Surgical instrument cleaning arrangement

The instrument cleaning apparatus of the present disclosure facilitates the cleaning of a scope inserted through a sealed portal during a surgical procedure by providing a cleaning solution within the operating cavity so that the surgical instrument doesn't have to be removed therefrom. In an embodiment, a surgical access device is provided with a housing, a sleeve extending distally from the housing, and a conduit disposed in mechanical cooperation with the sleeve. The sleeve defines a longitudinal axis and is dimensioned for passage through a tissue tract. The sleeve also defines a longitudinal bore for reception and passage of a surgical instrument. The conduit has a first portion configured to receive a fluid and a second portion configured to discharge the fluid. In another embodiment, an instrument cleaning apparatus includes a base portion and a fluid retention portion. The base portion includes a substantially tubular wall having a proximal end and a distal end and a longitudinal passageway extending therethrough. The fluid retention portion is in mechanical cooperation with the base portion and is adapted to retain a cleaning fluid therein.

BACKGROUND

1. Field of the Disclosure

The present disclosure relates to surgical devices and, more particularly, relates to an instrument cleaner adapted for cleaning an instrument while the instrument is within a sealed surgical portal apparatus during a minimally invasive, e.g., a laparoscopic, surgical procedure.

2. Description of the Related Art

Minimally invasive surgical procedures, including both endoscopic and laparoscopic procedures, permit surgery to be performed on organs, tissues and vessels far removed from an opening within the tissue. Laparoscopic and endoscopic procedures generally require that any instrumentation inserted into the body be sealed, e.g., provisions may be made to ensure that gases do not enter or exit the body through the incision as, for example, in surgical procedures in which the surgical region is insufflated. Particularly, a viewing scope may be introduced into the body through a sealed portal, such as a cannula, in order for the surgeon to view the region being treated on a video monitor and to see any of a variety of surgical instruments introduced either directly or through other portals into the surgical region.

In procedures that employ the internal introduction of a scope, lens smudging and/or other visual obstructions, such as fogging, can occur to obscure the surgeon's view. Known cleaning methods generally require that the scope be pulled completely out of the portal so that the lens can be cleaned and then re-inserted. It would be advantageous to be able to clean the lens while the scope is still inserted into the sealed portal.

SUMMARY

The present disclosure relates to an instrument cleaning apparatus which facilitates the cleaning of a scope inserted through a sealed portal during a surgical procedure by providing a cleaning arrangement, e.g., a cleaning solution, within the operating cavity so that the surgical instrument need not be removed therefrom.

In an embodiment, a surgical access device is provided with a housing, a sleeve extending distally from the housing, and a conduit disposed in mechanical cooperation with the sleeve. The sleeve defines a longitudinal axis and is dimensioned for passage through a tissue tract. The sleeve also defines a longitudinal bore for reception and passage of a surgical instrument. The conduit has a first portion configured to receive a fluid and a second portion configured to discharge the fluid. The second portion of the conduit is in mechanical cooperation with the sleeve.

The second portion of the conduit may be configured as a nozzle. In embodiments, the second portion of the conduit is configured as a proximally facing nozzle. The elongated portion of the conduit, positioned between the first and second portions, may be disposed adjacent to the sleeve. In other embodiments, the elongated portion is disposed within a wall of the sleeve.

Methods of using and cleaning a surgical instrument with the surgical access device are also disclosed. In accordance with the present methods, a trocar assembly is provided having a conduit operably coupled to a sleeve of the trocar assembly. The conduit includes a first portion for receiving a fluid and a second portion for discharging the fluid. The fluid may be passed from a fluid source into the first portion of the conduit. A surgical instrument is inserted through the trocar assembly to access a surgical site where a surgical function may be performed with the surgical instrument. Fluid is discharged from the second portion of the conduit to contact a distal-end of the surgical instrument.

In another embodiment, an instrument cleaning apparatus includes a base portion and a fluid retention portion. The base portion is adapted for positioning on a surgical instrument and includes a substantially tubular wall having a proximal end and a distal end and a longitudinal passageway extending therethrough. The fluid retention portion is in mechanical cooperation with the base portion and is adapted to retain a cleaning fluid therein.

DETAILED DESCRIPTION OF THE EMBODIMENTS

The scope cleaner of the present disclosure facilitates the cleaning of a scope inserted through a sealed portal during a surgical procedure by providing a cleaning solution within the operating cavity so that the surgical instrument doesn't have to be removed therefrom. In embodiments, the sleeve of a portal apparatus includes a conduit for dispensing the cleaning solution onto the lens of the scope. In other embodiments, the cleaning solution is pre-disposed on a detachable apparatus which may be fastened to an external surface of a surgical instrument upon which a scope may be contacted and cleaned. In other embodiments, the cleaning solution is pre-disposed on an apparatus which is integrally formed onto an external surface of a surgical instrument upon which a scope may be contacted and cleaned. In still other embodiments, the cleaning arrangement includes a detachable or undetachable absorbent apparatus which may be fastened to, or which is integrally formed with, an external surface of a surgical instrument upon which a scope may be contacted and cleaned, e.g., by the absorbent material absorbing any fluids, fog, etc., that is disposed on the scope.

While the device according to the present disclosure is especially suitable for cleaning surgical scopes, it is envisioned that the device can be used in connection with the cleaning of other surgical instruments which are introduced through a surgical portal. Examples of surgical instrumentation which may be introduced through the portal include clip appliers, graspers, dissectors, retractors, staplers, laser probes, photographic devices, tubes, electrosurgical cutting, coagulating, and ablation devices, and other tools within the purview of those skilled in the art.

Referring now to the drawings, in which like reference numerals identify identical or substantially similar parts throughout the several views,FIG. 1, in conjunction withFIGS. 2 and 3, illustrate an embodiment of the scope cleaner of the present disclosure. Surgical access device10of the present disclosure incorporates conduit20with portal30. Portal30may be any device suitable for the intended purpose of accessing a body cavity, such as a trocar or cannula assembly, through a tissue tract.

Portal30may be used in a variety of surgical applications and is particularly adapted for use in laparoscopic surgery where the peritoneal cavity is insufflated with a suitable gas, e.g., CO2, to raise the cavity wall from the internal organs therein. Portal30is typically used with an obturator assembly (not shown) which may be a blunt, a non-bladed, or a sharp pointed instrument positionable within the passageway of portal30. The obturator assembly is utilized to penetrate the abdominal wall or introduce portal30through the abdominal wall, and then subsequently is removed from portal30to permit introduction of scope60utilized to perform the procedure through the passageway.

The scope60may be any of a variety of laparoscopes and endoscopes, such as, for example, arthroscopes, thoracoscopes, bronchioscopes, hysteroscopes, choledochoscopes, cystoscopes, restectoscopes, and the like, depending on the surgical procedure being performed.

Portal30includes sleeve32having proximal (or leading) and distal (or trailing) ends34and36, respectively, and housing38mounted to proximal end34of sleeve32. Sleeve32defines a longitudinal axis “t” extending along the length of sleeve32and defines an internal longitudinal bore or passage35dimensioned to permit passage of scope60.

Housing38includes central aperture39arranged about axis “t” and seal assembly40. Central aperture39is configured and dimensioned to permit entry of scope60. Seal assembly40defines a seal assembly opening42within seal45, seal assembly opening42being in general alignment with the central aperture39of housing38. Seal assembly opening42is configured and dimensioned such that insertion of scope60into seal assembly opening42causes the material defining seal45to engage the outer surface of scope60in a substantially fluid tight manner to minimize the formation of gaps around scope60and prevent gases from escaping.

In embodiments seal assembly opening42may include a slit which is adapted to close in the absence of a surgical object and/or in response to insufflation gases of the pressurized cavity. It is also envisioned that seal45of seal assembly40may be fabricated from a relatively rigid biocompatible polymeric material or alternatively, from a resilient and/or flexible material such as a fabric, foam, elastomeric material, or combinations thereof in order to bend or deform about an inserted scope60while absorbing off-axis motion.

Conduit20is operably coupled to portal30. Conduit20may be joined with any part of sleeve32, including its inner or outer surface as illustrated inFIGS. 2 and 3, respectively. Conduit20includes opening22on proximal end24and nozzle26on distal end28. Conduit20defines a longitudinal axis “a”, as shown inFIG. 3, extending along the length of conduit20and defines an internal longitudinal channel29dimensioned to permit the flow of fluid therethrough. In embodiments, longitudinal axis “a” may be substantially parallel to axis “t” of sleeve32.

The size and dimension of channel29of conduit20may vary. In embodiments, channel29may be uniform in size and diameter along the length of conduit20. A change or decrease, however, in the surface area of channel29may aid in discharging fluid through nozzle26. Therefore, in other embodiments, channel29may taper towards distal end28of conduit20. It is also envisioned that channel29may be comprised of smaller channels29′ and29″ as illustrated inFIGS. 4A and 4B, respectively. By decreasing the diameter of channel29through which fluid may flow, the resistance of the fluid increases. Pressure is thereby built up for the discharge of the fluid through nozzle26.

Proximal opening22of conduit20is configured to connect to fluid source50. Opening22and fluid source50may be connected by tubing or other means as is within the purview of those skilled in the art. Fluid source50may be a syringe as illustrated inFIG. 5. Fluid source50may include syringes, pumps, valves, and the like which may be pressurized or un-pressurized. Nozzle26opens into distal end36of longitudinal passage35of sleeve32of portal30. Nozzle26may be a spigot, spout, or any other opening for discharging and/or spraying fluid52received by opening22from fluid source50. It is envisioned that nozzle26faces proximally, such that at least a portion of the projected spray of fluid52from nozzle26is proximal to the distal-most end of sleeve32.

Nozzle26may include one or more openings or include a series or pattern of openings conducive to applying and washing surgical instrumentation60. In embodiments, nozzle26may evenly distribute fluid52across a predetermined area or focus fluid52into one or more regions. In embodiments, nozzle26may include openings of varying sizes and/or angles in order to provide additional resistance to fluid52for a more forceful or jet-like flow of fluid52or to direct flow of fluid52.

Fluid52may be a washing or rinsing fluid such as saline or sterile water. Fluid52may be an anti-fogging solution or may be warmed to reduce the likelihood of fogging. Defogging solutions may be water, glycol, and water soluble wetting agents. In embodiments, fluid52is commercially available surgical anti-fog solution FRED™ available from Covidien (Mansfield, Mass.). Fluid52may contain a biocompatible cleaning agent or a bioactive agent that has clinical use.

Surgical access device10may be a single monolithically formed unit or composed of several components connected to each other through conventional means including a bayonet coupling, a threaded connection, snap fit, ultrasonic welding or any other means envisioned by one skilled in the art including, e.g., adhesive means. Sleeve32and housing38of portal30may be a monolithically formed unit or may be connected to each other through conventional means as described above. In a like manner, sleeve32of portal30and conduit20may be monolithically formed or may be connected to each other through conventional means. Surgical access device10, including conduit20and/or portal30, may be formed of any suitable medical grade material, such as stainless steel or other rigid materials, including polymeric materials, such as polycarbonate and the like. Surgical access device10may be transparent, translucent, or opaque.

To use the scope cleaner in connection with the performance of a surgical task during a laparoscopic procedure, the peritoneal cavity is insufflated to establish the pneumoperitonum. Surgical access device10is introduced into an insufflated abdominal cavity typically utilizing a sharp or non-blade trocar obturator to access the cavity and the obturator is removed. A scope60is advanced through surgical access device10by inserting instrument60into central aperture39of housing38and through seal assembly40whereby seal assembly40accommodates instrument60in substantial sealed relation therewith. Scope60is distally passed through seal assembly40, longitudinal passage35, and into the body cavity. The desired surgical task is performed with scope60. During manipulation of scope60, should scope60fog, become soiled, accumulate debris, or obstruct the surgeon's view in any way, scope60is adjusted within sealed portal30so that the soiled part of scope60, e.g., the lens, is substantially aligned with the projected spray of fluid52from nozzle26. Fluid52is then passed through channel29of conduit20and out through nozzle26in order to spray and clean scope60.

Turning now toFIG. 6, the scope cleaner70may be an apparatus which may be detachably secured to the outer surface or shaft of a surgical instrument62, such as the sleeve of a trocar assembly or any other instruments which are introduced into a surgical cavity during a minimally invasive surgical procedure as discussed above. In embodiments, scope cleaner70is attached to a surgical instrument62which remains in the surgical cavity for an extended period of time, such as a tissue grasping instrument.

Scope cleaner70includes a base portion80and a fluid retention portion90. Base80has a tubular configuration and includes wall82. Wall82includes proximal end84and distal end86and defines an internal longitudinal opening88extending along the entire length, from the proximal end84to the distal end86, of wall82. Wall82may be continuous as illustrated inFIG. 7Aor may have a longitudinally extending slit81formed therein, as illustrated inFIG. 7B.

Wall82may be formed from a flexible polymer and/or elastomeric material, such as, for example, polyolefins such as polypropylene and polyethylene, polyesters such as polyethylene terephthalate, polyamides such as nylon, polyurethanes, silicones, vinyl, and rubber. The flexible materials are adaptable and amendable for insertion onto a surgical instrument62. Wall82must have a sufficient elasticity to bend and deform upon placement onto the shaft of surgical instrument62while conforming about the outer dimensioning of the surgical instrument62. A grip or tab83may be added to base80, such as at proximal end84as illustrated inFIG. 6, to assist in inserting the scope cleaner70about instrument62. Tab83radially extends around and is raised from a portion of wall82to facilitate gripping by the hand of the holder.

In other embodiments, wall82is formed from a relatively rigid material, such as plastics. Plastics may be formed from polymers such as those described above. In embodiments, the wall is formed from a high density polymer and includes a longitudinally extending slit as described above to facilitate snap fitting of the scope cleaner onto a surgical instrument. It is contemplated that the scope cleaner could be assembled with the surgical instrument during manufacturing of the instrument.

Fluid retention portion90is in mechanical cooperation with base portion80. Fluid retention portion90may be integrated into wall82of base80or may be attached to the outer surface of wall82. In embodiments, the fluid retention portion is sufficiently thin so that the scope cleaner70maintains a substantially uniform diameter along the length thereof. As illustrated in the current embodiment, fluid retention portion90is a pad fastened to the surface of wall82by conventional coupling means, such as by the use of adhesives. In other embodiments, such as that illustrated inFIG. 8, the fluid retention portion92has a basket-like configuration which protrudes from the outer surface of wall82. As illustrated in this embodiment, the portion of the scope cleaner70upon which the fluid retention portion92is retained has an extended diameter. Fluid retention portion92must be made of a flexible material so that is will flex during insertion and withdrawal of the instrument on which it is applied during a surgical procedure.

Fluid retention portion90is adapted and configured to allow for the retention of fluid52therein. In embodiments, fluid retention portion90is formed from a porous material which includes openings or pores over at least a portion of a surface thereof. Examples include meshes, foams, and sponges. In other embodiments, fluid retention portion90is formed from an absorbent material. The absorbent material may be any natural or synthetic cloth or felt material within the purview of those skilled in the art. A moisture wicking material that does not absorb moisture into the fiber but maintains the moisture on the surface thereof may also be used separately or in combination with a porous or absorbent material. Examples include, for example, polyester, polyester-based fabrics, nylon, spandex, and blends or combinations thereof. In embodiments, fluid retention portion90is fabricated from a mesh of spandex. In other embodiments, fluid retention portion90includes a nitinol wire frame and an absorbent material contained therein.

As illustrated inFIG. 9, to use the scope cleaner70in connection with the performance of a surgical task during a laparoscopic procedure, scope cleaner70is inserted onto the shaft of instrument62. Fluid52, such as FRED™ anti-fog solution, is applied onto fluid retention portion90prior to insertion of the instrument62into the operating cavity. A scope60is also introduced into the body cavity through a separate port. The desired surgical task is performed with scope60and instrument62. During manipulation of scope60, should the scope60fog, become soiled, accumulate debris, or obstruct the surgeon's view in any way, scope60is moved in contact with fluid retention portion90of scope cleaner70. With the application of light pressure, the scope60is moved in a clockwise/counterclockwise motion in order to clean scope60.

It will be understood that various modifications and changes in form and detail may be made to the embodiments of the present disclosure without departing from the spirit and scope of the disclosure. Therefore, the above description should not be construed as limiting the invention but merely as exemplifications of embodiments thereof. Those skilled in the art will envision other modifications within the scope and spirit of the present disclosure as defined by the claims appended hereto.