Abstract:
An apparatus for applying a liquid substance comprises a bulb portion, a cannulated shaft in fluid communication with the bulb portion, and a swab portion in fluid communication with the cannulated shaft. The bulb portion comprises a capsule. The capsule comprises a liquid substance. The bulb portion further comprises a valve operable to control the flow of a medium through the bulb portion. The bulb portion is operable to rupture the capsule to release the liquid substance. The cannulated shaft is dimensioned to extend percutaneously into a patient. The swab portion is operable to apply the liquid substance. The apparatus may be used to percutaneously apply adhesives to tissue, such as through a trocar or other cannulated member.

Description:
BACKGROUND 
   Biosurgical adhesives have been used in a variety of ways in various medical procedures. An exemplary adhesive is disclosed in U.S. Pub. No. 2004/0190975, the disclosure of which is incorporated by reference herein. Similarly, a variety of devices and techniques have been used to deliver adhesives at various sites. While several systems and methods have been made and used for delivering adhesives, it is believed that no one prior to the inventors has made or used the invention described in the appended claims. 

   
     BRIEF DESCRIPTION OF THE DRAWINGS 
     While the specification concludes with claims which particularly point out and distinctly claim the invention, it is believed the present invention will be better understood from the following description of certain examples taken in conjunction with the accompanying drawings, in which like reference numerals identify the same elements and in which: 
       FIG. 1  depicts a perspective view of an exemplary adhesive delivery system; 
       FIG. 2  depicts an exploded view of the adhesive delivery system of  FIG. 1 ; 
       FIG. 3  depicts a cross-sectional view of the adhesive delivery system of  FIG. 1 ; 
       FIG. 4  depicts a cross-sectional view of the adhesive delivery system of  FIG. 1 , taken along line  4 - 4  of  FIG. 3 ; 
       FIG. 5  depicts a cross-sectional view of the proximal end of an alternative adhesive delivery system; 
       FIG. 6  depicts a cross-sectional view of the proximal end of an alternative adhesive delivery system; 
       FIG. 7  depicts a cross-sectional view of the proximal end of an alternative adhesive delivery system; 
       FIG. 8  depicts a cross-sectional view of the distal end of the adhesive delivery system of  FIG. 1 ; and 
       FIG. 9  depicts a cross-sectional view of the distal end of the adhesive delivery system of  FIG. 1  in an exemplary use. 
   

   DETAILED DESCRIPTION 
   The following description of certain examples of the invention should not be used to limit the scope of the present invention. Other examples, features, aspects, embodiments, and advantages of the invention will become apparent to those skilled in the art from the following description, which is by way of illustration, one of the best modes contemplated for carrying out the invention. As will be realized, the invention is capable of other different and obvious aspects, all without departing from the invention. Accordingly, the drawings and descriptions should be regarded as illustrative in nature and not restrictive. 
   As shown in  FIGS. 1-3 , an exemplary adhesive delivery system ( 10 ) comprises an applicator ( 20 ) inserted through a cannula member ( 30 ), which is inserted in a trocar ( 32 ). It will be appreciated that the particular cannula member ( 30 ) and trocar ( 32 ) that are depicted are shown for illustrative purposes only, and that applicator ( 20 ) of the present example may be used with any other type of cannula member ( 30 ) or trocar ( 32 ). Furthermore, cannula member ( 30 ) and trocar ( 32 ) are being shown merely to demonstrate that applicator ( 20 ) of the present example may be used in a minimally invasive surgical setting. It will also be appreciated that applicator ( 20 ) may be used without a cannula member ( 30 ) or trocar ( 32 ), such as in an open surgical setting. 
   Applicator ( 20 ) of the present example comprises a cannulated shaft ( 50 ), a bulb portion ( 40 ) at the proximal end of shaft ( 50 ), and a swab portion ( 60 ) at the distal end of shaft ( 50 ). Shaft ( 50 ) provides a conduit ( 52 ) for fluid communication from bulb portion ( 40 ) to swab portion ( 60 ). Shaft ( 50 ) is of sufficient length to permit applicator ( 20 ) be inserted through cannula member ( 30 ) and trocar ( 32 ), with swab portion ( 60 ) extending distally past the distal end of cannula member ( 30 ) and trocar ( 32 ), and with bulb portion extending proximally past the proximal end of cannula member ( 30 ) and trocar ( 32 ). However, any other suitable length for shaft ( 50 ) may be used. 
   As shown in  FIGS. 3-4 , bulb portion ( 40 ) of the present example comprises a bulb ( 42 ) and a capsule ( 44 ). An adhesive ( 46 ) is provided within capsule ( 44 ). In the present example, adhesive ( 46 ) is configured to bond tissue. For instance, adhesive ( 46 ) may comprise a cyanoacrylate, an isocyanate, or any other suitable substance. Capsule ( 44 ) of the present example comprises a generally rigid but breakable material, such as glass or plastic. Alternatively, capsule ( 44 ) may be flexible, resilient, malleable, or have any other suitable properties. As will be described in greater detail below, capsule ( 44 ) of the present example is configured to break in order to communicate adhesive through conduit ( 52 ) of shaft ( 50 ). Capsule ( 44 ) further comprises a stress riser ( 48 ) configured to facilitate breaking of capsule ( 44 ). While stress riser ( 48 ) is shown as having a “plus sign” configuration, it will be appreciated that stress riser ( 48 ) may have any other suitable configuration. In addition, stress riser ( 48 ) may be substituted with any other feature, or may be omitted altogether. 
   Bulb ( 42 ) of the present example is formed of a generally resilient plastic material, though any other material (e.g., rubber, etc.) or combinations of materials having other suitable properties may be used. Bulb ( 42 ) has a pair of inwardly protruding spikes ( 70 ). Spikes ( 70 ) are configured to assist the breaking of capsule ( 44 ). It will therefore be appreciated that spikes ( 70 ) may be formed of a material having a greater hardness than that of remainder of bulb ( 42 ). Other piercing members or other suitable alternatives for spikes ( 70 ) will be apparent to those of ordinary skill in the art. Bulb ( 42 ) further comprises inwardly projecting retainers ( 72 ) configured to maintain the position of capsule ( 44 ) within bulb ( 42 ). A duckbill valve ( 74 ) is also provided in bulb ( 42 ) to permit air to be communicated into bulb ( 42 ) while preventing air from being communicated out of bulb ( 42 ). It will therefore be appreciated that bulb ( 42 ) may be used to break capsule ( 44 ) to release adhesive ( 46 ) upon initial squeezing of bulb ( 42 ) by a user; and to pump the released adhesive ( 46 ) through conduit ( 52 ) of shaft ( 50 ) upon repeated squeezing of bulb ( 42 ). 
   A variation of bulb portion ( 40 ) is shown in  FIG. 5 . In this example, bulb portion ( 140 ) comprises a lower bulb portion ( 142 ) having spikes ( 70 ) and retainers ( 72 ) similar to bulb portion ( 40 ) described above. Bulb portion ( 140 ) also comprises capsule ( 44 ). However, instead of having a duckbill valve ( 74 ) for communicating adhesive through conduit ( 52 ) by repeated squeezing of bulb ( 42 ), a cartridge ( 150 ) is coupled with an upper member ( 160 ) of bulb portion ( 142 ). Cartridge ( 150 ) comprises a pressurized medium, such as a pressurized gas. Upper member ( 160 ) has threading ( 162 ) configured to engage with complimentary threading of cartridge ( 150 ), and an upwardly protruding cannulated spike ( 164 ) configured to pierce a seal ( 154 ) on cartridge ( 150 ). Cannulated spike ( 164 ) is in fluid communication with a needle valve assembly ( 170 ). Needle valve assembly ( 170 ) is also located in upper member ( 160 ), and comprises a needle ( 172 ) and a knob ( 174 ) for controlling axial positioning of needle ( 172 ). As will be apparent to those of ordinary skill in the art, needle valve assembly ( 170 ) may be used to controllably communicate pressurized medium from cartridge ( 150 ) to the interior of lower bulb portion ( 142 ). When adhesive ( 46 ) has been released from capsule ( 44 ), such controlled communication of pressurized medium from cartridge ( 150 ) may provide controlled communication of adhesive ( 46 ) through conduit ( 52 ) of shaft ( 50 ). 
   Another variation of bulb portion ( 40 ) is shown in  FIG. 6 . In this example, bulb portion ( 240 ) comprises a lower bulb portion ( 242 ) having spikes ( 70 ) and retainers ( 72 ) similar to bulb portion ( 40 ) described above. Bulb portion ( 240 ) also comprises capsule ( 44 ), cartridge ( 150 ), and a needle valve assembly ( 270 ) for controllably communicating a pressurized medium from cartridge ( 150 ) to lower bulb portion ( 242 ). However, instead of having a knob ( 174 ) for controlling axial positioning of needle ( 172 ), bulb portion ( 240 ) has a pistol grip mechanism ( 274 ). Pistol grip mechanism ( 274 ) is part of a handle assembly ( 260 ) that is coupled with lower bulb portion ( 240 ). Pistol grip mechanism ( 274 ) comprises a spring ( 276 ) to bias needle valve assembly ( 270 ) to a closed position. As will be appreciated by those of ordinary skill in the art, pressurized medium from cartridge ( 150 ) may be communicated to lower bulb portion ( 240 ) as a function of the degree to which pistol grip mechanism ( 274 ) is actuated. When adhesive ( 46 ) has been released from capsule ( 44 ), such controlled communication of pressurized medium from cartridge ( 150 ) may provide controlled communication of adhesive ( 46 ) through conduit ( 52 ) of shaft ( 50 ). 
   Another variation of bulb portion ( 40 ) is shown in  FIG. 7 . In this example, bulb portion ( 340 ) comprises a lower bulb portion ( 342 ) having spikes ( 70 ) and retainers ( 72 ) similar to bulb portion ( 40 ) described above. Bulb portion ( 340 ) further comprises an upper bulb portion ( 360 ) having a needle assembly ( 170 ) similar to needle assembly ( 170 ) described above with respect to the embodiment shown in  FIG. 5 . However, instead of having a cartridge ( 150 ) disposed in upper bulb portion ( 360 ), upper bulb portion ( 360 ) comprises a barbed connector ( 350 ) in fluid communication with needle valve assembly ( 170 ). Barbed connector ( 350 ) is connectable with a tube ( 352 ), and has a plurality of barbs ( 354 ) configured to retain tube ( 352 ). Tube ( 352 ) may be in fluid communication with an external source (not shown) of a pressurized medium. As will be apparent to those of ordinary skill in the art, needle valve assembly ( 170 ) may be used to controllably communicate pressurized medium from tube ( 352 ) and barbed connector ( 350 ) to the interior of lower bulb portion ( 342 ). When adhesive ( 46 ) has been released from capsule ( 44 ), such controlled communication of pressurized medium from tube ( 352 ) and barbed connector ( 350 ) may provide controlled communication of adhesive ( 46 ) through conduit ( 52 ) of shaft ( 50 ). 
   While several structures and methods for communicating adhesive ( 46 ) to and through conduit ( 52 ) have been described above, it is contemplated that all of the foregoing structures and methods can be modified, substituted, or supplemented in a variety of ways. For instance, adhesive ( 46 ) may be communicated through conduit ( 52 ) via actuation of levers, finger triggers, thumb pushers, sliders, motorized actuators, etc. Other suitable alternatives will be apparent to those of ordinary skill in the art. 
     FIG. 8  shows an exemplary swab portion ( 60 ). Swab portion comprises a plurality of fibers ( 62 ) and an initiator or activator substance ( 64 ). Fibers ( 62 ) may be secured relative to shaft ( 50 ) in any suitable fashion. In another embodiment, swab portion ( 60 ) comprises a sponge-like or foam-like structure. In the present example, adhesive ( 46 ) and activator substance ( 64 ) are configured such that adhesive ( 46 ) will not satisfactorily adhere to structures (e.g., to tissue) absent exposure to activator substance ( 64 ). It will be appreciated, however, that alternative adhesives may be used, including those whose performance does not require any activator substance ( 64 ). It will also be appreciated that an activator substance ( 64 ) may be provided in a location other than swab portion ( 60 ). By way of example only, activator substance ( 64 ) may be provided within a bulb portion ( 40 ) or elsewhere. For instance, a separate conduit (not shown) may be provided in shaft ( 50 ) for communicating activator substance ( 64 ) to swab portion ( 60 ) in any suitable fashion. Other ways in which an activator substance ( 64 ) may be used and provided will be apparent to those of ordinary skill in the art. 
     FIG. 9  depicts swab portion ( 60 ) in an exemplary use. As shown, swab portion ( 60 ) is being used to apply adhesive ( 46 ) to tissue ( 400 ). In the present example, an applicator ( 20 ) is used percutaneously and/or transmurally. Accordingly, it will be appreciated that any of the applicators ( 20 ) disclosed herein, including variations of the same, may be used in laparascopic, endoscopic, open, or other surgical settings. Suitable uses for adhesive ( 46 ) or other substances applied through applicator ( 20 ) include, but are not limited to, the following: to provide superficial or other cover for tissue (e.g., as a “liquid bandage”), to attain cellular attachment, to become an implant, to serve as a volume or bulking filler, to increase in volume when dispensed with fluid having tamponade properties, to adjoin tissue with other tissue, to adjoin a man-made component with tissue, or to adjoin two man-made components. To the extent that adhesive ( 46 ) is used as a bandage, dispensation of such adhesive ( 46 ) may be a preliminary step to subsequent curing or alteration of the bandage by exposure to light, external frequencies, pressure waves, heat, other chemicals, etc. 
   It will also be appreciated that applicator ( 20 ) may be used to apply a variety of substances in addition to or as an alternative to an adhesive ( 46 ). For instance, applicator ( 20 ) may be used to apply a solid substance carried by a fluid carrier. Applicator ( 20 ) may also be used to apply mixed media. To the extent that applicator ( 20 ) is used to apply mixed media, such media may be mixed within applicator ( 20 ) using any suitable mixing structures and techniques, including manual, mechanical, automatic, or combinations thereof. Other suitable substances that applicator ( 20 ) may be used to apply include, but are not limited to, sealants, drugs, sclerosing agents, necrosing agents, coagulants, ablation agents, image enhancing agents such as ultrasound, CT, MRI, PET, X-Ray (radiographic), or radio pharmaceuticals. Other substances will be apparent to those of ordinary skill in the art. Furthermore, substances applied through applier ( 20 ) may be colored to make such substances easily observable by the naked eye or otherwise. 
   Any of the applicators ( 20 ) described herein, including variations of the same, may be used as a single dosage device, as a reloadable (e.g., single patient) device, or as a device that is otherwise reusable at least in part. Furthermore, while applicator ( 20 ) is described and shown as being axially dispensing, it will be appreciated that applicator ( 20 ) may be oriented fixedly or adjustable to a variety of positions or orientations. 
   To the extent that an applicator ( 20 ) needs to be withdrawn relative to trocar ( 32 ) (e.g., to insert another applicator ( 20 ) relative to trocar ( 32 )), it may be desirable to prevent a used swab portion ( 60 ) from coming in contact with the trocar ( 32 ). To the extent that the distal end of cannula ( 30 ) extends distally beyond the distal end of trocar ( 32 ) in such situations, applicator ( 20 ) may be withdrawn relative to cannula ( 30 ), with cannula ( 30 ) remaining in a fixed axial position relative to trocar ( 32 ) at least until swab portion ( 60 ) has cleared the distal end of cannula ( 30 ). Cannula ( 30 ) may thus shield trocar ( 32 ) from swab portion ( 60 ). A new cannula ( 30 ) may thereafter be inserted with a new applicator ( 20 ). Other structures and methods for avoiding contact between swab portion ( 60 ) and trocar ( 32 ) will be apparent to those of ordinary skill in the art, to the extent that such contact is sought to be avoided. 
   Embodiments of the present invention have application in conventional endoscopic and open surgical instrumentation as well as application in robotic-assisted surgery. 
   Embodiments of the devices disclosed herein can be designed to be disposed of after a single use, or they can be designed to be used multiple times. Embodiments may, in either or both cases, be reconditioned for reuse after at least one use. Reconditioning may include any combination of the steps of disassembly of the device, followed by cleaning or replacement of particular pieces, and subsequent reassembly. In particular, embodiments of the device may be disassembled, and any number of the particular pieces or parts of the device may be selectively replaced or removed in any combination. Upon cleaning and/or replacement of particular parts, embodiments of the device may be reassembled for subsequent use either at a reconditioning facility, or by a surgical team immediately prior to a surgical procedure. Those skilled in the art will appreciate that reconditioning of a device may utilize a variety of techniques for disassembly, cleaning/replacement, and reassembly. Use of such techniques, and the resulting reconditioned device, are all within the scope of the present application. 
   By way of example only, embodiments described herein may be processed before surgery. First, a new or used instrument may be obtained and if necessary cleaned. The instrument may then be sterilized. In one sterilization technique, the instrument is placed in a closed an sealed container, such as a plastic or TYVEK bag. The container and instrument may then be placed in a field of radiation that can penetrate the container, such as gamma radiation, x-rays, or high-energy electrons. The radiation may kill bacteria on the instrument and in the container. The sterilized instrument may then be stored in the sterile container. the sealed container may keep the instrument sterile until it is opened in a medical facility. A device may also be sterilized using any other technique known in the art, including but not limited to beta or gamma radiation, ethylene oxide, or steam. 
   Having shown and described various embodiments of the present invention, further adaptations of the methods and systems described herein may be accomplished by appropriate modifications by one of ordinary skill in the art without departing from the scope of the present invention. Several of such potential modifications have been mentioned, and others will be apparent to those skilled in the art. For instance, the examples, embodiments, geometries, materials, dimensions, ratios, steps, and the like discussed above are illustrative and are not required. Accordingly, the scope of the present invention should be considered in terms of the following claims and is understood not to be limited to the details of structure and operation shown and described in the specification and drawings.