Abstract:
A single shaft double port cannula having a shaft with discrete and separated channels to provide a method and apparatus that allows entry and passage of any two elongate surgical instruments through a single cannula.

Description:
CROSS REFERENCES TO RELATED APPLICATIONS 
       [0001]    The present application claims the benefit of the filing date of U.S. patent application Ser. No. 61/988,681, filed May 5, 2014 (May 5, 2014), incorporated in its entirety by reference herein. 
     
    
     STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT 
       [0002]    Not applicable. 
       THE NAMES OR PARTIES TO A JOINT RESEARCH AGREEMENT 
       [0003]    Not applicable. 
       INCORPORATION-BY-REFERENCE OF MATERIAL SUBMITTED ON A COMPACT DISC 
       [0004]    Not applicable. 
       BACKGROUND OF THE INVENTION 
       [0005]    1. Field of the Invention 
         [0006]    The present invention relates generally to a cannula for use in arthroscopic surgery and endoscopic procedures, and more particularly to a novel double port cannula that facilitates arthroscopy of synovial joints and endoscopic procedures on the abdomen and spine. 
         [0007]    2. Background Discussion 
         [0008]    Arthroscopy has revolutionized the treatment of joint diseases. In the knee, arthroscopy has allowed for minimally invasive treatments of meniscal tears and cartilage pathology and facilitated other more extensive surgeries such as ACL reconstruction and meniscal transplantation. Arthroscopy has been expanded into other fields such as shoulder, hip elbow, ankle, and even the wrist. In joints, such as the hip and knee in particular, arthroscopic suturing techniques are particularly helpful for repair of the labrum and capsule. However, suture management can occasionally challenge even an experienced arthroscopist. The problem is one of access. In the hip, for instance, the presence of the femoral head and the depth of the joint can make it nearly impossible to access certain areas except with one cannula. Thus, it is impossible to implement a surgical action in that zone. In the spine, muscle-sparing approaches have been developed in the removal of disc material and the fusion of vertebral bones in the treatment of disc disease. However, access is limited to one to two pathways to the diseased area. 
       SUMMARY OF THE INVENTION 
       [0009]    The current invention has been developed to provide a method and apparatus to address the issue of access by providing two ports within a single double port cannula. The inventive double port mechanism allows entry and passage of any two elongate instruments, including an endoscope through one of the channels. This dramatically increases the options for achieving the surgical goals. The inventive double port cannula allows the surgeon to implement the surgical plan through the second port. The invention has applications to the shoulder for the repair of the rotator cuff where the sutures can be pulled through the second port and can help to apply traction of the cuff or store the sutures until they are ready to be tied. It can be utilized in the hip in the repair of the labrum or treatment of cartilage lesions. It can further be utilized in the knee for the repair of ligaments such as the anterior cruciate ligament or the menisci. The invention can be used in the spine for the treatment of intervertebral disc disease with a minimally invasive methodology with the endoscope entered through one channel or portal and the pathological material removed or repaired through the second portal. 
     
    
     
       BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS 
         [0010]    The invention will be better understood and objects other than those set forth above will become apparent when consideration is given to the following detailed description thereof. Such description makes reference to the annexed drawings wherein: 
           [0011]      FIG. 1  is a lower perspective end view of the inventive cannula; 
           [0012]      FIG. 2  is a side view in elevation of the inventive cannula shown in  FIG. 1 ; 
           [0013]      FIG. 3  is an enlarged detailed cross-sectional view of the inventive cannula taken along section line  3 - 3  in  FIG. 2 ; 
           [0014]      FIG. 4  is an enlarged detailed view of the interior (distal) end portion of the inventive cannula shown in  FIG. 1 ; 
           [0015]      FIG. 5  is an upper perspective external (proximal) end view of the inventive cannula; 
           [0016]      FIG. 6  is a rotated and enlarged view of the proximal end portion of the inventive cannula shown in  FIG. 5 ; 
           [0017]      FIG. 7A  is an exploded lower perspective view of a second preferred embodiment of the inventive cannula, which includes a threaded exterior end portion and an insertion stylette (pin); 
           [0018]      FIG. 7B  is the same view showing the insertion pin inserted into the threaded cannula; 
           [0019]      FIG. 8A  is a front view in elevation of the insertion pin of the second preferred embodiment; 
           [0020]      FIG. 8B  is a side view in elevation thereof; 
           [0021]      FIG. 8C  is a top plan view thereof; 
           [0022]      FIG. 8D  is a bottom plan view thereof; 
           [0023]      FIG. 9A  is a side view in elevation of the cannula of the second preferred embodiment; 
           [0024]      FIG. 9B  is the same view with the cannula axially rotated 90 degrees; 
           [0025]      FIG. 9C  is a top plan view thereof; 
           [0026]      FIG. 9D  is a bottom plan view thereof; 
           [0027]      FIG. 10A  is a in elevation of the second preferred embodiment assembled showing the insertion pin front side; and 
           [0028]      FIG. 10B  is the same view with the insertion pin and cannula rotated axially 90 degrees. 
       
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
       [0029]    Referring first to  FIGS. 1 through 6 , wherein like reference numerals refer to like components in the various views, there is illustrated therein a first preferred embodiment of a new and improved cannula with two ports, generally denominated  10  herein. 
         [0030]    As seen in  FIGS. 1-3 , in a first preferred embodiment the cannula of the present invention  10  preferably includes a cylindrical shaft  16 , having a an interior end  12 , truncated obliquely so as to form a beveled end or “point”  20 , an exterior end  14 , a collar or ferule  18  disposed on the exterior end, and first and second generally linear and parallel bores  22  and  24 , separated by a partition  23  from the exterior end  14  to the interior end  12 . The bores can be identical or variable in diameter. 
         [0031]      FIG. 3  provides detail showing the shaft  16 , an exterior end  14 , the collar  18 , and the interior end (or articular apparatus)  12  with the main channel opening  22  and the accessory channel opening  22 . The collar  18  may include a rim  25  that extends beyond the openings of the channels and defines a cylindrical cup  26  to facilitate placement of an arthroscope or a larger instrument, typically inserted into the exterior end (outer) entry site into the main channel. Alternatively, smaller instruments (such as radiofrequency probes, suture passers or retracting sutures) can be passed through the accessory channel. 
         [0032]      FIG. 4  provides detail concerning the double port cannula articular end tip  20 . The beveled opening of the cannula  10  makes it able to accommodate a variety of endoscope/arthroscopes (the terms used interchangeably herein) through the interior end of the main channel  22  and other smaller instruments through the accessory channel  24  with a clear structural separation between the two channels of the cannula. 
         [0033]      FIG. 5  is an end view in perspective showing the external end  14 . In this view, the main cannula assembly is shown. Looking from outside the external end, thus outside the patient&#39;s body, there is an outer entry hole  22   a  for the main channel  22  and the accessory channel outer entry  24   a  for the accessory channel  24 . An endoscope/arthroscope inserted into main channel  22  is maintained in position with a fluid seal using the endoscope/arthroscope attachment mechanism, collar  18 . 
         [0034]      FIG. 6  is a detailed end view of the double port cannula, again showing the exterior end  14 , rotated 180 degrees from its position as seen in  FIG. 5  so that accessory channel  24  is better appreciated. 
         [0035]      FIGS. 7A through 10B  show a second preferred embodiment  70  of the inventive cannula. These views show, collectively, that in a second preferred embodiment, the cannula includes an elongate shaft or tube  72  having first and second through ports  74 ,  76 , separated internally by a bifurcation or partition  78 , and extending from an exterior (proximal) end  80  to an interior (distal) end  82 . The exterior end  80  includes a collar or ferrule  84  that functions as an anthroscopic attachment structure. This embodiment further includes male threads  86 , which maintain the cannula in position at the desired depth from the skin. 
         [0036]    The second preferred embodiment next includes an insertion pin or stylette  90  having a head  92  with gripping elements  94 , including, but not limited to, nubs, knurls, fins, ribs, or any suitable surface feature that facilitates a secure finger hold. Integrally connected to head  92  are first and second split prongs  96 ,  98 , each configured for insertion into the through ports  74 ,  76  in cannula shaft  72  each extend to a beveled end  100 ,  102  which angle inwardly to form an effective point  104 , which extends through the interior end  82  of cannula  72  when inserted. This facilitates insertion into a patient&#39;s body. 
         [0037]    While the prongs are shown in the view having substantially the same dimensions, it will be appreciated that they may be sized for passage of different instruments while still achieving the functional features of the above-described insertion pin. 
         [0038]    The above disclosure is sufficient to enable one of ordinary skill in the art to practice the invention, and provides the best mode of practicing the invention presently contemplated by the inventor. While there is provided herein a full and complete disclosure of the preferred embodiments of this invention, it is not desired to limit the invention to the exact construction, dimensional relationships, and operation shown and described. Various modifications, alternative constructions, changes and equivalents will readily occur to those skilled in the art and may be employed, as suitable, without departing from the true spirit and scope of the invention. Such changes might involve alternative materials, components, structural arrangements, sizes, shapes, forms, functions, operational features or the like. 
         [0039]    Therefore, the above description and illustrations should not be construed as limiting the scope of the invention, which is defined by the appended claims.