Abstract:
A system for retrieving a specimen includes a collapsible bag having a first mating member and a retrieval device having a second mating member. The second mating member cooperates with the first mating member for coupling the collapsible bag with the retrieval device. A rotation mechanism is disposed in the retrieval device. Actuation of the rotation device collapses an excess portion of the collapsible bag.

Description:
CROSS REFERENCE TO RELATED APPLICATION 
       [0001]    The present application is a divisional application of U.S. patent application Ser. No. 13/645,544, filed on Oct. 5, 2012, which claims the benefit of and priority to U.S. Provisional Application Ser. No. 61/550,549, filed on Oct. 24, 2011, the entire contents of each of which are incorporated herein by reference. 
     
    
     BACKGROUND 
       [0002]    1. Technical Field 
         [0003]    The present disclosure relates to a surgical system for use in minimally invasive procedures. More particularly, the present disclosure relates to a system for a retrieval of a specimen from a minimally invasive surgical site. 
         [0004]    2. Background of the Related Art 
         [0005]    Laparoscopic and endoscopic surgical procedures are minimally invasive procedures in which operations are carried out within the body by means of elongated instruments inserted through small entrance or access openings in the body, e.g., an opening defined by a natural passageway of the body, an opening created by a tissue piercing instrument (e.g., a trocar), etc. 
         [0006]    Minimally invasive procedures are often used to partially or totally remove body tissue or organs from the interior of the body, e.g., nephrectomy, cholecystectomy and other such procedures. During such procedures, it is common that affected tissue or organ must be removed via the access opening in the skin, or through a cannula. Various types of entrapment devices are known in the art to facilitate this procedure. 
         [0007]    Many entrapment devices are configured to decrease a volume of a tissue or otherwise reshape a tissue to facilitate a removal of the tissue. For example, a specimen retrieval bag including a morcellation means configured to percutaneously debulk tissue may be utilized. In another example, a specimen retrieval device includes a drawstring to decrease the volume of a specimen retrieval bag and a tissue therein. Entrapment devices are ideally of minimal volume and/or cross-section to facilitate a passage thereof through an opening and a maneuvering thereof in an internal cavity. There is a continuing need for improved specimen retrieval devices of decreased volume and improved maneuverability. There further remains a need for improved methods of removing a specimen from a bodily opening. 
       SUMMARY 
       [0008]    In one aspect, a system for retrieving a tissue specimen is provided which includes a specimen retrieval bag having a first mating member and a retrieval device having a housing having a second mating member. The second mating member cooperates with the first mating member for coupling the bag with the retrieval device. A rotation mechanism is disposed in the retrieval device. Actuation of the rotation device draws an excess portion of the bag into the retrieval device. 
         [0009]    The system may retract the excess portion of the bag into the housing of the retrieval device. The rotation mechanism may include a knob for actuating the rotation mechanism. The retrieval device may include a ratchet mechanism to inhibit rotation of the rotation mechanism in at least one direction. The first mating member may be a lip and the second mating member may be a slit. The retrieval device can include an inner member around which the bag is wound. In some embodiments, the first mating member is slid into engagement with the second mating member. In some embodiments, the rotation mechanism includes a slot having a first width and the housing includes a slot having a second width greater than the first width. 
         [0010]    In another aspect, a method for retrieving a tissue specimen from a body cavity is provided which includes the steps of inserting a retrieval bag into the body cavity, placing a specimen into the bag, inserting a retrieval device into the body cavity, engaging the bag with the retrieval device, rotating an excess portion of the bag about an axis of the retrieval device to draw the excess portion of the bag into the retrieval device, and removing the retrieval device and the bag from the body cavity. 
         [0011]    The step of engaging the bag may include engaging a lip of the bag with a slit of the retrieval device. The retrieval device in the method may include a knob and an axle for rotating the excess portion of the bag. The retrieval device may include a ratchet mechanism to inhibit rotation of the rotation mechanism in at least one direction. The rotating step may store the excess portion of the bag. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0012]    Various embodiments of the present disclosure are described hereinbelow with references to the drawings, wherein: 
           [0013]      FIG. 1  is a side, perspective view of a specimen retrieval system according to the principles of the present disclosure; 
           [0014]      FIG. 2  is a side, perspective view of a retrieval device of the specimen retrieval system of  FIG. 1 ; 
           [0015]      FIG. 3  is a bottom, perspective view of a distal end of the retrieval device of  FIG. 2 ; 
           [0016]      FIG. 4A  is a side, perspective view of a ratchet mechanism of the retrieval device of  FIG. 2 ; 
           [0017]      FIG. 4B  is a side, cross-section view of the ratchet mechanism of  FIG. 2C ; and 
           [0018]      FIGS. 5A-5D  are side perspective views of the specimen retrieval system of  FIG. 1  removing a tissue from a body cavity through an opening. 
       
    
    
     DETAILED DESCRIPTION OF THE EMBODIMENTS 
       [0019]    Embodiments of the present disclosure will now be described in detail with reference to the drawings, in which like reference numerals designate identical or corresponding elements in each of the several views. As used herein, the term “distal” refers to the portion of the instrument which is farthest from the user, while the term “proximal” refers to that portion of the instrument which is closest to the user. In the following description, well-known functions or constructions are not described in detail to avoid obscuring the present disclosure in unnecessary detail. 
         [0020]    As used herein with reference to the present disclosure, the terms minimally invasive refer to instruments having a relatively narrow operating portion for insertion into a cannula, a small incision in the skin or through a body opening. Minimally invasive surgical procedures include for example laparoscopic, endoscopic, video assisted thoracic procedures, etc. It is believed that the present disclosure may find use in any procedure where access to the interior of the body is limited to a relatively small incision, with or without the use of a cannula, as in minimally invasive procedures. 
         [0021]    With reference to  FIG. 1 , a specimen retrieval system  10  according to an embodiment of the present disclosure is illustrated. Specimen retrieval system  10  includes a retrieval device  100  and a collapsible specimen retrieval bag  200  configured for mating together. Specimen retrieval system  10  may be composed of any suitable biocompatible materials, such as biocompatible plastics. 
         [0022]    Retrieval device  100  includes a knob  110 , an axle  120 , a housing  130 , and a housing slit  140 . Bag  200  includes a lip  240 , a connection  230 , and a body  250 . Connection  230  interconnects lip  240  and body  250 . Connection  230  is substantially flat. In one embodiment, lip  240  is substantially cylindrical. However, lip  240  may alternatively have any shape capable of mating with retrieval device  100 . 
         [0023]    Body  250  is sufficiently flexible to be rolled, folded, or otherwise compressed by retrieval device  100 . Body  250  has an open end  210  and a closed end  220 . Open end  210  is a proximal end of body  250 , and closed end  220  is a distal end of body  250 . Body  250  has a volume greater than a specimen “S” for receiving specimen “S” therein. Open end  210  allows a passage of material therethrough and has a perimeter sufficient for the passage of specimen “S” therethrough. 
         [0024]    Referring to  FIG. 2 , retrieval device  100  has a longitudinal axis “A” defined through axle  120 . Knob  110  is located at a proximal end of retrieval mechanism  100  and is fixedly attached to axle  120 , such that a rotation of knob  110  rotates axle  120 . Axle  120  extends from knob  110  through housing  130 . Housing  130  is a cylindrical, hollow structure configured for housing a ratchet mechanism  150 , an axle segment  122  of axle  120 , and a portion of bag  200 . Housing  130  has a proximal end distal to knob  110 . Ratchet mechanism  150  is located at the proximal end of housing  130  and provides for incremental rotation of axle  120 . Axle segment  122  is located within housing  130  distal to ratchet mechanism  150 . Axle segment  122  is hollow and configured for a receipt of lip  240 . Housing slit  140  is an elongated opening in retrieval device  100  extending from a position distal to ratchet mechanism  150  to a distal end of housing  130 . 
         [0025]    As seen in  FIG. 3 , axle segment  122  has a path  144  therein for receiving lip  240 . Axle segment  122  has an axle slit  142  that may be aligned with housing slit  140  upon a rotation of axle  120 . Axle slit  142  has a width less than a width of lip  240  to frictionally hold lip  240  within path  144 . Housing slit  140  has a width “W 1 ” at least as wide as the width of lip  240  to allow lip  240  to enter path  144 . A gap  146  exists between axle segment  122  and housing  130 . Gap  146  is sufficiently large to allow a substantial portion of bag  200  to wrap around axle segment  122 . 
         [0026]    Referring to  FIGS. 4A-4B , ratchet mechanism  150  includes a gear  152 , pawls  154 , teeth  156 , and a spring  158 . At least one pawl  154  and at least one tooth  156  are provided, though various embodiments may have greater numbers of teeth and pawls. Gear  152  is concentric with axle  120 , and gear  152  has a wider radius than a radius of axle  120 . Teeth  156  extend distally from gear  152 . Pawls  154  are fixedly attached to the inside of housing  130  in a position distal to gear  152  and in slidable contact with teeth  156 . Spring  158  is positioned within housing  130  between a proximal end of gear  152  and a proximal end of housing  130 . Spring  158  exerts a force that pushes gear  152  distally. 
         [0027]    Each tooth  156  has an acute side  156   a  extending at an acute angle from gear  152  and a perpendicular side  156   b  extending perpendicularly from gear  152 . Other configurations of teeth  156  that assist movement of gear  152  in a single direction are also contemplated, including arcuate teeth and teeth with sides extending from obtuse angles from gear  152 . Alternatively, it may be desirable for teeth  156  to have two acute sides  156   a  if bidirectional movement of gear  152  is needed. 
         [0028]    A rotation of knob  110  in a first direction rotates axle  120  in the first direction and further rotates gear  152  in the first direction. The rotation of gear  152  in the first direction places at least one side  156   a  into contact with at least one pawl  154 . Contact of a side  156   a  with a pawl  154  during rotation of gear  152  in the first direction causes a tooth  156  to slide proximally along the pawl  154  and translate gear  152  proximally along axis “A”. When the tooth  156  is fully proximal to the pawl  154 , the rotation of gear  152  in the first direction rotates the tooth  156  in the first direction until the tooth  156  is no longer in contact with the pawl  154 , allowing the force of spring  158  to push gear  152  distally until the tooth  156  is no longer fully proximal to the pawl  154 . Side  156   b  is configured such that rotational contact thereof with a pawl  154  does not cause the side  156   b  to slide proximally along the pawl  154 , thus inhibiting gear  152  from rotating in a second direction. 
         [0029]    Turning to  FIGS. 5A-5D , an exemplary method of use of specimen retrieval system  10  is illustrated. Any commonly known surgical tool, such as surgical forceps, may be suitable for manipulating specimen retrieval system  10  according to this method. As seen in  FIG. 5A , a tissue specimen “S” lies in a cavity “C” underlying a tissue “T”. An opening “O” exists in tissue “T” and is sufficiently wide for allowing a passage of specimen retrieval system  10  therethrough. An access port (not shown) can be inserted through the opening “O” through which system  10  is inserted. First, a cross-sectional area of bag  200  is decreased for insertion through opening “O” for example, through a rolling or folding of body  250 . As seen in  FIG. 5B , bag  200  may be expanded within cavity “C” by a surgical instrument such as a grasper (not shown) to allow an insertion of specimen “S” therein. Specimen “S” is inserted through open end  210  and placed in bag  250 . The bag  250  is thus inserted into the body cavity “C” without the housing  130 , and can remain in body cavity “C” without the housing  130  during the surgical procedure, until removal is desired. The absence of such elongated housing during the surgery facilitates access and maneuverability within the cavity “C”. 
         [0030]    As seen in  FIG. 5C , when it is desired to remove the bag, retrieval device  100  is inserted through opening “O” and mated with bag  200 . Lip  240  is inserted through path  144  and connection  230  is inserted through housing slit  140  and axle slit  142 . Knob  110  may then be rotated to retract an excess portion of bag  250  into gap  160  within housing  130 , which decreases a volume and/or cross-section of bag  250  and may compress specimen “S”. Such reduction in bag size and specimen compression facilitates removal. Ratchet mechanism  150  inhibits the excess portion of bag  250  from returning outside housing  130 . As seen in  FIG. 5D , retrieval device  100  compresses bag  250  until specimen retrieval device  10  has a sufficiently small cross section to pass through opening “O”. At this point, specimen retrieval device  10  may be lifted proximally through opening “O” to complete a removal thereof. 
         [0031]    As can be appreciated, being able to adjust the size of the bag while still in the body cavity, after the specimen is inserted, allows the use of a larger size bag. It also allows a single sized bag to be used for a wide range of specimen sizes as the bag size can be adjusted in situ, rather than relying on different size bags for different size specimens. 
         [0032]    Although the illustrative embodiments of the present disclosure have been described herein with reference to the accompanying drawings, the above description, disclosure, and figures should not be construed as limiting, but merely as exemplifications of particular embodiments. It is to be understood, therefore, that the disclosure is not limited to those precise embodiments, and that various other changes and modifications may be effected therein by one skilled in the art without departing from the scope or spirit of the disclosure.