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WO1994011771A1 - Instrument de chirurgie a systeme d'observation par fibres optiques adhesif - Google Patents

Instrument de chirurgie a systeme d'observation par fibres optiques adhesif Download PDF

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Publication number
WO1994011771A1
WO1994011771A1 PCT/US1992/009564 US9209564W WO9411771A1 WO 1994011771 A1 WO1994011771 A1 WO 1994011771A1 US 9209564 W US9209564 W US 9209564W WO 9411771 A1 WO9411771 A1 WO 9411771A1
Authority
WO
WIPO (PCT)
Prior art keywords
fiber
optic bundle
kit
attachment means
sensitive adhesive
Prior art date
Application number
PCT/US1992/009564
Other languages
English (en)
Inventor
Whitney A. Mcfarlin
Thomas C. Barthel
Miles A. Finn
Original Assignee
Clarus Medical Systems, Inc.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Clarus Medical Systems, Inc. filed Critical Clarus Medical Systems, Inc.
Priority to US08/428,258 priority Critical patent/US5667478A/en
Priority to PCT/US1992/009564 priority patent/WO1994011771A1/fr
Priority to AU30676/92A priority patent/AU3067692A/en
Publication of WO1994011771A1 publication Critical patent/WO1994011771A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B50/00—Containers, covers, furniture or holders specially adapted for surgical or diagnostic appliances or instruments, e.g. sterile covers
    • A61B50/30—Containers specially adapted for packaging, protecting, dispensing, collecting or disposing of surgical or diagnostic appliances or instruments
    • A61B50/33—Trays
    • G—PHYSICS
    • G02—OPTICS
    • G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
    • G02B23/00—Telescopes, e.g. binoculars; Periscopes; Instruments for viewing the inside of hollow bodies; Viewfinders; Optical aiming or sighting devices
    • G02B23/24—Instruments or systems for viewing the inside of hollow bodies, e.g. fibrescopes
    • G02B23/26—Instruments or systems for viewing the inside of hollow bodies, e.g. fibrescopes using light guides
    • G—PHYSICS
    • G02—OPTICS
    • G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
    • G02B6/00—Light guides; Structural details of arrangements comprising light guides and other optical elements, e.g. couplings
    • G02B6/04—Light guides; Structural details of arrangements comprising light guides and other optical elements, e.g. couplings formed by bundles of fibres
    • G02B6/06—Light guides; Structural details of arrangements comprising light guides and other optical elements, e.g. couplings formed by bundles of fibres the relative position of the fibres being the same at both ends, e.g. for transporting images
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B50/00—Containers, covers, furniture or holders specially adapted for surgical or diagnostic appliances or instruments, e.g. sterile covers
    • A61B2050/005—Containers, covers, furniture or holders specially adapted for surgical or diagnostic appliances or instruments, e.g. sterile covers with a lid or cover
    • A61B2050/0065—Peelable cover
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/08—Accessories or related features not otherwise provided for
    • A61B2090/0813—Accessories designed for easy sterilising, i.e. re-usable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/30—Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
    • A61B2090/306—Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure using optical fibres
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/361—Image-producing devices, e.g. surgical cameras
    • A61B2090/3614—Image-producing devices, e.g. surgical cameras using optical fibre

Definitions

  • This invention relates generally to the field of tools, medical instruments and especially surgical instruments, and more particularly to an improvement made to conventional instruments that allows the user to have improved visibility of the interaction between the working ends of those tools or instruments and the object or tissue being worked on.
  • the objective lens of the fiber-optic bundle is accurately positioned relative to the instrument's working element so as to allow viewing of the engagement between the working element and the tissue being manipulated.
  • a suitable viewing device at its proximal end, the surgeon may observe the engagement between the working element of the instrument and the tissue being manipulated, even when that tissue is internal to the body and not directly viewable through an incision.
  • the invention of the aforereferenced copending application presumes that the fiber-optic bundle or bundles will be secured to the instrument as a factory operation.
  • the viewing optics kit of the present invention comprises at least one fiber-optic bundle of the type including a plurality of elongated, flexible, image fibers having first and second ends with an objective lens attached to said first end and a connector attached to the second end.
  • the connector is adapted to mate with a viewing device.
  • the image fibers are contained within a flexible sheath which may also contain a plurality of illumination fibers.
  • An attachment means is also included in the kit and is adapted to secure the fiber-optic bundle(s) to the exterior surface of a selected one of a variety of instruments with the fiber-optic bundle(s) following and conforming to the profile of that instrument over substantially its entire length and with the objective lens on the fiber-optic bundle(s) positioned so as to include in the field-of-view of the lens the working element of the instrument with which it is used.
  • this kit prior to use, are preferably contained within an enclosure of the type including a bottom tray having compartments formed therein for retaining one or more fiber-optic bundles and the attachment means.
  • a top cover which may be formed from a spun-bonded polyolefin fiber material, completes the enclosure. By using this material, the kit can be sterilized after the fiber-optic bundle and the attachment means are enclosed within the enclosure.
  • the attachment means may be a coating of a pressure-sensitive adhesive on the sheath of the fiber-optic bundle or strips of double-sided pressure-sensitive adhesive tape having release paper protecting the adhesive layers.
  • the surgeon's assistant when in the operating room, may unseal the enclosure and use the doubled-sided adhesive tape or coating to adhere the fiber-optic bundle to the exterior surface of the instrument.
  • the kit may include a positioning device or jig adapted to fit the particular instrument and which functions to accurately fix the position of the objective lens on the distal end of the fiber-optic bundle to ensure that the lens will be properly focused so as to include at least a portion of the instrument's working element in its field-of-view.
  • BRIEF DESCRIPTION OF THE DRAWINGS Figure 1 is a side elevation of a typical surgical instrument with which the viewing optics of the present invention may be used;
  • Figure 2 illustrates a fiber-optic bundle component of the kit
  • Figure 3 is a cross-sectional view of the fiber-optic bundle taken along the line 3-3 in Figure 2;
  • Figure 4 illustrates one form of an attachment means included in the kit for securing the fiber-optic bundle of Figure 2 to the instrument;
  • Figure 5 is a cross-sectional view taken along the line 5-5 in Figure 4;
  • Figure 6 is a side elevation of a positioning device useful in properly locating the distal end of the fiber ⁇ optic bundle relative to the instrument's working element;
  • Figure 7 is a cross-sectional view taken along the line 7-7 in Figure 6; and
  • Figure 8 illustrates the packaging system for the viewing optics kit of the present invention.
  • a tool or instrument represented as a surgical scissors, which may, for example, be used during the course of laparoscopic surgery. It includes an elongated tubular barrel or shaft 12 having a proximal end 14 and a distal end 16. Fixedly attached to the proximal end 14 is a handle member 18 which includes first and second levers 20 and 22 which are pivotally joined at a hinge point 24 and which include finger-receiving loops 26 and 28 at the lower end thereof.
  • the lever 22 has an integrally formed barrel segment 24 having an internal bore formed therein for receiving the proximal end portion of the shaft 12.
  • a push-pull rod 30 Extending through that bore and the lumen of the tubular shaft 12 is a push-pull rod 30 whose proximal end is fixedly attached to the movable lever member 20.
  • the other end of the push-pull rod 30 leads to the instrument's working element which, in the instrument of Figure 1, comprises a movable scissors blade 32 which is arranged to cooperate with a fixed blade 34.
  • the instrument's working element which, in the instrument of Figure 1, comprises a movable scissors blade 32 which is arranged to cooperate with a fixed blade 34.
  • the lumen of the tubular shaft 12 may be provided near its proximal end with a flush port, allowing saline to be ejected for clearing blood from the area of the working element.
  • the instrument thus far described is entirely conventional and is being used to illustrate the manner in which the viewing optics kit of the present invention may be utilized.
  • the invention herein described is much more versatile and can be applied to a wide variety of different surgical instruments or other types of tools.
  • grasping instruments such as forceps
  • other cutting instruments such as scalpels, hook knives, electrosurgical instruments, arthroscopic rotary cutting/debridement tools, etc.
  • a fiber-optic bundle which may, for example, comprise the type of device described in the Utsu i et al. Patent 4,867,529. That patent describes a super-thin fiber scope having a main scope body which is shown in cross-section in the view of Figure 3. It comprises an outer tubular sheath 38 surrounding a large plurality of very fine image fibers 40. The image fibers are fused together at the opposed ends of the device so that they remain in relative registration. With a sheath 38 having an outside diameter of about 0.5 mm, it is currently possible to contain as many as 10,000 image fibers 40 to thereby provide excellent resolution of the image being observed. It is expected that with strides being made in fiber-optic technology, even greater numbers of fibers will be containable in a sheath of this size in the next few years.
  • a bundle 42 of light or illumination fibers 44 which allows light to be transmitted from the proximal end of the fiber scope 36 to its distal end to thereby illuminate the scene in the field-of-view of the device. It should be recognized, however, that a separate illumination bundle can be used along with a bundle of image fibers and that they need not be within a common sheath. Moreover, there may be only a single illumination fiber.
  • an objective lens 46 which functions to collect the light reflected from the objects being viewed and which focuses that light on the distal ends of the image fibers.
  • a hub 48 Located near the proximal end of the bundle 36 is a hub 48 where the light fibers 44 are separated from the image fibers 40 and are brought out to a connector 50 adapted to mate with a light source (not shown) .
  • the image fibers in the bundle 36 are brought out through a sheath 52 to a connector 54 adapted to mate with a viewing device, such as an eyepiece or a video camera.
  • a viewing device such as an eyepiece or a video camera.
  • the fiber-optic bundle 36 is affixed to the exterior surface of the instrument 10 along substantially the entire length thereof and with the objective lens 46 positioned so that at least a portion of the working element of the instrument (blades 32 and 34) fall within with the field-of-view of that lens. While only one bundle is shown attached to the instrument, it is contemplated that two or more of such bundles may be attached to provide a view from differing perspectives.
  • a coating 56 of a suitable pressure-sensitive adhesive may be applied to a predetermined surface of the outer sheath 38 of the fiber-optic bundle(s), with that adhesive layer being protected by a strip of release paper 58.
  • a surgical assistant may remove the fiber-optic bundle 36 from its sterile pack ( Figure 8) and then peel off the release paper layer 58 as the fiber-optic bundle 36 is strung along and pressed against the surface of the instrument.
  • double-sided pressure-sensitive tape strips as at 60 in Figure 4, may be used to effect the attachment.
  • the tape strip 60 comprises a thin, flexible film substrate 62 which is coated on its opposed major surfaces with first and second layers 64 and 66 of pressure-sensitive adhesive. Release paper layers 68 and 70 may be used to shield the adhesive layers until the strip is to be used.
  • the tape strips may be straight, curved, or a combination of the two so that there will be no appreciable wrinkling of the attachment means as it is affixed to the tool's surface. It is also contemplated that the instrument may have appropriate markings thereon or a groove formed therein for facilitating the routing of the tape strips and, ultimately, the fiber-optic bundle along the exterior of the instrument.
  • a positioning device 72 as shown in Figure 6. It comprises a generally cylindrical member which may be molded from plastic and which includes a cavity 74 of generally cylindrical cross-section for receiving a predetermined distal portion of the shaft 12 therein.
  • a pair of longitudinally extending slots 76 and 78 dimensioned to receive the blades 32 and 34 therein extend longitudinally from the surface 80.
  • the lens is located sufficiently close to the open distal end 16 of the shaft 12 so that if a flushing liquid, such as saline, is injected into the shaft at its proximal end, it will serve to clean the lens, should it become coated with blood or other body fluids.
  • a flushing liquid such as saline
  • a variety of positioning devices 72 may be included as a part of the kit to facilitate locating the objective lens of the fiber-optic bundle on a variety of surgical instruments.
  • the enclosure includes a bottom cover or tray 83, preferably formed from plastic in a vacuum-forming operation, so as to provide cavities or compartments as at 84, 86 and 88.
  • the cavity 84 is designed to receive the fiber-optic bundle(s) 36 therein when wrapped as a coil.
  • the cavity 86 is designed to contain one or more double-sided adhesive strips 60.
  • Cavity 88 receives the positioning jig 72 therein. While only one such jig is illustrated, additional cavities can be provided in the bottom cover for retaining other jigs to be used with different instruments.
  • a cover member 90 is appropriately sealed to the side flanges 92, 94, 96 and 98 of the tray bottom.
  • the top cover member 90 is preferably fabricated from spun-bonded plastic fibers, such as polyolefin, such as Tyvek (a registered trademark of the Dupont Corporation) . This material is preferred in that it allows the package to be sterilized after the components are sealed within the enclosure. While the invention has been particularly shown and described with reference to a preferred embodiment, those skilled in the art will appreciate that various changes and modifications in form and detail may be made therein without departing from the scope and spirit of the invention. For example, it is not necessary that the fiber-optic bundle 36 contain the illumination fibers within the sheath 38.
  • the positioning devices for establishing an accurate point of attachment of the objective lens 46 to the instrument body will vary, depending upon the type of instrument to which the stick-on optic-fiber is to be applied. Accordingly, modifications, such as those suggested above, but not limited thereto, are to be considered to fall within the scope of the invention.

Landscapes

  • Health & Medical Sciences (AREA)
  • Physics & Mathematics (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Optics & Photonics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • General Physics & Mathematics (AREA)
  • Veterinary Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Public Health (AREA)
  • Animal Behavior & Ethology (AREA)
  • Biomedical Technology (AREA)
  • Molecular Biology (AREA)
  • Medical Informatics (AREA)
  • General Health & Medical Sciences (AREA)
  • Ophthalmology & Optometry (AREA)
  • Astronomy & Astrophysics (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne un kit d'optique d'observation constitué d'au moins un faisceau de fibres optiques flexible (36) et d'un moyen de fixation (60). Ledit kit peut également comprendre un gabarit de positionnement (72). Il est emballé dans un boîtier (83) formé sous vide présentant des cavités définissant des compartiments (84, 86, 88) servant à retenir les éléments mentionnés ci-dessus. Ledit boîtier (83) peut être fermé hermétiquement par un couvercle (90) en fibres plastiques non tissées telles que du Tyvek R, ce qui permet la stérilisation des éléments après qu'ils aient été enfermés hermétiqueemnt dans le boîtier. Le moyen de fixation est constitué, de préférence, d'un adhésif de contact (60) permettant de coller, le faisceau de fibres optiques sur une surface extérieure d'un instrument chirurgical immédiatement avant la procédure chirurgicale.
PCT/US1992/009564 1992-11-06 1992-11-06 Instrument de chirurgie a systeme d'observation par fibres optiques adhesif WO1994011771A1 (fr)

Priority Applications (3)

Application Number Priority Date Filing Date Title
US08/428,258 US5667478A (en) 1992-11-06 1992-11-06 Surgical instrument with stick-on fiber-optic viewing system and method of using
PCT/US1992/009564 WO1994011771A1 (fr) 1992-11-06 1992-11-06 Instrument de chirurgie a systeme d'observation par fibres optiques adhesif
AU30676/92A AU3067692A (en) 1992-11-06 1992-11-06 Surgical instrument with stick-on fiber-optic viewing system

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/US1992/009564 WO1994011771A1 (fr) 1992-11-06 1992-11-06 Instrument de chirurgie a systeme d'observation par fibres optiques adhesif

Publications (1)

Publication Number Publication Date
WO1994011771A1 true WO1994011771A1 (fr) 1994-05-26

Family

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Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1992/009564 WO1994011771A1 (fr) 1992-11-06 1992-11-06 Instrument de chirurgie a systeme d'observation par fibres optiques adhesif

Country Status (2)

Country Link
AU (1) AU3067692A (fr)
WO (1) WO1994011771A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1998001074A1 (fr) * 1996-07-08 1998-01-15 Boston Scientific Corporation Procede de diagnostic et de realisation de procedures interventionnelles sur un tissu in vivo

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4597030A (en) * 1985-01-31 1986-06-24 American Hospital Supply Corporation Surgical illuminator
US4648168A (en) * 1983-12-19 1987-03-10 N.V. Raychem S.A. Optical fibre breakout
US4825850A (en) * 1988-05-13 1989-05-02 Opielab, Inc. Contamination protection system for endoscope control handles
US4867529A (en) * 1987-05-09 1989-09-19 Mitsubishi Cable Industries, Ltd. Super-thin fiberscope
US5039198A (en) * 1989-08-02 1991-08-13 Vanbeek Allen L Stereoscopic microsurgery system

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4648168A (en) * 1983-12-19 1987-03-10 N.V. Raychem S.A. Optical fibre breakout
US4597030A (en) * 1985-01-31 1986-06-24 American Hospital Supply Corporation Surgical illuminator
US4867529A (en) * 1987-05-09 1989-09-19 Mitsubishi Cable Industries, Ltd. Super-thin fiberscope
US4825850A (en) * 1988-05-13 1989-05-02 Opielab, Inc. Contamination protection system for endoscope control handles
US5039198A (en) * 1989-08-02 1991-08-13 Vanbeek Allen L Stereoscopic microsurgery system

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1998001074A1 (fr) * 1996-07-08 1998-01-15 Boston Scientific Corporation Procede de diagnostic et de realisation de procedures interventionnelles sur un tissu in vivo
US6296608B1 (en) 1996-07-08 2001-10-02 Boston Scientific Corporation Diagnosing and performing interventional procedures on tissue in vivo
US8135454B2 (en) 1996-07-08 2012-03-13 Boston Scientific Corporation Diagnosing and performing interventional procedures on tissue in vivo

Also Published As

Publication number Publication date
AU3067692A (en) 1994-06-08

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