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Multifunctional tool and method for minimally invasive surgeryRelated Patent Categories: Surgery, Instruments, ForcepsMultifunctional tool and method for minimally invasive surgery description/claimsThe Patent Description & Claims data below is from USPTO Patent Application 20070179525, Multifunctional tool and method for minimally invasive surgery. Brief Patent Description - Full Patent Description - Patent Application Claims
REFERENCE TO RELATED APPLICATIONS [0001] This application is a Continuation of Ser. No. 10/213,645 filed Aug. 5, 2002, which is based upon U.S. Provisional Application Ser. No. 60/310,314, filed Aug. 6, 2001, and Ser. No. 60/310,315, filed Aug. 6, 2001, all are incorporated by reference herein. I. BACKGROUND OF THE INVENTION [0002] 1. A. Field of the Invention [0003] This invention relates to Minimally Invasive Surgery tools and methods, and in particular, to multifunction tools and methods. [0004] 2. B. Problems in the Art [0005] Recent advances in the medical sciences have lead to the continued acceptance of Minimally Invasive Surgery ("MIS"). Originally envisioned as far back as about 1900, MIS is today being considered as a replacement to traditional "open" surgeries throughout the body including the chest, spine, abdomen, and pelvis. The major difference between MIS and traditional surgery is the surgeon's access to the patient. During MIS, the surgeon makes several small incisions (under one centimeter) in the patient's skin to gain access to the patient's body. Through one of these incisions is placed the endoscope--a narrow cylindrical scope attached to a camera. The remaining ports allow a variety of specially designed surgical instruments to enter the operating area. [0006] MIS offers many significant advantages to conventional surgery. Traditionally, most postoperative problems have been a result of the large wounds left from open surgery. This leads to long hospital stays, lengthy aberration from normal life, high health care costs, and great personal pain and discomfort. MIS has the potential to reduce recovery time from weeks to days. Furthermore, MIS reduces bowel handling and serosal drying--the two major causes of recovery irritation (Cuschieri, Alfred, 1992. Laparoscopic Biliary Surgery. Oxford: Blackwell Scientific, 1992, pp. 26-98.) [0007] While MIS offers many potential benefits to the patient, there are a number of obstacles standing in the way of more widespread use. First, the surgeon cannot view the operating area in three dimensions. This is a result of the endoscope's image being displayed on a television monitor. Second, the perception of distances within the body is a function of their orientation with respect to the endoscope. Objects that are closer to the endoscope will appear much larger than objects that are further away (Cuschieri, 1992. Id.). Finally, the surgical instruments themselves continue to be a limiting factor in the advancement of MIS because of limited mobility and lack of multifunctionality. While the first two of these obstacles can be overcome with practice and proficiency on the surgeon's part, the third suggests the need for the development of new and innovative tools for MIS. [0008] There is a need in the art for more versatile tools for MIS that have the potential to expand the capability of MIS surgical instruments currently commercially available. To meet this goal, a number of current limitations have been identified. [0009] First, most conventional tools possess only four degrees of freedom. These include translation along the longitudinal axis of the instrument, rotation around the longitudinal axis of the instrument, relative rotation around the entry point of the instrument to the body, and the opening and closing of the gripper's jaws (Melzer, A Q., G. Buess, and A. Cuschieri, 1992. Operative Manual of Endoscopic Surgery. Berlin: Springer Varlag, 1992, pp. 14-36.) Due to the kinetic qualities of the human hand and arm, during open surgery the surgeon can perform movements of approximately twenty degrees of freedom (Melzer, 1996. "Endoscopic Instruments--Conventional and Intelligent.", Endosurgery, New York: Churchill Livingstone, 1996, pp. 69-95.) Because the conventional surgeon's motion is virtually unimpeded by external constraints, the minimally invasive surgeon looses a significant amount of control due to limited degrees of freedom. [0010] Second, there is a need for multifunctional MIS tools. Multifunctional tools could provide several advantages over standard single function tools. Studies have shown that 10-30% of total operating time is used for changing between tools with single functions (Metzler 1996, Id.). Multifunctional tools have the potential to reduce tool changeover time by having the ability to perform two or more previously distinct functions in one. Besides increasing operative time, tool changeover can lead to uncontrollable bleeding. During a tool switch the tissue being worked on needs to be subsequently grasped, coagulated and transected before a new tool can be inserted. Bleeding may occur at any point during this process immediately impeding the view of the surgeon (Melzer 1996, Id.). Studies have shown that the primary reason for converting from a minimally invasive technique to open surgery is uncontrollable bleeding (Cuschieri, A., F. Dubois, J. Mouiel, P. Mouret, H. Becker, G, Buess, M. Trede, H. Troild, 1991. "The European Experience with Laparscopic Cholecystectomy." American Journal of Surgery, Vol. 161, pp. 385-387.) Exchange time, disruption of process flow for the surgical procedure, risk of tissue injury, and other issues regarding tool utilization in MIS are discussed in more detail at Mehta, N., Haluck R., Frecker M., Snyder, A. (2002) Sequence and Task Analysis of Instrument Use in Common Laprascopic Procedures. Surgical Endoscopy, 16, 280-285. [0011] Third, minimally invasive surgical tools are only mobile around the fixed access point of entry into the operating area. Once an initial insertion is made into a patient, a fixed trocar sleeve is put in place through which tools can then be slid in and out. The trocar sleeve defines a conical section in the operative cavity that will be accessible with the surgical instrument. The limitations of this conical section require significant manual dexterity on the part of the operating surgeon (Cuschieri, 1992, supra). [0012] Fourth, conventional tools lack the ability to reach behind obstructions. There are a number of instances during surgery that the surgeon needs to access a point behind a vessel or tissue. Presently available tools make this motion impossible and require the surgeon to find a different, less optimal, line of approach. [0013] There are a number of issues that must be dealt with when developing a new minimally invasive tool. The first of these issues is reposability. A reposable instrument is one that can be re-used. If an instrument is to be reposable then it must have the ability to be completely sterilized. In order to be sterilized, the instrument must have the ability to withstand autoclave temperature of 15 to 120.degree. C. or gas sterilization temperature of 127.degree. F. with 100% humidity (Cappelleri, D., M. Frecker, T. Simpson, and A. Snyder. 1999. "A Metamodel-Based Approach for Optimal Design of a PZT Bimorph Actuator for Minimally Invasive Surgery." ASME Journal of Mechanical Design, 24, 2, pp. 354-357.) Alternatives to reposable instruments are disposable instruments. Disposable instruments greatly reduce preparation time by eliminating the need for sterilization. However, using disposable instruments is approximately ten times most costly than using reposable instruments. Furthermore, disposable instruments tend to be less precise than reposable ones and raise ecological concerns (Melzer, 1996, Id.). [0014] Another issue is the ergonomics of the instrument. It has been suggested that an MIS instrument handle has to function independently of the rotation of the instrument tip. Expanding this axiom to a multi-degree of freedom design, preferably all degrees of freedom must function independently of one and other. Additionally, all functions of the instrument preferably must be capable of being carried out with one hand. [0015] There are a number of present design preferences for a MIS grasping tool including but not limited to opening width of jaws, length of jaws, t response time of jaws, and force required to clamp a suture needle. [0016] The maximum diameter of the tool is limited by the inner diameter of the trocar sleeve being used in surgery. Presently trocar sleeve inner diameters of twelve, nine, seven, five, and three millimeters are in common use. The trend in MIS is towards instruments of smaller and smaller diameters. This trend places more emphasis on the development of instruments at the smallest end of the available spectrum. [0017] Therefore, a need in the art has been identified, namely the need for a new tool for MIS that responds to the current limitations and the general requirements of minimally invasive instruments. [0018] There have been several attempts at creating a multi-degree of freedom gripper prior to this paper. An example of a commercially available multi-degree of freedom gripper is called the Roticulator.TM. available from USSC, Norwalk, conn., USA. The Roticulator achieves its fifth degree of freedom with the addition of a semi-rigid link between the handle and the jaws of the instrument. As the link is extended beyond the confinement of the handle, the stresses causes by the handle are released allowing the link to return to its naturally curved shape. When the link is fully extended, the gripper is at approximately a 63.5-degree angle with the centerline of the instrument. One issue is the Roticulator's inability to resist a force perpendicular to its jaws when extended. To combat this problem, surgeons have taken to placing a clamp on the instrument such that the tool cannot rotate along the long axis of the instrument. This allows the tool to resist a perpendicular force however it also eliminates a degree of freedom from the instrument. This returns the tool's capabilities to the standard three degrees of freedom. [0019] Furthermore, as the instrument is rotated around its long axis, the tip sweeps out a circle. This is substantially different from the traditional gripper who exhibits simple rotation about its axis during the same action. As a result, the axial orientation of the tip cannot be changed in the extended position without considerable experience on the part of the surgeon (Melzer, 1996, supra.). [0020] A. Melzer et. al. has proposed meeting the need for instruments with increased degrees of freedom by introducing a controllable ball-and-socket joint into the shaft of a gripper (Melzer, 1992, supra.). Every movement of the handle at the outer joint would be translated to a similar movement of the inner ball-and-socket. Such an instrument would be based on the mechanical remote-control grasper currently used in advanced industrial applications (Melzer, 1992, Id.). Presently, it is not believed that such a design has advanced beyond the conceptual phase for use in MIS. [0021] In order to allow a gripper's tip to both pivot and rotate, the axis of pivot preferably should lie along the centerline of the instrument. A need has been identified in the art to achieve this criterion. II. SUMMARY OF THE INVENTION Continue reading about Multifunctional tool and method for minimally invasive surgery... Full patent description for Multifunctional tool and method for minimally invasive surgery Brief Patent Description - Full Patent Description - Patent Application Claims Click on the above for other options relating to this Multifunctional tool and method for minimally invasive surgery patent application. ###  How KEYWORD MONITOR works... a FREE service from FreshPatents1. Sign up (takes 30 seconds). 2. Fill in the keywords to be monitored. 3. Each week you receive an email with patent applications related to your keywords. Start now! - Receive info on patent apps like Multifunctional tool and method for minimally invasive surgery or other areas of interest. ### Previous Patent Application: Handle for surgical instruments Next Patent Application: Surgical clamp with improved traction Industry Class: Surgery ### FreshPatents.com Support Thank you for viewing the Multifunctional tool and method for minimally invasive surgery patent info. 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