Abstract:
Multifunctional telescoping cleaning devices and methods of using the devices are provided for cleaning the interior of surgical trocars and cannulas. The multifunctional cleaning device may include a telescoping feature which may be used in bariatric procedures where reach is important. The device may also be configured in some instances to clean all standard trocars and cannulas sized between 5-12 mm with depth of up to 50 cm. The device may have porous cleaning absorbent members. The device may also include the ability to perform aspirating, dissecting, filtering, irrigating and evacuating in surgical laparoscopic procedures through a fluid flow passage in the telescoping tool. The device may quickly and efficiently cleans trocars, cannulas, and laparoscopic lens.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
       [0001]    This application is entitled to the benefit of and incorporates by reference subject matter disclosed in the International Patent Application No. PCT/US2014/048017 filed on Jul. 24, 2014 and U.S. Provisional Patent Application No. 61/858,168 filed on Jul. 25, 2013. 
     
    
     TECHNICAL FIELD 
       [0002]    The present invention relates to a laparoscopic multifunctional telescoping cleaning device and a method for use in cleaning, dissecting, irrigation, filtration, traction, and evacuation in surgical laparoscopic procedures. 
       BACKGROUND 
       [0003]    Laparoscopic surgery sometimes called Keyhole or “Minimally Invasive Surgery” (MIS) is a relatively new type of surgery recently introduced into the general surgical field in 1988. It involves the introduction of small incisions in a patient (usually between 0.5 and 1.5 cm) whereby access to the thoracic, abdominal or pelvic cavities is obtained by the use of a medical device called a trocar. The word trocar comes from the French trois-carre meaning three-edged or triangular point. Trocars typically have a three edged point at their distal end which is used for inserting through the skin layer and into the cavity area of a patient. A trocar is often used in combination with another surgical tool called a cannula. 
         [0004]    A cannula is a hollow cylinder or tube that is inserted into the body to deliver or remove fluids. Prior to starting a surgical procedure, a small incision is performed on the patient whereby a trocar is inserted. Care must be taken in choosing the location of entry to prevent accidental severing of blood vessels such as the veins and arteries of the anterolateral abdominal wall. A procedure called trans illuminating is sometimes used to prevent this problem. This is a procedure whereby light is shined from inside the abdominal wall clearly illuminating where the blood vessels are located. Illumination allows the surgeon to determine the best approach for performing the medical procedure, thus, minimizing blood loss and trauma to the patient. An insufflator also referred to as a pump, is then used to inflate the cavity area with carbon dioxide (CO2), thus, providing a means of creating greater space by expanding the abdominal walls. This expansion provides better viewing for the surgeon during the medical procedure. A special medical device called a laparoscope is subsequently inserted through the trocar/cannula allowing the surgeon to look inside the cavity area. 
         [0005]    A laparoscope is the main medical tool used in Laparoscopic or Minimally Invasive Surgery (MIS). During this procedure, there is a constant insertion and removal of surgical tools through the trocar/cannula device. These exchanges comprise between 10 to 30 percent of the total procedure time. Minimizing these exchanges has many benefits to the patient among them are: the reduction of surgical time, operating costs, trauma and amount of anesthesia required to keep the patient sedated. The surgeon also benefits by reducing the overall operating time. The introduction of multifunctional devices is a popular way to reduce the number and time of surgical tool exchanges. 
         [0006]    Trocars often have small ports that range in size from 5-12 mm used in the insertion of medical devices. The deciding factor in choosing the proper trocar size varies, but is primarily decided by the size of the instruments, the procedure used, and the surgeon&#39;s individual preferences. The standard trocar length used today is 10 cm, with extra-long trocars of 15 cm used in bariatric surgery. Bariatric surgery is often performed on obese people who have thick or extra layers of fat, requiring longer surgical tools to access, deliver, and clean the affected area. Larger sized ports of entry are preferred because small ports impede the timely exchange of surgical tools and inhibit the surgeon&#39;s dexterity. These larger ports provide access to larger surgical tools needed for dissecting and retrieving the larger tissue specimens. These larger specimens would typically not pass through narrower trocar/cannulas. 
         [0007]    Surgical tools include, but are not limited to: trocars, cannulas, evacuating devices, irrigation devices, laparoscopes, dissectors, grabbers, forceps, cautery&#39;s, probes and ligating appliers. In this constant interaction of surgical tools being inserted and removed through the trocar, deposits of blood, tissue and other bodily fluids can adhere to the trocar/cannula or laparoscope. These accumulated residues often blur or completely block the viewing area of the surgeon requiting the temporary stopping of the surgical procedure giving greater rise to peril. The procedure continues once the medical device has been cleaned or unblocked. 
         [0008]    For example in laparoscopic urology surgery, it is common practice to use multiple tools such as aspiration, irrigation, cauterization, and dissection tools. The goal is to complete the surgery as quickly as possible minimizing blood loses. The problem with this approach is that the constant interchanging of tools increases the overall surgical time. In order to help reduce the surgical time, multifunctional tools are used. Hemostasis is the process which causes bleeding to stop. Some surgical devices deliver temporary hemostatic agents to a particular area thus reducing blood loss. The drawback to this is that the irrigation process tends to encompass a broader area than intended. This causes unintended side effects to the surrounding areas. There is a need in the field for multifunctional tools and a method of specific delivery of hemostatic agents. 
         [0009]    There exists in the field a need for an improved cleaning device. 
       SUMMARY 
       [0010]    The present device overcomes the deficiencies of the known art and the problems that remain unsolved by providing a method and apparatus for a telescoping multifunctional cleaning device. 
         [0011]    The telescoping multifunctional cleaning device includes a plurality of telescoping tubes with an absorbent member disposed on each end of the device. The device also includes a locking mechanism for locking the telescoping tubes in place. The telescoping tubes allow overall length adjustment of the device such that the device can be used in various types of surgeries and situations. The absorbent members can be of varying sizes to accommodate cleaning of medical devices of varying sizes. The device can be connected to a suction source or a fluid source to facilitate passage of fluids therethrough. 
         [0012]    The foregoing summary is illustrative in nature and is not intended to be in any way limiting. In addition these and other aspects, features, and advantages of the present device will become more readily apparent from the attached drawings and the detailed description of the embodiments. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0013]    In order to better explain the characteristics of the present device, the embodiments will hereinafter be described in conjunction with the drawings provided to illustrate and not to limit the device, in which: 
           [0014]      FIG. 1  is a sectional view of an exemplary laparoscopic multifunctional telescoping cleaning device; 
           [0015]      FIG. 2  is an exploded assembly view of the exemplary laparoscopic multifunctional telescoping cleaning device; 
           [0016]      FIG. 3  is an exploded view of an alternative embodiment of the laparoscopic multifunctional telescoping cleaning device; 
           [0017]      FIG. 4  is a sectional view of proximal and distal ends of an alternative embodiment of the laparoscopic multifunctional telescoping cleaning device; 
           [0018]      FIG. 5  is an isometric sectional view of an embodiment locking mechanism; 
           [0019]      FIG. 6  presents a sectional view of an alternative embodiments locking mechanism; and 
           [0020]      FIGS. 7A / 7 B are perspective views of an alternative embodiment of an adhesive locking mechanism. 
       
    
    
       [0021]    The drawings are included to provide a further understanding of the disclosure, and are incorporated into and constitute a part of this specification. The drawings illustrate various embodiments of the disclosure and together with the description serve to explain the principles and operations of the disclosure. Like reference numerals refer to like parts throughout the several views of the drawings. 
       DETAILED DESCRIPTION 
       [0022]    The following detailed description is merely exemplary in nature and is not intended to limit the described embodiments or the application and uses of the described embodiments. As used herein, the word “exemplary” or “illustrative” means “serving as an example, instance, or illustration.” Any implementation described herein as “exemplary” or “illustrative” is not necessarily to be construed as preferred or advantageous over other implementations. All of the implementations described below are exemplary implementations provided to enable persons skilled in the art to make or use the embodiments of the disclosure and are not intended to limit the scope of the disclosure, which is defined by the claims. For purposes of description herein, the terms “upper”, “lower”, “left”, “rear”, “right”, “front”, ‘.vertical”, “horizontal”, and derivatives thereof shall relate to the device as oriented in  FIG. 1 . Furthermore, there is no intention to be bound by any expressed or implied theory presented in the preceding technical field, background, brief summary or the following detailed description. It is also to be understood that the specific devices and processes illustrated in the attached drawings, and described in the following specification, are simply exemplary embodiments of the inventive concepts defined in the appended claims. Hence. Specific dimensions and other physical characteristics relating to the embodiments disclosed herein are not to be considered as limiting, unless the claims expressly state otherwise. 
         [0023]    A multifunctional telescoping laparoscopic cleaning device, or wipe, of  FIG. 1  extends from a proximal end  145  to a distal end  150  and includes two or more hollow telescoping tubes  105 , 110  with the telescoping tubes  105 ,  110  fitting within each other. Each of the telescoping tubes  105 ,  110  includes a proximal end  106 ,  108  and a distal end  107 ,  109 , respectively. 
         [0024]    One telescoping tube is slid relative to the other telescoping tube altering the device&#39;s overall length. The telescoping tubes  105 , 110  have different diameters. The outer diameter of the distal telescoping tube  110  is slightly smaller than the inner diameter of the larger proximal telescoping tube  105 . Once the length of the multifunctional laparoscopic device  100  has been chosen, the device maintains its length by means of a locking mechanism  500 ,  600 ,  700  as shown in  FIG. 5, 6 , or  7 B. Numerous different possibilities for the locking mechanism exist. 
         [0025]    With reference to  FIG. 1 , two attachment tubes  115 ,  120  may be threaded or glued to their respective telescoping tubes  105 , 110 . The proximal and distal telescoping tubes are the primary determinants for choosing the size of absorbent members  125 ,  130 . When threaded screws  135 ,  140  of the telescoping tubes  105 ,  110  are used, they allow the user to change the size of the absorbent members  125 ,  130  to the particular trocar/cannula opening desired. The absorbent members  125 ,  130  can be fastened to the telescoping tubes  105 ,  110  through gluing, adhesives, heat shrinking or any number of well established procedures well known in the field. Alternatively, the absorbent members  125 ,  130  can be attached directly onto the telescoping tubes  105 ,  110 . 
         [0026]    With reference to  FIG. 2 , proximal and distal attachment tubes  115 ,  120  are securely attached into the telescoping tubes  105 ,  110  to make the final device. Methods of connecting the attachment tubes  115 , 120  to the telescoping tubes  105 , 110  include but are not limited to: heating the attachment tubes  115 , 125  past their melting temperature and then pressing the attachment tubes  115 , 120  onto the telescoping tubes  105 , 110 . Other methods used could be, mechanically joining the tubes with fasteners, intermediary materials such as heat shrink materials, or integrally forming the telescoping tubes  105 , 110  with the attachment tubes  115 , 120 . Still another method could be the use of plastics, metals or composite materials interconnected with the use of a threaded screw or end  155 ,  160  and screw insert  135 ,  140  such as also seen in  FIG. 3 , whereby the telescoping tubes  105 , 110  are connected to the attachment tubes  115 ,  120 . Methods that are generally practiced and well known in the art can also be used to join the two pieces of members. 
         [0027]    Each telescopic tube  105 ,  110  can have a hole provided near the proximal  145  or its distal end  150  for joining the attachment tubes  115 ,  120  to the telescopic tubes  105 ,  110 . The attachment tubes  115 ,  120  can have protrusions  510  similar to those shown in  FIG. 5 , on its inner surface that fit into a corresponding recess of the telescopic tubes  105 ,  110 . Thus, mating locking features may be formed in the telescoping tubes  105 ,  110  and attachment tubes  115 ,  120  to facilitate attachment. A crimped end  165  may be used with the proximal telescoping tube  105 , forcing the underlining brass members  170  to lock it in place when fully extended. 
         [0028]    With reference to  FIG. 3 , an alternative embodiment of the telescoping multifunctional laparoscopic wipe  100  includes a proximal attachment tube  115  used for a larger sized trocar/cannula. The proximal attachment tube  115  includes a bulbous rounded portion  195  and a threaded end  155 . The attachment tube can be made from any material not limited to but including plastics, stainless steel, metals, or composite materials. In some instances the attachment tube may be made from polyethylene such as HDPE. The bulbous rounded portion  195  is shaped for easy attachment to a suction source (not shown). When attached to the suction source, the suction source tubing (also not shown) is pressed over the bulbous rounded portion  195  until the tubing tightly engages. The tubing is tightly sealed around the proximal attachment tube  115  and will prevent any blood or fluid from leaking from the multifunctional laparoscopic wipe  100 . The suction source can be connected to the multifunctional laparoscopic wipe  100  with tubing capable of permitting the flow of blood and other fluids from the body through hollow passageways  180 ,  185 ,  190 , as shown in  FIG. 4 , out to a holding vessel. Proximal attachment tube  115  is hollow and receives a proximal absorbent member  125  on its outer surface. The absorbent member  125  is of sufficient size to clean the largest trocars commonly encountered in laparoscopic surgery today. The proximal absorbent member  125  may be sized so as to clean the diameter of a 12 mm trocar/cannula and laparoscopic lenses. The proximal absorbent member  125  can also be used to abrade tissue materials. The proximal absorbent members  125 ,  130  can have a variety of shapes that enhance their surface area. In an alternate embodiment, insert screws  135 ,  140  attach to proximal and distal attachment tubes  115 ,  120 , allowing different sized absorbent members to be selected. 
         [0029]    With reference to  FIG. 4 , in an alternative embodiment of the multifunctional laparoscopic wipe  100 , the distal attachment tube  120  is used for cleaning smaller sized trocars. The proximal and distal attachment tubes  115 ,  120  are substantially cylindrical with threaded ends  155 , 160 . Screw inserts  135 ,  140  are used to hold it in place. In one embodiment, no screws are used and other methods of attachment can be used. The distal cylindrical portion&#39;s outer surface receives the smaller distal sized absorbent member of the multifunctional laparoscopic wipe. The hollow absorbent member  130  is slid over the distal telescopic tube  120  and then formed onto the multifunctional laparoscopic wipe. The positioning of attachment tube holes  170  is important because they allow for fluid to enter the hollow canal of the telescopic tubes and allow fluid to flow towards the exit. The distal end of the attachment tube  120  has features for suctioning liquids such as blood. These features include circular holes  170  located circumferentially on the outer surface of the distal attachment tube  120 . The circular holes  170  provide a fluid path for blood or other bodily fluids to enter the hollow cylindrical tube portion of the distal attachment tube  120 . The holes  170  increase the effective suctioning of liquids from the affected area. The distal end of the attachment tube has a rounded or chamfered edge  175 . The smooth shape of the edge reduces pressure created when the multifunctional laparoscopic wipe  100  is manipulating tissue or organs. The rounded edge also reduces the potential tearing of the absorbent member  130 . 
         [0030]    Proximal absorbent member  125  need not extend past the bulbous rounded portion  195  of proximal attachment tube  115 . Absorbent member  125  may be the same length as its attachment tube  115  in some instances. The absorbent members  125 , 130  fit into different sized trocar/cannulas (not shown) and make contact with and/or rub against the interior surface of the trocar/cannula for providing the best cleaning effect. The material for absorbent member  125 , 130  should be porous enough that fluid can flow through the surface and into the telescopic tubes  105 , 110  when the multifunctional laparoscopic device  100  is performing suction procedures. Depending on the materials used for the attachment member, the absorbent member can be attached, but is not limited to, being glued, pressed together with the attachment tube, or integrally formed onto the attachment tube, etc. The diameters of the absorbent members  125 , 130  may be selected to allow the cleaning of trocar/cannula diameters between 5-12 mm. 
         [0031]    With reference to  FIG. 5 , a locking mechanism  500  for the proximal and distal telescoping tubes  105 , 110  includes features, or deformations,  510 ,  515  formed in walls of the telescoping tubes  105 ,  110 . Each feature, or as shown in  FIG. 5 , a deformation,  510 ,  515  has a depression which forms a valley in the tube wall. The deformations can either encircle the complete diameter of the telescoping tubes or be formed intermittedly. The inner telescoping tube  110  has a slight taper which allows the outer tube  105  to slide within one another without interference. The protrusion  510  of the outer tube  105  and the inner tube recess wall  515  combine to lock the device in place. This is only one of many ways of attaching two medal tubes. The number of deformations used when manufactured can vary. The distance between the deformations can also be varied. Different numbers of telescoping tubes may also be used with locking mechanisms. If more than one locking point of the multifunctional laparoscopic wipe  100  is desired, one of the telescoping tubes can include multiple deformations to allow adjustability and selection of different overall lengths of the device. The other telescoping tube may need one protrusion because this protrusion can correspond with multiple deformations of the inner telescoping tube, corresponding with different lengths. Multiple deformations of the telescoping tube enhance the adjustability of the multifunctional laparoscopic wipe  100 . The last deformation of each tube should be located close to the end of the telescopic tubes  105 , 110  to achieve the maximum length of the multifunctional laparoscopic wipe  100 . When force is applied, protrusion  510  should correspond with recessed areas  515  preventing the movement of the telescopic tubes  105 ,  110 . The locking force may be strong enough to resist potential collapsing of the multifunctional laparoscopic wipe  100  during a surgical procedure, but weak enough to allow adjustability. In this embodiment, the shape of the deformation is a V shape, but the deformations can be varied to adjust the locking force of the telescoping tubes. 
         [0032]    With reference to  FIG. 6 , a bushing locking mechanism  600  of the multifunctional laparoscopic device  100  includes a bushing  615 . The bushing  615  is attached onto an outer surface  625  near distal end  640  of inner telescopic tube  110  and makes contact with outer telescopic tube  105 . The bushing  615  makes contact with the outer telescopic tube  105  along its inner wall surface  620 . The bushing  615  is shaped to conform to the outer telescopic tube  105  having a beveled outer telescoping tube end  645 . The movement of the inner telescopic tube  110  having a beveled tip  630  is restricted by the frictional force created by the bushing  615  as it contacts the inner wall surface  620  of the outer telescopic tube  105 , The frictional forces prevent movement of the telescopic tubes  105 ,  110  unless the surgeon or surgical assistant applies a larger force than the friction. The frictional force has to be strong enough to hold the telescoping multifunctional laparoscopic wipe  100  in place, during the abrasion process of tissue dissection within the body, the cleaning process of the laparoscope lens, or the insertion of the multifunctional laparoscopic wipe  100  through a trocar/cannula device. 
         [0033]    With reference to  FIGS. 7A-7B , another embodiment of the multifunctional laparoscopic wipe  100  includes an attachable adhesive strip  700 . The adhesive strip  700  acts as a locking mechanism to prevent the telescoping tubes  105 ,  110  from moving relative to one another during a surgery. The adhesive strip  700  has proximal and distal upper adhesive portions  715 , 725 . The proximal adhesive portion  715  is pre-attached to a proximal telescopic tube  105  outer surface. The distal upper adhesive portion  725  is not pre-attached to the telescopic tube  110 . This is done so that the adhesive tape  700  can slide over the distal telescoping tube  110  prior to selecting a proper length. There is space between upper curved portions  725  inner surface and the distal telescopic tube  110  to allow the outer proximal telescopic tube  110  to slide freely to the desired length prior to curved position  715  attaching to proximal telescopic tube  105 . Flat portions  720 ,  730  have an adhesive flat surface backing. Bottom curved portion  715  also has an adhesive covered inner surface with backing. Once the multifunctional laparoscopic wipe  100  is of the desired length, all backing is removed and the adhesive surfaces are pressed into contact with the telescopic tubes  105 ,  110  outer surface. Bridge  735  helps prevent the telescopic tubes from separating, by locking the multifunctional laparoscopic wipe at the desired length. Adhesive strip bridge  700  is connected to both of the flat surfaces of the adhesive strip  720 , 730 . 
         [0034]    The device can be opened at the beginning of the surgical procedure and kept ready for surgical staff on a sterile back table or may be opened during the surgical procedure as needed. The device is operated by holding one end through a trocar. The device may be pushed in and pulled out of the trocar as needed to clean fluids, and other debris that have collected along the circular internal wall of the trocar. In some instances the device may be designed for a single patient use and disposed of at the end of each procedure, but the device may be used repeatedly over the course of a single procedure until it becomes saturated with fluids other debris. The device may have an X-ray detectable element embedded in the sponges, connecting rod or both. 
         [0035]    The material of the sponges can be foam, fabric or any other material or combination of materials that are both durable and absorptive, such as a microfiber material. This can be a piece of microfiber fabric folded, pressed or rolled onto itself, or it could be a surface of microfiber cloth over a foam, cotton or rayon core. What constitutes the microfiber material is the D.P.F. or denier per filament. The microfiber material may have a D.P.F. from about 0.05 to about 1.5. The absorptive sponge can take on numerous shapes. 
         [0036]    Proximal attachment tube  115  and distal attachment tube  120  can be screwed into or permanently attached to the telescoping tubes  105 ,  110  thus enabling the foam/fabric material heads to be replaced to compensate for specific trocar/cannula sizes. 
         [0037]    The laparoscopic multifunctional telescoping cleaning device can also be of a unitarian construction with absorbent members permanently attached at the ends used in the cleaning of trocar/cannula devices. 
         [0038]    The multifunctional laparoscopic wipe also referred to as the wipe is a disposable adjustable device that cleans multiple laparoscopic devices. It may clean trocar cannulas of diameters between 5-12 mm in some instances. The device may have an extended reach of between 15-50 cm in some instances. The extended length in some instances may be selected to be between 20-24 cm, though other ranges may be used in different instances. The device cleans different types and sizes of trocars including bariatric trocars. 
         [0039]    Both ends of the multifunctional laparoscopic wipe have absorbent members for cleaning the inside of a trocar cannula or a laparoscope lens. The two absorbent members have different diameters, but are of similar lengths. The smaller diameter absorbent member can be sized to clean the inner cannula of the smallest trocar in laparoscopic surgery. In general, the absorbent member is sized to clean a 5 mm trocar. The smaller diameter absorbent member is inserted through the abdomen wall when it is necessary to suction or remove fluids from within the body. The larger proximal absorbent member can clean various trocar cannula inner diameter sizes prevalently used in laparoscopic procedures. In some instances, the absorbent member is of sufficient diameter to clean a 12 mm trocar. The absorbent members can be made from but are not limited to absorbent materials such as polyurethane foam, microfiber, or cotton. Both absorbent members can have a reflective or shiny surface for enhanced visibility. The color of the absorbent members can be chosen for high contrast with bodily tissue. In some instances, white foam may be used to make it easier for the surgeon to see any attached materials. The absorbent members fit easily through the trocar cannula of the corresponding size. The absorbent members have sufficient surface area for repeatedly cleaning the laparoscope lens during a laparoscopic procedure. 
         [0040]    Furthermore, the multifunctional laparoscopic wipe performs suctioning of blood and fluids through the telescopic tubing. One end of the multifunctional laparoscopic wipe is shaped to attach to a suction source. The other end of the multifunctional laparoscopic wipe has holes or fenestrations for the passage of blood and other fluids into the hollow telescopic tubing. The suction strength of the multifunctional laparoscopic wipe is varied by covering an opening located on the outside of the telescopic tubing. The opening may be located on the section of the telescopic tubing that contains the suction attachment. The opening is similar in size to a surgeon&#39;s thumb or finger. The surgeon alters the suction strength by placing his thumb or finger over the opening. 
         [0041]    Additionally, the multifunctional laparoscopic wipe can serve as an irrigation/evacuation tool. Since the shaft of the multifunctional laparoscopic wipe is hollow, fluid can travel through the interior shaft of the device that also provides a secure sealed passage for fluids to flow. When fitted with a mechanism for attaching the hollow shaft to a source of fluid, the multifunctional laparoscopic wipe can act as a laparoscopic irrigator. The multifunctional laparoscopic wipe can be connected to a source of irrigation fluid such as a sterile water, or saline solution by means of tubing. 
         [0042]    Further, the irrigation function can supply a heated fluid for enhancing the cleaning effect and/or defogging of the multifunctional laparoscopic wipe on a laparoscope lens. The heated fluid can contain a surfactant for breaking up fats and oils left on the laparoscope lens surface. 
         [0043]    Additionally, the multifunctional laparoscopic wipe changes its length by the relative motion of the multiple telescoping tubes. The telescoping tubes are rigid and made of hollow thin wall tubing. The tubes may be made from stainless steel in some instances, but other materials including plastics or composite materials are possible. The telescoping tubes are x-ray detectable within the human body. Once the multifunctional laparoscopic wipe is expanded to the surgeon&#39;s desired length, the surgeon locks the telescoping tubes with the locking mechanism. In the locked position, the telescoping tubes will not collapse when the multifunctional laparoscopic wipe is deployed within the body. The locking of the telescoping tubes prevents the absorbent member or cleaning head from moving when it contacts another object such as a laparoscope lens or body tissue (when abrading the tissue). 
         [0044]    Formed over each telescopic tube is another tube. The two outer tubes of the multifunctional laparoscopic wipe include the attachment surfaces for the absorbent members and have specialized functions. The outer tube corresponding to the distal smaller cleaning end of the multifunctional laparoscopic wipe has holes or fenestrations around its perimeter. The evacuating holes or fenestrations allow blood or fluid to enter into the multifunctional laparoscopic wipe. The proximal end has a separate outer tube formed over the inner telescoping tube. The outer tube formed on this end of the multifunctional laparoscopic wipe is designed for attaching up to a 12 mm foam member and a suction tube. Unlike the distal 5 mm tube, the proximal tube does not contain fenestrations or holes. The outer tube is hollow with a solid outer wall. One end of the outer tube has a protrusion for attaching a piece of tubing to the multifunctional laparoscopic wipe. The protrusion has a large enough diameter that tubing can be attached to the device, but a small enough diameter so that the device can fit into a 12 mm diameter trocar. 
         [0045]    The device also has the ability to apply anti-fogging liquid used to clean medical scopes and other medical items before, during and after medical procedures. An x-ray detectable element may be coupled to at least one of the connecting rods, absorbent sponge, or second absorbent sponge. 
         [0046]    A surgical device may include two or more telescoping tubes having a fluid flow passage. The fluid flow passage may extend through a length of the surgical device. A first of the tubes may have a fluid inlet. A second tube may have a fluid outlet. Two or more absorbent members may be attached to the telescoping tubes. At least one of the absorbent members may at least partially cover at least one of the fluid inlet and the fluid outlet. Each absorbent member may be sized to rub against an inner surface of a different sized surgical port cannula when the surgical device is inserted therein. 
         [0047]    The surgical device may include a locking mechanism to prevent collapsing of the telescoping tubes. The locking mechanism may include a first feature formed in the first telescoping tube matingly engaging with a second feature formed in the second telescoping tube as discussed herein. In some instance two or more of the first and/or second features may be formed in different positions in order to prevent collapsing of the telescoping tubes in each of the different positions while still allowing an adjustability of an overall length of the device. 
         [0048]    In some instances, the locking mechanism may include a bushing on the first telescoping tube and a fitting on the second telescoping tube engaging with the bushing. In some instances, the locking mechanism may include an adhesive strip securing the first telescoping tube to the second telescoping tube. 
         [0049]    In some instances, at least one intermediate telescoping tube may be disposed between the first telescoping tube and the second telescoping tube. 
         [0050]    In some instances, the first telescoping tube may include a threaded attachment tube component containing at least one of the absorbent members. The threaded attachment tube component may be selectively detachable from the first telescoping tube and replaceable with another threaded attachment tube component containing a different sized absorbent member. 
         [0051]    One or more of the absorbent members may have a porosity that is large enough to allow one or more fluids to pass through. One or more of the absorbent members may attach to the telescoping tubes via attachment members. 
         [0052]    The surgical device may include an irrigation mode and/or a suction mode. In an irrigation mode, the fluid inlet may be connected to a fluid source. In a suction mode, the fluid outlet may be connected to a suction source. 
         [0053]    In the irrigation mode, at least one of the absorbent members may cover the fluid outlet. Fluid may be sent from the fluid source through the fluid flow passage to the at least one absorbent member covering the fluid outlet. 
         [0054]    In the suction mode, at least one of the absorbent members may cover the fluid inlet. Fluid may be sucked through the at least one absorbent member covering the fluid inlet into the fluid flow passage to the fluid outlet. 
         [0055]    A bulbous portion may be disposed on at least one of the fluid inlet and the fluid outlet. The bulbous portion may be designed and/or adapted for respective attachment to the fluid source or the suction source. 
         [0056]    In some instances, at least one end of at least one of the telescoping tubes may include a chamfered edge. In some instances the second telescoping tube may slidably fit into the first telescoping tube. 
         [0057]    In some instances, the surgical device may be a minimally invasive surgical device having a device proximal end and a device distal end. This device may include a first telescoping tube having a first tube proximal end and a first tube distal end. The first telescoping tube may be disposed on the device proximal end. The second telescoping tube may have a second tube proximal end and a second tube distal end. The second telescoping tube may be disposed on the device distal end. The second tube proximal end may slidably fit into the first tube distal end. A first absorbent member may be disposed on the proximal end of the first telescoping tube. A second absorbent member may be disposed on the distal end of the second telescoping tube. The first telescoping tube and the second telescoping tube may be adjusted with respect to each other to vary the overall length of the device and lock with respect to each other once the overall length has been determined. This surgical device may include at least one hole to allow passage of fluids through the device when the device is attached to a suction source or a fluid source. In some instances, the absorbent members may be of different sizes between about 5 and 12 millimeters to allow cleaning of cannulas of those sizes during minimally invasive surgery. 
         [0058]    A method may be performed for cleaning a cannula in a minimally invasive surgical port. Telescoping tubes having a fluid flow passage extending therethrough may be adjusted to a predetermined telescopic length. An end of the telescoping tubes may be inserted into a surgical port cannula. The inserted end may have an absorbent member associated with it that may be sized to rub against an inner surface of the surgical port cannula when the surgical device is inserted therein. A noninserted end of the telescoping tubes may have a different sized absorbent member associated with it. A fluid flow through the fluid flow passage may be triggered or otherwise caused to occur at least while the end of the telescoping tubes is inserted in the surgical port cannula. 
         [0059]    Flowing fluid may pass through the absorbent member associated with the inserted end of the telescoping tubes while the end is inserted in the surgical port cannula. A suctioning of fluid in the surgical port cannula through the absorbent member and the fluid flow passage may be activated while the inner surface of the surgical port cannula is rubbed clean with the same absorbent member associated with the inserted end of the telescoping tubes as the end is inserted in the surgical port cannula. 
         [0060]    Irrigation of the fluid flow passage may be initiated with fluid from an external source while the end of the telescoping tubes is inserted in the surgical port cannula. Irrigation of the absorbent member associated with the inserted end of the telescoping tubes may also be initiated with the external source fluid in the fluid flow passage while the end is inserted in the surgical port cannula. The external source fluid irrigated on the absorbent member may be applied to an inner surface of the surgical port cannula while the inner surface of the surgical port cannula is also rubbed clean with the same absorbent member. 
         [0061]    The above-described embodiments are merely exemplary illustrations of implementations set forth for a clear understanding of the principles of the invention. Many variations, combinations, modifications or equivalents may be substituted for elements thereof without departing from the scope of the invention. Therefore, it is intended that the invention not be limited to the particular embodiments disclosed as the best mode contemplated for carrying out this invention, but that the invention will include all the embodiments falling within the scope of the appended claims.