Abstract:
A multifunctional surgical device particularly for use during electro cauterization for irrigation, and/or smoke and/or fluid evacuation as required. The device comprises a working hub incorporating an elongated tube and including a vacuum port disposed through an exterior wall of the hub, the port being fluidly connectable to a source of vacuum or irrigation fluid; a stopcock which selectively connects the vacuum port and an outlet into the stopcock from the elongated tube, the stopcock selectively allowing a fluid connection to be formed between the vacuum port and the elongated tube; an open central passage longitudinally disposed through the device; the elongated tube having proximal and distal ends and being disposed co-linearly with the central passage, sized and configured to seat within a cannula and receive within the central passage the shaft of an endoscopic tool, while space remains therearound to pass fluid in either direction about the tool shaft.

Description:
CROSS REFERENCE TO RELATED APPLICATION 
       [0001]    This non-provisional utility patent application claims priority from provisional patent application Ser. No. 61/822,760 filed on May 13, 2013 and entitled Multifunctional Attachment for Electro-Cautery Surgical Devices, the teachings of which are incorporated herein by reference. 
     
    
     FIELD OF THE INVENTION 
       [0002]    This invention is related to laparoscopic instruments. More particularly, this invention is a multifunction vacuum attachment device for a standard electrocautery device. 
       BACKGROUND OF THE INVENTION 
       [0003]    Originally, surgeries were performed through large incisions in the body. These open surgeries and their large incisions allowed surgeons to visually see and manipulate the diseased part of the body with their hands. Recently, minimally invasive surgery has become popular because of the benefits associated with smaller incisions. Termed minimally invasive surgery or keyhole surgery, these surgeries utilize ports called cannulas inserted through the abdomen. They pass through the abdominal wall by piercing through the layers of skin. The puncture wounds created are small and lessen postoperative healing time and pain. There are a number of drawbacks for the surgeon in minimally invasive surgery. Of most concern, is the surgeon&#39;s loss of direct visual and tactile contact with the patient&#39;s internal organs. In order for the surgeon to visualize them, one cannula port contains a laparoscopic camera for visualization. The image generated by the camera is sent to a viewing screen that displays the inner body parts. The trend towards smaller sized cannulas because of patient benefits creates challenges for the manufacturers of minimally invasive medical devices. The small sizes create extreme dimensional requirements. The devices often must be thin but remain strong. The conflicting requirements require special materials and novel engineering design. 
         [0004]    Another trend in surgery is increased awareness of health and safety of the staff performing the procedures. One area of concern is surgical smoke created by electrocautery devices and electrosurgical devices during minimally invasive surgical procedures. 
         [0005]    Electrocautery is a term used to refer to both a surgical instrument and the procedure for which that instrument is used. An electrocautery instrument or apparatus is a surgical tool used for tissue dissection and/or hemostasis. In an electrocautery surgical procedure, the working end of an electrocautery device is heated by a high voltage, high frequency alternating current passed through an electrode in the device. The now heated working portion of the electrocautery instrument is used for the destruction of tissue, such as for removing warts or polyps and cauterizing small blood vessels to limit blood loss during surgery. There are two types of electrocautery: bipolar and monopolar. 
         [0006]    In bipolar electrocautery, active and return electrodes are incorporated into a single handheld electrocautery instrument, so that the current passes between the tips of the two electrodes and affects only a small amount of tissue. In monopolar electrocautery current is applied through a handheld active electrode and travels back to the generator through an inactive electrode attached to the patient (the grounding pad), so that the patient is part of the electrical circuit. 
         [0007]    Electrosurgery is the application of a high frequency electric current to biological tissue as a means to cut, coagulate, desiccate, or fulgurate tissue. This is accomplished by converting electrical energy into heat through tissue resistance to the passage of the electrical current. Two types of current are utilized in electrosurgery, damped and undamped; a damped current destroys and coagulates tissue and stops bleeding, and undamped current destroys minimal tissue and incises tissue. 
         [0008]    Electrocautery devices are used by surgeons to sear and cut tissue during a surgery. In the surgical process, body tissue can char and produce smoke or steam byproducts. 
         [0009]    Electrocautery shall be more frequently discussed herein. However, those of ordinary skill in the art will appreciate that the invention disclosed and claimed herein is equally useful with other electrosurgical devices and methods as well. 
         [0010]    Another trend in surgery is an increased number of robotic surgeries. Robotic surgeries have recently become more prevalent for performing laparoscopic surgeries. However, robotic surgeries create additional problems for smoke evacuation. Robotic surgeries require a surgeon to operate from a console that is separated from the patient. During a robotic surgery, assistants must add and remove laparoscopic tools for the surgeon. Exchanging laparoscopic tools, including electrocautery devices is a lengthy procedure because the tools often require disconnection from the robotic system. Additionally, robotic surgeries require smaller trocar such as the 8.5 mm and 10 mm. Many of the current multifunction electrocautery devices are not designed for these small trocars. There is a need for an improvement of smoke evacuation systems for robotic surgery. 
         [0011]    All electrocautery devices create smoke. Smoke created during laparoscopic procedures can be difficult to remove because the enclosed abdomen in laparoscopic procedures contains the surgical smoke within the patient&#39;s body. The retained smoke, if not evacuated from the body, interferes with the surgeon&#39;s visualization of the procedure. The lack of visibility can lengthen the procedure, adding to costly operating room time and subjecting the patient to increased time under anesthesia. Other studies have indicated that surgical smoke is potentially infectious and toxic. Many hospitals are increasingly emphasizing safety and have demanded devices that will remove smoke from the operating room without side effects to the patient or surgical team. 
         [0012]    During surgery there is a need to wash away blood after coagulating (burning an area of tissue) to assure the vessel is no longer bleeding. Presently, surgeons have to remove the instrument, insert a suction device, and then reinsert the coagulator again. A need exists for a device that allows those functions to occur without removing the coagulator from the cannula by sliding the multifunction laparoscopic device through the cannula. 
         [0013]    Improvements to electrocautery devices have included smoke evacuators integrated with the electrocautery device. The addition of a smoke evacuator to the electrocautery device creates a multifunction tool for surgery. The smoke evacuator is often located near the tip of the electrocautery device so that the smoke can be quickly evacuated after it is produced. Some electrocautery devices have been further enhanced by adding irrigating capabilities. The irrigating capabilities allow the surgeon to wash blood or tissues away from the cutting tip of the electrocautery. These multifunction devices can perform suction (smoke evacuation), irrigation, and electrocautery. The combination of multiple features into one device reduces the number of devices needed for a surgical procedure. Multifunction devices reduce operating time. However, these devices do not allow the surgeon to operate with an electrosurgical device. Instead the surgeon must learn how to operate a new electrocautery device incorporated into their multifunctional unit. 
         [0014]    Stand alone smoke evacuation devices and methods have been developed for laparoscopic procedures utilizing small trocar ports. The most popular method adopted by surgeons has been the opening of the trocar insufflation port. By opening a path from the pressurized abdomen to the surgical room, the opening of the insufflation port forces the smoke retained within the abdomen to the operating room. The opening of the trocar insufflation port has been widely adopted by surgeons because of its simplicity. It does not require an additional device and can be operated in an expedient manner. The downsides to the opening of the trocar insufflation port are the safety concerns associated with surgical smoke and the decrease in abdominal insufflation pressure when CO 2  is released from the body. 
         [0015]    Because of the disadvantages associated with the trocar insufflation port method, devices that attach to trocar ports have been developed. These devices act as filters, removing smoke from the CO 2  within the body and recirculating the smoke free CO 2  back into the body. Generally, the filter devices connect to multiple trocar ports. The CO 2  from the body is diverted through the filter because of pressure differences created by the pressurized abdomen. One advantage of the system is that insufflation pressure of the abdomen can be maintained while smoke is removed. However, it has been found that these devices do not rapidly reduce the smoke within the body. The distance from the source of the surgical smoke to the trocar cannula opening within the body and the smoke evacuation filter causes slow smoke evacuation. 
         [0016]    What is needed in the art, however, is an integrated device that can provide suction, irrigation and smoke evacuation while attaching to the surgeon&#39;s preferred electrocautery device. 
       SUMMARY OF THE INVENTION 
       [0017]    The present invention is a multifunction laparoscopic device that attaches to standard electrocautery or laparoscopic tools to provide smoke evacuation, irrigation, and suction of bodily fluids. Advantageously, the multifunction device of the present invention provides integrated suction, irrigation, and smoke evacuation functionality, such that the electrocoagulator need not be removed from a patient&#39;s body and the surgeon can continue to use a favorite electrocoagulator. The multifunction laparoscopic device comprises an elongated tube and a vacuum port. The vacuum port comprises housing with an integral passage for smoke and other fluids. The vacuum port is adapted to receive a sealing mechanism. The multifunction laparoscopic device is adjustable along the length of an electrocautery or laparoscopic tool cauterizing shaft. The adjustment of the multifunction laparoscopic device allows smoke evacuation and the intra abdominal suction of fluids. The multifunction laparoscopic device maintains insufflation pressure inside the patient&#39;s body during the movement of the device along the cauterizing shafts of standard electrocautery devices because of the sealing mechanism. The vacuum port further comprises a port for removing smoke or other fluids during an operation. 
         [0018]    The present invention is uniquely able to suction smoke and bodily fluids through the annular opening between the shaft of the electrocautery device and the trocar cannula housing without removing the electrocoagulator from the patient&#39;s body. The multifunction attachment is disposed coaxially around the shaft of an electrocautery device or a laparoscopic tool. The invention further improves upon previous devices by allowing electrocautery, smoke evacuation, irrigation, and suction through a single laparoscopic trocar port. 
         [0019]    Another advancement of the current invention is the small size of the multifunction laparoscopic device. The small size of the device reduces the affect the attachment has on the functionality of current laparoscopic devices including trocars and electrocautery instruments. 
         [0020]    The multifunction laparoscopic device is sized for insertion into standard size trocars/cannulas without interference with the cannula inner diameter. The extremely thin wall construction of the multifunction laparoscopic device&#39;s elongated tube is an advance in medical irrigator and smoke evacuator design. By eliminating the dimensional interference between the trocar cannula housing and the outer surface of the multifunction laparoscopic device, standard electrocautery devices, when combined with the multifunction laparoscopic device, will fit through standard sized trocars/cannulas and can be operated as currently practiced by surgeons. 
         [0021]    The multifunction laparoscopic device vacuum port, seals to the outer diameters of standard electrocautery device shafts by a sealing mechanism within the evacuation port housing. The sealing mechanism closes against the shaft of the electrocautery device to prevent loss of insufflation pressure during surgery. When the electrocautery device is cauterizing bodily tissue, the valve of the vacuum port housing is opened for smoke evacuation. The opening of the valve provides a path for surgical smoke to exit the abdomen. 
         [0022]    The multifunction laparoscopic device can be positioned anywhere along the proximal end of the shaft of the electrocautery device. Since the position of the multifunction laparoscopic device is adjustable, the smoke evacuation ability of the device is enhanced because the distal end of the elongated tube can be positioned close to the origin of smoke generation. The distal end of the elongated tube can be positioned past the tip of the electrocautery device. The positioning of the elongated tube past the electrocautery tip increases the amount of fluid that can be suctioned by the suction functionality of the multifunction laparoscopic device. Suctioning of fluids can be performed by adjusting the multifunction laparoscopic device&#39;s location on the electrocautery shaft. The sealing mechanism of the multifunction device maintains insufflation pressure while adjusting the multifunction laparoscopic device. The sealing mechanism is an elastomeric material that seals around the shaft of the electrocautery device to maintain insufflation pressure. Any body fluids are transported through the same path as the surgical smoke. 
         [0023]    In one embodiment, the vacuum port of the multifunction laparoscopic device attaches to a standard vacuum source with specialized tubing. The specialized tubing is easily extensible so that the surgeon&#39;s range of motion will not be affected during the operation. The specialized tubing has a spring or “slinky” configuration for enhanced flexibility. 
         [0024]    The vacuum port housing has a small overall thickness to maximize the surgeon&#39;s range of motion. The position of the vacuum port housing between the trocar and the body of the electrocautery device necessitates its small size. During a surgery, repositioning of the electrocautery device occurs frequently. The surgeon continuously moves the electrocautery device into and out of the body of the patient in order to position the tip of the electrocautery device near the target tissue. These motions decrease the distance between the trocar and the distal surface of the vacuum port housing of the electrocautery device. Since the multifunction laparoscopic device is attached to the shaft of the electrocautery device below the electrocautery device&#39;s housing, the effective length of the combined attachment and the electrocautery device is reduced when compared with the electrocautery device by itself. The depth within the body that the electrocautery device can achieve is reduced by the thickness of the multifunction laparoscopic device&#39;s vacuum port housing. 
         [0025]    Another embodiment of the multifunction laparoscopic device provides tip attachments for the end of the elongated tube. The elongated tube can receive attachments such as absorptive surgical peanuts, specialized irrigation heads, specialized suction heads, dissectors, standard instrument heads (i.e.: scissors, blades, clamps, etc.), heads for dispensing active agents (i.e. hemostatic agents, antibacterial agents, etc.) or other attachments that are typically used in laparoscopy and would enhance the capabilities of the multifunction laparoscopic device. 
         [0026]    One of several advantages of the present invention, is that it provides a tool that allows surgeons to remove blood from the surgical site after coagulating (burning an area of tissue) to assure the vessel is no longer bleeding, without requiring that the surgeon to remove the surgical instrument, insert a suction device, and reinsert the coagulator again. The present invention does not require that any instruments be brought in or out of the body to perform those functions. 
         [0027]    These and other aspects, features, and advantages of the present invention will become more readily apparent from the attached drawings and the detailed description of the preferred embodiments, which follow. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0028]    The preferred embodiments of the invention will hereinafter be described in conjunction with the appended drawings provided to illustrate and not to limit the invention, in which: 
           [0029]      FIG. 1  presents a front isometric view of a multifunctional device according to the present invention; 
           [0030]      FIG. 2  presents a rear isometric view of the device of  FIG. 1 ; 
           [0031]      FIG. 3  presents an exploded isometric view of the device of  FIG. 1 ; 
           [0032]      FIG. 4  presents a cross sectioned elevation view of the multifunctional device of  FIG. 1 , the section being taken along section line  4 - 4  of  FIG. 1 ; 
           [0033]      FIG. 5  presents a cross sectioned elevation view of the multifunctional device of  FIG. 1 , introducing a retaining clip, the section being taken along section line  5 - 5  of  FIG. 1 ; 
           [0034]      FIG. 6  presents a top isometric view of a working hub of the multifunctional device of  FIG. 1 ; 
           [0035]      FIG. 7  presents a bottom isometric view of the working hub of the multifunctional device of  FIG. 1 ; 
           [0036]      FIG. 8  presents a top isometric view of the top portion of the retaining clip for use with the multifunctional device of  FIG. 1 ; 
           [0037]      FIG. 9  presents a bottom isometric view of the top portion of a retaining clip for use with the multifunctional device of  FIG. 1 ; 
           [0038]      FIG. 10  presents a sectioned end view of a retaining clip for use with the multifunctional device of  FIG. 1 , the section being taken along section line  10 - 10  of  FIG. 8 ; 
           [0039]      FIG. 11  presents a magnified, front, isometric view of the stopcock for the multifunctional device of  FIG. 1 ; 
           [0040]      FIG. 12  presents a top, isometric view of an alternative embodiment of a retaining clip; 
           [0041]      FIG. 13  presents a sectional end view of the retaining clip of  FIG. 12 , the section being taken along section line  13 - 13  of  FIG. 12 ; and 
           [0042]      FIG. 14  presents a side assembly view of the present invention in use during laparoscopic surgery. 
       
    
    
       [0043]    Like reference numerals refer to like parts throughout the several views of the drawings. 
       DETAILED DESCRIPTION 
       [0044]    The following detailed description is merely exemplary in nature and is not intended to limit the described embodiments or the application and uses of the described embodiments. As used herein, the word “exemplary” or “illustrative” means “serving as an example, instance, or illustration.” Any implementation described herein as “exemplary” or “illustrative” is not necessarily to be construed as preferred or advantageous over other implementations. All of the implementations described below are exemplary implementations provided to enable persons skilled in the art to make or use the embodiments of the disclosure and are not intended to limit the scope of the disclosure. For purposes of description herein, the terms “upper”, “lower”, “left”, “rear”, “right”, “front”, “vertical”, “horizontal”, and derivatives thereof shall relate to the invention as oriented in  FIG. 1 . 
         [0045]    Furthermore, there is no intention to be bound by any expressed or implied theory presented in the preceding technical field, background, brief summary or the following detailed description. It is also to be understood that the specific devices and processes illustrated in the attached drawings, and described in the following specification, are simply exemplary embodiments of the inventive concepts defined in the appended claims. Hence, specific dimensions and other physical characteristics relating to the embodiments disclosed herein are not to be considered as limiting, unless the claims expressly state otherwise. 
         [0046]    A front isometric view of a multifunctional, laparoscopic, device  1000  is illustrated in  FIG. 1 . A rear isometric view of the multifunction laparoscopic device  1000  is illustrated in  FIG. 2 . The multifunction laparoscopic device or tool  1000  generally comprises: a working hub  100  in the form of a vacuum attachment  300  of  FIG. 3  and an elongated hollow tube  200  extending distally therefrom. The elongated hollow tube  200  is preferably constructed of a strong, lightweight, biocompatible material suitable for use during surgery, preferably of plastic, aluminum, stainless steel, or other rigid metal. The elongated hollow tube  200  can have an extremely thin wall thickness, as thin as 0.004″. When the elongated hollow tube  200  is constructed of metal, preferably the elongated hollow tube  200  is coated with a nonconductive material such as parylene (not shown). The parylene coating of the metal tube prevents the elongated hollow tube  200  from conducting electricity. 
         [0047]    The working hub  100  is seen to be in the form of a generally wide but somewhat flattened cylinder. However, those of skill in the art will appreciate that the working hub  100  may have any convenient or desired shape. The working hub  100  includes a substantially flat proximal surface  310  and a substantially parallel substantially flat distal surface  320  ( FIG. 3 ), with a cylindrical outer or side wall  315  ( FIG. 2 ), extending between the proximal surface  310  and distal surface  320 . 
         [0048]    The working hub  100  further includes a stopcock  500 , which extends through the side wall  315  of working hub  100 , as will better be described below. The working hub  100  further includes a slot  800  ( FIG. 3 ) for receiving a retaining clip  700 , as will also be better described below. 
         [0049]    The working hub  100  further includes an outwardly extending vacuum port  400 , which traverses the cylindrical side wall  315  at a location substantially opposite to the location of stopcock  500 . 
         [0050]    The working hub  100  also includes a central hollow passage  600  which is coaxial with a central axis of working hub  100  and communicates with openings in both the proximal, generally flat wall  310  and the distal, generally flat wall  320 , as best illustrated in  FIG. 3 . In a preferred embodiment, the central passage  600  comprises a funnel or conical shaped proximal opening  605  in the proximal wall  310  and an opening  606  in the distal wall  320  of  FIG. 3 . 
         [0051]    An exploded, isometric view of the multifunctional laparoscopic device  1000  is illustrated in  FIG. 3 . The distal wall  320  of working hub  100  is in the form of a flat plate of  FIG. 3  and has an inner proximal surface  330  from which bottom posts  324  extend upwardly into the hub  100  for engaging within post bottom receiving openings  326  in posts  314  of  FIG. 7  extending downwardly from a distal surface  327  of a center wall  328  of the hub  100  ( FIG. 7 ). The proximal wall  310 , also in the form of a flat plate, includes a distal surface  303  from which posts  304  extend downwardly for engaging with post receiving members  318  defining receiving openings  310  formed in a proximal surface  319  of center wall  328 . The flat proximal and distal walls  310  and  320 , respectively, form an enclosed working hub  100  of  FIG. 1 . A peripheral edge  322  of the distal wall  320  of  FIG. 3  seals against an inner surface undercut flange  333  of the peripheral wall  315  of the working hub  100  ( FIG. 7 ). 
         [0052]    Turning back to  FIG. 3 , the working hub  100  is also provided with a seal or gasket  900  having a central bore  910  which is coaxial with the central passage  600  when seated appropriately upon proximal surface  319  of the center wall  328 . The seal  900  may be formed from any reasonably flexible material suitable for preventing leakage of bodily fluids therethrough or therearound, the seal  900  preferably being made of a rubber, or plastic polymer of any known composition. A retaining clip  700  is received in a slot  800  of the working hub  100  and engages therebeneath a second seal member  930  with a center bore  940 , along a distal surface  952  thereof. Center bore  940  of second seal member  930  is also coaxial with central passage  600 , which passes through the center wall  328  when the clip  700  is appropriately seated and the second seal member is properly oriented to seat upon first seal member  900 . Second seal member  930  is also preferably made of a rubber or plastic polymer of any suitable known composition. 
         [0053]    The elongated hollow tube  200  engages the central passage  600  of the working hub  100  and, subsequently, the central bore  910  of the seal  900 . A bore  210  extends through the length of elongated hollow tube  200 . In one preferred embodiment, the central passage  600  has a larger diameter than the bore  210  of elongated tube  200 , though this should not be construed as limiting. 
         [0054]    Cross sectional views of multifunctional laparoscopic device  1000  are illustrated in  FIGS. 4 and 5 . The illustrations present relationships between the central passage  600 , the elongated tube  200 , the retaining clip  700 , and the retaining clip seal member  930  of  FIG. 3 , the vacuum attachment seal member  900 , and the stopcock  500 . As presented in  FIG. 5 , the retaining clip seal member  930  seats against the seal member  900  of  FIG. 3  and the central passage  600  is shown to extend through the multifunctional laparoscopic device  1000  when seal member  930  is appropriately positioned, as shown. 
         [0055]    In operation, when the retaining clip  700  is fully engaged within the slot  800  of the working hub  100 , the opening  940  through the retaining clip seal member  930  is aligned with the central passage  600  of the multifunction laparoscopic device  1000 . In this configuration, both seal members  900  and  930  of the multifunction laparoscopic device  1000  seal against a shaft of an electrocautery device or laparoscopic tool  3000  ( FIG. 14 ) extending through the multifunction laparoscopic device  1000 . The retaining clip  700  when being partially slid radially outwardly within the retaining clip slot  800  of  FIG. 6  prevents the loss of insufflation pressure when the laparoscopic tool  3000  is removed from central passage  600 . The retaining clip  700  may also be slid out of retaining clip receiving slot  800  as a result of a biasing force generated by biasing members or springs  770  seated in recesses  765  ( FIG. 9 ) of the retaining clip  700 . These biasing members or springs  770  are compressed against inner ends  802  of the retaining clip guides  317 , as illustrated in  FIG. 6  maintaining the retaining clip  700 , when the retaining clip  700  is fully inserted into the working hub  100 . As the retaining clip  700  slides out of the retaining clip slot  800  through an opening  841  in cylindrical wall  315 , the opening  940  of  FIG. 1  in the seal member  930  of the retaining clip  700  and the central passage  600  are no longer aligned. In this skewed position, the two seal members  900  and  930  of the multifunction laparoscopic device  1000  prevent the passage of carbon dioxide from the abdomen. The retaining clip  700  is maintained within the working hub  100  by contact between the retaining clip shoulders  720  ( FIG. 8 ) and the edges of the opening  841  in cylindrical outer wall  315 . 
         [0056]    A detailed top view into the working hub  100  showing the proximal surface  319  of center wall  328  is illustrated in  FIG. 6  wherein hollow post receiving means  318  including openings  320  for receiving posts  304   FIG. 3  of the proximal wall  310  of the working hub  100  are provided. The generally cylindrical outer wall  315  of working hub  100  above the level of the center wall  328  also defines retaining clip slot  800 , and retaining clip guides  317 . 
         [0057]    A detailed bottom view the distal surface  327  of the center wall  328  of the working hub  100  is illustrated in  FIG. 7  and shows the hollow post attachment means  314   FIG. 1  including openings  326   FIG. 7  to which the posts  324  on the proximal surface  330  of the bottom wall  320  are engaged. Also visualized is a nipple like structure or center tube  311  defining a distal connector for tube  311  onto which a proximal end  202  of the elongated hollow tube  200  of  FIG. 3  is fed and frictionally engaged. Vacuum port  400  is shown to be disposed through the sidewall  315  of the working hub  100 . Further, the working hub  100  is seen to include a port  602  of  FIG. 7  in a stopcock sleeve  450   FIG. 4  thereof which selectively aligns with a cooperating side wall port or opening  520  in the stopcock  500  of  FIG. 3  to provide for control for the flow of smoke  4000 , fluids, and the like through the multifunction laparoscopic device  1000 . 
         [0058]    The longitudinal bore  520   FIG. 11  of the stopcock  500  extends into the working hub  100   FIG. 7  to a point where it intersects with a port  606  feeding into central opening  600  within the center tube  311  of  FIG. 6 . 
         [0059]    A top isometric view of the top of retaining clip  700  is illustrated in  FIG. 8 . The retaining clip  700  fits into the slot  800  as shown in  FIG. 6 . The retaining clip  700  is releasably inserted into the slot  800   FIG. 6  and may include quick connect features, such as shoulders  720  for cooperatively, releasably engaging against side walls  801   FIG. 7  of the retaining clip receiving slot  800   FIG. 6 . Two openings an outer opening  760  and an inner opening  761  extend through a distal stepped down portion  702  of the retaining clip  700 , with each opening serving a specialized function related to retaining second seal clip member  930   FIG. 9 . In this respect, opening  761  aligns with the centering  940  in the second seal member  930   FIG. 1  to allow passage of a laparoscopic tool through central passage  600   FIG. 1  while the outer opening  760  allows the second seal member  930   FIG. 3  to deform, creating a closure contact between a solid area of second seal member  930  and the primary seal member  900   FIG. 1  when a device, such as an electrocautery instrument, is not inserted within central passage  600 . 
         [0060]    Referring now to  FIG. 9 , the secondary seal member  930  of the retaining clip  700  fits within a recess  710  defined by the distal stepped down portion  702  of the retaining clip  700 . The second seal member  930  is of substantially the same thickness as the retaining clip recess  710 . The secondary seal member  930  has one opening  940  for allowing the insertion of a laparoscopic tool such as an electrocautery device and may be made of any reasonably flexible material suitable for preventing leakage of bodily fluids, therethrough or therearound. Preferably, the retaining clip secondary seal  930  is fabricated of a rubber, or a plastic polymer of any known suitable composition, and the like. Referring back to  FIG. 8 , the retaining clip  700  includes a plurality of protrusions or nubs  750 , which prevent the retaining clip  700  from rocking within the slot  800  of  FIG. 6 . By preventing the clip  700  from rocking within the slot  800  of  FIG. 6 , the secondary seal member  930  of the retaining clip  700  makes flush contact with the primary seal member  900   FIG. 3 , enhancing the sealing effect. 
         [0061]    An end view of the retaining clip  700  is presented in  FIG. 10 . The retaining clip  700  includes small protrusions or nubs  750  for stabilizing the retaining clip  700  within the retaining clip slot  800 , the nubs  750  engaging against the distal surface of the proximal wall  310 . The retaining clip  700  includes recesses  765  for receiving biasing springs  770  which maintain shoulders  720  against the side walls  801   FIG. 7  of the retaining clip receiving slot  800 , maintaining the retaining clip  700  in a normally closed position. 
         [0062]    A hollow tube  510  defining an interiorized portion of the stopcock  500 , extends generally perpendicularly to the handle  540  as illustrated in  FIG. 11 . The tube  510  includes two openings: a side opening  520  and a distal opening  530 . The distal opening  530  is located at an end of the tube  510  that is opposite from handle  540 . 
         [0063]    The stopcock  500  is used to control the evacuation of smoke and/or bodily fluids from the operative site. All that is required for creating a fluid path from the operative site through vacuum attachment  300  is for opening  530  of stopcock  500  to be in fluid communication with vacuum connecting port  400  of  FIG. 3 . 
         [0064]    The stopcock openings  520  and  530  allow for the selective passage of smoke, bodily fluids, and the like from the elongated tube  200 , through the central passage  600 , and through the stopcock  500 . The hollow tube portion  510  allows the passage of smoke, bodily fluids, and the like through the stopcock  500  into the working hub  100  when the stopcock  500  is open. In the open position, the distal opening  520  of the stopcock  500  of  FIG. 3  and is fluidly connected to the side bore  606  in the center tube  311  of  FIG. 4 . The path of fluid or smoke from the body to the vacuum source is as follows: 
         [0000]    (1) Fluid enters the distal end  201   FIG. 1  of elongated tube  200  and travels through the tube  200  toward the working hub  100 ;
 
(2) at the side bore  606  in the center tube  311   FIG. 4 , the fluid passes through a distal end opening  452  in the stopcock sleeve  450  and enters the central hollow passage defining the hollow tube portion  510  of stopcock  500 ;
 
(3) the fluid exits the stopcock  500  through a side opening  520  and a side opening  602   FIG. 7  in the stopcock sleeve  450 ;
 
(4) the fluid then travels through a bottom chamber  454  of working hub  100  defined between the center wall  328   FIG. 6  and the distal wall  320  and toward the interior open end  401   FIG. 4  of vacuum connecting port  400 ;
 
(5) the fluid exits the working hub  100  via vacuum port  400 ; and
 
(6) the fluid exits the working hub  100  through tubing  460  of  FIG. 7  attached between the vacuum connecting port  400  and a vacuum source (not shown).
 
         [0065]    In  FIG. 11  the closed position, the side opening  520  of stopcock  500  is not aligned with the opening  602   FIG. 7  in the stopcock sleeve  450   FIG. 4 . Into which stopcock  500  enters via sidewall opening  513 . Instead, a portion of the stopcock wall  515  covers the opening  602 , preventing any vacuum draw. 
         [0066]    An alternative exemplary embodiment of a retaining clip  700 , referred to as retaining clip  705 , is presented in  FIGS. 12 and 13 . The alternative retaining clip  705  includes alternative quick connect protruding side tabs  770  which would releasably engage with cooperating grooves (not shown) within side walls  801  of the clip retaining slot  800   FIG. 6  of the working hub  100 . 
         [0067]    As shown in  FIG. 14 , the outer diameter of elongated hollow tube  200  is less than the inner diameter of standard cannula  2000 . Thus, elongated tube  200  slidably fits inside a cannula  2000 . In a preferred embodiment, cannula  2000  has an inner diameter of about 5 mm. The multifunction laparoscopic device  1000  is preferably sized to slide freely within cannula  2000 . The multifunction laparoscopic device  1000  is preferably sized and configured so that any known embodiment of an electrocautery device or other laparoscopic instrument  3000  would pass through the central passage  600  of  FIG. 1  and extend out beyond the distal end  201  of the multifunctional laparoscopic device  1000 , with smoke and/or fluid evacuation occurring substantially at the smoke generating location. The multifunction laparoscopic device  1000  slides in the cannula  2000  without resistance. The multifunctional laparoscopic device  1000  is preferably constructed of a strong, lightweight, biocompatible material suitable for use during surgery, preferably of plastic, aluminum, stainless steel, or other rigid metal. A cannula  2000  may even be provided with a mechanism (not shown) which will cooperatively engage with the device  1000  so that surgeons may selectively position the device  1000  within the cannula  2000  and lock the device  1000  at the desired position within cannula  2000 . 
         [0068]    The inner diameter of the elongated hollow tube  200  is larger than the outer diameter of standard laparoscopic cautery device shafts or other laparoscopic tool shafts, such as laparoscopic tool  3000  shown in  FIG. 14 . The thin wall thickness of the elongated hollow tube  200  permits attachment of the multifunction laparoscopic device  1000  to an electrocautery device or laparoscopic tool and allows the device  3000  and the multifunction laparoscopic device  1000  to share the same cannula  2000 . The sharing of cannula  2000  reduces the number of incisions in the patient and reduces surgery time. 
         [0069]    The central passage  600  of the working hub  100  preferably includes two different diameter end openings such that the proximal end of the central passage  600  is larger than the distal end of the central passage  600 . The resultant funnel shape  605  of  FIG. 4  allows standard electrocautery and/or laparoscopic tools  3000  to be more easily inserted into the central passage  600 , as shown in  FIG. 14 . The distal end of the central passage  600  is slightly smaller than the inner diameter of the elongated tube  200  to allow the elongate tube  200  to be permanently joined with the working hub  100 . 
         [0070]    In practice, the multifunction laparoscopic device  1000  vacuums smoke, fluids, and the like through an annular space between an inner diameter of the multifunction laparoscopic device  1000  and the shaft  3100  of an electrocautery device or laparoscopic tool  3000 . Fluid is drawn toward vacuum connection port  400  where it exits the device. The vacuum/smoke evacuation function is controlled by operation of the stopcock  500 . Rotation of the stopcock  500  controls the opening and closing of the passage  520 , shown in  FIG. 11 , to a vacuum source (not shown), which is attached to vacuum port  400 . 
         [0071]    As shown in  FIGS. 4 ,  5 , and  14 , retaining clip  700  serves as a sealing device for preventing pressurized CO 2  from exiting an insufflated abdomen (not shown). The position of multifunction laparoscopic device  1000  along the shaft of an electrocautery device or laparoscopic tool  3000 , as shown in  FIG. 14 , is adjusted by moving multifunction laparoscopic device  1000  relative to said device shaft  3100 . The retaining clip  700  may further include additional exemplary sealing structures to prevent loss of vacuum pressure therearound or therethrough. 
         [0072]    Referring generally to  FIG. 14 , the multifunction laparoscopic device  1000  is shown seated about an electrocautery device  3000  during surgery. Electrocautery device  3000  is inserted into central passage  600  and into the elongated hollow tube  200  until a tip  3005  of the electrocautery device exits the distal end  201  of the elongated hollow tube  200 . In a preferred embodiment, the overall length of multifunction laparoscopic tool  1000  is less than the shaft length of standard electrocautery devices  3000 . 
         [0073]    The retaining clip  700  must be engaged by pushing the retaining clip  700  completely into the slot  800  before an electrocautery or laparoscopic tool  3000  can enter the multifunction device  1000 . For electrocautery devices  3000 , the cauterizing tip  3005  is advanced down the elongated hollow tube  200  of the multifunction laparoscopic device  1000  until it exits the distal end  201  of the elongated hollow tube  200 . 
         [0074]    The vacuum port  400  is connected to a vacuum pump or source (not shown) via tube  460  shown in  FIG. 7 . The electrocautery device  3000  has a cauterizing tip  3005  which extends past the distal end  201  of the elongated hollow tube  200 . Tissue within, for example, an abdomen, is brought into contact with the cauterizing tip  3005  to cauterize same. Smoke is generated when the cauterizing tip  3005  contacts bodily tissue. This smoke is removed from the abdomen via distal end  201  of elongated hollow tube  200 . 
         [0075]    In a proposed further exemplary embodiment, a sensing device may be operatively connected to the electrocautery device  3000  of the present invention which would automatically start smoke evacuation from the surgical site upon sensing activation of the electrocautery device  3000 , blood coagulation, temperature, or time at the surgical site. 
         [0076]    When the multifunction laparoscopic device  1000  suctions blood or other fluids from the surgical site, the orientation of the elongated hollow tube  200  relative to the shaft  3100  of the electrocautery or other laparoscopic device  3000  of  FIG. 14  may be altered to improve suctioning. The surgeon will slide the multifunction laparoscopic device  1000  along the electrocautery or other laparoscopic tool shaft  3100  until the distal end  201  of the elongated hollow tube  200  extends past tip  3005  of the electrocautery device or laparoscopic tool  3000 . Since the electrocautery or other laparoscopic tool is withdrawn within the elongated hollow tube  200  of the multifunction laparoscopic device  1000 , the opening at the distal end  201  of the elongated hollow tube  200  can make direct contact with pools of blood and other fluids without interference from the tip of the electrocautery or laparoscopic device. Such orientation will enhance the suctioning of pools of blood or other fluids into the multifunction laparoscopic device  1000 . 
         [0077]    The multifunction laparoscopic device  1000  can also be operated as an irrigator during surgical procedures by replacing the vacuum source with a source of sterile fluid. The source of fluid can be an IV bag or any other common surgical fluid source. The fluid source can be manual; meaning gravity will cause the fluid to flow from the source to the multifunction laparoscopic device  1000 , or the fluid may be pressurized by a pump (not shown). The source of fluid is connected to the vacuum port  400  of the multifunction laparoscopic device  1000  by means of tubing  460  capable of carrying fluid. In this instance, the surgeon uses the stopcock  500  to control in an on/off manner the provision of fluid to the operating site. However, it will be understood that fluid flow is reversed from the suctioning previously described. Fluid now flows from the vacuum port  400  through the working hub  100  before entering opening  452   FIG. 4  in the stopcock sleeve  450  and then through opening  520  in the stopcock  500 . Once the fluid enters the stopcock  500 , the fluid passes along the length of the stopcock  500  until it exits the stopcock  500  and enters side wall opening  606  into the center tube  311  of the central passage  600  and out the distal end  201  of elongated tube  200 , reaching the operative site. 
         [0078]    For increased efficiency, the suction and irrigation functions of the multifunctional laparoscopic device  1000  can share the same tubing, and valves external to the multifunctional laparoscopic device  1000  may be used to selectively connect either the vacuum source or the source of fluid to the multifunction laparoscopic device vacuum port  400 . In another embodiment not shown an external automatic vacuum system and or device may be used to automatically evacuate the smoke filled air in the abdomen of the patient when cauterization or evacuation takes place. 
         [0079]    The above-described embodiments are merely exemplary illustrations of implementations set forth for a clear understanding of the principles of the invention. Many variations, combinations, modifications, or equivalents may be substituted for elements thereof, some of which have been broached above, without departing from the scope of the invention. Therefore, it is intended that the invention not be limited to the particular embodiments disclosed as the best mode contemplated for carrying out the invention, but that the invention will include all embodiments falling within the scope of the appended claims.