Abstract:
A laparoscopoic tool includes a handle assembly, a tool implement, an outer tube defining an inner lumen and a wire assembly positioned within the lumen of the outer tube and coupled to the handle assembly and the tool implement. The outer tube and the wire assembly are configured to be shaped to form at least one bend region.

Description:
BACKGROUND 
       [0001]    Laparoscopic surgery includes forming small incisions in a patient and performing a procedure through the incision using one or more laparoscopic surgical tools. Current laparoscopical surgical techniques utilize one or more trocars that establish a port for introduction of the surgical tools. One type of surgical technique is known as single incision laparoscopic surgery (“SILS”), where only a single incision and single trocar are used during the surgical procedure. In one example, SILS procedures utilize an umbilical trocar introduced through an incision in the umbilical region of a patient. As incisions in the umbilical region tend to be relatively invisible after surgery and allow for quicker recovery of the patient, SILS procedures can be a preferred method of surgery in many instances. Even with inherent benefits to utilizing the umbilical region for SILS procedures, procedures using entry through the umbilical region can be difficult due to lack of space and proximity with a targeted tissue site. As such, specialty curved or articulated tools have given physicians opportunity to have more clearance in reaching and operating upon a targeted tissue site. These curved tools can still be difficult to work with, since patients can be varied in size and varied target surgical sites can be difficult to access. 
       SUMMARY 
       [0002]    A laparoscopic surgical tool is disclosed that includes a handle assembly, a tool implement, an outer tube and an inner wire assembly coupling the handle assembly to the tool implement. The outer tube and inner wire assembly can be manipulated to conform to a desired shape. 
         [0003]    In one embodiment, the wire assembly is positioned within an inner lumen of the outer tube. A surgical environment can be evaluated to identify a path from an incision to a targeted tissue site. Upon evaluation, the outer tube and wire assembly can be shaped to form one or more bend regions. As such, a surgeon is afforded easier access to the targeted tissue site. Subsequently, the laparoscopic tool can be withdrawn and the handle assembly and/or tool implement can be replaced with an alternative handle assembly and/or tool implement while maintaining the one or mor bend regions. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0004]      FIG. 1  is a side view of a laparoscopic tool in a disassembled state. 
           [0005]      FIG. 2  is a side view of a laparoscopic tool after final assembly. 
           [0006]      FIG. 3  is a side view of a laparoscopic tool in a first curved shape. 
           [0007]      FIG. 4  is a side view of a laparoscopic tool in a second curved shape. 
           [0008]      FIG. 5  is a schematic view of a surgical environment. 
       
    
    
     DETAILED DESCRIPTION 
       [0009]      FIG. 1  is an exploded side view of a laparoscopic tool  10  whereas  FIG. 2  is a side view of tool  10  in an assembled state. The tool  10  includes a handle assembly  12 , an outer tube or sleeve  14 , an inner wire assembly  16  and a tool implement  18 . Handle assembly  12  is operably coupled to tool implement  18  through wire assembly  16 . Tube  14  is coaxially arranged around wire assembly  16  and coupled to handle assembly  12 . A surgeon utilizing tool  10  is able to bend tube  14  and wire assembly  16  to a desired shape to form a configuration suitable to perform a procedure. As such, the surgeon conforms the outer tube  14 /wire assembly  16  to a shape that leads from an incision to a target tissue site. Tube  14  and wire assembly  16  are configured to be coupled with alternative handle assemblies and tool implements as desired. As such, the shape of the tube  14  and wire assembly  16  can be maintained to perform various tasks within a surgical environment. 
         [0010]    Handle assembly  12  includes a trigger handle  20  and a fixed handle  22  for operation of the tool implement  18 . Additionally, handle assembly  12  includes a coupling portion  24  for attachment to the tube  14  and wire assembly  16 . In particular, coupling portion  24  includes a threaded shaft  26  for coupling to tube  14  and an aperture  28  for receiving wire assembly  16 , which is directly coupled to trigger handle  20 . In addition, handle assembly  12  includes a control knob  29 , which can be utilized to effect rotational movement of wire assembly  16  and thus tool implement  18 . Other handle assemblies can also be used having one or more features such as rotatable, fixed, axial, angled, with a monopolar connection, with a bipolar connection and/or combination thereof. 
         [0011]    Outer tube  14  includes a proximal end  30  and a distal end  32  opposite the proximal end  30 . Proximal end  30 , in one embodiment, defines a threaded bore configured to mate with threaded shaft  26  of handle assembly  12 , so as to secure tube  14  to handle assembly  12 . Outer tube  14  further defines a lumen  34  (referenced generally) configured to receive the wire assembly  16 . In one embodiment, tube  14  is formed of annealed  300  series stainless steel, wherein an outer diameter of the tube  14  is approximately 4.0 millimeters and a diameter of lumen  34  is approximately 2.6 millimeters. In particular, the tube  14  is formed to be malleable to a degree such that outer tube  14  can be bent to a desired shape, yet maintain the desired shape during operation of the tool  10 . Other diameters/dimensions of the tube  14  can be used in alternative embodiments. In one embodiment, tube  14  can be covered with an insulating material. As desired, tube  14  can be formed in various lengths, for example to accommodate normal patients, obese patients and/or pediatric patients. 
         [0012]    Wire assembly  16  includes a proximal end  40  and a distal end  42  positioned opposite the proximal end  40 . In one embodiment, wire assembly  16  is formed of annealed 300 series stainless steel comprising a single wire having an outer diameter of approximately 1.4 to 1.8 millimeters. In an alternative embodiment, wire assembly  16  is a cable having a plurality of wires with an outer diameter of approximately 1.4 to 1.8 millimeters. In any event, wire assembly  16  is formed so as to conform to the shape of outer tube  14  and still move within lumen  34  relative to the outer tube  14  in a longitudinal direction upon actuation of handle assembly  12 . To this end, wire assembly  16  can be coated with a non-sticking material, in one embodiment, so as to facilitate movement of the wire assembly  16  within lumen  34 . In the embodiment illustrated, proximal end  40  defines a feature (e.g., a notch or ball) configured to be inserted into aperture  28  and coupled to trigger handle  20 . Additionally, distal end  42  defines a feature (e.g., a notch or ball) configured to be coupled to tool implement  18 . Wire assembly  16  is coupled to trigger handle  22  in such a way that by squeezing handle assembly  12  (i.e., by causing movement of trigger handle  20  relative to fixed handle  22 ), distal end  42  is actuated toward handle assembly  12 . This actuation, in turn, causes operation of tool implement  18 . As such, a surgeon can operate tool implement  18  remotely via actuation of the handle assembly  12 . Moreover, as discussed above, control knob  29  can be rotated to cause rotation of wire assembly  16  and tool implement  18 . 
         [0013]    As discussed above, outer tube  14  and inner wire assembly  16  are formed to be malleable such that a surgeon can deform and manipulate the shape of the outer tube  14  and inner wire assembly  16 . As a result, prior to inserting tool  10  into a laparoscopic port, a surgeon can evaluate a surgical area and in particular a desired approach angle from a port opening (e.g., the umbilical region) to a target surgical site. The surgeon can then form the outer tube  14  and inner wire assembly  16  to a desired shape by creating one or more bend regions therein. 
         [0014]    Tool implement  18  is operably coupled to the handle assembly  12  through the wire assembly. As such, operation of the handle assembly  12  causes operation of the tool assembly  18 . In various embodiments, tool implement  18  can take various forms in various shapes and sizes. Moreover, the tool implements can be configured to perform various functions such as grasping, cutting, clamping and/or coagulation. 
         [0015]    As illustrated in  FIG. 3 , the surgeon can form tool  10  such that outer tube  14  forms a first bend region  50  and a second bend region  52  along a length of the outer tube  14 . In an alternative configuration, illustrated in  FIG. 4 , tool  10  forms a first bend region  60 , a second bend region  62  and a third bend region  64  along a length of outer tube  14 . Other bend regions can be formed within tool  10  as desired. Once a desired shape is selected, tool implement  18  can be delivered to a targeted tissue site to perform a desired procedure. 
         [0016]      FIG. 5  is a schematic illustration of a surgical environment  100 . A patient body  102  includes an incision  104  formed therein for insertion of a port  106 . A surgeon desires to operate on a target tissue site  108  located within patient body  102  and remote from the incision  104 . After inspection and evaluating the location of target site  108 , a surgeon forms a shape of tool  10  to include one or more bend regions. In the embodiment illustrated, tool  10  is formed to include a first bend region  110  and a second bend region  112 . Once the desired bend regions are formed, tool  10  is inserted into port  106  until tool implement  18  engages tissue site  108 . Handle assembly  12  can then be actuated so as to operate tool implement  18 . After operating tool implement  18 , tool  10  can be withdrawn from the patient body  102 . After withdrawal of tool  10 , handle assembly  12  and/or tool implement  18  can be replaced with different handle assemblies or tool implements as desired while maintaining the shape of outer tube  14 , in particular including bend region  110  and bend region  112 . 
         [0017]    Although the present disclosure has been described with reference to preferred embodiments, workers skilled in the art will recognize that changes can be made in form and detail without departing from the spirit and scope of the present disclosure.