Abstract:
A percutaneous tube assembly is provided for performing minimally invasive surgery, the system comprising a percutaneous tube comprising a translucent main body; an external attachment fixture attached to the main body; an access channel longitudinally bored through the main body; an internal attachment channel longitudinally bored through the main body, wherein the internal attachment channel comprises a partially smooth inner surface adjacent to a partially rough inner surface; and an internal attachment, mating with the internal attachment channel.

Description:
BACKGROUND 
     1. Technical Field 
     The embodiments herein generally relate to surgical instruments, and, more particularly, to a percutaneous tube used during minimally invasive surgical procedures. 
     2. Description of the Related Art 
     Traditional surgical procedures for pathologies located within the body can cause significant trauma to the intervening tissues. These procedures often require a long incision, extensive muscle stripping, prolonged retraction of tissues, denervation and devascularization of tissue. These procedures can require operating room time of several hours and several weeks of post-operative recovery time due to the destruction of tissue during the surgical procedure. In some cases, these invasive procedures lead to permanent scarring and pain that can be more severe than the pain leading to the surgical intervention. 
     The development of percutaneous procedures has yielded a major improvement in reducing recovery time and post-operative pain because minimal dissection of tissue, such as muscle tissue, is required. For example, minimally invasive surgical techniques are desirable for spinal and neurosurgical applications because of the need for access to locations within the body and the danger of damage to vital intervening tissues. While developments in minimally invasive surgery are steps in the right direction, there remains a need for further development in minimally invasive surgical instruments and methods. For example, a conventional percutaneous tube employed during minimally invasive surgical procedures often require temporary placement of auxiliary attachments during the procedure to be located in a position that obstructs the view of the surgeon or to be in an unstable position. These shortcomings to convention minimally invasive surgical instruments frequently raise the risk of additional morbidity to a patient undergoing a minimally invasive surgical procedure. 
     SUMMARY 
     In view of the foregoing, an embodiment herein provides a system for performing minimally invasive surgery, the system comprising a percutaneous tube comprising a translucent main body; an external attachment fixture attached to the main body; an access channel longitudinally bored through the main body; an internal attachment channel longitudinally bored through the main body, wherein the internal attachment channel comprises a partially smooth inner surface adjacent to a partially rough inner surface; and an internal attachment, mating with the internal attachment channel. 
     In such a system, the external attachment fixture may mate with an external attachment. Moreover, the external attachment fixture may be offset from the main body of the percutaneous tube by an angle providing unobstructed access to the access channel as the external attachment is coupled to the external attachment fixture. In addition, the main body of the percutaneous tube may comprise an access slot cut through the main body. Additionally, the main body of the percutaneous tube may comprise an upper inner smooth surface and a lower inner rough surface. 
     Furthermore, in such a system, the lower inner rough surface may increase the intensity of light directed into the percutaneous tube compared with the upper inner smooth surface. Moreover, the internal attachment may comprise an internal attachment fixture. In addition, the internal attachment fixture may comprise a clamp-like device. Additionally, the clamp-like device may close in response to a linear pulling force applied to the internal attachment. Furthermore, the clamp-like device may open in response to linear pushing force applied to the internal attachment. Moreover, the internal attachment fixture may comprise at least one of a pin, a screw, and a hook. In addition, the internal attachment may comprise a threaded portion that mates with the internal attachment fixture. Additionally, the internal attachment may comprise a socket-like top portion. 
     Another embodiment herein provides a percutaneous tube apparatus comprising a translucent main body; an external attachment fixture attached to the main body; an access channel longitudinally bored through the main body; and an internal attachment channel longitudinally bored through the main body, wherein the internal attachment channel comprises a partially smooth inner surface adjacent to a partially rough inner surface. 
     With such an apparatus, the main body may comprise a notch and the notch comprises a reflective patch on an interior surface of the notch. Moreover, the external attachment fixture may be adapted to mate with an external attachment. In addition, the external attachment may comprise a light source. Furthermore, the main body of the percutaneous tube may further comprise an upper inner smooth surface and a lower inner rough surface. Additionally, the lower inner rough surface increases the intensity of light directed into the main body compared with the upper inner smooth surface. 
     Another embodiment herein further provides a system for performing minimally invasive surgery, the system comprising a percutaneous tube comprising a translucent main body; an external attachment fixture coupled to a first end of the main body and coupled at an acute angle from the main body; an access slot partially cut longitudinally through the main body, wherein the access slot is longitudinally cut from a second end of the main body to a point on the main body between the second end and the first end, and wherein the second end is positioned opposite to the first end; an access channel longitudinally bored through the main body; an internal attachment channel longitudinally bored through the main body, wherein the internal attachment channel comprises a partially smooth inner surface adjacent to a partially rough inner surface, wherein the partially smooth inner surface begins at the first end and the partially rough inner surface terminates at the second end; and an internal attachment mating with the internal attachment channel, wherein the internal attachment comprises a top portion that comprises a socket and a bottom portion that comprises at least one of a clamp attachment, a pin attachment, and a screw attachment. 
     These and other aspects of the embodiments herein will be better appreciated and understood when considered in conjunction with the following description and the accompanying drawings. It should be understood, however, that the following descriptions, while indicating preferred embodiments and numerous specific details thereof, are given by way of illustration and not of limitation. Many changes and modifications may be made within the scope of the embodiments herein without departing from the spirit thereof, and the embodiments herein include all such modifications. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The embodiments herein will be better understood from the following detailed description with reference to the drawings, in which: 
         FIG. 1(A)  illustrates a schematic diagram of a percutaneous tube assembly according to an embodiment herein; 
         FIG. 1(B)  illustrates a schematic diagram of a percutaneous tube according to an embodiment herein; 
         FIG. 2  illustrates a schematic diagram of an internal attachment according to an embodiment herein; 
         FIG. 3(A)  illustrates a disassembled view of a percutaneous tube assembly according to an embodiment herein; 
         FIGS. 3(B) and 3(C)  illustrate alternate views of a percutaneous tube assembly according to an embodiment herein; 
         FIGS. 4(A) through 4(C)  illustrate a schematic diagram of a percutaneous tube assembly with a internal attachment extended according to an embodiment herein; 
         FIGS. 5(A) through 5(C)  illustrate a schematic diagram of a percutaneous tube assembly with a internal attachment retracted according to an embodiment herein; 
         FIGS. 6(A) through 6(C)  illustrate a schematic diagram of a percutaneous tube according to an embodiment herein; 
         FIGS. 7(A) through 7(C)  illustrate a schematic diagram of an internal attachment with a clamp fixture according to an embodiment herein; and 
         FIGS. 8(A) through 8(B)  illustrate a schematic diagram of an internal attachment according to an embodiment herein. 
     
    
    
     DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS 
     The embodiments herein and the various features and advantageous details thereof are explained more fully with reference to the non-limiting embodiments that are illustrated in the accompanying drawings and detailed in the following description. Descriptions of well-known components and processing techniques are omitted so as to not unnecessarily obscure the embodiments herein. The examples used herein are intended merely to facilitate an understanding of ways in which the embodiments herein may be practiced and to further enable those of skill in the art to practice the embodiments herein. Accordingly, the examples should not be construed as limiting the scope of the embodiments herein. 
     As mentioned above, there remains a need for a novel percutaneous tube for use during minimally invasive surgical procedures that allows auxiliary instruments (e.g., internal and external attachments) to be securely coupled to the novel percutaneous tube and provide an unobstructed view of critical areas during surgery. The embodiments herein provide a percutaneous tube assembly with an internal fixation device embedded within the length of the percutaneous tube to allow secured attachment of the fixation device and unobstructed viewing of crucial areas during the minimally invasive surgical procedure. Referring now to the drawings, and more particularly to  FIGS. 1(A) through 8(B) , there are shown preferred embodiments of the invention. 
       FIGS. 1(A) and 1(B)  illustrate a schematic diagram of a percutaneous tube assembly  1  according to an embodiment herein. As shown, percutaneous tube assembly  1  includes percutaneous tube  10 , which includes a translucent main body  12 , external attachment fixture  14 , access slot  16 , and notch  18 . While not shown in  FIG. 1(A) , external attachment fixture  14  is configured to accept external attachments. External attachment fixture  14  is offset by angle  14   a , where angle  14   a  is sufficient to prevent external attachments from obscuring the view of a surgeon when attached to external attachment fixture  14 . Access slot  16  provides access to interior anatomical structures of a bodily cavity during a minimally invasive surgical procedure and allows manipulation of surgical implants during the minimally invasive surgery. For example, access slot  16  may be used as a passageway for inserting a rod (not shown) during a minimally invasive surgical procedure for spinal applications. Notch  18  provides a counter-shape to percutaneous tube assembly  1 . For example, notch  18  may prevent percutaneous tube assembly  1  from being blocked by interior anatomical structures of a bodily cavity during a minimally invasive surgical procedure. Percutaneous tube assembly  1  also includes internal attachment  30 . While not shown in  FIGS. 1(A) and 1(B) , internal attachment  30  may include a clamp attachment, a pin attachment, a screw attachment, a hook attachment or any other similarly useful attachments that may be used during a minimally invasive surgical procedure. 
       FIG. 2 , with reference to  FIGS. 1(A) and 1(B) ,  FIG. 3(A) , and  FIGS. 8(A) and 8(B) , illustrates a perspective view of an internal fixation device  30  according to an embodiment herein. The internal attachment  30  includes main body  32  and clamp attachment  34 . While clamp attachment  34  is shown in  FIG. 2(B)  coupled to main body  32 , internal attachment  30  is not limited to clamp attachment  34  and may include a pin attachment (e.g., pin attachment  38 , shown in FIG.  3 (A)), a screw attachment (e.g., screw attachment  40 , shown in FIGS.  8 (A) and  8 (B)), a hook attachment or any other device appropriate during minimally invasive surgical procedures. 
       FIG. 3(A) , with reference to  FIGS. 1 through 2(B) , illustrates a disassembled view of a percutaneous tube assembly  1  according to an embodiment herein. In addition,  FIGS. 3(B) and 3(C) , with reference to  FIGS. 1 through 3(A) , illustrate alternate views of a percutaneous tube assembly  1  according to an embodiment herein. Percutaneous tube  10  includes main body  12 , external attachment fixture  14 , access slot  16 , and notch  18 , as shown previously, as well as an access channel  20 , and an internal attachment channel  22 . Both access channel  20  and internal attachment channel  22  are channels bored through main body  12 . In addition, internal attachment  30  is shown with a main body  32  and pin attachment  38 . Main body  32  is configured to loosely mate with internal attachment channel  22 . In  FIG. 3(C) , which is an A-A cross-section from  FIG. 3(B) , internal attachment channel  22  with main body  32  of internal attachment  30  is shown in percutaneous tube assembly  1 . 
       FIGS. 4(A) through 4(C) , with reference to  FIGS. 1(A) through 3(C) , illustrate a schematic diagram of a percutaneous tube assembly  1  with an internal attachment  30  extended according to an embodiment herein. Additionally,  FIGS. 5(A) through 5(C) , with reference to  FIGS. 1(A) through 4(C) , illustrate a schematic diagram of a percutaneous tube assembly  1  with an internal attachment fixture  30  retracted according to an embodiment herein. As shown previously, percutaneous tube  10  includes internal attachment channel  22  (not shown in  FIGS. 4(A) through 5(C) , but shown in  FIG. 3(C) ) that accepts internal attachment  30 . As shown in  FIGS. 4(A) through 5(C) , internal attachment  30  may include a clamp attachment  34 . While clamp attachment  34  is shown in  FIGS. 4(A) through 5(C) , internal attachment  30  is not limited thereto and may include a pin attachment (e.g., pin attachment  38 , shown in  FIG. 3(A) ) or a hook attachment. In addition, internal attachment  30  may permit mechanical manipulation of clamp attachment  34  without removal from internal attachment channel  22 . For example, in  FIGS. 4(A) through 4(C) , clamp attachment  34  is a clamp-like device with each clamp-like protrusion coupled to a spring-like device and the clamp-liked protrusions are fully extended. In  FIGS. 5(A) through 5(C) , however, the clamp-like protrusion of clamp attachment  34  are partially retracted because main body  12  is compressing each clamp-like protrusion causing the spring-like devices to compress and retract clamp attachment  34 . Percutaneous tube assembly  1  may translate from the configuration shown in  FIGS. 4(A) through 4(C)  to the configuration shown in  FIGS. 5(A) through 5(C)  when a force (e.g., a pulling force or a pushing force) is applied to a top portion  36  of internal attachment  30 , which translates through internal attachment channel  22  to effectuate the clamping mechanism (e.g., through the spring-like devices coupled to the clamp-like protrusions of clamp attachment  34 ) shown in  FIGS. 4(A) through 5(C) . 
       FIGS. 6(A) through 6(C) , with reference to  FIGS. 1(A) through 5(C) , illustrate an isolated view of a percutaneous tube  10  according to an embodiment herein. In the views shown, percutaneous tube  10  includes main body  12 , external attachment fixture  14 , angle  14   a , access slot  16 , notch  18 , access channel  20 , internal attachment channel  22 , upper inner smooth surface  24  and lower inner rough surface  26 . While not shown, external attachment fixture  14  is embodied as a universal fixture that accepts a variety of different external attachments. For example, a light source (e.g., a lamp) (not shown) may be attached to external attachment fixture  14  to provide light while percutaneous tube  10  is in use during surgery. In addition, external attachment  14  is offset from main body  12  by angle  14   a  to allow an external attachment to be transfixed to external attachment fixture  14  and continue providing unobstructed access to access channel  20 . Percutaneous tube  10  also includes an optional upper inner smooth surface  24  and an optional lower inner rough surface  26 . Generally, light reflected on the smooth surface  24  creates specular reflection such that the reflected light rays are all parallel to each other causing a generally uniform light reflection on the smooth surface  24 . Whereas, light reflected on the rough surface  26  creates diffuse reflection such that the reflected light rays travel in random directions causing an enhanced visibility on the rough surface  26 , which increases illumination towards the notch end  18  of the percutaneous tube  10 , where increased/enhanced light/visibility is desired during surgery. 
       FIGS. 7(A) through 7(C) , with reference to  FIGS. 1(A) through 6(C) , illustrate a schematic diagram of an internal attachment  30  with a clamp attachment  34  according to an embodiment herein. In addition,  FIGS. 8(A) through 8(B) , with reference to  FIGS. 1(A) through 7(C) , illustrate a schematic diagram of an internal attachment  30  with a pin attachment  38  according to an embodiment herein. In the views shown, internal attachment  30  includes main body  32  and either clamp attachment  34  (shown in FIGS.  7 (A) through  7 (C)), pin attachment  36  (shown in  FIG. 3(A) ) or a screw attachment  40  (shown in  FIGS. 8(A) and 8(B) ). In addition, main body  32  includes a top portion  36 , which is the portion of internal attachment  30  that protrudes above percutaneous tube  10  and permits manipulation during a minimally invasive surgical procedure (e.g., a pulling force or a pushing force may be applied to top portion  36 ). As shown, internal attachment  30  may include a clamp attachment  34  (as shown in FIGS.  7 (A) through  7 (C)), or a screw attachment  40  (as shown in FIGS.  8 (A) and  8 (B)), but may also include a pin attachment (shown in  FIG. 3(A) , a hook attachment (not shown) or any other similarly attachment useful during a minimally invasive surgical procedure. While top portion  36  is shown in  FIGS. 8(A) through 8(B)  as a polygonal socket, top portion  36  is not limited to such a configuration. In addition, as discussed above, top portion  36  may provide mechanical assistance in manipulating internal attachment fixture  32  when internal attachment  30  is secured within internal attachment channel  22  (e.g., as shown in  FIG. 3(C) ). 
     The embodiments herein provide a percutaneous tube assembly (e.g., percutaneous tube assembly  1 ) with an internal fixation device (e.g., internal attachment  30 ) embedded within the length of the percutaneous tube (e.g., through internal attachment channel  22 ) to allow secured attachment of the fixation device (e.g. internal attachment  30 ) and unobstructed viewing of crucial areas during the minimally invasive surgical procedure. Since a sturdy and unobstructed access to the surgical location is easily achievable using such a percutaneous tube assembly (e.g., percutaneous tube assembly  1 ), the usage of cannulated implant may be avoided. For example, instead of using a cannulated pedicle screw system, a non-cannulated pedicle screw system would be available during a minimally invasive surgical procedure. 
     The foregoing description of the specific embodiments will so fully reveal the general nature of the embodiments herein that others can, by applying current knowledge, readily modify and/or adapt for various applications such specific embodiments without departing from the generic concept, and, therefore, such adaptations and modifications should and are intended to be comprehended within the meaning and range of equivalents of the disclosed embodiments. It is to be understood that the phraseology or terminology employed herein is for the purpose of description and not of limitation. Therefore, while the embodiments herein have been described in terms of preferred embodiments, those skilled in the art will recognize that the embodiments herein can be practiced with modification within the spirit and scope of the appended claims.