Abstract:
Disclosed herein are medical instruments having an elongate member having a first end, a second end, and a bore extending the length of the elongate member, a body is coupled to the second end of the elongate member where the body having a suctioning control means in communication with the bore of the elongate member, and a fenestrated tip coupled to the first end of the elongate member, wherein the fenestrated tip is sufficiently rigid to dissect and retract tissues and prevents obstruction of the bore.

Description:
BACKGROUND  
       [0001]     Various medical instruments have been designed and developed for use in surgical procedures. Typically, these instruments are specialized for particular uses during surgical procedures. For instance, a suctioning device is used to remove fluids such as blood from solid debris such as tissue, bone fragments, or the like. Other specialized devices such as forceps, dissectors, probes, and the like are used to move, separate, and retract tissues.  
         [0002]     While these specialized devices are useful for performing particular functions, requiring and switching between a plurality of instruments can be a time consuming process for a surgeon. Additionally, there may be situations where the surgeon would not have the use of a free hand and the assistance of other medical staff may not be practical or possible. Thus, the use of many instruments during a surgical procedure can increase the duration of the surgical procedure, which subjects the patient to longer periods of anesthetization. Accordingly, multi-functional instruments have been developed in art. However, there still remains a need for multi-functional instruments that reduces the number of instruments required by a surgeon during a medical procedure.  
       SUMMARY  
       [0003]     Briefly, and in general terms, various embodiments of a multi-functional instrument are disclosed herein. The multi-functional instrument includes a padded and porous tip, an elongate body, and a suction control means. The multi-functional instrument is a handheld instrument that can be used to dissect or retract tissue, and remove liquids from solid debris from the surgical field without becoming obstructed. The instrument may be used in open, minimally invasive, or laparoscopic procedures. Additionally, the instrument may be a single use device or a reusable device. In use, a surgeon can perform these functions with one hand thereby allowing free use of the surgeon&#39;s other hand while not having to pause to unclog the instrument.  
     
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       [0004]      FIG. 1  is a top plan view of one embodiment of the multi-functional medical instrument;  
         [0005]      FIG. 2  is a side view of an alternate embodiment;  
         [0006]      FIG. 2A  is a fragmented top plan view of one embodiment of a suction control means for a multi-functional medical instrument;  
         [0007]      FIG. 2B  is a fragmented top plan view of another embodiment of a suction control means for a multi-functional medical instrument;  
         [0008]      FIG. 3  is a side view of another embodiment of the multi-functional medical instrument;  
         [0009]      FIG. 4  is a cross-sectional view of multi-functional medical instrument of  FIG. 3  taken along line  4 - 4 ;  
         [0010]      FIG. 5  is a cross-sectional view of multi-functional medical instrument of  FIG. 3  taken along line  5 - 5 ;  
         [0011]      FIG. 6  is a fragmented side view of an embodiment of a multi-lumen tube for a multi-functional medical instrument;  
         [0012]      FIG. 7  is a fragmented side view of another embodiment of a multi-lumen tube for a multi-functional medical instrument;  
         [0013]      FIG. 8  is top plan view of another embodiment of the multi-functional medical instrument;  
         [0014]      FIG. 9  is a side view of embodiment depicted in  FIG. 8 ;  
         [0015]      FIG. 10  is a fragmented side view of an embodiment of a suction controller for a multi-functional medical instrument;  
         [0016]      FIG. 11  is a fragmented side view of another embodiment of a suction controller for a multi-functional medical instrument; and  
         [0017]      FIG. 12  is a fragmented side view of yet another embodiment of a suction controller for a multi-functional medical instrument.  
     
    
     DESCRIPTION OF EMBODIMENTS  
       [0018]     The embodiments disclosed herein are directed to a multi-functional medical instrument that may be used in open, minimally invasive, or laparoscopic procedures. The multi-functional instrument is a handheld instrument that can be used to dissect or retract tissue, and remove liquids from solid debris from the surgical field without becoming obstructed. In use, a surgeon can perform these functions with one hand thereby allowing free use of the surgeon&#39;s other hand while not pausing to unclog the instrument.  
         [0019]      FIG. 1  depicts one embodiment of the multi-functional medical instrument  10 . Generally, the multi-functional medical instrument  10  includes a tip  11 , a body  12 , a suctioning means  14 , and a connector  15 . The instrument  10  may be coupled to a vacuum source (not shown) via the connector  15 . Of course, one of ordinary skill in the art will appreciate that not all multi-functional medical instruments  10  will have all these components, and may, indeed, have other components in addition to or in lieu of those components mentioned here.  
         [0020]     The tip  11  is made of a fenestrated, perforated, or woven material, which allows the suction of liquids and not solids and prevents the obstruction of the suctioning channel. The tip material also provides padding to the end of the instrument  10 , which prevents damage to structures when pressure is applied. The material that makes up the tip  11  has sufficient density to allow the tip to be used as a dissector and/or retractor. That is, the tip material has sufficient rigidity so that the tip  11  does not collapse when pressure is applied to the tip. The tip  11  has a coefficient of friction which eases separation of tissues. Accordingly, the tip  11  can be used for tissue dissection or to retract delicate structures such as, but not limited to, nerve tissue, vascular tissue, bowel, or the gall bladder. As shown in  FIG. 1 , the tip  11  has a generally rounded shape. As those skilled in the art will appreciate, the tip may be configured in any shape known or developed in the art.  
         [0021]     As shown in  FIG. 1 , the tip  11  is coupled to a tube  12  by a coupling means. In one embodiment, the tip  11  may be coupled to the tube  12  by an adhesive. In another embodiment, the tip  11  may be coupled to the tube  12  by a friction fit. In yet another embodiment, the tip  11  may be molded directly to the tube  12 . As those skilled in the art will appreciate, the tip  11  may be coupled to the tube by any means known or developed in the art. In these embodiments, the tip  11  is permanently coupled to the tube  12 . Give the porous nature of the tip  11 , these instruments  10  cannot be cleaned for reuse and are generally single use instruments.  
         [0022]     By reversibly coupling the tip  11  to the end of the tube  12 , the tip  11  may be removed from the end of the tube  12  so that that the remaining portion of the multi-functional device  10  may be reused and a new tip  11  may then be applied to the end of the tube. According to one embodiment, the tip  11  may be reversibly coupled to the end of the tube  12 . For instance, the tip  11  may be sewn onto the end of the tube  12  with nylon thread or other thread known or developed in the art. In another embodiments, the tip  11  may be coupled to the tube  12  by nylon ties or the like. In this embodiment, the proximal end of the tip  11  may include loops or slits that are sized to receive the nylon ties. In other embodiments, the tip  11  may be attached to the tube  12  via a friction fit or detachable coupler.  
         [0023]     In  FIG. 1 , the tube  12  is generally an elongate body having a bore. As those skilled in the art will appreciate, the tube  12  can have varying lengths, diameters, and one or more lumens. As shown in  FIG. 1 , the tube  12  has a uniform diameter. In other embodiments, the tube  12  may be tapered. In another embodiment, the tube  12  may be only tapered at the end of the tube by the tip  11 .  FIG. 2  depicts another embodiment of a multi-functional instrument  20  having a tube  21  bent at a fixed angle α. It is contemplated that the angle a may be between approximately 0° C. to approximately 90° C. As those skilled in the art will appreciate, the tube  12  can be made from a plurality of materials such as, but not limited to, polycarbonate, polypropylene, or other plastics, fiberglass or stainless steel.  
         [0024]     In  FIG. 1 , the tube  12  is coupled to a suction control means  13 . As shown in  FIG. 1 , the suction control means  13  is a hollow plenum having an opening  14  and is coupled to a connector  15 . The suction control means  13  may be a box-like structure having a rectangular, cubic, or any other polygonal shape having at least one flat surface. Generally, the suction control means  13  has a greater cross-section than the tube  12  in order to provide a collection area for clotted fluids thereby minimizing clotting of the instrument  10 . Additionally, the larger size of the suction control means  13  provides a larger surface area for the user to grasp for user comfort. However, in one embodiment, the suction control means  13  may have the same cross-sectional area as the tube  12 .  
         [0025]     In  FIG. 1 , the connector  15  coupled to the end of the suction control means  13  and is sized to accommodate various sizes of tubing that is in communication with the vacuum source (not shown). Generally, the connector  15  is integral with the suction control means  13 , but it is contemplated that the connector  15  may be a separate component that is coupled to the suction control means. As shown in  FIGS. 1-2 , the connector  15  is tapered and includes barbs to securely grasp the tubing. In other embodiments, the connector may have a uniform outside diameter and may or may not include barbs as shown in  FIG. 1 . Accordingly, in these embodiments, nylon ties, threads or detachable couplers (none shown) may be used to secure the tubing to the connector.  
         [0026]     The suction control means  13  also includes an opening  14  that controls the suction force at the tip  11 . As shown in  FIG. 1 , the opening  14  is tear-shaped. In other embodiments, it is contemplated that the opening  14  may have any shape known or developed in the art. In another embodiment, the suction control means  13  may include one or more openings  16  that are generally aligned along a common line. For instance, as shown in  FIG. 2A , the openings  16  may have similar diameters or have varying diameters as depicted in  FIG. 2B . Accordingly, in use, maximum suctioning force is obtained when the user covers all the openings and as each opening is exposed to ambient environment, the suctioning force is reduced.  
         [0027]     In other embodiments, the suction control means  13  may be a spring-loaded trumpet valve  100 , a rotating thumb wheel  110 , or a sliding lever  120  as shown in  FIGS. 10-12 . As those skilled in the art will appreciate, the suction control means  13  can be any means to control the suction force at the tip  11  of the multi-functional instrument that has been known or developed in the art.  
         [0028]     In use, the suction forces at the tip  11  of the instrument is controlled by varying the amount of the opening  14  that is covered by the user&#39;s finger. If the opening  14  is completely covered, then maximum suctioning force is available at the tip of the instrument. Alternatively, if a portion of the opening  14  is exposed to the ambient environment, the suctioning force available at the tip of the instrument is reduced.  
         [0029]     It is also contemplated that one embodiment of the multi-functional device  25  is composed of the tip  11  coupled to the tube  12  as shown in  FIG. 2C . The tube  12  has a diameter slightly larger than the outside of the diameter of a standard suctioning device (not shown). In use, the tube  12  of the device  25  may be friction fitted over the existing suction device. Accordingly, an existing suctioning device retrofitted with the multi-functional device  25  may be used to dissect or retract tissue while removing fluids from the surgical field.  
         [0030]     Turning now to  FIG. 3 , yet another embodiment of a multi-functional instrument  30  is illustrated. The instrument  30  has a flexible tube  31  that may be bent to any angle or configuration. For instance, as shown in  FIG. 3 , the tube  31  is bent in a S-shaped configuration. In another configuration, the tube  31  may be bent in a J-shaped configuration.  FIGS. 4 and 5  illustrate two cross-sectional views of the tube  31 . In  FIG. 4 , the tube  31  is reinforced with a malleable wire  41  that allows the tubing  31  to be adjustable yet capable of holding various shapes while maintaining the patency of the lumen(s). In  FIG. 5 , the tube  31  includes a single malleable wire  40  that may be used to maintain the configured shape of the tube  31 . In yet another embodiment, one or more malleable wires may be embedded within the walls of the tube. In another embodiment, one or more malleable wires may be positioned on the outside of the tube. With respect to the embodiment disclosed above, it is contemplated that the malleable wires may extend the entire length of the tube. In alternate configurations, the malleable wires may be located on one or more sections of the tube. For instance, in one embodiment, the malleable wires may be positioned near the tip of the device.  
         [0031]     As shown in  FIGS. 1-5 , the instrument  10  has a tube  12  having a single lumen. In other embodiments, the tube  12  may have more than one lumen. For instance, the tube  12  may have walls that extend the length of the lumen to bifurcate the tube into multiple channels that provide suctioning, irrigation, and medicament delivery.  FIG. 6  illustrates another embodiment of the multi-functional medical instrument having a plurality of secondary tubes  60  coupled to the external surface of the tube  12 . Generally, the secondary tubes  60  extend the length of the instrument and terminate near the tip  11 . The secondary tubes  60  are generally smaller in diameter than the main tube  12 . However, it is contemplated that the diameter of secondary tubes  60  may be varied. As shown in  FIG. 6 , the secondary tubes  60  are spaced about the circumference of the tube  12 .  FIG. 7  illustrates yet another embodiment where the ends  71  of the secondary tubes  70  are flared away from the surface of the tube  12 . As those skilled in the art will appreciate, the secondary tubes may be varied in number, position, point of termination, or diameter from what is depicted in  FIGS. 6-7  depending on the purpose of the secondary tubes.  
         [0032]      FIGS. 8 and 9  illustrate another embodiment of the multi-functional medical instrument  80 . These figures show an instrument  80  that is intended for use in laparoscopic procedures. That is, this instrument  80  is held like a pencil or knife rather than a drumstick. Like the previous embodiments shown in  FIGS. 1 and 2 , the instrument  80  shown in  FIGS. 8 and 9  include a tip  81 , tube  82 , and suction control means  84 . The instrument  80  includes an enlarged area  83  around the suction control means  84  as shown in  FIG. 8 . The enlarged area may be curved as shown in  FIG. 9 , but other embodiments where the enlarged area  83  is flat. Furthermore, the side opposite the enlarged area  83  may also be curved. The curved surfaces allow the user to comfortably hold the instrument  80 . The instrument  80  also includes an accumulator  85  having a generally cylindrical structure that is coupled to the suction control means. However, as those skilled in the art will appreciate, the accumulator may have any shape known or developed in the art. As shown in  FIGS. 8-9 , the accumulator  85  also has a diameter larger than the tube  82 . The accumulator  85  is a collection area for clotted fluids thereby minimizing clotting of the instrument  10 . Furthermore, the larger diameter also allows the user to comfortably hold the instrument  80 . In an alternate embodiment, the accumulator  85  may have the same diameter as the tube  80 . In yet another embodiment, the instrument  80  may be configured so that it does not include an accumulator.  
         [0033]     As those skilled in the art will appreciate, the various embodiments of the components of the multi-functional instrument depicted in the figures may be combined or substituted to form other multi-functional instruments that are not depicted or explicitly illustrated or disclosed herein.  
         [0034]     In use, a vacuum source is placed in communication to the multi-functional medical instrument  10  via tubing (not shown), which, in turn is coupled to the connector  15 . In particular embodiments, nylon ties or other coupling means such as threads or friction may be used to ensure that the tubing is securely coupled to the connector. Accordingly, the vacuum source creates a suction force at the tip  11  of the instrument  10 . The suctioning force at the tip  11  of the instrument  10  may be adjusted with the suction control means  13 . In some embodiments, the suctioning force is controlled by adjusting the amount or number of openings  14  that are exposed to the ambient environment. Whether or not a suctioning force is present, the surgeon may use the tip  11  to dissect or retract soft tissue or other delicate structures. However, it is possible that the surgeon may use the suctioning force to retract or hold a structure. Any fluid in the surgical field is then drawn into the instrument  10  through the tip  11 . The tip  11  acts as a filter preventing any loose debris from being drawn into the instrument  10 . Any fluid that clots or coagulates in the instrument may be collected in the accumulator  13 . The fluid may then be accumulated in a reservoir or similar structure downstream of the instrument  10 .  
         [0035]     In closing, it is to be understood that the embodiments disclosed herein are illustrative and other modifications that may be employed are within the scope of the specification. Thus, by way of example, but not of limitation, alternative configurations may be utilized in accordance with the teachings herein. Accordingly, the drawings and the description are illustrative and not intended to be a limitation thereof.