Abstract:
An endoscope for performing minimally invasive surgery includes along a portion of its length a means such as a groove for slidingly engaging with a corresponding means such as a tongue in a second endoscope and guiding the second endoscope into the patient. Multiple endoscope may be connected together and guide one another into or out of a patient. The tongue structure may include incongruous portions to permit two endoscopes to be partially connected and guided by one another.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS  
       [0001]     The present application claims the benefit of the filing date of U.S. Provisional Application Ser. No. 60/734,182 entitled “Combination Laparoscopic and Endoscopic Delivery System,” and filed on Nov. 7, 2005.  
         [0002]     The above cross-referenced related application is hereby incorporated by reference herein in its entirety. 
     
    
     STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT  
       [0003]     None.  
       BACKGROUND OF THE INVENTION  
       [0004]     1. Field of the Invention  
         [0005]     The present invention relates to surgical devices for use in endoscopic and minimally invasive surgery.  
         [0006]     2. Brief Description of the Related Art  
         [0007]     Endoscopic and minimally invasive surgery has been known for many years and recently has become increasingly useful in treating various medical conditions. In such surgery, a class of devices commonly known as endoscopes may be used. The term endoscope is used here in its broad sense, encompassing all kinds of “scopes” such as laparoscope, colonoscopes, etc.  
         [0008]     An endoscope typically but not necessarily has an elongated body having one or more channels therein. Various devices, such as snares, biopsy forceps or other surgical tools, may be inserted into the channels in the endoscope or may be built into, mounted into, or on the endoscope. Thus, once the endoscope is placed into the patient, a surgeon may use a variety of surgical tools by placing them into or removing them form the endoscope. An endoscope may have one or a plurality of channels therein, and the channels may be of a variety of sizes and shapes and are limited only by size of the endoscope.  
         [0009]     Traditional endoscopes have suffered from a shortcoming in that once an endoscope has been chosen for a particular surgery and has been inserted into a patient, the surgeon is limited to tools that fit into the number and types of channels in that particular endoscope. Often, the surgeon needs to remove the endoscope during the procedure, such as to remove a specimen, and then re-insert the endoscope or another device. Thus, if a surgeon desired to use a variety of different surgical instruments or tools (or optics), the surgeon often must remove one tool or the like to make available a channel in the endoscope for another tool.  
       SUMMARY OF THE INVENTION  
       [0010]     The present invention is a flexible or rigid endoscope or channel, or plurality of endoscopes or channels, having a mechanism for permitting the attachment of a second endoscope or channel of various shapes or sizes to the outside of the endoscope via a sliding engagement mechanism such as a tongue and groove structure such that when a first endoscope is within a patient, a surgeon may insert a second endoscope into the patient and have the second endoscope in sliding engagement with the first endoscope such that the first endoscope guides the insertion of the second endoscope into the patient. The channels or endoscopes may be controlled by manual or robotic means.  
         [0011]     In an embodiment of the invention, an endoscope comprises an elongated body; at least one operative channel in the body; an engagement means, located along a circumference of said body, for engaging with a second endoscope or other operative channel and guiding the second endoscope or other operative channel into a patient. The engagement means may comprise a groove or tongue or other sliding engagement means parallel to the length of the body of the endoscope.  
         [0012]     Another embodiment of the invention comprises first and second endoscopes, each having a body and at least one channel therein, wherein the first endoscope further comprises a groove parallel to a length of its body; and the second endoscope further comprises a tongue parallel to a length of its body for engaging with said groove of the first endoscope. The first or second endoscope may further comprise second, third, or fourth engagement means parallel to their length for engaging with additional endoscope or surgical tools.  
         [0013]     In still other embodiments, an endoscope of the present invention has an engagement member that comprises a magnetic strip. An endoscope in accordance with the present invention further may comprise a plurality of ridges, grooves, or a combination of ridges and grooves spaced along a length of said endoscope.  
         [0014]     In another embodiment, the present invention is an endoscope that comprises an elongated body having an inner periphery and an outer periphery and an engagement means, member or mechanism on the inner periphery of the body for engaging with a complementary engagement means on a different item and for guiding that item into the body. The item may comprise a sheath having a channel therein for inserting surgical instruments or may comprise other endoscopes, optical means, surgical tools, probes or instruments.  
         [0015]     Still other aspects, features, and advantages of the present invention are readily apparent from the following detailed description, simply by illustrating a preferable embodiments and implementations. The present invention is also capable of other and different embodiments and its several details can be modified in various obvious respects, all without departing from the spirit and scope of the present invention. Accordingly, the drawings and descriptions are to be regarded as illustrative in nature, and not as restrictive. Additional objects and advantages of the invention will be set forth in part in the description which follows and in part will be obvious from the description, or may be learned by practice of the invention. 
     
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       [0016]     For a more complete understanding of the present invention and the advantages thereof, reference is now made to the following description and the accompanying drawings, in which:  
         [0017]      FIG. 1  is a are perspective view of a dual endoscope in accordance with a preferred embodiment of the invention in a disconnected position.  
         [0018]      FIGS. 2   a  and  b  are end views of a dual endoscope in connected and disconnected positions in accordance with a preferred embodiment of the present invention.  
         [0019]      FIG. 3  is a perspective view of a triple endoscope in accordance with a preferred embodiment of the invention in a connected position.  
         [0020]      FIG. 4  is an end view of a triple endoscope in accordance with a preferred embodiment of the present invention in a disconnected position.  
         [0021]      FIGS. 5   a  and  b  are end view of alternative embodiments of endoscopes in accordance with preferred embodiments of the present invention.  
         [0022]      FIG. 6  is a side view of an endoscope having an alternative embodiment of an engagement means in accordance with the present invention.  
         [0023]      FIG. 7  is a perspective view of a dual endoscope incorporating an alternative embodiment of the engagement means in accordance with the present invention.  
         [0024]      FIG. 8  is an end view of alternative embodiment of an endoscope having moveable or removable sheaths or channels within the endoscope. 
     
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS  
       [0025]     A first preferred embodiment of the invention is shown in  FIGS. 1   a  and  b  and  2   a  and  b . A first endoscope  110  has one or more channels  114  therein with ports at a distal end  112  of the endoscope  110 . While the endoscope  110  shown in  FIGS. 1   a  and  b  is a flexible endoscope, the present invention may be used with rigid or flexible endoscopes of any type. The channel(s)  114  may be of any type and for any use, whether they be for inserting optics or surgical tools or for suction or delivery of fluid, plasma, gas or the like. The endoscope  110  further has a means located along at least a portion of its length for attaching and/or guiding another device. Such “another device” may be a second endoscope  120  having a distal end  122  and one or more channels  124  having ports at the distal end  122  of the endoscope  120 . Like the channel(s)  114 , the channels  124  may be of any type and for any use. The endoscope  120  has a means  126  for engaging with the means  116  on the endoscope  110 . Preferably, the two endoscopes (or devices) are in sliding engagement such that the endoscope that first was inserted into a patient may act as a guide for insertion of the second endoscope or device. The means  116  and  126  may be of any type such as a tongue and groove, rounded ridge and annular groove, or other engagement means such as magnetic strips. The engagement means may be of any size or shape and is not limited a tongue, ridge or groove. Each endoscope may or may not have its own controller (manual or power) at its proximal end.  
         [0026]     A second preferred embodiment is shown in  FIG. 3 . In this second preferred embodiment an endoscope  220  has a distal end  222  and one or more channels  224  therein. The endoscope  220  has means  226  and  228  at different positions around its circumference for attaching and/or guiding additional endoscopes or other devices along its length. In  FIG. 3 , engagement or guiding means  226  is shown as protruding from endoscope  220  and engagement or guiding means  228  is shown as being concave. As shown in  FIG. 4 , variation on this arrangement are possible such that both engagement means on endoscope are concave. Alternatively, the both may be convex. Returning to  FIG. 3 , a second endoscope  210  is shown in engagement with the endoscope  220 . The second endoscope  210  has a distal end  212  and a plurality of channels  214  therein. The endoscope  210  further has a means  216  for engaging with the means  226  in endoscope  220 , such that one of the endoscopes  210 ,  220  may act as a guide for the other during insertion into the patient. An engagement means  218  is shown on an opposite side of endoscope  210 . A third endoscope  230  is shown in  FIG. 3 . The third endoscope  230  has a distal end  232  and a channel  234  therein. The third endoscope  230  further has a means  238  for engaging with the means  228  in endoscope  220  such that one of endoscopes  220 ,  230  may act as a guide for the other during insertion into the patient. A concave engagement means  236  is shown on an opposite side of endoscope  230 .  
         [0027]     The present invention provides surgeons with great flexibility in performing minimally invasive surgery. The surgeon may use any of a variety of different endoscope having a variety of different channels, tools, delivery mechanisms, suction tubes, etc. therein. Further, while all of the endoscope may have optics therein, the present invention allows for optics to be placed in only one of the endoscope shown in  FIGS. 1-4 , because the surgeon may view the tools or items inserted into the channels of the second and third endoscope with the optics in the first endoscope. This provides further flexibility for the surgeon.  
         [0028]      FIGS. 5   a  and  b  each show an embodiment of the invention in which an endoscope has engagement means or members for connecting four endoscopes to the endoscope shown. In  FIG. 5   a , the endoscope has four ridges placed around its circumference. In  FIG. 5   b , the endoscope is shown as having four grooves around its outer circumference. While four engagement means are shown in  FIGS. 5   a  and  5  are shown, any number of engagement means may be used. Similarly, a single endoscope may have combinations of different types of engagement means around its circumference, such as two grooves and two ridges.  
         [0029]      FIG. 6  is a side view of an endoscope in which the engagement means is a series of ridges along its length with reach ridge extending along a portion of the length of the endoscope. With this type of engagement means, a portion of the length of the endoscope may be attached to the length of an endoscope having a complimentary or mating engagement means or mechanism. As shown in  FIG. 7 , with this type of embodiment, the distal ends of the two connected endoscope may be moved independently of one another.  
         [0030]     In each of the disclosed embodiments, the endoscopes being connected to one another may be the same or may be different in type, size or configuration. Likewise, each may or may not have its own optical means or may or may not have suction means.  
         [0031]     Many variations of the present invention are possible. For example, scopes having different types or numbers of channels may be combined using the present invention. Further, scopes of different types may even be combined if that is desired by the surgeon.  
         [0032]     In yet another embodiment shown in  FIG. 8 , an endoscope  800  has a body  810  having one or more engagement means, mechanism or member  820  along its inner periphery to permit the insertion, removal, movement, and control of one or more channels or sheaths  830  within the endoscope. The channel or sheath  830  has an engagement means or mechanism  832  for engaging with the engagement means or mechanism  820  of the endoscope body  810 . Similarly, instruments having corresponding engagement means could be connected along the inner periphery of the endoscope rather than being inserted into a channel or sheath  830 . Any engagement mechanism, means or member may be used to connect the sheath or channel to the endoscope. Additionally, the endoscope may have engagement mechanisms, means or members along its outer periphery for the attachment or guidance of additional endoscopes, channels or tools.  
         [0033]     With the present invention, a plurality of endoscopes may be connected together in a manner in which one endoscope may be used to guide a second endoscope into a patient. The second endoscope may be inserted to the same depth into the patient as the first endoscope, less depth into the patient or greater depth into the patient. Similarly, rather than a plurality of endoscope being connected together or one endoscope guiding other endoscopes into a patient, the present invention permits tools or instruments to be connected to a first endoscope and be guided into a patient.  
         [0034]     Additionally, in each embodiment of the present invention, a locking means, mechanism or device may be used to hold the various endoscopes and tools in desired positions relative to each other. The locking means may be part of one or more of the endoscopes or may be a separate component that is attached to the endoscope(s) once they are in their desired positions relative to each other. The locking mechanism or means may take any form such as a clamp, band or other means.  
         [0035]     The foregoing description of the preferred embodiment of the invention has been presented for purposes of illustration and description. It is not intended to be exhaustive or to limit the invention to the precise form disclosed, and modifications and variations are possible in light of the above teachings or may be acquired from practice of the invention. The embodiment was chosen and described in order to explain the principles of the invention and its practical application to enable one skilled in the art to utilize the invention in various embodiments as are suited to the particular use contemplated. It is intended that the scope of the invention be defined by the claims appended hereto, and their equivalents. The entirety of each of the aforementioned documents is incorporated by reference herein.