Surgical instrument for providing suction and irrigation

Details Surgical instrument for providing suction and irrigation Surgical instrument for providing suction and irrigation

2000-01-18

2002-08-06

Walberg, Teresa (Department: 3742)

Surgery

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

Material introduced into and removed from body through...

C606S041000

Reexamination Certificate

active

06428503

ABSTRACT:

FIELD OF THE INVENTION
The present invention relates to surgical instruments and in particular, to an electrosurgical laparoscopic instrument that provides suction and irrigation.
BACKGROUND
Surgical instruments are available that provide irrigation fluid and suction force to irrigate and evacuate the tissue at a surgical site or area where a surgical procedure is being performed. One example of such an instrument is an electrosurgical laparoscopic instrument
10
,
FIG. 1
, which comprises a housing enclosure (or cannula)
12
having a distal end
16
and an electrode
18
extending from the distal end
16
. The housing
12
forms a lumen or passageway
19
and is typically constructed of stainless steel with a Teflon shrink wrap insulation. The electrode
18
includes an insulated electrode connector
20
that extends into the stainless steel tube housing
12
and is attached to a portion of the inner surface
22
of the housing
12
. In use, the laparoscopic instrument
10
is passed through a trocar.
According to one application of this instrument
10
, the tip of the electrode
18
is used to dissect a gallbladder from the liver. Energy is applied through the surgical instrument
10
to the electrode
18
to assist in coagulation and cauterization during this dissection procedure. The passageway
19
allows for suction/irrigation of fluids through the housing
12
, which is controlled, for example, by a trumpet valve. This type of electrosurgical laparoscopic instrument is described in greater detail in U.S. Pat. No. 5,261,905, incorporated herein by reference.
One problem with this type of electrosurgical laparoscopic instrument
10
as well as other surgical instruments that provide suction/irrigation is that the passageway
19
is obstructed by the electrode
18
or other surgical tool disposed at the distal end
16
of the instrument
10
. In the electrosurgical laparoscopic instrument
10
, the electrode
18
includes a mounting portion
24
mounted within the passageway
19
, for example, by welding to the inner surface
22
. The mounting of the electrode
18
thus obstructs the passageway
19
and results in separate flow regions
19
a
,
19
b
,
FIGS. 2 and 3
, on either side of the mounting portion
24
of the electrode
18
. As a result, the surgical instrument is unable to provide full flow of irrigating fluid during irrigation and does not provide a full passageway for suction of fluid and tissues.
Another drawback of mounting the electrode
18
or other type of tool to the inner surface
22
within the passageway
19
of the housing
12
is the difficulty involved in cleaning the instrument. Tissue and other debris will often become lodged against the mounting portion
24
of the electrode
18
or other tool located within the passageway
19
. Proper cleaning of surgical instruments is important to allow the instruments to be reused safely. The rigid tools commonly used to free debris and clear the passageways within the instruments often cause damage to the instruments. For example, the insulation around the housing
12
may break or become damaged, resulting in an unsafe electrosurgical instrument that cannot be reused or repaired.
A further drawback of the obstructed passageway is the inability to pass other surgical devices, such as, for example, a biopsy needle, through the passageway
19
at the distal end
16
of the surgical instrument
10
with the housing
12
acting as a guide. This capability would allow other surgical procedures, such as a biopsy procedure, to be performed at the surgical site more easily and less invasively without having to remove the instrument
10
.
One attempt at solving this problem might be to weld the electrode
18
or tool to the outside of the housing
12
. However, this increases the diameter unevenly and creates two outside diameters (ODs) on the cannula or housing
12
, making it difficult to pass the cannula or housing
12
through a trocar. Further, the trocar typically includes a silicone seal that should fit snugly around the cannula to prevent site leakage. If the electrode
18
is welded to the outer surface of the cannula or housing
12
, the electrode
18
might damage the seal or prevent the seal from fitting snug around the smaller OD of the cannula. A channel or dimple can be formed in the housing
12
to receive the electrode
18
and make the OD consistent, but this will affect the inside diameter (ID) and cause a partial obstruction within the passageway.
A further disadvantage of this electrosurgical laparoscopic instrument
10
and other such surgical instruments is the attachment between the electrode
18
and the inner surface
22
of the housing
12
. One way of attaching the electrode
18
,
FIG. 4
, to the inner surface
22
of the housing
12
is by laser welding the edges
26
a
,
26
b
of the mounting portion
24
by applying the laser generally in the direction of arrows
28
. The laser welding, however, only welds the portions of the edges
26
a
,
26
b
that touch the inner surface
22
of the housing
12
. If the edges
26
a
,
26
b
have any irregularities such as a non-linear edge
30
a
or a burr
30
b
caused, for example, by stamping the electrode
18
, the edges
26
a
,
26
b
may have insufficient contact with the inner surface and may not be adequately welded. Thus, welding the electrode
18
to the inner surface
22
of the housing
12
can result in a weak attachment, possibly causing the electrode
18
to fall out, for example, during cleaning. The same problem with the strength/durability of the attachment occurs when the electrode is welded or otherwise secured to the outside surface of the housing
12
.
A further problem occurs as a result of the passage of electrical current through an electrode
18
that is welded to the inside or outside surface of the housing
12
. The gaps that form between the electrode
18
and the housing
12
may cause arcing or capacitive coupling to other insulated uninsulated areas.
Some electrosurgical instruments have the electrode formed integrally with the housing. In these instruments, however, certain tip shapes and geometries are not possible, such as a ball-shaped tip that has a diameter larger than the wall of the cannula.
Accordingly, a surgical instrument is needed that provides full flow irrigation and suction, that can be properly cleaned without damaging the instrument and safely reused, and that allows passage of another instrument or pharmaceuticals through the passageway. In particular, a need exists for an electrosurgical instrument having an electrode that is mounted as part of the wall of the housing to provide a substantially unobstructed passageway, to provide a stronger attachment between the electrode and the housing, to improve electrical contact, and to provide a number of different tip shapes.
SUMMARY OF THE INVENTION
The present invention features a surgical instrument comprising an elongated housing having a proximal end, a distal end, and a wall defining an inner lumen or passageway extending from the proximal end to the distal end. The surgical instrument further comprises a surgical tool extending from the wall of the elongated housing at the distal end such that the lumen or passageway is substantially unobstructed at the distal end. The tip of the surgical tool can have numerous different shapes including, but not limited to, a J hook, and an L hook, a spatula, a needle, and a ball. In one example, the surgical tool is bent such that the tip is positioned generally in the flow path extending from the passageway.
According to the preferred embodiment, the wall of the housing includes a mounting notch at the distal end and the surgical tool includes a mounting tab that mounts within the mounting notch, for example, by laser welding outer edges of the mounting tab to inner edges of the mounting notch. The inner edges of the mounting notch and the outer edges of the mounting tab are preferably angled to substantially match. In one embodiment, the mounting notch is generally rectangular shaped. In another embodiment,

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