Ultrasonic snare for excising tissue

Surgery – Instruments – Means for removing tonsils – adenoids or polyps

Reexamination Certificate

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Details

C606S046000

Reexamination Certificate

active

06231578

ABSTRACT:

BACKGROUND
1. Technical Field
The present disclosure relates to a surgical instrument assembly for use in excising body tissue from an internal body cavity, and more particularly to a snare device for removing polyps.
2. Background of Related Art
Colonoscopic polypectomy is a commonly used method for removing and optionally retrieving polyps from the colon. Such operations are performed so that the polyps can be examined by a pathologist for malignancy. Devices for such removal and retrieval of tissue are disclosed and described in U.S. Pat. Nos. 5,486,182, 5,336,227, 5,201,740 and 5,190,542, to Nakao et al.
Typically, a snare device is used which has a distal loop of wire which can be inserted into the colon and positioned around the base of the polyp. Thereafter, the loop is closed around the stalk of the polyp to sever the tissue.
One complication which can develop with simple mechanical excision of the polyp is excessive bleeding. In order to reduce the amount of bleeding that can result from severing the polyp from its stalk some surgical apparatus employ an electrocautery snare. The electrocautery device can be monopolar as disclosed for example in U.S. Pat. No. 5,158,561, or bipolar as disclosed for example in U.S. Pat. Nos. 5,026,371 and 4,905,691. Monopolar devices generally use radio frequency (“rf”) current.
Nevertheless complications can occur during electrocautery polypectomy procedures. For example, colonic perforation can result from the electrocautery current travelling via blood vessels to the base of the polyp and the wall of the colon, from the current travelling through the head of the polyp to the opposite wall, and from the accidental contact of the active electrode with surrounding tissue. Also, unobserved damage can occur from microperforations of the bowel wall and from pooled body fluids which contact the electrified wire and carry the current along unintended pathways to locations outside the field of view.
There yet remains a need for a polypectomy snare which provides the advantage of tissue cutting and coagulation while avoiding the disadvantages of electrocautery current.
SUMMARY
A surgical instrument is provided herein for cutting body tissue. The instrument includes a housing, an endoscopic portion including an ultrasonically vibratable element at least partially extending from the housing, an actuator movably connected to the housing and fixedly attached to the ultrasonically vibratable element, and an ultrasonic transducer operatively connected to the ultrasonically vibratable element.
The ultrasonically vibratable element possesses a loop at a distal end, the loop being movable between an open configuration for the reception of the body tissue therethrough and a closed configuration. Movement of the actuator between a first position and second position effects corresponding movement of the loop between the open configuration and closed configuration.
Also provided herein is a method for surgically removing polyps by employing the surgical instrument described herein.
The surgical instrument described herein advantageously limits bleeding during polypectomy operations while providing a greater margin of safety to the patient.


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