System for Single-Puncture Endoscopic Surgery

This application claims the benefit of prior filed U.S. Provisional Application No. 60/011,269, filed Feb. 7, 1996, now abandoned.

The present invention relates a system which allows endoscopic surgery to be performed using a single puncture in the patient, rather than two or more punctures required with the prior art.

The described system for performing laparoscopic surgery includes a cannula divided longitudinally into a camera chamber and an instrument passage. The distal end of the camera chamber is sealed by an optically clear cap. In use, a camera assembly is inserted into the camera chamber, a conventional laparoscopic instrument is inserted into the patient through the instrument passage, and sources of CO.sub.2 and suction/irrigation are connected to ports provided on the cannula. In one embodiment of the invention, when the instrument is fully inserted into the instrument passage, the forward handle of the instrument is engaged by an attachment member which extends from the cannula. This allows the entire system (the cannula, the camera assembly, and the instrument) to be manipulated within the patient with one hand. In another embodiment of the invention, an attachment member engages the instrument adjacent to the junction of the instrument's handles.

Two camera assemblies are described. Both camera assemblies include a charge-coupled device ("CCD") camera. In one embodiment, the camera is mounted at the distal end of a sled. In another embodiment, the camera is mounted at the proximal end of the sled and a fiber optic bundle is optically connected to the camera and extends to the distal end of the sled. Both camera assemblies include two high-intensity lights mounted at the distal end of the sled. Finally, both camera assemblies include a cable which connects the camera to a display device, such as a video monitor, and the lights to a source of electrical power.

An embodiment of the invention will be described, by way of example only, with reference to the accompanying drawings, in which:

FIG. 1 is a perspective view of a system for single-puncture laparoscopic surgery embodying the invention;

FIG. 2 is an enlarged cross-sectional view of the cannula of FIG. 1 taken through plane 2--2 in FIG. 1:

FIG. 3 is a perspective view of the camera assembly of FIG. 1; and

FIG. 4 is a perspective view of an alternate camera assembly.

FIGS. 1-3 illustrate a system 1 for performing laparoscopic surgery in accordance with the invention. The system comprises a cannula 3, a camera assembly 5, and a conventional laparoscopic instrument 7. The camera assembly 5 and laparoscopic instrument 7 are removably mounted in the cannula 3.

An attachment member 9 extends from the cannula 3 to engage a fixed handle 11 of the instrument 7, thereby rigidly securing the instrument 7 to the cannula 3. As a result, the system 1 can be manipulated by manipulating the laparoscopic instrument 7.

The laparoscopic instrument 7 shown in FIG. 1 is a "European style" instrument. That is, only the proximal handle 13 of the instrument 7 is movable. With an "American style" instrument both handles are movable, and the attachment member 9 is adapted to engage the instrument 7 adjacent to the junction of the handles 11, 13.

The camera assembly 5 comprises a CCD camera 17 mounted adjacent to the proximal end of an elongated sled 19. The camera 17 is connected to a display device (not shown) by a camera cable 21. The cable 21 also includes conductors which extend to and provide electrical power to a pair of high-intensity lights 23 mounted at the distal end of the sled 19. A fiber optic bundle 25 extends proximally from the distal end of the sled 19 and is optically connected to the camera 17. The sled 19 is removably mounted in the camera chamber 27 of the cannula 3. When the camera assembly 5 is mounted in the cannula 3, the fiber optic bundle 25 carries images from the distal end of the cannula 3 to the camera 17.

The cannula 3 is divided longitudinally into a camera chamber 27 and an instrument channel 29. An optically clear cap 31 at the distal end of the cannula 3 seals the camera chamber 27, isolating the camera assembly 5 from the patient (not shown). As a result, it is not necessary to sterilize the camera assembly 5.

A gas port 33 on the cannula 3 allows introduction of CO.sub.2 gas to inflate the patient's abdominal cavity. The gas flows into the patient through the instrument channel 29. Two conventional seals (not shown) are provided near the proximal end of the instrument channel 29 to prevent escape of the gas. If the gas port 33 is not used, it is sealed with a cap 35.

A suction/irrigation port 37 on the cannula 3 is connected to a tube 39 which extends to the distal end of the instrument channel 29. In use, the suction/irrigation port 37 is connected to a conventional suction/irrigation trumpet-valve assembly (not shown). When the suction/irrigation port 37 is not used, it is sealed with a cap 41.

The cannula 3 and attachment member 9 are constructed of a suitable plastic material, such as polyurethane. They are provided in a sterilized condition and are intended to be disposed of after use.

FIG. 4 illustrates an alternate camera assembly 51. The camera assembly 51 comprises a CCD camera 53 attached to the distal end of an elongated sled 55. Also attached to the distal end of the sled 55 are two high intensity lights 57. A cable 59 connects the camera 53 to a display device (not shown) and the lights 57 to a source of electrical power. Sled 55, like sled 19, is removably mounted in the camera chamber 27 of the cannula 3.

Those skilled in the art will recognize that the invention provides a number of advantages over the prior art. Only one puncture is required, as opposed to at least two punctures with the prior art. This obviously benefits the patient, as it shortens recovery time and decreases the chance of infection.

The invention eliminates the need for an endoscope and associated light source, both of which are expensive.

The invention allows the surgeon to manipulate the camera and instrument with one hand. With the prior art, the surgeon manipulates the instrument and another person generally manipulates the endoscope/camera combination.