the retracted position.
Also provided is a method for ligating and severing a vessel. The method comprising: looping a flexible suture material around a periphery of the vessel; looping a flexible cutting material around the periphery of the vessel; ligating the vessel by decreasing the size of the loop of flexible suture material; and severing the vessel by decreasing the size of the loop of flexible cutting material.
Preferably, the method further comprises drawing the vessel against a cutting surface. Preferably, the cutting surface is a knife blade, in which case the method further comprises extending the knife blade distally to interact with the flexible cutting material and vessel.
Preferably, the flexible suture material comprises a looped portion, an extended portion extending from the looped portion, and a slipknot at the transition between the looped and extended portions, in which case the severing step further comprises severing the extended portion of the flexible suture material.
REFERENCES:
patent: 3476115 (1969-11-01), Graeff et al.
patent: 5290284 (1994-03-01), Adair
patent: 5330491 (1994-07-01), Walker et al.
patent: 5486186 (1996-01-01), Yoon
patent: 5814052 (1998-09-01), Nakao et al.
Guido Ron
Nering Robert
Ethicon Inc.
Woo Julian W.
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