Patent Publication Number: US-11026711-B2

Title: Specimen retrieval device including an integrated sliding grasper

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application is a continuation of U.S. patent application Ser. No. 14/270,658 filed on May 6, 2014, now U.S. Pat. No. 9,987,031, which claims the benefit of and priority to U.S. Provisional Patent Application No. 61/834,948, filed Jun. 14, 2013, and the disclosures of each of the above-identified applications are hereby incorporated by reference in their entirety. 
    
    
     BACKGROUND 
     Technical Field 
     The present disclosure relates to a specimen retrieval device. More particularly, the present disclosure relates to a specimen retrieval device including an integrated sliding grasper. 
     Background of Related Art 
     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. 
     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, duodenectomy, ileectomy, jejunectomy and other such procedures. During such procedures, it is common that affected tissue or organs 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. Conventional entrapment devices typically include an elongated applicator including a handle at a proximal end that is operable to deploy a pouch or other suitable device from a distal end of the applicator. The pouch, typically, is formed from a thin sheet of material (e.g., nylon) that is impervious to prevent unwanted tissue cell migration. 
     One of the difficulties that may occur during minimally invasive procedures is when large excised tissue specimens are being positioned within the pouch, e.g., long specimens, into the pouch. For example, placing a relatively long excised specimen into an unsupported pouch using a separate implement (e.g., graspers) may sometimes prove difficult for a surgeon because the pouch may not maintain its unfolded configuration. Further, long excised specimens sometimes tend to “bunch up” when positioned inside the pouch, which may make it difficult to retrieve the pouch through the usually small laparoscopic incision. As can be appreciated, tissue specimen retrieval under such conditions can cause the pouch to rupture, which, in turn, may result in the excised specimen (or portion thereof) migrating out of the pouch. 
     SUMMARY 
     As can be appreciated, a specimen retrieval device including an integrated sliding grasper that is provided within a pouch of the specimen retrieval device may prove useful in the surgical arena. 
     An aspect of the instant disclosure provides a specimen retrieval device. The specimen retrieval device includes a housing that includes an outer shaft extending distally therefrom. An inner shaft is disposed within the outer shaft. The inner shaft includes one or more tissue engaging devices configured to engage tissue and one or more springs. A pouch is coupled to the inner shaft and the at least one spring. The pouch includes an open proximal end and a closed distal end and is movable from a first configuration for deployment from the outer shaft to a second configuration for receiving tissue therein. The tissue engaging device is repositionable within the pouch and movable along the inner shaft for engaging tissue and pulling the tissue into the pouch. 
     The tissue engaging device may be movable along a rail of the inner shaft. The rail may include a channel configured to allow the tissue engaging device to move along the rail. 
     The tissue engaging device may be a pair of jaw members, a needle, a barbed suture or a suction device. The specimen retrieval device may include an actuation device that is configured to move the pair of jaw members from an open configuration for grasping tissue to a closed configuration for pulling the tissue within the pouch. Moreover, the actuation device also may be configured to move the pair of jaw members longitudinally along the inner shaft. 
     The spring may be configured to move the pouch from the first configuration to the second configuration. The specimen retrieval device may include a cinch handle including a cinch that couples to the open proximal end the pouch for cinching the pouch to a cinched configuration. The pouch may taper towards the closed distal end thereof when the pouch is in the second configuration. 
     An aspect of the instant disclosure provides a specimen retrieval device. The specimen retrieval device includes a housing that includes an outer shaft extending distally therefrom. An inner shaft is disposed within the outer shaft and is deployable therefrom. The inner shaft including one or more channels and one or more springs. The channel has one or more tissue engaging devices positioned therein for longitudinal movement therealong. A pouch is coupled to a distal end of the inner shaft and the spring so as to abut a portion of the channel of the inner shaft. The pouch includes an open proximal end and a closed distal end and is movable via the at least one spring from a first configuration for deployment from the outer shaft to a second configuration for receiving tissue therein. The tissue engaging device is movable within the pouch along the channel for engaging tissue and for pulling tissue into the pouch. 
     The channel of the inner shaft may be provided on a rail of the inner shaft. The tissue engaging device may be a pair of jaw members or a needle. The specimen retrieval device may include an actuation device that is configured to move the pair of jaw members from an open configuration for grasping tissue to a closed configuration for pulling the tissue into the pouch. Moreover, the actuation device also may be configured to move the pair of jaw members 
     The specimen retrieval device may include a cinch handle including a cinch that couples to the open proximal end of the pouch for cinching the pouch to a cinched configuration. The pouch may taper towards the closed distal end thereof when the pouch is in the second configuration. 
     An aspect of the instant disclosure provides a method for removing tissue from a body of a patient. Initially, an outer shaft of a specimen retrieval device is inserted within a body cavity of a patient. Thereafter, an inner shaft of the specimen retrieval device is deployed from the outer shaft to move a pouch of the specimen retrieval device from a first configuration to a second configuration. Subsequently, at least one tissue engaging device provided on the inner shaft is positioned towards a proximal end of the pouch for engaging tissue. Then, tissue of interest is engaged. Next, the tissue engaging device is positioned towards a distal end of the pouch for pulling tissue into the pouch. Subsequently, the pouch is removed from the body cavity of the patient. 
     Prior to removing the pouch, the open end of the pouch may be cinched. Prior to inserting the outer shaft of the specimen retrieval device, an access port may be positioned on tissue of the patient. 
     The inner shaft of the specimen retrieval device may be provided with at least one channel that is configured to receive the at least one tissue engaging device therein. Moreover, the inner shaft of the specimen retrieval device may be provided with at least one spring that is configured to couple to the pouch. A pair of jaw members, a needle, a barbed suture or a suction device may be utilized for the at least one tissue engaging device. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       Embodiments of the presently disclosed specimen retrieval device are described hereinbelow with reference to the drawings wherein: 
         FIG. 1  is a side, perspective view of a specimen retrieval device according to an embodiment of the instant disclosure; 
         FIG. 2  is a partial, side view of a distal end of an inner shaft of the specimen retrieval device shown in  FIG. 1  illustrating components of the distal end; 
         FIG. 3  is a perspective view of the inner shaft and a pouch of the specimen retrieval device shown in  FIG. 1  positioned within a body cavity through an access port, wherein the pouch is in an open configuration for receiving tissue; 
         FIG. 4  is a perspective view of the inner shaft and pouch shown in  FIG. 3  with tissue positioned within the pouch; 
         FIG. 5  is a perspective view of the inner shaft and pouch shown in  FIGS. 3-4  with tissue positioned within the pouch and the pouch in a cinched configuration; and 
         FIGS. 6A-6C  are sides views illustrating various tissue engaging devices that may be utilized with the specimen retrieval device shown in  FIG. 1 . 
     
    
    
     DETAILED DESCRIPTION OF THE EMBODIMENTS 
     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. 
     As used herein with reference to the present disclosure, the terms laparoscopic and endoscopic are interchangeable and refer to instruments having a relatively narrow operating portion for insertion into a cannula or a small incision in the skin. They also refer to minimally invasive surgical procedures. 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. 
     With reference to  FIGS. 1-5 , and initially with reference to  FIG. 1 , a specimen retrieval device  10  according to an embodiment of the present disclosure is illustrated. Briefly, specimen retrieval device  10  includes a housing  12  that includes handle portions  14  and  16  ( FIG. 1 ) that are fixedly joined together. An elongated tube or outer shaft  18  extends from the housing  12  and is dimensioned for insertion through a trocar cannula or access port  19  ( FIG. 3 ) for endoscopic or laparoscopic procedures. In certain embodiments, the outer shaft  18  may be configured to articulate. A longitudinal axis “A-A” is defined through the outer shaft  18  and is oriented in a substantially parallel direction with respect to a longitudinal axis “B-B” that is defined through a pouch  22  when the pouch  22  is in the deployed state ( FIGS. 3-5 ). 
     An inner shaft  24  that extends within and along a length of the outer shaft  18  operably couples to a grasping member  26  ( FIG. 1 ). Grasping member  26  is configured for engagement by a user&#39;s fingers and is configured to translate or move the inner shaft  24  within the outer shaft  18 . 
     A pull ring  28  is operably coupled to a proximal end of a cinch  30  (e.g., a suture “S,” thread, wire, cable or the like) by any suitable coupling method, e.g., tied, adhesive, etc., and is configured to facilitate pulling the cinch  30  proximally through the inner shaft  24 . In the illustrated embodiment, pull ring  28  releasably couples, via one or more suitable coupling methods, e.g., a press or friction fit, to the grasping member  26 . A distal end of the cinch  30  operably coupled to a portion, e.g., an open proximal portion  32  ( FIGS. 3-4 ), of the pouch  22 . 
     A deformable spring  34  (shown in phantom in  FIG. 3 ) operably couples to the inner shaft  24  via one or more suitable coupling methods (e.g., the spring  34  may be overmolded to the inner shaft  16 ) and includes two generally flexible or resilient strips  35   a ,  35   b  (shown in phantom in  FIG. 3 ) that move from a stressed or non-expanded state ( FIG. 5 ) to an unstressed or freely expanded state ( FIGS. 3-4 ) when the pouch  22  is deployed from the outer shaft  18 . In the stressed or non-expanded state, the pouch  22  is wound or wrapped around the resilient strips of the inner shaft  24 . Wrapping the pouch  22  around the resilient strips facilitates deploying the pouch  22  from the relatively small area within the outer shaft  18 . In an unstressed or freely expanded condition, the two resilient strips collectively form a generally circumferential or triangular configuration for supporting a periphery of the open proximal portion  32  of the pouch  22  (see  FIGS. 3-4  for example). 
     For a more detailed description of the specimen retrieval device  10  and operative components associated therewith, reference is made to commonly-owned U.S. Pat. No. 5,647,372 to Tovey et al., filed on Sep. 16, 1994, the entirety of which being incorporated herein by reference. 
     With reference again to  FIG. 1 , and with reference to  FIG. 2 , inner shaft  24  includes an actuation device  36  that is configured to control operation of a tissue engaging device, e.g., a pair of jaw members  38 ,  40  ( FIG. 2 ). To this end, actuation device  36  includes a base portion  41  that may be configured for grasping by a user and a flexible rod  42  (or other suitable device, e.g., a wire). Base portion  41  releasably couples, via one or more suitable coupling methods, e.g., a press or friction fit, to the grasping member  26 . Rod  42  includes a proximal end that couples to a distal end of the base  41  and extends distally from the base portion  41 . A distal end of the rod  42  is positioned through an aperture (not explicitly shown) provided at a proximal end of the grasping member  26 . The distal end of the rod  42  extends from the grasping member  26  to a rail  46  disposed on the inner shaft  24  and couples to the jaw members  38 ,  40  by suitable coupling methods ( FIG. 2 ). 
     Continuing with reference to  FIG. 2 , in accordance with the instant disclosure, proximal and distal movement of the actuation device  36  moves the jaw members  38 ,  40  proximally and distally within the pouch  22  along the inner shaft  24 . Actuation device  36  is configured such that as the base portion  41  of the actuation device  36  is moved proximally, the jaw members  38 ,  40  move towards the open proximal portion  32  and automatically to an open configuration ( FIGS. 2-3 ). Likewise, as the base portion  41  of the actuation device  36  is moved distally, the jaw members  38 ,  40  move towards a closed distal portion  44  of the pouch  22  and automatically to a closed configuration (see  FIGS. 2 and 4-5 ). A spring or other suitable device (not shown) may be coupled to the jaw members  38 ,  40  to bias the jaw members to the open or closed configuration. 
     Alternatively, in an embodiment, a cam member (not shown) may be positioned on the jaw members  38 ,  40  and to move the jaw members  38 ,  40  between the open and closed configurations. In this particular embodiment, rotation of the base  41  of the actuation device  36  in a first direction may actuate the cam member to cam the jaw members  38 ,  40  to the closed configuration and rotation of the base  41  in a second direction may actuate the cam member to cam the jaw members  38 ,  40  to the open configuration. Those skilled in the art will appreciate other methods and/or devices that may be utilized to move the jaw members  38 ,  40  between the open and closed configuration. 
     In the illustrated embodiment, a channel  48  is provided at the distal end of the rail  46  and extends at least partially along a length thereof  46  ( FIG. 2 ). In an embodiment, such as the illustrated embodiment, the channel  48  extends along the inner shaft and is positioned to abut the pouch  22 . Specifically, the channel  48  extends along the rail  46  and abuts the open proximal portion  32  and the closed distal portion  44  of the pouch  22 . As can be appreciated, by not allowing the channel  48  to extend proximally past the open upper portion  32  helps to ensure that the jaw members  38 ,  40  (and excised tissue grasped therebetween) do not extend beyond the confines of the pouch  22 , which, in turn, helps to ensure that the excised tissue does not migrate from the pouch  22 . 
     Pouch  22  may be made from any suitable biocompatible materials (e.g., nylon) capable of forming an impermeable flexible membrane. Pouch  22  includes a generally tubular or elongated configuration that is defined by the openable and closable proximal portion  32  and closed distal portion  44 . A channel of suitable configuration extends along the pouch  22  and includes a portion of the cinch  30  therein that is utilized to cinch the pouch  22  after tissue is positioned within the pouch  22 . Moreover, proximal portion  32  includes a sleeve (not explicitly shown) that is configured to receive the resilient members of the spring  34 . The sleeve may be formed on pouch  22  via folding the proximal portion  32  into an interior of the pouch  22  and, subsequently, gluing the proximal portion  32  thereto. Alternatively, in embodiments, the spring  34  may not be utilized and the proximal portion  32  of the pouch  22  may be formed from a compressible material that allows the proximal portion  32  of the pouch  22  to move between a compressed condition to a non-compressed condition. In the non-compressed condition, proximal portion  32  defines an opening that is configured to allow a clinician to position tissue of interest within the pouch  22 . Moreover, in the non-compressed condition, the pouch  22  may taper towards the closed distal end  44  thereof when the pouch  22 . Alternatively, the pouch  22  may not taper towards the closed distal end  44  thereof when the pouch  22 . 
     A pair of sidewalls  52 ,  54  of the pouch  22  are coupled to the rail  46  adjacent the channel  48  of the rail by suitable coupling methods ( FIG. 2 ). Each of the sidewalls  52 ,  54  abuts a corresponding side of the channel  48  to allow unobstructed movement of the jaw members  38 ,  40  within the pouch  22 . 
     With reference to  FIGS. 3-5 , operation of the specimen retrieval device  10  is now described. In use, the access port  19  may be positioned on a patient to allow access of the specimen retrieval device  10  into a body cavity of a patient ( FIG. 3 ). Thereafter, inner shaft  24  may be deployed from the outer shaft  18  and the outer shaft  18  may be removed from the body cavity of the patient while the inner shaft  24  is kept within the body cavity. As can be appreciated, after deployment of the inner shaft  24 , the outer shaft  18  may also be kept within the body cavity. Once the inner shaft  24  is deployed from the outer shaft  18 , the openable proximal end  32  of the pouch  22  is forced to the open configuration via the biasing force of the resilient members of the spring  30  ( FIG. 3 ). 
     In the open configuration, the jaw members  38 ,  40  may be moved towards the open proximal end  32  of the pouch  22 . In this position, the jaw members  38 ,  40  are in the open configuration and set to grasp excised tissue. In embodiments, such as the illustrated embodiment, a surgeon may grasp the excised tissue with a separate implement (e.g., graspers) and position the excised tissue between the jaw members  38 ,  40 . Alternatively, a surgeon may move the pouch  22  including the jaw members  38 ,  40  adjacent excised tissue and grasp the excised tissue with the jaw members  38 ,  40 . 
     Once tissue is positioned between the jaw members  38 ,  40  the base portion  41  of the actuation device may be moved distally, which, in turn, moves the jaw members  38 ,  40  along the channel  48  of the rail  46  toward the closed distal portion  44  of the pouch  22  and to the closed configuration ( FIG. 4 ). 
     A surgeon may then pull the pull ring  28  proximally which cinches the pouch  22  ( FIG. 5 ). Thereafter, the inner shaft  24  including the cinched pouch  22  may be removed from the body cavity of the patient through access port  19 . 
     The specimen retrieval device  10  of the present disclosure allows a user to insert excised tissue (e.g., relatively large samples of excised tissue) within the pouch  22  while maintaining the compactness (e.g., unfolded configuration) of the pouch  22 . Moreover, because the excised tissue is pulled into the pouch  22 , the likelihood of the excised tissue bunching up when being positioned inside the pouch is reduced, if not eliminated, which, in turn, may make it easier to retrieve the pouch  22  through the usually a small laparoscopic incision or access port  19 . 
     From the foregoing and with reference to the various figure drawings, those skilled in the art will appreciate that certain modifications can also be made to the present disclosure without departing from the scope of the same. For example, while the jaw members  38 ,  40  have been described herein as being utilized as the tissue engaging device, other tissue engaging devices may also be utilized. For example, any type of needle  56  ( FIG. 6A ), a barbed suture  58  ( FIG. 6B ), a suction device  60  ( FIG. 6C ) or other suitable device may be utilized in place of the jaw members  38 ,  40 . As can be appreciated, certain modifications may need to be made to specimen retrieval device  10  to accommodate the different tissue engaging devices implemented. 
     In embodiments, one or more support members  50  (see  FIG. 3  for example) may be provided along a surface of the pouch  22  and may be configured to facilitate moving the pouch  22  to the open configuration. For example, a resilient bar, wire or the like may extend along the surface of the pouch  22  that is provided opposite the side walls  52 ,  54  of the pouch  22 . In this particular embodiment, the bar and/or wire may be woven or other attached to an interior or exterior of the pouch  22 . 
     While several embodiments of the disclosure have been shown in the drawings, it is not intended that the disclosure be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. Therefore, the above description should not be construed as limiting, but merely as exemplifications of particular embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.