Abstract:
A morcellator is described which may be operated with one hand, thus providing semi-automatic functionality, for the reduction of solid tissue into smaller pieces, which may then transported and emptied into a specimen bag. The morcellator eliminates the need for stand-alone grasping forceps that are currently used to grasp and pull the tissue against a sharp rotating tubular conduit. The grasping, cutting and transporting of the tissue may be accomplished via the handheld morcellator which provides triggers and control buttons, thus eliminating conventional handheld graspers and foot switches. The surgeon can now hold the scope and visualize the morcellation arena, thus eliminating the need for a second surgeon presently used for this purpose. Moreover, the ability to perform morcellation single handedly, while holding the scope, improves control and avoids wasted time compared to the procedure when it is done by two surgeons.

Description:
CROSS-REFERENCE TO RELATED APPLICATION 
       [0001]    The instant application claims priority to U.S. Provisional Patent Application Ser. No. 61/551,554, filed Oct. 26, 2011, pending, the entire specification of which is expressly incorporated herein by reference. 
     
    
     FIELD OF INVENTION 
       [0002]    The present invention relates generally to morcellators, and more specifically to new and improved morcellators for use in minimally invasive surgery. 
       BACKGROUND OF INVENTION 
       [0003]    General surgery, endoscopy, and especially laparoscopic endoscopy have been rapidly growing practices in the past decades. In many cases of minimally invasive surgery, there is a need to remove large pieces of tissue such as tumors, and sometimes even a whole organ, such as the uterus, kidney, and/or the like. 
         [0004]    To facilitate this task, a device generally known as a morcellator has been employed. Accordingly, the morcellator is a device that is typically used for the task of tissue size reduction and transportation. The morcellator is typically a powered (e.g., electrically) device that is used to reduce large sections of tissue into smaller pieces. These smaller pieces are then transported out of the patient&#39;s body, typically through the morcellator shaft, resulting in a generally small scar and minimal injury to the patient (as compared to conventional open surgical procedures that would require a relatively large incision to be made in the patient&#39;s body in order to access the area of the tissue/organ to be excised or removed). 
         [0005]    Current morcellators designs typically require the user, usually a surgeon, to use both hands and one foot to effectively operate the device. For example, one hand generally holds the morcellator with its shaft inside the body cavity, while the other hand generally operates a grasping device, used to operate through the morcellator&#39;s shaft and retrieve tissue pieces through the rotating, distally sharp, shaft. The cut pieces are then placed in a collecting container, e.g., for pathological review. The on/off activation of current morcellators is typically done via foot-switch controls. Thus, the surgeon is forced to constantly and repeatedly use both hands and at least one foot during the morcellation procedure. This imposes inconvenience and fatigue on the surgeon and the result is usually slow performance which translates to higher costs for the organ removal/morcellation portion of the surgical procedure. 
         [0006]    Accordingly, there exists a need for new and improved morcellators that overcome at least one of the aforementioned disadvantages. 
       SUMMARY OF THE INVENTION 
       [0007]    In accordance with the general teachings of the present invention, new and improved morcellators are provided for use in minimally invasive surgery. 
         [0008]    More specifically, the present invention provides an endoscopic morcellator that can be operated with one hand, thus providing semi-automatic functionality for the reduction of solid tissue (e.g., such as tumors, as well as organs such as the uterus, kidney and/or the like) into relatively small pieces, which are then transported and emptied into a specimen bag, e.g., for later pathological review. 
         [0009]    The morcellator of the present invention eliminates the need for stand-alone grasping forceps that are currently used to grasp and pull the tissue against a sharp rotating tubular conduit in conventional morcellators. The morcellator of the present invention provides a system to perform such tasks singlehandedly, with greater convenience and efficiency. 
         [0010]    The morcellator of the present invention was developed, in part, as a response to numerous complaints from surgeons regarding fatigue and slowness in connection with current morcellator designs. The new and improved morcellator designs of the present invention provide a major improvement to the morcellation of tissue and organs, e.g., by providing a system to perform the task by using a single hand operated morcellator. These devices of the present invention perform the grasping, cutting and transporting of the tissue via a hand held morcellator that provides triggers and control buttons, thus eliminating the need for a hand held grasper and foot switches. 
         [0011]    The morcellator designs of the present invention also allows for the automatic collection of the morcellated tissue into a designated container/specimen bag. 
         [0012]    By way of the present invention, the surgeon now can hold the scope and visualize the morcellation arena, relieving the second surgeon presently used for this purpose. Moreover, the ability to perform morcellation single handedly while holding the scope improves control and avoids wasting time, as compared to the conventional procedure when it is done by two surgeons. Accordingly, morcellation time is shortened, fatigue is reduced, and the leading surgeon&#39;s control of the process is much improved. 
         [0013]    In accordance with a first embodiment of the present invention, a morcellator system for morcellating tissue is provided, comprising: 
         [0014]    a conduit member including an end potion having a cutting surface formed thereon, wherein the conduit member includes an area defining a through bore extending therethrough; 
         [0015]    a jaw assembly including a pair of pivotable jaw members, wherein at least a portion of the jaw assembly is positioned proximate to the end portion of the conduit member; and 
         [0016]    an auger assembly at least partially received in the through bore of the conduit member, wherein at least a portion of the auger assembly is positioned proximate to the end portion of the conduit member. 
         [0017]    In accordance with a second embodiment of the present invention, a morcellator system for morcellating tissue is provided, comprising:
       a conduit member including an end potion having a cutting surface formed thereon, wherein the conduit member includes an area defining a through bore extending therethrough;   a jaw assembly including a pair of pivotable jaw members, wherein at least a portion of the jaw assembly is positioned on an exterior surface of the conduit member proximate to the end portion of the conduit member;   an auger assembly at least partially received in the through bore of the conduit member, wherein at least a portion of the auger assembly is positioned proximate to the end portion of the conduit member;   a first actuation system selectively operable to cause the jaw assembly to extend distally away from the end portion of the conduit member;   a second actuation system selectively operable to cause the jaw members to pivot to an open position; and   a third actuation system selectively operable to cause the jaw members to pivot to a closed position.       
 
         [0024]    In accordance with a third embodiment of the present invention, a morcellator system for morcellating tissue is provided, comprising:
       a conduit member including an end potion having a cutting surface formed thereon, wherein the conduit member includes an area defining a through bore extending therethrough;   a jaw assembly including a pair of pivotable jaw members, wherein at least a portion of the jaw assembly is positioned on an exterior surface of the conduit member proximate to the end portion of the conduit member;   an auger assembly at least partially received in the through bore of the conduit member, wherein at least a portion of the auger assembly is positioned proximate to the end portion of the conduit member;   a handle member operably associated with the conduit member, jaw assembly and the auger assembly;   a first actuation system operably associated with the handle member and selectively operable to cause the jaw assembly to extend distally away from the end portion of the conduit member;   a second actuation system operably associated with the handle member and selectively operable to cause the jaw members to pivot to an open position;   a third actuation system operably associated with the handle member and selectively operable to cause the jaw members to pivot to a closed position;   a fourth actuation system selectively operable to cause the jaw assembly to recede proximally towards the end portion of the conduit member; and   a fifth actuation system operably associated with the handle member and selectively operable to cause the conduit member and the auger assembly to rotate, wherein the conduit member and the auger assembly counter rotate with respect to one another.       
 
         [0034]    Further areas of applicability of the present invention will become apparent from the detailed description provided hereinafter. It should be understood that the detailed description and specific examples, while indicating the preferred embodiment of the invention, are intended for purposed of illustration only and are not intended to limit the scope of the invention. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0035]    Other advantages of the present invention will be readily appreciated as the same becomes better understood by reference to the following detailed description when considered in connection with the accompanying drawings wherein: 
           [0036]      FIG. 1   a  illustrates a perspective view of an electromechanical morcellator, wherein the left handle panel has been removed for purposes of clarity of illustration, in accordance with a first embodiment of the present invention; 
           [0037]      FIG. 1   b  illustrates a sectional view of the morcellator depicted in  FIG. 1   a , in accordance with a second embodiment of the invention; 
           [0038]      FIG. 1   c  illustrates an elevational view of the right side of the morcellator depicted in  FIG. 1   a , in accordance with a third embodiment of the invention; 
           [0039]      FIG. 2  illustrates a perspective view of a rack and motor assembly of the morcellator depicted in  FIG. 1   a , in accordance with a fourth embodiment of the present invention; 
           [0040]      FIG. 3  illustrates an exploded view of a rack and motor assembly of the morcellator depicted in  FIG. 1   a , in accordance with a fifth embodiment of the present invention; 
           [0041]      FIG. 4  illustrates a jaw assembly of the morcellator depicted in  FIG. 1   a , in accordance with a sixth embodiment of the present invention; 
           [0042]      FIG. 5  illustrates a detailed view of a gear system of the morcellator depicted in  FIG. 1   a , in accordance with a seventh embodiment of the present invention; 
           [0043]      FIG. 6  illustrates an exploded view of an auger assembly of the morcellator depicted in  FIG. 1   a , in accordance with an eighth embodiment of the present invention; 
           [0044]      FIG. 7  illustrates a perspective view of a tube member of the morcellator depicted in  FIG. 1   a , in accordance with a ninth embodiment of the present invention; 
           [0045]      FIG. 8  illustrates a perspective view of a tip assembly of the morcellator depicted in  FIG. 1   a , in accordance with a tenth embodiment of the present invention; 
           [0046]      FIG. 9  illustrates a perspective view of an alternative electromechanical morcellator, wherein the left handle panel has been removed for purposes of clarity of illustration, in accordance with an eleventh embodiment of the present invention; 
           [0047]      FIG. 10  illustrates a perspective view of a rack system of the alternative morcellator depicted in  FIG. 9  in accordance with a twelfth embodiment of the present invention; 
           [0048]      FIG. 11  illustrates an elevational view of the alternative electromechanical morcellator depicted in  FIG. 9 , in accordance with a thirteenth embodiment of the present invention; and 
           [0049]      FIGS. 12   a - 12   d  depict fragmentary views of a morcellator, in accordance with the general teachings of the present invention, advancing towards a piece of tissue ( FIG. 12   a ), about to grasp a piece of tissue ( FIG. 12   b ), grasping a piece of tissue ( FIG. 12   c ), and then morcellating a piece of tissue ( FIG. 12   d ), in accordance with a fourteenth embodiment of the present invention. 
       
    
    
       [0050]    The same reference numerals refer to the same parts throughout the various Figures. 
       DETAILED DESCRIPTION OF THE INVENTION 
       [0051]    The following description of the preferred embodiment(s) is merely exemplary in nature and is in no way intended to limit the invention, or uses. 
         [0052]    The morcellators of the present invention provides greatly improved performance over conventional morcellators by offering the following main advantages: 
         [0053]    (1) A pair of integral grasper jaws that may be advanced, opened, and/or closed onto the target tissue and then be caused to recede proximally automatically, thus forcing the tissue against a sharp, rotating, tubular conduit, to then be reduced to relatively smaller cylindrical portions. This integral grasper feature eliminates the need for the stand-alone graspers that are currently used in conventional morcellators. Accordingly, the morcellator of the present invention frees up one of the surgeon&#39;s hands; 
         [0054]    (2) An internal auger/cutter that aids in grasping the tissue internally as it approaches the tubular conduit, and then transporting the relatively smaller cylindrical portions proximally towards a cutter and into a specimen container. The auger/cutter rotates in counter direction to that of the tubular conduit; 
         [0055]    (3) The morcellator of the present invention allows for automatic collection of the morcellated tissue into a specimen container; 
         [0056]    (4) All of the primary controls of the grasping jaws and morcellation may be performed with a single hand. Additionally, all of the primary control features may be placed ergonomically on the handle of the morcellator. The need for conventional foot switch controls is thus eliminated; and 
         [0057]    (5) The morcellator of the present invention is also provided with a system to rotate/align the jaws at the surgeon&#39;s discretion. 
         [0058]    By way of a non-limiting example, the surgeon will typically operate the morcellator of the present invention as follows: 
         [0059]    The morcellator will typically be inserted with the jaws in a closed position into an insufflated laparoscopic cavity through a typically dedicated cannula, preferably having a non-return valve to maintain sufficient insufflations pressure; 
         [0060]    By depressing the jaws advancement trigger, the jaws and corresponding supporting arms and links will slide distally, ending with the jaws&#39; activation arms stopping a short distance (e.g., 2-4 mm) behind the tube&#39;s distal end; 
         [0061]    The jaws may then be opened at any time, e.g., by depressing the jaws opening trigger; 
         [0062]    The jaws&#39; orientation may be aligned by the surgeon by manipulating a rotation knob; 
         [0063]    The surgeon then closes the jaws and hence grasps the target tissue to be morcellated; 
         [0064]    The surgeon then releases a ratchet or like device (e.g., in the mechanical version of the present invention) and depresses the morcellation trigger simultaneously. A return spring or a morcellation feed motor pulls the jaws assembly with the grasped tissue proximally, thus having the tissue cut by the rotating tube&#39;s sharp distal end and further pulled into the tube by an internal counter rotating auger; and 
         [0065]    The transported, morcellated tissue then exits through an opening in the handle (e.g., one formed on a left panel thereof) of the morcellator and into an optional attached specimen container. 
         [0066]    The following is a more detailed description of the design and operation of the various morcellator designs of the present invention. 
         [0067]    Referring to  FIGS. 1   a - 1   c , there is shown a morcellator generally at  10 . In this view, a left handle panel member  130  (e.g., see  FIG. 1   c ) has been removed for purposes of illustration and clarity. 
         [0068]    The morcellator  10  may be provided with an upper grasping jaw member  20  and a lower grasping jaw member  30 . The jaw members  20 ,  30 , respectively, may be used to grasp the tissue/organ to be morcellated as previously described. 
         [0069]    By way of a non-limiting example, jaw members  20 ,  30 , respectively, may be supported by support link members  40 , which may be attached to jaw members  20 ,  30 , respectively, via pin members  70 . The support link members  40  may be connected by control arm members  50  positioned radially around a tube member  90  and connected to the support link members  40  via pin members  80 . The jaw members  20 ,  30 , respectively, may be rotatably hinged on activation arm members  60  (it should be noted that in this view only the left jaw member&#39;s activation arm is shown in  FIG. 1   a ) via pin members  100 ,  110 , respectively. 
         [0070]    With reference to  FIGS. 2 and 3 , and by way of a non-limiting example, jaw members  20 ,  30 , respectively, may be opened and closed via an electric motor  140 , which may be attached, e.g., permanently, to a rack member  150 . The electric motor  140  may push/pull a slingshot member  160  by the rotation of a threaded shaft member  170 . The slingshot member  160  may have an area defining a threaded hole  289  that may be engaged with threaded shaft member  170  of electric motor  140 . 
         [0071]    Referring again to  FIGS. 1   a - 1   c , activating electric motor  140  may cause the push/pull of a ring connector member  180 , which may be rotatably retained in slingshot member  160 . Both the jaw member&#39;s activation arms  60  may be connected to ring member  180  by pin members  190 . Thus, by activating electric motor  140 , slingshot member  160  will either move fore or aft, depending on the motor&#39;s rotation, and cause either an advance or retreat of activation arm members  60  and hence cause either the opening or closing of jaw members  20 ,  30 , respectively, simultaneously. 
         [0072]    Referring to  FIGS. 1   a - 1   c  and  4 , and by way of a non-limiting example, a jaw assembly  410  may be advanced distally/forward in order to grasp a piece of tissue to be morcellated. For example, advancing jaw assembly  410  distally may be achieved by depressing an advancement trigger  200 . Advancement trigger  200  may pivot on a pin member  210  and may include, for example, a permanently attached/integral gear portion  220  that may engage with an idling pinion member  230  (e.g., see  FIGS. 1   b  and  5 ), which may be engaged with a minor pinion member  240 . Minor pinion member  240  may be permanently attached to a major pinion member  250 . The resulting rotation of major pinion member  250  may cause a linear movement of rack member  150  distally/forward as major pinion member  250  is engaged with the teeth  260  on rack member  150 . Rack member  150  may have a rear slingshot portion  270 . Slingshot portion  270  may move distally, pushing an assembly ring member  290  and hence compressing a compression spring member  280  and simultaneously pushing forward jaw assembly  410 , i.e., jaw members  20 ,  30 , respectively, control link members  40 , control arm members  50 , and activation arm members  60 . The advanced jaw assembly  410  may be limited in forward movement by design and may stop short of the distal end of tube member  90 . 
         [0073]    Referring to  FIGS. 1   b  and  6 - 8 , an auger assembly  300  may be rotatably positioned or received within tube member  90  and may be permanently connected via its shaft member  310  to an auger pinion member  320 , positioned within a transmission box  330 . A power input shaft member  340  (e.g., connected to an electric motor or an electric motor flexible shaft drive (both of which are not shown)) may enter transmission box  330  and may carry an auger drive-pinion member  350 , e.g., permanently attached to a shaft member  340  and an upper pulley member  360  to provide for tube member  90  rotation. Power may be transmitted to auger member  300  via an idler pinion member  370  which may be engaged between pinion members  320  and  350 . Power may be transmitted to tube member  90  via a toothed belt member  380  and pulley member  390 , e.g., permanently attached to tube member  90 . Thus, by depressing the morcellation on-off button  400  (e.g., see  FIG. 1   c ), power may be delivered via shaft member  340  into transmission box  330 , resulting in simultaneous counter rotation and different rotation directions for both tube member  90  and auger member  300 . By way of a non-limiting example, two jaw control buttons may be provided. For example, a top button  420  may be depressed to open the jaw members and a bottom button  430  may be depressed to close the jaw members. Buttons  400 ,  420  and  430  may be wired to a printed circuit board (not shown), positioned within handle member  120 . The printed circuit board may be electrically connected to a cable member  440 , e.g., entering handle member  120  via an area defining an opening  450 . Cable member  440  may connect to an external power source (e.g. an electrical outlet, power pack, battery, and/or the like) and feed the printed circuit board. 
         [0074]    Referring to  FIGS. 1   a - 1   c , and by way of a non-limiting example, a ratchet member  460  may be pivotally attached to a pin member  470  and may be normally (except when morcellation takes place) securely locked with a tooth member  490 , e.g., permanently attached to advancement trigger member  200 . Depressing a ratchet lever member  500  may cause disengagement of ratchet member  460  from tooth member  490  and hence the simultaneous pull-back of the jaw members assembly by compression spring member  280 . 
         [0075]    The present invention also provides another variant of the morcellator, generally referred to as an “all electric controls” variation. Referring to  FIGS. 9-11 , there is shown a perspective view of such an “all electric” morcellator  1000  (in this view, a left handle panel member (e.g., see  FIG. 11 ) has been removed for purposes of illustration and clarity) and the rack system  1100  that is generally required for its operation.  FIG. 11  shows an elevational view of the alternative morcellator  1000 . 
         [0076]    In this variant, there are no mechanical triggers. That is, the jaw assembly  410  moves fore and aft due to the activation of the jaw assembly movement motor  560 . The pinion member  580  at the end of the shaft of the motor  560  causes the movement of rack assembly  570  and hence the advancement/retreat of the jaw assembly  410  via a double fork structure  590  that retains ring member  290  that connects the jaw assembly  410 . Jaw activation motor  140  may be moved to its upper location as shown and a double slingshot member  160 , facing downwardly, may retain ring member  180  that connects to the jaw members  20 ,  30 , respectively, via activation arm members  60 . Referring to  FIG. 11 , there is shown control buttons  420  and  430  for opening and closing the jaws members  20 ,  30 , respectively, and button  400  for the morcellation process. When button  400  is depressed, mechanical power enters transmission box  330  via shaft member  340  and, as a result, tube member  90  and auger member  300  counter-rotate simultaneously. At the same time, powered jaw assembly movement motor  560  is rotating so as to cause rack assembly  570  to move proximally, thus forcing the grasped tissue  600  towards the sharp distal end  510  of tube member  90  (e.g., see  FIGS. 12   a - 12   d ). 
         [0077]    A rotation knob member  610  may be provided for both variants of the morcellators of the present invention. Rotation knob member  610 , e.g., once depressed tangentially by the surgeon&#39;s finger, may rotate jaw assembly  410  correspondingly and align the jaws as per the surgeon&#39;s preference at this time. That is, the orientation of the jaw assembly may be rotated or otherwise manipulated so as to suit a particular need of the surgeon. 
         [0078]    The following description will further illustrate a sample morcellation process, in accordance with the general teachings of the present invention, wherein it is assumed that the morcellator of the present invention has already been inserted into the patient&#39;s insufflated body cavity. That is, the surgeon has inserted the morcellator shaft into the patient&#39;s body cavity through a cannula, for example. 
         [0079]    The surgeon may hold the morcellator handle in one of his hands, wherein the jaws are preferably in the closed position. The surgeon may then depress trigger member  200  and thus advance the closed jaw assembly  410  forward towards the area of the target tissue to be morcellated (e.g., see  FIG. 12   a ). Once the shaft appears in the field of view of an endoscope (e.g., see  FIG. 12   b ), the surgeon may then depress the “open” button  420  that activates electric motor  140 , thus resulting in the opening of the jaw assembly  410 , i.e., the jaw members  20 ,  30 , respectively, rotatingly move apart from one another. The surgeon may then place the jaw members  20 ,  30 , respectively, within grasping reach of the tissue to be morcellated (e.g., see  FIG. 12   c ) and then depresses the “close” button  430 , resulting in the jaw assembly closure and grasping of the tissue to be morcellated (e.g., see  FIG. 12   d ). The surgeon may then release ratchet member  460  and depress morcellation button  400 . Power may then be fed into transmission box  330  via shaft member  340 , resulting in the simultaneous counter rotation of tube member  90  and auger member  300 . The receding jaw assembly forces the tissue against the sharp distal end  510  of tube member  90 . The tissue is therefore being sheared into relatively smaller cylindrical portions. The screw portion  520  at the tip of the auger member  300  may thread into the tissue and assist in dragging it rearwardly into a fluted portion  530  (e.g., see  FIG. 6 ) of auger member  300  and thus transport the tissue towards a chamber  540  at the rear of morcellator  10 . The morcellated tissue may exit via an area defining an opening  550  and into an optional specimen bag/container that may be attached to opening  550 . 
         [0080]    While the invention has been described with reference to an exemplary embodiment, it will be understood by those skilled in the art that various changes can be made and equivalents can be substituted for elements thereof without departing from the scope of the invention. In addition, many modifications can be made to adapt a particular situation or material to the teachings of the invention without departing from the essential scope thereof. Therefore, it is intended that the invention not be limited to the particular embodiment disclosed as the best mode contemplated for carrying out this invention, but that the invention will include all embodiments falling within the scope of the appended claims.