Abstract:
An irrigation and suction tip for laparoscopic surgery having an increased range of transport within a surgical cavity during laparoscopic surgery. The tip moves in a circumferential trajectory rather than linearly when a surgeon is irrigating and suctioning tissue. The tip is substantially resilient, withstanding great force and pressure during irrigation and suction procedures. The tip is bowed, having a pair of straight portions, a short distal portion and a long proximal portion joined by a bowed portion, the bowed portion allowing the distal portion to rotate, circumscribing a large area. The bow is limited so that the tip moves within a narrow wall of a cannula of a trocar.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
       [0001]    This application is a continuation application of the nonprovisional utility application Ser. No. 13/954,482 filed in the United States Patent Office on Jul. 30, 2013, and claims the priority thereof and is expressly incorporated herein by reference in its entirety, and which is the nonprovisional application of the provisional patent application, Ser. No. 61/682,536 filed in the United States Patent Office on Aug. 13, 2012 and claims the priority thereof and is expressly incorporated herein by reference in its entirety. 
     
    
     TECHNICAL FIELD 
       [0002]    The present disclosure relates generally to a laparoscopic surgical tool. More particularly, the present disclosure relates to a bowed suction and irrigation tip for laparoscopic surgery, including robotic surgery. 
       BACKGROUND 
       [0003]    Laparoscopic surgery is a modern surgical technique in which a surgeon performs operations in the abdomen of a patient through relatively small incisions (usually 0.5-1.5 cm). Laparoscopic surgery includes operations within the abdominal or pelvic cavities. Older surgical techniques, such as laparotomy, required large abdomen incisions. The laparoscopic procedure is referred to as minimally invasive surgery (MIS) because or the small incisions. 
         [0004]    The key element in laparoscopic surgery is the use of a laparoscope which is inserted into the abdomen through a small incision. The abdomen is usually insufflated, or essentially blown up like a balloon, with carbon dioxide gas. This elevates the abdominal wall above the internal organs like a dome to create a working and viewing space. Carbon dioxide is used because it is common to the human body and can be absorbed by tissue and removed by the respiratory system. 
         [0005]    There are a number of advantages to the patient with laparoscopic surgery versus an open laparotomy procedure. These include reduced hemorrhaging, reducing the chance of needing a blood transfusion, reduced exposure of internal organs to possible external contaminants thereby reducing the risk of acquiring infections, smaller incisions, reducing pain thereby requiring less pain medication, less post-operative scarring, shorter hospital stay, shorter recovery time with a faster return to everyday living. 
         [0006]    While there are many advantages to the patient, laparoscopic surgery requires great surgical skill to offset some of the technical disadvantages of the procedure. The surgeon has limited range of motion at the surgical site resulting in a loss of dexterity and must use tools to interact with tissue rather than directly manipulating by hand, reducing tactile sensation and eliminating palpating tumors. The surgeon must compensate for the misleading depth perception and estimate how much force is being applied to tissue. The endpoints of the surgical tools move in the opposite direction to the surgeon&#39;s hands due to the pivot point, making laparoscopic surgery a non-intuitive motor skill that is challenging to learn. 
         [0007]    Laparoscopic surgery has been greatly enhanced by the development of robotic minimally-invasive surgery. Instead of directly moving the instruments, the surgeon uses computer-assisted techniques to control the instruments. 
         [0008]    Many have proposed improvements to laparoscopic surgical equipment such as flexible rods and shafts with distally attached tools inserted through a trocar placed in the incision. Others have proposed articulated devices that rotate to some degree but do not provide an internal fluid transport channel within the device. 
         [0009]    While these units may be suitable for the particular purpose employed, or for general endoscopic use, they would not be as suitable for the purposes of the present disclosure as disclosed hereafter. 
         [0010]    While these units may be suitable for the particular purpose employed, or for general use, they would not be as suitable for the purposes of the present disclosure as disclosed hereafter. 
         [0011]    In the present disclosure, where a document, act or item of knowledge is referred to or discussed, this reference or discussion is not an admission that the document, act or item of knowledge or any combination thereof was at the priority date, publicly available, known to the public, part of common general knowledge or otherwise constitutes prior art under the applicable statutory provisions; or is known to be relevant to an attempt to solve any problem with which the present disclosure is concerned. 
         [0012]    While certain aspects of conventional technologies have been discussed to facilitate the present disclosure, no technical aspects are disclaimed and it is contemplated that the claims may encompass one or more of the conventional technical aspects discussed herein. 
       BRIEF SUMMARY 
       [0013]    It is an aspect of the present disclosure to provide a tool for laparoscopic surgery that increases a range for irrigating and suctioning. Accordingly, an aspect of the present disclosure provides an irrigation and suction tip for laparoscopic surgery having an increased range of irrigating and suctioning within a surgical cavity. 
         [0014]    It is another aspect of the present disclosure to provide a tool for laparoscopic surgery that transports beyond a linear trajectory when a surgeon is irrigating and suctioning tissue. Accordingly, an aspect of the present disclosure provides an irrigation and suction tip for laparoscopic surgery that transports in a circumferential trajectory when a surgeon is irrigating and suctioning tissue. 
         [0015]    It is a further aspect of the present disclosure to provide a tool for laparoscopic surgery that is able to transport in a circumferential trajectory and withstand great force and pressure. Accordingly, an aspect of the present disclosure provides an irrigation and suction tip for laparoscopic surgery that is substantially resilient, withstanding great force and pressure during irrigation and suction procedures. 
         [0016]    It is yet another aspect of the present disclosure to provide a tool for laparoscopic surgery with an increased trajectory of motion. Accordingly, an aspect of the present disclosure provides an irrigation and suction tip for laparoscopic surgery that is bowed, having a pair of straight portions, a short distal portion and a long proximal portion joined by a bowed portion, the bowed portion allowing the distal portion to rotate, circumscribing a large area. 
         [0017]    The present disclosure describes an irrigation and suction tip for laparoscopic surgery having an increased range of transport within a surgical cavity during laparoscopic surgery. The tip moves in a circumferential trajectory rather than linearly when a surgeon is irrigating and suctioning tissue. The tip is substantially resilient, withstanding great force and pressure during irrigation and suction procedures. The tip is bowed, having a pair of straight portions, a short distal portion and a long proximal portion joined by a bowed portion, the bowed portion allowing the distal portion to rotate, circumscribing a large area. The curve of the bow portion is limited so that the tip moves within a narrow wall of a cannula of a trocar. 
         [0018]    The present disclosure addresses at least one of the foregoing disadvantages. However, it is contemplated that the present disclosure may prove useful in addressing other problems and deficiencies in a number of technical areas. Therefore, the claims should not necessarily be construed as limited to addressing any of the particular problems or deficiencies discussed hereinabove. To the accomplishment of the above, this disclosure may be embodied in the form illustrated in the accompanying drawings. Attention is called to the fact, however, that the drawings are illustrative only. Variations are contemplated as being part of the disclosure. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0019]    In the drawings, like elements are depicted by like reference numerals. 
           [0020]    The drawings are briefly described as follows. 
           [0021]      FIG. 1  is a diagrammatic perspective view of a surgical field prepared for a laparoscopic abdominal procedure with a bowed tip inserting into a trocar. 
           [0022]      FIG. 2A  is a diagrammatic perspective view of the bowed tip inserted into the trocar. 
           [0023]      FIG. 2B , similar to  FIG. 2A , is a diagrammatic perspective view of the bowed tip inserted into the trocar, showing a full rotation of a distal end of the tip. 
           [0024]      FIG. 2C , similar to  FIG. 2A , is a diagrammatic perspective view of the bowed tip inserted into the trocar, an angle of the bowed tip substantially close to a maximum curve of the bow. 
           [0025]      FIG. 3A  is a diagrammatic perspective view of the bowed tip inserting into the trocar, with a portion having a straight portion inside the trocar. 
           [0026]      FIG. 3B , similar to  FIG. 3A , is a diagrammatic perspective view of the bowed tip inserting into the trocar, with a portion having a bowed portion inside the trocar. 
           [0027]      FIG. 3C , similar to  FIG. 3B , is a diagrammatic perspective view of the bowed tip fully inserted into the trocar. 
       
    
    
       [0028]    The present disclosure now will be described more fully hereinafter with reference to the accompanying drawings, which show various example embodiments. However, the present disclosure may be embodied in many different forms and should not be construed as limited to the example embodiments set forth herein. Rather, these example embodiments are provided so that the present disclosure is thorough, complete and fully conveys the scope of the present disclosure to those skilled in the art. 
       DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS 
       [0029]      FIG. 1  illustrates a bowed suction and irrigation tip  20  approaching a trocar  10  inserted in a patient&#39;s abdomen  100 . The illustration shows a laparoscopic procedure in process, with the abdomen  100  typically draped with a plurality of surgical drapes  102 , exposing an exterior field of surgery. In this disclosure, the term laparoscopic procedure includes robotic minimally-invasive surgery and other surgical procedures that are performed through a trocar inserted into a torso of a patient and the term laparoscopic procedure is not a limitation. 
         [0030]    The trocar has been inserted through a small incision  110 , generally about 1 to 2 centimeters in length. The trocar has a collar  12  and a cannula  14 , the collar  12  having an opening  16  in fluid communication with the cannula  14 . Trocars are well known to those of ordinary skill in the art and the illustration does not show the trocar in detail, but only showing those elements common to many. 
         [0031]    While the illustration shows the exterior surgical field, what is not easily illustrated is an interior surgical field that is accessed through the trocar. A user, for example, a surgeon, a surgery technician or other operating room personnel, access the interior surgical field through the trocar  10  by inserting a surgical tool through the opening  16  and into the cannula  14 . The user sees the interior surgical field through a variety of devices, such as a camera or fiber optics which are well known to those of ordinary skill. 
         [0032]    The opening of the trocar is typically annular and is provided with an interior diameter that accommodates differing instruments. For example, typically the interior diameters of the opening and cannula is 8 mm for robotic instruments, 5 mm for irrigation and suction and 12 mm for larger (non-robotic) surgical instruments, such as a stapler. Often in robotic surgery only one incision is made and irrigation and suction is performed through a single trocar having 8 mm interior diameter cannula. When single trocar surgery is performed, the opening of the trocar and the cannula becomes very crowded with a plurality of instruments. 
         [0033]    The cannula  14  of the trocar has a wall  14 W which is typically annular in cross-section, having a diameter, the diameter of the wall cross-section matching the diameter of the opening of the trocar to which it is in fluid communication. All surgical tools must fit through the narrow cross-section diameter of the trocar cannula to reach the internal surgical field. 
         [0034]    The bowed suction and irrigation tip  20  is about to be inserted into the opening  16 . The tip  20  must fit within the opening  16  and cannula  14 , the wall  14 W of the cannula being substantially rigid. The tip  20  is used in suctioning tissue and fluids with a vacuum as well as irrigating the internal surgical field by delivering a fluid, thereby the tip being substantially resilient, able to withstand a force from the fluid delivery and a force of the vacuum required to suction tissue and fluids. 
         [0035]    In one example embodiment, the tip  20  is provided in a reusable form, constructed from materials that are capable of repeated sterilization, such as metal and engineered plastics. For example, the tip is constructed from, but not limited to, stainless steel, titanium, titanium steel, titanium-based alloys, nickel-based alloys, superalloys, zirconium and hafnium alloys and engineered plastics such as for example, but not limited to, polyether ether ketone (PEEK). For the purpose of this disclosure, the term resilient means a material that requires some force or pressure to change shape, without permanent deformation or rupture but easily recovers its shape after a force is applied. 
         [0036]    In a further example embodiment, the tip is provided in a disposable form, constructed from engineered and commodity plastics, that are initially sterilized such as, but not limited to PET (polyethylene terephthalate), polyethylene, polycarbonate and copolymers. The disposable bowed tip is substantially pliable, having a bow providing a substantial range of motion when inserted through the narrow cannula as will be explained hereinbelow. For the purpose of this disclosure, the term pliable means a material supple enough to bend freely without breaking. 
         [0037]      FIG. 2A  shows the trocar and the tip free-standing from the surgical field to demonstrate the features of the bowed tip  20 . The tip is a hollow tube having a wall, the hollow tube has a length ranging from about 40 cm to 60 cm. 
         [0038]    The tip has a straight proximal portion  20 P, having a proximal end proximal end exterior to a trocar when the tip is inserted therein, the proximal end attaching to a connector  22  that selectively connects the tip with a suction or irrigation source. The tip has a straight distal portion  20 D, the distal portion terminating with a blunt end  24  having a plurality of apertures  26  for an egress of irrigation fluid during an irrigation procedure and an ingress of tissue and fluids during a suction procedure. The blunt end is firm. For the purpose of this disclosure, the term firm means a material that resists pressure and is not easily deformed. 
         [0039]    Connecting the proximal portion and the distal portion is a bow portion  20 B, the bow portion in fluid communication with the proximal portion  20 P and the distal portion  20 D, the bow portion producing a curve in the tube, the curve having an angle θ  20 A, the angle subtending the bow portion with an imaginary straight reference line  28  of the proximal portion, the curve enabling the blunt distal end  24  of the tube to circumscribe a large area while manipulating the proximal end of the tube without manipulating the trocar, said trocar having said tube inserted therein. 
         [0040]    In one embodiment, the blunt end  24  curves away from the imaginary line  28  at a distance slightly more about 5 mm at minimum and about 8 mm at maximum, so that the tip inserts within the 5 mm inner diameter of the cannula  14  within the cannula walls  14 W as described hereinbelow. 
         [0041]    In one embodiment, the proximal portion, bow portion and distal portion form a unitary piece. In further embodiments the portions are connected to form a unitary piece. 
         [0042]    The hollow tube has a midpoint equidistant between the distal end  20 D and the proximal end  20 P and the bow portion is between said midpoint and said distal end. In one embodiment, the bow portion  20 B is positioned somewhat towards the distal blunt end  24 , around twenty percent of the length of the tip from the blunt end, the distal portion and the proximal portion having a ratio of around  1 : 4  respectively. 
         [0043]    The proximal portion continues in the imaginary straight line  28 , the imaginary straight line a reference line for describing the bowing of the tip. The bow portion  20 B forms an angle θ  20 A of a range of about 5 to 30 degrees, preferably 15 to 25 degrees with the straight line  28  of the proximal portion  20 P. In  FIG. 2A , the angle θ  20 A is about twenty degrees. 
         [0044]      FIG. 2C  illustrates a further example embodiment, the bow portion  20 B forming the angle θ  20 A at a maximum curvature of 30 degrees with the straight line  28  of the proximal portion. In this example embodiment, the tip  20  is formed from pliable material. 
         [0045]      FIG. 2B  clearly illustrates the advantages of the bowed tip  20 . Unlike straight tips that are well-know in the prior art which only suction or irrigate at a single point within the interior surgical field, the user having to manipulate the trocar from the exterior surgical field within the incision, possibly causing the incision to expand to move the blunt end of the straight tip within the field, the bowed tip circumscribes a larger area within the interior surgical field without manipulating the trocar from the exterior surgical field. Within the larger area now available to the user, the user can irrigate and suction behind a plurality of organs and tissue masses with a minimum of disturbance with potential for damage to said organs and masses. 
         [0046]    As demonstrated in  FIG. 2B , the blunt end  24  of the tip  20  circumscribes a circular area  30  having a radius  30 D of at least 5 mm and an area of at least  78 . 5  mm squared, the radius having the length from the blunt end  24  to the imaginary line  28  continuing from the proximal portion. With slight manipulation of the trocar, the range of the blunt end  24  is greatly enhanced beyond the at least 78.5 mm squared, allowing the user greater range when irrigating and suctioning. Further advantageously, the bowed tip eliminates parallax error for the user as the blunt end, the distal portion and the bowed portion are no longer directly in the line of vision. 
         [0047]      FIGS. 3A ,  3 B and  3 C show the insertion of the tip  20  into the trocar  10  in stages, demonstrating how the bowed tip conforms to the cannula  14 . In  FIG. 3A , the distal portion  20 D inserts into the trocar  10  and down the cannula  14  to the bow portion  20 B is in the opening, the proximal portion held at about a 15 to 25 degree angle θ  14 A with reference to the cannula, the angle θ equal to the angle θ described hereinabove with reference to the angle of the bow. In  FIG. 3B , the tip  20  is slightly tilted while the trocar  10  remains essentially fixed. The blunt end  24  is in contact with the cannula wall  14 W, the bow portion  20 B is in contact with the cannula wall opposite the blunt end  24 . In  FIG. 3C , the proximal portion  20 P is vertically upright through the trocar collar  12  and cannula  14 , the bow portion  20 B and the distal portion  20 D protruding into interior surgical field. The blunt end freely rotates, circumscribing a larger area in the surgical field. 
         [0048]    To use the bowed tip, the user inserts the tip into the opening of the trocar collar, and down the cannula  14  until the bow portion  20 B, reaches the opening of the collar, the proximal portion held at about a 15 to 25 degree angle θ  14 A with reference to the cannula. The user slightly tilts the tip while the trocar  10  remains essentially fixed, contacting the cannula wall with the blunt end and contacting the bow portion  20 B with the cannula wall opposite the blunt end  24 . The user uprights the proximal portion  20 P through the trocar collar  12  and cannula  14 , inserting the bow portion  20 B and the distal portion into interior surgical field. The blunt end freely rotates, circumscribing a larger area in the surgical field. The user irrigates or suctions as needed and can access a larger area by gently manipulating the trocar. 
         [0049]    To withdraw the tip, the user reverses the steps, by withdrawing the tip until the bowed portion reaches the collar, tilting the tip to the angle θ described hereinabove and further withdrawing the bowed portion and the distal portion from the trocar. 
         [0050]    The advantages of the bowed tip  10  are numerous as disclosed hereinabove. The blunt end  24  has a large area for irrigating and suctioning, circumscribed by the end when rotated and is not limited to a single point that limits a straight tip. The large area allows the user to reach around and behind organs and tissue masses that are in the surgical field. The bowed tip can be manipulated by the user with minimal disturbance of the trocar in the incision and the bowed tip eliminates parallax error for the user. 
         [0051]    Referring to  FIG. 2A , a method of manufacturing a suction and irrigation tip for inserting into a trocar can be demonstrated. The method comprises providing a hollow tube  20 , said tube having the distal portion  20 D having the blunt distal end  24 , said tube having a proximal portion  20 P. The plurality of apertures  26  are provided on the wall of said tube adjacent to said blunt distal end  24 . The hollow tube is bent, thereby creating a bow portion  20 B connecting the distal portion and the proximal portion of the hollow tube, the bow portion in fluid communication with the proximal portion and the distal portion, the bow portion producing a curve in the tip  20 , the curve enabling the blunt distal end of the tube to circumscribe a large area when inserted into an internal surgical field through a trocar while manipulating the proximal end of the tube without manipulating said trocar. 
         [0052]    Once the tip is bent, it is sterilized in preparation for use in surgical procedures including the disposable form, constructed from engineered and commodity plastics and the reusable form constructed from materials that are capable of repeated sterilization. 
         [0053]    It is understood that when an element is referred hereinabove as being “on” another element, it can be directly on the other element or intervening elements may be present therebetween. In contrast, when an element is referred to as being “directly on” another element, there are no intervening elements present. 
         [0054]    Moreover, any components or materials can be formed from a same, structurally continuous piece or separately fabricated and connected. 
         [0055]    It is further understood that, although ordinal terms, such as, “first,” “second,” “third,” are used herein to describe various elements, components, regions, layers and/or sections, these elements, components, regions, layers and/or sections should not be limited by these terms. These terms are only used to distinguish one element, component, region, layer or section from another element, component, region, layer or section. Thus, “a first element,” “component,” “region,” “layer” or “section” discussed below could be termed a second element, component, region, layer or section without departing from the teachings herein. 
         [0056]    Spatially relative terms, such as “beneath,” “below,” “lower,” “above,” “upper” and the like, are used herein for ease of description to describe one element or feature&#39;s relationship to another element(s) or feature(s) as illustrated in the figures. It is understood that the spatially relative terms are intended to encompass different orientations of the device in use or operation in addition to the orientation depicted in the figures. For example, if the device in the figures is turned over, elements described as “below” or “beneath” other elements or features would then be oriented “above” the other elements or features. Thus, the example term “below” can encompass both an orientation of above and below. The device can be otherwise oriented (rotated 90 degrees or at other orientations) and the spatially relative descriptors used herein interpreted accordingly. 
         [0057]    Example embodiments are described herein with reference to cross section illustrations that are schematic illustrations of idealized embodiments. As such, variations from the shapes of the illustrations as a result, for example, of manufacturing techniques and/or tolerances, are to be expected. Thus, example embodiments described herein should not be construed as limited to the particular shapes of regions as illustrated herein, but are to include deviations in shapes that result, for example, from manufacturing. For example, a region illustrated or described as flat may, typically, have rough and/or nonlinear features. Moreover, sharp angles that are illustrated may be rounded. Thus, the regions illustrated in the figures are schematic in nature and their shapes are not intended to illustrate the precise shape of a region and are not intended to limit the scope of the present claims. 
         [0058]    In conclusion, herein is presented a bowed suction and irrigation tip for laparoscopic surgery. The disclosure is illustrated by example in the drawing figures, and throughout the written description. It should be understood that numerous variations are possible, while adhering to the inventive concept. Such variations are contemplated as being a part of the present disclosure.