Abstract:
A cannula assembly including a camera system to help provide multiple viewing angles of a surgical site. This added visualization provides the surgeon with more comprehensive feedback during the surgical procedure, leading to better patient outcome and a reduction in the surgical failure rate. The cannula has a main lumen and a smaller secondary lumen and is insertable into the surgical site for easy surgeon adaptation. The camera is coupled to the secondary lumen toward the side of the cannula. This allows the camera to provide visualization without obstructing the main lumen for the use of tools. The camera wiring runs through a long tube connected to the camera and through a handle at the end of the tube without blocking access to the surgical site.

Description:
CROSS-REFERENCE TO RELATED APPLICATION 
       [0001]    The instant application claims priority to U.S. Provisional Patent Application Ser. No. 61/954,232 filed Mar. 17, 2014. The disclosure of the above application is incorporated herein by reference. 
     
    
     FIELD OF THE INVENTION 
       [0002]    The present invention relates to a cannula system with at least a pair of lumen and an imaging device used for surgical procedures. 
       BACKGROUND OF THE INVENTION 
       [0003]    Arthroscopic surgery is increasingly being preferred over open surgery due to its minimally invasive nature and shorter post-surgery recovery time. Current estimates state that there are 4 million arthroscopic procedures each year in the United States. During each procedure, surgeons typically use 2 to 3 cannulas: one is occupied by the arthroscope and the others are utilized for the insertion of surgical tools. The arthroscope provides only a single, two-dimensional vantage point of the joint during surgery. If the surgeon wants to view the surgical site from a different angle, the arthroscope must be moved from one cannula to another. Pressure fluctuations may occur, resulting in turbulent saline flow within the joint and increased bleeding that can hinder visualization. In addition, the single field of view provided by the arthroscope is limited, which may result in imprecision, and consequently lower the surgical success rate. In addition, current technology does not allow for instrumentation and visualization from the same portal, such that the ideal view afforded by the arthroscope may often need to be compromised to permit instrumentation of the pathology. These visualization setbacks, along with a lack of standardization in the current surgical technique, can lead to a surgical failure rate that exceeds 40% in certain joints. The ability to view and use an instrument from the same portal may afford several advantages, including less incisions and soft tissue trauma, improved visualization, and consequently, surgical accuracy. Furthermore, the ability to visualize without active handling of the arthroscope may eliminate the need for trained surgical assistants and improve surgical efficiency. 
       BRIEF SUMMARY OF THE INVENTION 
       [0004]    The present invention is a cannula-camera system to help provide multiple viewing angles of the surgical site. This added visualization will provide the surgeon with more comprehensive feedback during the surgical procedure, leading to better patient outcome and a reduction in the surgical failure rate. The cannula has a lumen portion comprising main lumen and a smaller secondary lumen. A modified trocar is inserted into the lumen portion. The cannula is then inserted into the surgical site in a similar way to current cannulas for easy surgeon adaptation. Once inside the body cavity the trocar is removed for insertion of an imaging device and surgical tools. The imaging device is housed in a long tube and is inserted through the designed secondary lumen on one side of the cannula. This allows the imaging device to provide visualization without obstructing the main lumen for the use of tools. The imaging device wiring runs through the housing and out of the handle without blocking access to the site. In another embodiment the imaging device is inserted through the lumen portion, rotated to outside the cannula, and pulled back through a slit in the cannula. A plurality of cannulas are usable simultaneously within the joint to provide tool interaction and additionally video output with multiple views to a monitor. 
         [0005]    Further areas of applicability of the present invention will become apparent from the detailed description provided hereinafter. It should be understood that the detailed description and specific examples, while indicating the preferred embodiment of the invention, are intended for purposes of illustration only and are not intended to limit the scope of the invention. 
     
    
     
       BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWING 
         [0006]    The present invention will become more fully understood from the detailed description and the accompanying drawings, wherein: 
           [0007]      FIG. 1  is a perspective view of a cannula assembly with some portions in phantom and having an exterior imaging device, in accordance with one embodiment of the present invention; 
           [0008]      FIG. 1A  is an enlarged view of the distal end of the cannula assembly of  FIG. 1  depicting a slit and with the imaging device omitted for clarity, in accordance with the present invention; 
           [0009]      FIG. 2  is a perspective view of the cannula assembly of  FIGS. 1-2  with the imaging device omitted for clarity, in accordance with the present invention; 
           [0010]      FIG. 3  is a bottom plan view of a cannula assembly, in accordance with a second embodiment of the present invention; 
           [0011]      FIG. 4  is a perspective view of an imaging assembly of the cannula assembly having an internal imaging device, in accordance with the second embodiment of the present invention; 
           [0012]      FIG. 5  is a top plan view of the cannula assembly, in accordance with either embodiment of the present invention; 
           [0013]      FIG. 6  is a top plan view of a cannula of the cannula assembly, in accordance with either embodiment of the present invention; 
           [0014]      FIG. 7  is a top perspective view of the cannula assembly with a handle omitted for clarity, in accordance with either embodiment of the present invention; 
           [0015]      FIG. 8  is a perspective view of the cannula assembly, in accordance with the present invention; 
           [0016]      FIG. 9  is a side elevation view of a trocar of the cannula assembly used with either embodiment of the present invention; 
           [0017]      FIG. 10  is a perspective view of the distal end of the cannula assembly with a trocar, in accordance with the present invention; 
           [0018]      FIG. 11  is a schematic illustrating three cannula assemblies within a body cavity for a joint and video feeds to a monitor device. 
       
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
       [0019]    The following description of the preferred embodiment(s) is merely exemplary in nature and is in no way intended to limit the invention, its application, or uses. 
         [0020]    Referring to  FIGS. 1-11  generally, in accordance with the present invention, there is provided a cannula assembly generally shown at  10  for surgical procedures such as performed within joint areas of the body or other areas. 
         [0021]    The cannula assembly  10  includes a cannula generally indicated at  12  that is threaded and a cap portion generally indicated at  14 . A trocar generally shown at  18  ( FIG. 9 ) is selectively inserted into the cannula assembly  10  for inserting the assembly  10  into a body cavity, as will be explained in further detail below. The threads  16  on the external surface of the cannula  12  generally assist with holding placement in the body cavity. 
         [0022]    The cannula assembly  10  includes a lumen portion with at least two adjoining lumen comprising a main lumen  20  and at least one secondary lumen  22 . Either of the lumen  20 ,  22  are generally tubular shaped with smooth walls for easy passage of surgical tools and/or an imaging device. Generally, the lumen  20 ,  22  have the same diameter. Typically, the diameter of the secondary lumen  22  is smaller than the diameter of the main lumen  20 . Preferably, the main lumen  20  is at least about double the diameter of the secondary lumen  22 . Most preferably, the diameter of the main lumen  20  is at least about 1.0 inches and the secondary lumen  22  is less than 0.5 inches. The secondary lumen  22  has an opening  60  along its length to the main lumen  20 . 
         [0023]    The cannula  12  includes a bifurcation indicated generally at  24  comprising a first port  26  and a second branch  28 . The first port  26  is in fluid communication with at least the main lumen  20  for fluid release to clear contaminated saline or other substances from the body joint space. A threaded valve cap  30  is removable from the end of the first port  26  for providing a connection point with any tubing or other secondary conduit for suction of the saline from the joint space. The second branch  28  has a tapped hole on the opposite side for insertion of a set screw  32  that allows a user to lock the translation and rotation of a long tube  34  by turning a second cap  36 . 
         [0024]    The cannula assembly  10  also includes a larger diameter portion generally shown at  38  integrally formed with the cannula  12 , the larger diameter portion  38  comprising a first chamber  40  that generally funnels to the end of the main lumen  20  and is open to either lumen  20 ,  22  of the cannula  12 . The larger diameter portion  38  is provided with a seal  42 , most preferably, a two-layer silicone seal. A smaller diameter portion  44  ( FIG. 8 ) of the cap portion  14  is inserted into the open end of the larger diameter portion  38  of the assembly to secure the seal  42  in place. The seal  42  prevents the outflow of pressurized saline from within the joint. A plurality of tabs  46  are provided on the cap portion  14  to attach the cap to the larger diameter portion  38 , such as by snap fit engagement with each of a plurality of opposing first apertures of the larger diameter portion  38 . Alternatively, the tabs  46  are disposed on the larger diameter portion  38  and the smaller diameter portion  44  has apertures. 
         [0025]    Referring to  FIGS. 1-2 ,  5  and  7  generally, in accordance with a first embodiment of the present invention, an imaging assembly or visualization tool or assembly generally indicated at  48  includes the long tube  34  that is attached to a handle  50  at one end and coupled to an imaging device  52  such as a camera device at a second end. The long tube  34  is operably sized for inserting into the secondary lumen  22  and housing wiring  56  for the imaging device  52 . The wiring  56  passes through the handle  50  which has at least one second aperture  54  for the wiring  56  to exit out of the handle  50  without blocking access to the surgical site. Wireless communications with video feeds are contemplated. 
         [0026]    The cannula assembly  10  is provided with a locking mechanism to lock the imaging assembly in place to prevent rotation. The locking mechanism can be the set screw  32 . Alternatively, or in addition to the set screw  32 , the outside of the secondary lumen  22  of the cannula  12  is provided with a slit  58  having a predetermined length to provide a locking mechanism. The slit  58  does not extend the entire length of the cannula  12  and is operably sized to receive and retain a portion of the imaging device  52 . The imaging assembly  48  with the imaging device  52  is aligned with the end of the cannula with the imaging device  52  aligned to the main lumen  20  and the tube  34  aligned to the secondary lumen  22 . The imaging assembly  48  is inserted through the entire cannula  12  and is then rotated, e.g., 180 degrees, until the imaging device  52  is outside the cannula  12 , and is then retracted back along the side of the distal end of the cannula  12  through the slit  58 . 
         [0027]    The cap portion  14  is provided with a segmented portion indicated generally at  62  that acts as a first guide for the handle  50  to allow 180 degree rotation of the handle  50 , the guide comprising at least two raised segments  64  that act as stops to prevent further degrees of rotation. Thus, the segment portion  62  interacts with the imaging assembly  48  to act as a guide and allow for a distinct predetermined amount of rotation of the imaging assembly  48 , providing a key like mechanism or interaction where the segment portion  62  acts as the guide and the handle of the imaging assembly  48  acts as a key. 
         [0028]    The imaging device  52  is provided with a lens  66  and lighting source. The lens  66  is flat, and, alternatively, angled. By way of non-limiting example, angled to look at different angles of about 30 degrees either direction instead of straight on. 
         [0029]    Referring to  FIGS. 3-4  generally, in accordance with a second embodiment of the present invention, the cannula assembly  100  is identical to the first embodiment except that there is no outside slit in the secondary lumen  122  of the cannula  12  and the imaging assembly has an internal imaging device or camera; not an externally located imaging device. The imaging assembly or visualization tool or assembly generally indicated at  148  includes the long tube  134  that is attached to the handle  150  at one end. Toward the other end and located within the long tube  134  is an imaging device  152 . The long tube  134  is operably sized for aligning with and sliding into the secondary lumen  122  and for housing wiring  156  for the imaging device  152  within the tube. The handle  150  has at least one second aperture  154  for wiring  156  of the imaging device  152  to exit out of the handle  150  without blocking access to the surgical site. Wireless communications/video feeds are contemplated. 
         [0030]    As with the first embodiment, a locking mechanism is provided. Most preferably, the locking mechanism is the set screw  32 . No segmented portion  62  with raised segments  64  is required. Alternatively, the cap portion  14  is provided with the segmented portion  62  that acts as a guide for the handle  150  to allow controlled rotation of the handle  150 , and thereby of the imaging device  152  disposed therein. 
         [0031]    The imaging device  152  is provided with a lens  166  and lighting source  168 . The lens  166  is angled a predetermined amount to look at different angles. Most preferably, angles of about 30 degrees in either direction instead of straight on or any other angle suitable for particular surgical application. Alternatively, the lens  166  is flat. 
         [0032]    Referring to  FIGS. 5-7  generally, in either embodiment in accordance with the present invention, the larger diameter portion  38  of the cannula assembly includes a second guide  70  adjacent the secondary lumen  22  to guide the tube  34 ,  134  of the imaging assembly  48 ,  148 . The cap portion  14  is provided with a third guide  72  adjacent to the second guide  70  to guide the tube  34 ,  134 . 
         [0033]    Referring to  FIGS. 9-10  generally, in either embodiment in accordance with the present invention, the trocar  18  is inserted into the cannula  12  for inserting the cannula assembly  10  into the body cavity. The trocar  18  freely slides within the lumen portion of the cannula assembly  10 . When inserted, the trocar  18  fills the distal ends of both the main and secondary lumen  20 ,  22  so that nothing from inserting into the body cavity enters either of the lumen  20 ,  22 . The trocar  18  is provided with a second projection  74  that fills the secondary lumen  22  of the cannula  12 , which prevents tissue build up during insertion into the joint. The trocar  18  has a sharper tip  80  on the distal end, that when inserted into the cannula, is outside the distal end of the cannula  12 . The trocar  18  also has a handle  82  on the proximal end of the trocar  18  for grasping by a user. 
         [0034]    Referring to  FIG. 11  generally, in either embodiment in accordance with the present invention, once the cannula is within the body cavity, the trocar  18  is removed by the user and tools and/or the imaging assembly  48 ,  148  are selectively inserted into the cannula  12 . Wiring  56 ,  156  from the imaging device  52 ,  152  exits the aperture  54 ,  154  of the handle  50 ,  150  and is connected to a multiplexer for video feed to a monitor indicated generally at  76 . A plurality of cannula assemblies  10  are insertable into the joint area, e.g., at least three cannulas  10 , for multiple views and access points to the site for using tools.  FIG. 11  illustrates three quadrants shown on the screen with different vantage points provided by each cannula inserted in the shoulder joint. Each surgical tool, e.g., suturing devices  78 , extending through the main lumen  20  into the body cavity are shown in a respective quadrant fed from each of the imaging devices  52 ,  152  of the respective cannula assembly  10 . Thus, each suturing device is extending from the main lumen  20  while each imaging device  52 ,  152  is either within the secondary lumen  22  or on the outside of the secondary lumen  22 , providing an unobstructed view to the site and suturing device for the user to view on the monitor. The multiplexer has many different options for viewing the distinct feeds, such as picture-in-picture, split screen, full screen and much more. 
         [0035]    Preferably, the cannula assembly  10  is disposable. Generally, the cannula  12  is made of a rigid or semi-rigid material. Typically, at least the cannula  12  is made of a medical-grade resin. Preferably, at least the cannula  12  is made of a rigid medical-grade resin with clarity or that is transparent. Most preferably, a medical-grade resin substantially simulating the properties and aesthetics of polycarbonate is used. 
         [0036]    Parts, with the exception of the threaded portion of the set screw  32 , were prototyped with Accura60 resin using a Viper si2™ SLA® machine. The imaging device  52  and/or  152 , by way of non-limiting example, is an Omnivision OV6922 image sensor. 28 AWG enamel coated wires are used to connect the imaging device to a 3V power source and the multiple inputs are transmitted to a multiplexer for a simultaneous video feed. 
         [0037]    The description of the invention is merely exemplary in nature and, thus, variations that do not depart from the essence of the invention are intended to be within the scope of the invention. Such variations are not to be regarded as a departure from the spirit and scope of the invention.