System and method for positioning a laparoscopic device

Abstract: A system for positioning a laparoscopic device includes a curvilinear articulating arm and a holder. The holder has at least two rotational regions and a clamping portion for receiving the laparoscopic device, and the holder is coupled to the curvilinear articulating arm. The at least two rotational regions are permitted to articulate. In addition, a method of positioning a laparoscopic device in a skin port of a mammal includes: securing the laparoscopic device to a holder having at least two rotational joints; coupling the holder to a curvilinear articulating arm; disposing the laparoscopic device partially within the skin port; positioning the laparoscopic device by selectively articulating the curvilinear articulating arm and selectively rotating portions of the holder with respect to one another. (end of abstract)

Agent: Steptoe & Johnson LLP - Washington, DC, US
Inventors: Roger F. Wilson, Willet F. Whitmore
USPTO Applicaton #: #20070185376 - Class: 600102000 (USPTO)
Related Patent Categories: Surgery, Endoscope, With Chair, Table, Holder, Or Other Support

System and method for positioning a laparoscopic device description/claims

The Patent Description & Claims data below is from USPTO Patent Application 20070185376, System and method for positioning a laparoscopic device.

Brief Patent Description - Full Patent Description - Patent Application Claims

CROSS-REFERENCE TO RELATED APPLICATIONS

[0001] This application is a continuation-in-part of application Ser. No. 11/095,586 filed Apr. 1, 2005 and entitled "Support System for Use When Performing Medical Imaging of a Patient" which claims the benefits of Provisional Application No. 60/559,414 filed Apr. 2, 2004, Provisional Application No. 60/575,792 filed May 28, 2004, and Provisional Application No. 60/614,593 filed Oct. 1, 2004 under 35 U.S.C. .sctn. 119(e), and the entire contents of each of these applications are expressly incorporated herein by reference thereto.

[0002] In addition, the benefits of Provisional Application No. 60/709,098 filed Aug. 18, 2005, Provisional Application No. 60/730,853 filed Oct. 28, 2005, Provisional Application No. 60/772,863 filed Feb. 14, 2006, and Provisional Application No. 60/773,638 filed Feb. 16, 2006, each entitled "System for Positioning a Laparoscopic Device," as well as Provisional Application No. 60/821,692 filed Aug. 7, 2006 and entitled "System and Method for Positioning a Laparoscopic Device" are claimed under 35 U.S.C. .sctn. 119(e), and the entire contents of these provisional applications are expressly incorporated herein by reference thereto.

FIELD OF THE INVENTION

[0003] The invention relates to a system for positioning a laparoscopic device. In particular, the invention relates to a holder and curvilinear articulating arm for positioning a laparoscopic device such as an endoscopic camera.

BACKGROUND OF THE INVENTION

[0004] During laparoscopy, a minimally invasive surgical procedure in which tissue for example may be removed from the abdomen or chest through a small puncture wound, the laparoscopic surgery is performed with the aid of an endoscopic camera. The camera is placed through a port in the skin into a working cavity and may be used for example to visually examine the interior of the cavity such as the peritoneum or surgical planes or spaces created for purposes of dissection. Typically, the camera includes a light source. Correct positioning and aim of the laparoscopic camera and light throughout a procedure are fundamental to laparoscopy.

[0005] Most commonly, the endoscopic camera is held by an assistant who must continually watch the video monitor and hold a steady position until the surgeon requests a change in the field of view. Alternatively, a variety of robotic arms have been designed to hold the camera and move for example on voice command by the surgeon. Such systems include the AESOP.RTM. (Automated Endoscopic System for Optimal Positioning) voice controlled robot system and the Zeus.RTM. minimal invasive surgical robot system from Computer Motion Inc./Intuitive Surgical Inc. Mechanical/electrical servomotor controlled systems that move by foot controls, palm and fingertip controls include the LAPMAN.RTM. by MedSys s.a. of Belgium, while a remote, manual control system da Vinci.RTM. is available from Intuitive Surgical Inc.

[0006] In addition, a variety of known mechanical frameworks that have multiple adjustment and locking points can be used to hold an endoscopic camera including a laparoscopic retractor from Thompson Surgical Instruments, the Martin Arm System from Gebruder Martin GmbH & Co. KG, and the Omni-Tract.RTM. surgical retractors from Minnesota Scientific Inc. These devices have the capability of holding other laparoscopic instruments as well, although different connections at the instrument interface may be required depending on the instrument and the application.

[0007] The first choice for any surgeon is to have a good human assistant, who can continuously and accurately aim and focus the camera and light on the moving surgical field. Unfortunately, good assistance, or any assistance for that matter, is frequently unavailable, and the surgeon must work solo. Also, occasions frequently arise where an assistant's hands may be occupied by other tasks, such as retraction and suction, and in these circumstances other means for holding the camera also are required. The alternatives for holding and positioning the camera cited above then come into play. However, these alternatives each have one or more troublesome drawbacks. The high end robotic arms (such as da Vinci) are expensive, have high maintenance requirements, are time consuming and cumbersome to set up and may have high cost disposable components. They also require an experienced assistant or technician to be present. The simpler, voice controlled (AESOP) or palm radio controlled (LAPMAN) robotic arms also require significant maintenance and set up time, move too slowly for many surgeons, and are hard to precisely control. The mechanical arms and frameworks that are available typically have too many movable parts that require adjustment, require two hands for re-positioning, may have a large footprint near the surgical field, and are very slow to re-position because of the several joints that must be loosened and retightened.

[0008] Thompson Surgical Instruments also offers a Flexbar Scope Holder (product #42133C). This device has a clamp to the bedside railing and a set of stainless steel rods that may be clamped at a desired length with right angle clamps to position the base attachment of a curvilinear flexible arm. The arm uses a combination of a screw and cam locking mechanism to achieve an adjustable friction lock of the arm. In this device, the clamp that holds the laparoscopic camera at the free end of the flexible arm has limited capabilities; the clamp becomes locked dimensionally with the arm and is not a universal joint. The design of the scope holder generally requires a user to loosen and then retighten the locking mechanism for the arm whenever it is necessary to reposition the laparoscope.

[0009] Thus, there remains a need for better holding and positioning devices for laparoscopic instruments in general and for the laparoscopic camera (laparoscope) in particular. In particular there is a need for a device that will hold a laparoscope steady when it is not in hand, may be quickly re-positioned using one hand, allows quick engagement and disengagement to a laparoscopic instrument, and has a minimal and movable footprint on the surgical field.

SUMMARY OF THE INVENTION

[0010] The invention relates to a system for positioning a laparoscopic device, the system having a holder. The holder includes a central portion having a first member operatively associated with a second member, the members selectively movable with respect to one another along a central axis, the central portion having a proximal end defined by the first member and a distal end defined by the second member. The holder also has at least three proximal rotational joints coupled to the first member proximate the proximal end, at least two distal rotational joints coupled to the second member proximate the distal end, a clamp configured and dimensioned for retaining a laparoscopic device, and a coupling portion proximate a first of the proximal rotational joints. A first of the distal rotational joints is coupled to the distal end of the central portion and a second of the distal rotational joints is coupled to the clamp.

[0011] In some embodiments, the members may telescope with respect to one another. The second member may be slidably received in the first member. The first member may have a slot and the second member may have a protrusion, the protrusion movable within the slot. For example, the protrusion may include a roller key. Also, in some embodiments, the second member may include a piston member proximate an end thereof the piston member disposed within the first member. The piston member may be spring-loaded with a spring oriented transverse to the central axis.

[0012] The first member may include a receiving end for receiving the second member and a bushing coupled to the receiving end, with the bushing having a plurality of fingers disposed radially with respect to the central axis.

[0013] Each of the proximal and distal rotational joints may include a thrust bearing which may be a steel ball thrust bearing. In addition, each of the proximal rotational joints may include a washer abutting a spacer and rotatable with respect to each other. In some embodiments, the spacer may be formed of a material that is polytetrafluoroethylene-based. Each of the distal rotational joints may include a washer abutting a spacer and rotatable with respect to each other. In some embodiments, the spacer may be formed of a material comprising acetal homopolymer. Each of the proximal and distal rotational joints may include a spacer, each of the spacers of the proximal rotational joints having a first thickness and each of the spacers of the distal rotational joints having a second thickness, the first thickness being smaller than the second thickness.

[0014] The at least three proximal rotational joints may be three proximal rotational joints that each permit movement in a separate plane, and at least two of the planes may be parallel to one another.

[0015] The first of the distal rotational joints may permit rotation about an axis coinciding with the main axis and the second of the distal rotational joints may permit rotation about an axis transverse to the main axis. Also, the second of the distal rotational joints may permit rotation about an axis generally perpendicular to the main axis.

[0016] The clamp may include a pair of spring-biased jaw members each having a cover formed of a material softer than aluminum, the clamp being configured and dimensioned to retain the laparoscopic device while contacting the covers. For example, each cover may be formed of polyurethane.

[0017] The laparoscopic device may have a cylindrical portion. The first member may be tubular. Each of the proximal and distal rotational joints may have a first portion rotatable with respect to a second portion about a fixed axis. The first and second members may be movable with respect to each other along the central axis but may not be rotatable with respect to each other.

[0018] The system may further include a curvilinear articulating arm, the holder being coupled to the curvilinear articulating arm. In addition, the system may further include a tray configured and dimensioned for supporting a mammal, the curvilinear articulating arm being coupled to the tray.

[0019] The coupling portion may include a clamp for coupling to a support, wherein the support is selected from the group consisting of a rail of a table and a rail of a bed.

[0020] Each proximal rotational joint and each distal rotational joint may permit 360.degree. of rotation about an axis thereof.

Brief Patent Description - Full Patent Description - Patent Application Claims
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