Abstract:
A versatile irrigation system dissector for laparoscopic surgery comprises an elongated lumen having an elongated slim tip electrode slidably mounted therein and having a cutting tip extendable therefrom at one end. The lumen is connected at the other end to a manifold mounted on a handle, which includes a pair of switches to regulate the inlet and outlet flow through the lumen for irrigation and suction purposes. A control panel on the handle regulates the current to the tip for either cutting or coagulating. Thus, several operations may be performed with a single handheld instrument in a highly efficient and rapid action.

Description:
CROSS REFERENCE TO RELATED APPLICATIONS 
   Not Applicable 
   STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT 
   Not Applicable 
   PARTIES TO A JOINT RESEARCH AGREEMENT 
   Not Applicable 
   BACKGROUND OF THE INVENTION 
   This invention comprises a new and improved instrument for irrigating and dissecting tissue during laparoscopic procedures. 
   1. Field of the Invention 
   In the field of laparoscopic surgery, many new instruments have been introduced with the increasing number of procedures and the growing familiarity with the endoscopic modality of operating. The use of such instruments for dissecting is shown in applicant&#39;s earlier U.S. Pat. No. 5,817,121, which discloses an endodissector. A more recent instrument by applicant for dissecting is shown in U.S. Pat. No. 6,391,040, which discloses an endodissector with a distinctive tip at the operative end. 
   2. Description of Related Art Including Information Disclosed Under 37 CFR 1.97 &amp; 1.98 
   U.S. Pat. No. 6,620,161 to Schulze et al discloses an electrosurgical instrument useful in controlling-coagulating blood vessels such as veins and arteries. The instrument includes a handle assembly with first and second actuators and an elongated tube assembly, which is supplied with current for grasping a dissecting tissue. 
   U.S. Pat. No. 6,908,463 to Treat et al discloses an electrothermal device for sealing and dividing tissue, which is particularly suitable for laparoscopic and endoscopic surgery. 
   The prior art, however, fails to disclose the unique instrument of the present invention which is simple to use, highly manipulative and inexpensive. The electrode for dissecting is retractable within a lumen, which also includes concentric space about the electrode for irrigation and suction or alternatively, the electrode could be easily withdrawn within the lumen to facilitate irrigation and suction. A control panel on the handle regulates the current at the tip for either coagulation or cutting. A pair of switches mounted on the handle for the lumen and electrode controls a pair of tube lines coupled to a manifold for irrigating or suction during a procedure. Advantageously, dissecting, irrigation and suction may be performed with a single handheld instrument. Electrocoagulation is operated in conjunction with an electrocoagulation and a suction-irrigation system with a gauze dissector tip. 
   BRIEF SUMMARY OF THE INVENTION 
   This invention involves a unique dissector comprising an elongated lumen having an electrode mounted therein and slidable in or out at the working end from the elongated lumen. The other end of the electrode protrudes from the lumen and includes a manipulating protrusion used for gripping and limiting the extension of the electrode from the working end and means coupling the electrode to a power source. 
   The lumen is connected to a manifold at the non-working end, which has an inlet on one side thereof and an outlet on the other side and is mounted on a handle to manipulate the dissector. An inlet tube is connected to the lumen for irrigation purposes, whereas the other outlet tube is connected to the lumen for suction purposes. Respective switches are mounted to the manifold to control the flow that can be adjusted at variable volumes from the inlet tubing and the outlet tubing. The tubing is connected to the respective manifold openings. The switches each control a projecting pin, which engages and opens or closes the respective tubing as desired, or engages the tubing at variable but stable positions, which alters the flow at different volumes. 
   To operate, the instrument or cannula is inserted into a body opening and the electrode with a particular slim tip is extended to contact the particular tissue. A switch on the manifold controls the current to the electrode. The electrode is activated for dissection and/or coagulation as desired. The particular switch is then activated for irrigation or suction as indicated or desired. The operations are all conveniently performed with the same handheld instrument with a particular digit such as the thumb. 
   Accordingly, an object of this invention is to provide a new and improved dissector for use in laparoscopic surgery. 
   Another object of this invention is to provide a new and improved irrigation system and dissector, which includes a dissecting electrode mounted within an elongated lumen, which is also used for irrigation and suction with the controls for all activities resting within the reach of the activating digit i.e., the thumb. 
   A further object of this invention is to provide a new and improved dissector, which includes an electrode slidable within a lumen and mounted to a manifold with separate lines under control of respective switches connected to said manifold for purposes of irrigation and suction in a single instrument. 
   Another object of this invention is to provide a new and improved dissector, which includes control means conveniently located on a manifold to regulate the irrigation and suction action of the lumen as desired during a dissecting procedure and a switch to control current for dissecting and coagulation with a unique slim tip electrode. 
   A more specific object of this invention is to provide a new and improved handheld dissector having an elongated retractable electrode positioned within a lumen, and suction and irrigation means coupled to the lumen and mounted on a manifold having control means for regulating the current to the electrode and suction-irrigation control means and said controls and mounted on a handle for ease of manipulation. 
   A further more specific object of this invention is to provide simultaneous electrocoagulation and suction for a smoke free surgical field by allowing simultaneous activation of the electrocoagulation and suction controls. 

   
     BRIEF DESCRIPTION OF THE DRAWINGS 
     The above and other objects and advantages of the present invention may be more clearly seen when viewed in conjunction with the accompanying drawings wherein: 
       FIG. 1  is a schematic side view of a prior art system showing electrocoagulation operated in conjunction with a suction-irrigation arrangement; 
       FIG. 2  shows a prior art foot control electrocoagulation system; 
       FIG. 3  shows a prior art hand-control electrocoagulation system; 
       FIG. 4  shows a unique slim tip electrode used in conjunction with a suction-irrigation system; 
       FIG. 5  is a perspective view of a unique versatile irrigation system-dissector using the electrode of  FIG. 4 ; 
       FIG. 6  is a rear view of the handle and controls for the electrode and for the irrigation and suction valves; 
       FIG. 7   a  is a side view of a standard electrode while  FIG. 7   b  shows a slim tip electrode and  FIG. 7   c  shows a conventional slim electrode; and 
       FIG. 8   a  represents an alternate embodiment of the invention involving a coagulation system and  FIG. 8B  shows the electrical control panel for the system of  FIG. 8   a ; and, 
       FIG. 9  shows a prior art version of a coagulation system. 
   

   DETAILED DESCRIPTION OF THE INVENTION 
   Referring now to the drawings,  FIG. 1  depicts a prior art device  10  for electrocoagulation operated in conjunction with a gauze dissector tip  11  on one end of the cannula  12 . The electrode  13  comprises a cutting and coagulating tip  14  extending outwardly from the gauze tip  11  on the cannula  12  to contact target tissue  28 . An insulated body portion  15  extends axially along the lumen  28  and protrudes outwardly from the other end  16  thereof. The electrode end with stalk  29  is connected by wire  17  to a power supply  18 . A foot control  19  activates the power supply  18  to supply current to the tip  14  for coagulating or cutting. The foot pedal or control  19  has separate switches  20   a  and  20   b  for cutting or coagulation. 
   The cannula  12  is mounted on a handle  21  which includes a hollow chamber  22  connected to a cannula aperture  23 . Hoses  24  and  25  for suction and irrigation respectively, are connected to a suction control  26  and an irrigation control  27  to regulate flow. 
     FIG. 2  shows a prior art device  30  for electrocoagulation using a foot control  31 . An electrode  32  having a cutting/coagulating tip  33  at one end is mounted in an electrode receptacle  34 . A connecting wire  35  is mounted to the receptacle  34  at one end and to an electrical source or power supply  36  at the other end. A foot control  31  is connected via wire  37  and regulates the power supply  36 . The foot control  31  includes pedal  39   a  to regulate coagulating current and  39   b  to regulate current for cutting. 
     FIG. 3  depicts schematically a hand control electrocoagulation device  40  of the prior art. An electrode  41  having a coagulating/cutting tip  42  at one end is mounted at the other end  43  in an electrode receptacle  44  in a pencil like body  45 . A switch  46  having a setting for coagulation current control and a setting for cutting current control is mounted on the body  45  and is connected by wire  46  to the electrical source  47 . The target tissue  48  is contacted by the tip  42  for either coagulation or cutting as determined by the switch setting. 
     FIG. 4  shows an electrode  50  used in the embodiment of the invention shown in  FIG. 5 . The slim tip electrode  50  is used in conjunction with a suction/irrigation device with a hand control panel  51  mounted on the control handle of the device. The 1.5 mm slim tip  52  allows passage through the 5 mm end of a dissector&#39;s lumen and terminates in an exposed coagulating-cutting tip  53 . The electrode  50  includes an electrode-connecting stalk  54  at the other end, a wire  55  joining the control panel  51  to said stalk  54  and a wire  57  joining the panel  51  to a power source  56 . 
     FIG. 5  shows the versatile irrigation system dissector  60  of this invention. The electrode  50  of  FIG. 4  is mounted within the irrigation cannula  61 , which may be 5 mm or 10 mm in diameter. A gauze dissector  62  for blunt dissection is mounted on one end of the cannula  61 . The cannula  61  is mounted to a manifold  63  adjacent its other end  64  through which the electrode  50  extends. An electrode manipulation disc  65  is mounted about the electrode for movement within the cannula  61 . The end of the electrode  50  is connected to a coiled wire  66  via coupling  67 . The wire  66  connects to control panel  51 , which includes switches  68  and  69 , which regulate the current for either electrocoagulation or cutting. The panel  51  is mounted to the handle  70  of the suction irrigation device for hand-controlled electrocoagulation. The control panel  51  is connected by wire  71  to a generator  72 . 
   The manifold  63  includes a suction valve  73  on one side of the handle  70  and an irrigation valve  74  on the other side of the handle  70 . The valves  73  and  74  are connected to the respective hoses  75  and  76  to control suction and irrigation through the manifold  63  and lumen  77 . Thus, the versatile irrigating system dissector  60  includes all the controls on a handle  70  for hand operation of the electrode  50  and irrigation and suction using the cannula lumen  77 . 
     FIG. 6  shows the handle controls in greater detail. The electrode manipulation device  65  is connected by a coiled wire  66  to the control panel  51 . The panel includes centrally pivotal switches  68  for coagulation and  69  for cutting. The switches  68  and  69  are connected as shown to power supply and regulate the current supplied to the tip  88 . The suction control valve  73  includes a pin  78 , which presses against the flexible suction tubing  75  to regulate suction. Similarly, control valve  74  includes a pin  79 , which engages flexible irrigation tube  79  to control the flow therethrough. 
     FIG. 7   a  depicts a standard 3-5 mm OD electrode  80  with a connecting stalk  81  at one end and coagulating tip  82  at the other end. The main body portion  83  is covered with a sheath of insulation  84 . 
     FIG. 7   b  shows a unique slim tip electrode  85  used in this invention. The elongated main shaft  86  is 3 mm in OD thereby helping to maintain the stability of the instrument in lengths necessary for use in laparoscopic surgery. At one end, a slim tip  87  approximately 1.5 mm OD extends 4 cm in length from the insulated shaft  86 . At the very end of the slim tip portion  87  is an exposed coagulating tip  88 . At the other end of the electrode  85  is a connecting stalk  89  and spaced inwardly therefrom is a manipulator disc  90  mounted about the shaft  86  for insertion or withdrawal of the electrode  85  from the cannula shown in  FIG. 5 . The slim tip  87  will fit through a 5 mm Christoudias endodissector mentioned in the discussion of the prior art. 
     FIG. 7   c  discloses a standard 15 mm electrode  95  wherein the thin shaft  97  renders the electrode  95  flexible and unstable in lengths necessary for laparoscopic surgery. The slim tip electrode  85  eliminates this problem. The electrode  95  also includes a connecting stalk  95  at one end and an exposed coagulating tip  97  at the other end. 
     FIGS. 8   a  and  8   b  disclose a handheld coagulation system  130  with a control panel  131  mounted on the instrument body  118 . The control panel  131  is connected via wire  133  to the electrical source  134 . A wire  135  connects the control panel  131  to the electrode connector receptacle  136 . Electrode jaws  137  extend outwardly from the tube  132  to engage the target tissue  138  for cutting and coagulation. The insulated electrode  139  protrudes from tube  132  and is actuated by finger loop  140 , which moves the jaws  138  into engagement. Loop  141  serves as a gripping loop in the completely handheld coagulation system  130 . 
     FIG. 8   b  shows the control panel  131  in greater detail with switches  142   a  and  142   b  mounted thereon for cutting and coagulating respectively. Straps  143   a  and  143   b  are provided for attaching the panel  131  to the instrument body  132 . The electrical supply  134  provides current through the control panel  131  to the electrode connector and the electrode  139 . 
     FIG. 9  shows a prior art coagulation system  110  with a foot pedal  111  having a cutting switch  113  coupled to a power source  114 . A connecting wire  115  is connected to the power source  114  at one end and to an electrode instrument receptacle  116  at the other end where it engages a connecting tip  117  on the instrument body  118 . An electrode  119  extends through on elongated through an elongated supporting tube  120 . Electrode instrument jaws  121  extend from one side of the tube  120  to engage the target tissue  122 . Pivotal finger grip  123  controls the jaws  121  while finger grip  124  is chiefly for gripping purposes. 
   While the invention has been explained by a detailed description of certain specific embodiments, it is understood that various modifications and substitutions can be made in any of them within the scope of the appended claims that are intended also to include equivalents of such embodiments.