A surgical simulation scope system is provided as effective as a surgical scope without the added expense and complexities. The surgical simulation scope comprises an optics housing, a lens and an image sensor placed in such a way to ensure the location of the sensor is within the depth of focus of the lens is maintained while not damaging the sensor and, in some cases, to provide angled and/or rotational viewing.
A surgical training model for teaching, practicing, and assessing motor and cognitive skills associated with laparoscopic surgery is provided. The surgical training model has at least a portion (e.g., limbs) that is manipulatable by a user in order to maneuver those portions in a desired manner in order to interact with other portions of the surgical training model. Force perception mechanisms can also be included to inform a user when an applied force on one or more portions of the surgical training model is over a pre-determined amount.
A simulated training model having a force perception mechanism to identify and notify to a user when an amount of force being applied to the model exceeds a pre-determined amount. The force perception mechanism has two states that are used to identify when an amount of force being applied to the model exceeds the pre-determined amount. In a first state, one or more portions of the simulated training model are removably connected to each other; for example the body to the base and/or the post to the body. The second state corresponds to when one or more of the portions of the simulated training model become detached from each other. When the transition occurs between the first state to the second state, the surgical training model informs the user that the force being applied to one or more of the portions of the simulated training model had exceeded the pre-determined amount.
A colpotomy model is provided for assisting in the training and practice of users performing a colpotomy procedure. The colpotomy model has a simulated vaginal opening which covers a proximal end of a simulated pelvic frame and a simulated vaginal canal which defines an internal space that encompasses a simulated cervix. The simulated cervix is suspended via at least one cord to provide a realistic response to user interaction with the simulated cervix. The user is directed to manipulate the simulated cervix and make one or more incisions where the simulated vaginal canal becomes reflected near the simulated cervix from the manipulations. The user is then directed to continue through the colpotomy model to access a simulated peritoneal cavity or other portions of the colpotomy model in accordance with a simulated procedure being performed.
A simulated tissue structure and a method for making the same is provided. The simulated tissue structure is made to have a longitudinal strength that is sufficient to withstand manipulations and movements when used with a simulated surgical training model while still being severable by conventional and electro- surgical tools. The simulated tissue structure has a first and second inner layer that is encompassed by an outer layer. Portions of the first inner layer are connectable with other simulated organs to simulate conditions for training laparoscopic procedures.
A surgical simulation network system is provided that facilitates user training in various surgical procedures and subsequent assessments of the user by allowing the users and assessors to be at different physical locations. The surgical simulation network system is part of a network having various surgical trainers that capture user performance data related to various surgical simulations. The user performance data is subsequently accessible by one or more assessors via the surgical simulation network system that allows the assessors to assess the user's competency. Thus, the users and the assessors can be located at different locations. Furthermore, the performance of the simulation and the assessments can be performed at different times.
Embodiments of the present invention provide GYN pathology simulation models for surgical training. These models are energy-compatible models emulating the tissue-based diseases of the female reproductive system to allow the surgical trainees and surgeons to practice advanced OB/GYN surgical skills. One simulated GYN model includes an electrically conductive elongated tube encapsulating a mass of non-conductive material. The elongated tube having a sidewall with an inner surface and outer surface extending between a proximal end and distal end. The sidewall is configured to have a cavity with a specific volume to yield an external protuberance when filled with the mass of non-conductive material. Another simulated GYN model includes a fluid-filled cystic body encapsulated within an electrically conductive bulbous hollow structure. The fluid-filled cystic body is selectively adhered to the bulbous hollow structure in at least one or more regions, thereby creating a plane for a combination of blunt and sharp dissection.
A circumferential retractor system is provided that includes a circumferential retractor and a flexible retainer. The circumferential retractor and retainer retracts and protects a patient's body opening, providing access into a patient.
A handle assembly for a surgical stapler can comprise a rotatable actuation shaft. The actuation shaft can have a first rotational orientation in which it can actuate a jaw assembly in a staple firing mode, and a second rotational orientation in which it can actuate a jaw assembly in a reversing mode. The handle assembly can include an articulation mechanism including a ball screw to selectively articulate the jaw assembly relative to an elongate shaft. The handle assembly can include a mechanism to lock out selection of the staple firing mode and actuation of the articulation mechanism if a reload shaft is not securely coupled to the handle assembly.
A retractor introducer system is provided that includes a circumferential retractor and a retractor introducer. The circumferential retractor retracts and protects a patient's body opening while the retractor introducer facilitates insertion and positioning of the circumferential retractor within the patient's body.
A powered handle for a surgical stapler can have a drive system including an electric motor. The powered handle can include a manual return mechanism. The powered handle can also include a retention mechanism to prevent unintentional movement of drivetrain components upon actuation of the manual return mechanism. For example, the retention mechanism can apply a direction-dependent frictional force on an actuation shaft of the handle assembly to prevent unintentional movement of the actuation shaft towards a distal end of the handle assembly. The retention mechanism can include a featherboard-like configuration with a plurality of ribs oriented transversely to the actuation shaft to restrict movement of the actuation shaft in one direction while allowing movement of the shaft in the opposite direction.
A powered handle for a surgical stapler has a drive system including an electric motor. The powered handle includes a shaft recognition mechanism such that when a reload shaft for use with the surgical stapler is installed, a control system can actuate the drive system with the recognized shaft. The powered handle further comprises a LED light ring driven by a light control scheme to display a handle status. The control system also includes a startup module to assess hardware and control system performance before use. The startup module assesses different criteria depending on whether the handle is new, previously used, or previously reset. The control system of the powered handle further includes a lockout module configured to identify when a lockout has been encountered. The lockout module applies different criteria depending on whether the motor is operating at a maximum speed state or less than a maximum speed state.
Surface preparation for sliding surfaces can enhance wear performance for surgical instruments such as surgical staplers which include reusable mechanisms that are used multiple times with single use reload cartridges. To reduce the potential for galling wear in a metal-to-metal sliding engagement, a combination of surface hardening, surface finish, and surface coatings can be applied to metallic components of a surgical instrument. Surface hardening techniques can allow further manufacturing operations such as welding without compromising the strength of the underlying metal substrate. With stainless steel metal substrates, as surface or case hardening techniques can reduce corrosion resistance, a surface coating can be applied to inhibit surface oxidation as well as provide a barrier to metal-to-metal contact. A further lubricious coating layer such as a bone wax coating layer can enhance galling resistance.
The lighted surgical access system is provided that includes a circumferential retractor (3) and a plastic optical fiber (POF) (16) attached thereto. The circumferential retractor retracts and protects a patient's body opening while the POF illuminates the internal surgical site, body cavity or body opening.
The lighted surgical access system is provided that includes a circumferential retractor/protector and a light emitter system attached thereto. The circumferential retractor/protector retracts and protects a patient's body opening while the light emitter system illuminates the internal surgical site, body cavity or body opening.
The disclosed technology described pertain to collection swabs that are designed to capture and retain specimen, tissue, or fluids from a patient. The collection swabs are generally inserted into a desired location, such as a nasal cavity. During the process of insertion, a user maneuvers the collection swab and in the process dislodges and collects various specimen, tissue, or fluids from the patient. The collection swab utilizes specially designed distal or tip portions and/or sleeves or cages in order to capture and retain the specimen, tissue, and fluids. The various designs associated with the distal or tip portion and the sleeve or cages affect not only how much specimen, tissue, or fluids can be collected but also how much of the specimen, tissue, or fluids can be retained after the collection swab is removed from the patient. By obtaining the various specimen, tissue, or fluids, studies can be performed regarding the patient's health, for example, identifying the presence of specific virus such as COVID-19.
A61B 10/00 - Other methods or instruments for diagnosis, e.g. for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
A61B 10/02 - Instruments for taking cell samples or for biopsy
17.
TWO-PIECE CLIP APPLIER JAW ASSEMBLY AND METHOD OF MANUFACTURE
A clip applier jaw assembly and processes for manufacturing a clip applier jaw are described. The clip applier jaw assembly includes a first jaw and a second jaw joined to the first jaw. The first and second jaws are independently formed and subsequently joined. A progressive stamping process can be used to form each of the first and second jaws by cutting a compound cut in a sheet of material, deburring the cut jaw blank with an edge coining process, and coining a clip groove in the jaw blank. A second jaw can be formed using the same process in a die configured to produce a mirror image of the first jaw. The first and second jaws can be joined by a welding process.
A61B 17/128 - Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or umbilical cord for applying or removing clamps or clips
A61B 17/42 - Gynaecological or obstetrical instruments or methods
A61B 17/00 - Surgical instruments, devices or methods, e.g. tourniquets
A61B 17/04 - Surgical instruments, devices or methods, e.g. tourniquets for closing wounds, or holding wounds closed, e.g. surgical staples; Accessories for use therewith for suturing wounds; Holders or packages for needles or suture materials
18.
ELECTROSURGICAL SYSTEM WITH TISSUE AND MAXIMUM CURRENT IDENTIFICATION
An electrosurgical system is provided and includes an electrosurgical instrument and an electrosurgical generator. The electrosurgical system obtains information about the tissue undergoing a sealing process in order to calculate information about the tissue undergoing the sealing process and, in real-time, modify the RF energy being provided to the electrosurgical instrument from the electrosurgical generator. In this way, the electrosurgical system manages the supply of RF energy to optimally seal different types of tissue. The electrosurgical instrument is configured to seal the tissue using the RF energy.
A61B 18/12 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
A tissue retrieval system including a tissue retrieval bag deployable by an actuator from an introducer and suspended in an open configuration by support arms can be serially redeployed between a partially or fully stowed configuration and a first deployed configuration to be used in procedures to collect multiple samples. The system can include defeasible proximal and distal stop mechanisms to limit movement of the actuator for serial redeployment. The tissue retrieval system can include a retention latch to couple a bead of the tissue retrieval bag to the actuator with the retrieval bag in the first deployed position and a user-selectable deployment release to allow deployment of the retrieval bag to a fully deployed position where it is released from the actuator. A bead stop is positioned to engage the introducer to prevent reintroduction of the bead and bag into the introducer once the bag has been fully deployed.
Surgical stapler systems can include a jaw assembly with one jaw defining a reload support capable of receiving and firing multiple disposable reload cartridges in a single surgical procedure. The reload cartridge can be protected by a reload cover engageable therewith. The reload cover can include snap features configured to prevent manual removal of the reload cover from the reload cartridge before proper positioning and installation in the reload support. The reload cover can desirably maintain a plurality of staples within staple pockets in the reload cartridge and can maintain a staple deployment mechanism in an unfired position.
A61B 17/072 - Surgical staplers for applying a row of staples in a single action
A61B 17/29 - Forceps for use in minimally invasive surgery
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
A61B 17/00 - Surgical instruments, devices or methods, e.g. tourniquets
21.
SURGICAL STAPLING INSTRUMENT HAVING A TWO-POSITION LOCKOUT MECHANISM
Surgical stapler systems can include lockout mechanisms to restrict further movement of a jaw assembly and provide different functionality when a jaw assembly is empty and when a partially or fully fired reload cartridge is present in the jaw assembly. When the jaw assembly is empty, the empty jaw assembly lockout mechanism can arrest an open-close stroke of the jaw assembly. When an at least partially fired reload is present in the jaw assembly, a fired reload lockout mechanism can allow operation of the jaw assembly through a substantial portion of an open-close stroke, but restrict actuation of the jaw assembly in a firing stroke. The separate lockout mechanisms can be embodied in a single lockout lever actuatable by lockout actuators to three distinct positions or by two independently-operable lockout levers.
An electrosurgical system is provided and includes a bipolar electrosurgical instrument and an electrosurgical generator. The bipolar electrosurgical instrument is arranged to seal and cut tissue captured between jaws of the instrument. The jaws include particularly positioned, shaped and/or oriented electrodes to perform the sealing of tissue. The electrosurgical generator is arranged to supply RF energy through the instrument, monitor the supplied RF energy and adjust or terminate the supplied RF energy to optimally seal the tissue.
A61B 18/12 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
An electrosurgical system is provided and includes a bipolar electrosurgical instrument and an electrosurgical generator. The bipolar electrosurgical instrument is arranged to seal and cut tissue captured between jaws of the bipolar electrosurgical instrument. The electrosurgical generator is arranged to supply RF energy through the bipolar electrosurgical instrument, monitor the supplied RF energy, and adjust or terminate the supplied RF energy to optimally seal the tissue.
A61B 18/12 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
A tissue retrieval system including a tissue retrieval bag deployable from an introducer and suspended in an open configuration by support arms can include retention features to prevent inadvertent movement of the tissue retrieval bag relative to the support arms. The support arms can include protruding domes, folds, or curls to restrict sliding of the tissue retrieval bag relative to the support arms. Alternately, tension can be maintained in a cord loop coupled to an opening of the tissue retrieval bag to prevent the tissue retrieval bag from inadvertently sliding relative to the support arms.
A61B 17/00 - Surgical instruments, devices or methods, e.g. tourniquets
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
25.
LAPAROSCOPIC GRASPER WITH FORCE-LIMITING GRASPING MECHANISM
A surgical instrument is provided having an actuator (310) mechanism with an integrated extension element (316). The surgical instrument comprises a handle assembly (400), an elongate shaft (300), and an end effector (200). The end effector (200) can comprise a jaw assembly (200) having atraumatic pads (220, 240) positioned thereon to reduce force on grasped tissue. An actuator (310) is movable within the elongate shaft to actuate jaws (210, 230) of the jaw assembly (200) responsive to movement of a movable handle (420) of the handle assembly (400). The actuator (310) can have an integrated extension element (316) that allows the actuator (300) to translate within the elongate shaft upon application of a relatively low force and translate and extend upon application of a relatively higher force to the actuator (310) to limit the force applied by the jaw assembly (200). The actuator (310) is also able to utilize force stored with the integrated extension element (316) to provide a dynamic amount of force used to grasp the tissue in scenarios where the tissue volume decreases while in the jaws (210, 230).
A61B 17/29 - Forceps for use in minimally invasive surgery
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
The tissue removal containment system is provided that includes a tissue removal and/or containment bag arranged to be inserted through an opening into a confined space. The bag has a support or ring having a compressed, partially compressed and/or uncompressed state or position. The bag can also include an enclosure or film defining the enclosure connected to the support with the enclosure having a confined state and a deployed or unconfined state.
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
A61B 17/00 - Surgical instruments, devices or methods, e.g. tourniquets
Systems and methods for performing a self-verification system test upon activation of an electrosurgical generator are described. The systems and methods allow for enhancing surgical outcomes by providing generators having accurate RF energy generation, measurement, calibration and self-testing system. This is achieved through implementation of an automated self-verification process at a power start-up of the generator, which allows for rapidly identifying a potential generator issue prior to any use of a connected electrosurgical instrument or supply of any RF energy to the tissue or vessel through the electrosurgical instrument. Additionally, one or more internal impedance loads are integrated within the electrosurgical generator. The internal impedance loads with multiple configurations are utilized to verify the voltage, current, power, and/or phase measurements of the generator. By incorporating or integrating the self-verification process and its related hardware resources within the electrosurgical generator, many improvements in outcome of pre-surgical procedures may be achieved.
A61B 18/12 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
Systems and methods for enhancing surgical outcomes by providing generators having optimal RF output for sealing, fusing and/or cutting tissue or vessels under all dynamic conditions are described. Examples of dynamic conditions may include varying tissue impedance load due to electrosurgical operations or tissue affects, any operational conditions and commands determined by the surgeon, surgical procedure and/or device script. This is achieved by implementing a digital closed-loop control system within the electrosurgical generator to regulate voltage, current, and power of the RF output. The digital closed-loop control system may include an RF amplifier for generating RF energy, a feedback system for constantly monitoring the electrical characteristics, e.g., voltage, current, and power, of the supplied RF energy to a connectable electrosurgical instrument and a microcontroller for processing measurement data from the feedback system and adjusting the output of the RF amplifier to meet a desired regulation target under any varying conditions.
A61B 18/12 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
A renal hilum surgical simulation system is provided. The renal hilum surgical simulation system includes simulated tissue layers and simulated renal organs and/or vasculatures. The renal hilum surgical simulation system is adapted for but not limited to laparoscopic donor nephrectomy surgical procedures.
A powered handle for a surgical stapler can have a drive system including an electric motor. The powered handle can include a manual articulation mechanism to articulate a jaw assembly coupled to a reload shaft connected to the handle. The manual articulation mechanism can include a ball screw mechanism that translates an articulation member responsive to rotation of an articulation knob when an instrument shaft is engaged with the handle. The articulation mechanism includes a release function that allows the jaw assembly to return to a longitudinally centered orientation. The powered handle includes a battery pack serving as a power supply for the drive system. A control system can control actuation of the motor based on user inputs and operating parameters of the stapler and can provide certain motor drive profiles for predetermined positions of the stapler. The powered handle can include a manual return mechanism.
A61B 17/072 - Surgical staplers for applying a row of staples in a single action
A61B 17/00 - Surgical instruments, devices or methods, e.g. tourniquets
A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
A61B 17/29 - Forceps for use in minimally invasive surgery
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
A surgical simulation camera scope is provided as effective as a surgical scope without the added expense and complexities. The surgical simulation camera scope comprises a lens mount with a lens and a sensor mount with an image sensor disposed between the sensor mount and the lens mount and placed in such a way to ensure the location of the sensor is within the depth of focus of the lens is maintained while not damaging the sensor.
A61B 1/00 - Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
A61B 1/05 - Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances characterised by the image sensor, e.g. camera, being in the distal end portion
G02B 23/24 - Instruments for viewing the inside of hollow bodies, e.g. fibrescopes
G09B 23/28 - Models for scientific, medical, or mathematical purposes, e.g. full-sized device for demonstration purposes for medicine
A TME surgical simulator is provided. The TME surgical simulator includes a simulated tissue layers and simulated vasculature and/or organ structures. The simulated tissue surgical simulator is adapted for but not limited to laparoscopic and/or transanal TME surgical procedures.
A surgical simulator for surgical training is provided. The simulator includes a frame defining an enclosure and a simulated tissue model located inside the frame. The simulated tissue model is adapted for practicing a number of surgical procedures including but not limited to transanal excisions and transvaginal hysterectomies. Portions of the frame comprises a material adhesively compatible with the material of portions of the simulated tissue model to secure and suspend the simulated tissue model within the frame. The simulated tissue model may also include simulated vasculature configured to loop through apertures in the frame to secure and suspend the simulated tissue model within the frame.
A surgical training model can have features for training surgical suturing techniques. The training model can be formed as a sheet of simulated tissue having at least one cut with markings arranged on either side of the cut. The markings can be formed of a first layer of resilient simulated tissue material having a color that contrasts with a color of the remainder of the sheet of simulated tissue material. The sheet of simulated tissue material can have several cuts having different configurations and orientations to facilitate suturing training for a variety of tissue orientations. The sheet of simulated tissue material can further include holes positioned to be mounted to a base of a surgical training system. The sheet of simulated tissue material can be manufactured by molding a marking layer and casting a tissue layer over the marking layer.
A system for surgical training is provided. The system includes a laparoscopic surgical instrument with at least one retroreflective marker on its shaft. A typical box trainer is provided with two cameras and two accompanying infrared light sources. When the instrument is inserted through a top of the trainer to perform mock procedures or exercises, light from an infrared light source is reflected back by the retroreflective marker and captured by an adjacent video camera. The position of the instrument is calculated by triangulating the image data obtained from the two cameras. When the markers are obscured behind models or artificial organs disposed inside the trainer, an inertial measurement unit on the handle of the instrument provides data for calculating the instrument position to fill in the gap in useful image data. Instrument position data over time is provided for useful trainee feedback and performance assessment purposes.
A system for training surgical camera navigation skills is provided. A plurality of two-dimensional targets is printed on an upper surface of a flat sheet of material. The sheet is easily transportable and placed onto a base of a typical box trainer that defines a simulated abdominal cavity between the base and a top. A scope is inserted through a port in the top and the targets are viewed on a live video feed displayed to a trainee on a screen with the targets being otherwise obscured from view by the box trainer. The trainee can move the scope back and forth, roll and angulate the scope about the port in order to view the targets on the sheet at different angles and distances. The trainee is instructed to follow a sequence of targets marked on the sheet and manipulate the scope to align consecutively each target with the edges of the screen in the sequence provided.
A simulated rectum model for training transanal minimally invasive surgery is provided. The model includes three substantially concentric layers, a first layer, a second layer and a third layer, made of electrically conductive hydrogel material sized and configured to simulate a mucosal layer, a muscle layer and a mesorectum layer, respectively. Each layer is made of a dual interpenetrating cross-linked network having a ratio of covalently cross-linked acrylamide to ionically cross-linked alginate. The ratio for each layer is selected for the desired adhesion properties between two adjacent layers. The model is capable of expanding in size when insufflated and simulating a billowing condition. When the model is dissected with electrosurgical instruments, the hydrogel material realistically emits vapor simulating smoke and causes char to build up on instruments. Artificial polyps and transverse folds are molded on the inner surface of the model.
A sensorized surgical instrument for training users laparoscopic surgical procedures is provided. The instrument includes at least one sensor selected from a group consisting of a strain gauge, accelerometer, magnetometer, and gyroscope. The sensor is attached directly to a handle of the instrument. A shaft assembly having a tool tip is interchangeably connectable to the handle. The sensor is connected to a computer configured to provide feedback useful to the user for improving the user's surgical skills. The feedback includes the time to complete a procedure, economy of motion, smoothness of motion and the force exerted at the tool tip.
The surgical robotic access system provides access for robotic instruments and/or actuators including the introduction, operation and withdrawal of such robotic manipulators into a body cavity without permitting the escape of pressurized fluid or gas. The surgical robotic access system also provides a multi-faceted range of movement without touching or effecting pressure on the opening in the patient's body cavity.
A simulated abdominal wall for laparoscopic surgical training and methods of making the wall are provided. The simulated abdominal wall is dome-shaped having a visual appearance of an insufflated abdomen. Also, the wall is strong enough to withstand penetration with surgical trocars without unrealistic buckling or deformation. The wall is supported by a frame along the perimeter without any support structures traversing the wall that would interfere with port placement. The wall includes multiple layers connected together to form a unitary wall to fit a laparoscopic trainer. In one method, a projection of a dome is cut from a flat layer of foam material and assembled within a mold cavity. Consecutive layers with the same or different projection pattern are laid up inside the mold cavity. In another method, a vacuum mold together with heat is used to deform each foam layer. Adhesive is applied between layers to simultaneously join the adjacent layers upon deformation.
Simulated tissue structures and methods of making them are disclosed. An elastic first material is placed in tension. An elastic second material is adhered to the first material while the first material is in tension. The adhered second material and the first material in tension forms a first shape of the simulated tissue structure. Tension on the first material is released. In releasing the tension of the first material, a force is exerted on the adhered second material bring the combination of the first material and the second material into a second shape. The first shape is maintained by a mold or mandrel and the second shape is the desired shape of the simulated tissue structure.
A laparoscopic clip applier can have a geared clip feed mechanism and a direct jaw clamping mechanism to provide smooth operation over a clip application stroke of a movable handle. The geared clip feed mechanism can include an idler gear and two drive gear racks to advance a feed slider feeding a clip to a jaw assembly. The two drive gear racks can be positioned to provide different gearing during clip feed and firing portions of the clip application stroke, allowing efficient packaging of the clip feed mechanism. A spring can rapidly withdraw the feed slider once the clip has been fed and before clamping begins. The movable handle can have a direct connection to a clamping slider to enhance user feedback during clamping of the clip. After clamping the clip, the movable handle can also assist in returning the clamping slider to an initial position for firing another clip.
A61B 17/128 - Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or umbilical cord for applying or removing clamps or clips
A powered handle for a surgical stapler can have a drive system including an electric motor. The powered handle can include a manual articulation mechanism to articulate a jaw assembly coupled to a reload shaft connected to the handle. The manual articulation mechanism can include a ball screw mechanism that translates an articulation member responsive to rotation of an articulation knob. The articulation mechanism includes a release function that allows the jaw assembly to return to a longitudinally centered orientation. The powered handle includes a battery pack serving as a power supply for the drive system. A control system can control actuation of the motor based on user inputs and operating parameters of the stapler. The powered handle can include a manual return mechanism.
A surgical stapling system can include a reload shaft. The shaft can include an elongate tubular member with have a jaw assembly at the distal end thereof and a coupling collar at the proximal end thereof. The shaft assembly also includes an articulation joint coupling the jaw assembly to the distal end. A drive member and an articulation member extend within the tubular body of the shaft from the proximal end to the distal end. A firing member is connected to the distal end of the drive member such that advancement of the drive beam advances the firing member to close the jaw assemblies and fire staples from a reload positioned in the jaw assembly. The shaft assembly can also include a lockout mechanism to prevent a firing operation on a previously-fired reload or no reload.
A61B 17/00 - Surgical instruments, devices or methods, e.g. tourniquets
A61B 17/06 - Needles; Holders or packages for needles or suture materials
A61F 13/20 - Tampons, e.g. catamenial tampons; Accessories therefor
A61F 13/472 - Sanitary towels, incontinence pads or napkins specially adapted for female use
A61F 13/475 - Sanitary towels, incontinence pads or napkins characterised by edge leakage prevention means
A61B 5/00 - Measuring for diagnostic purposes ; Identification of persons
A61F 13/494 - Absorbent pads, e.g. sanitary towels, swabs or tampons for external or internal application to the body; Supporting or fastening means therefor; Tampon applicators characterised by the shape specially adapted to be worn around the waist, e.g. diapers, nappies characterised by edge leakage prevention means
A61F 13/513 - Topsheet, i.e. the permeable cover or layer facing the skin having areas of different permeability
A61B 1/00 - Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
A61B 1/12 - Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with cooling or rinsing arrangements
A61B 1/253 - Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the mouth, i.e. stomatoscopes, e.g. with tongue depressors; Instruments for opening or keeping open the mouth with means for viewing areas outside the direct line of sight, e.g. dentists' mirrors with means for preventing fogging
A61F 2/00 - Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
A61F 2/04 - Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
A61M 1/00 - Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
A handle assembly for a surgical stapler can comprise a rotatable actuation shaft. The actuation shaft can have a first rotational orientation in which it can actuate a jaw assembly in a repeatable open and close mode, a second rotational orientation in which it can actuate a jaw assembly in a staple firing mode, and a third rotational orientation in which it can actuate a jaw assembly in a reversing mode. The handle assembly can include an articulation mechanism including a ball screw to selectively articulate the jaw assembly relative to an elongate shaft.
A tablet is provided for simulating abdominal first entry in laparoscopic surgery. The tablet includes a screen configured to display visual content input from a connected scope located inside a trocar. The tablet includes a removable simulated tissue insert configured to simulate an abdominal wall located adjacent to the screen. The insert is penetrable from the front of the tablet through to the back of the tablet where the depth of penetration of the tip of the trocar beyond the insert can be evaluated. The penetration of the insert is observed in real time on the screen. Trocars are interchangeable and the insert is penetrable many times before being easily interchanged. The tablet is useful for demonstrating surgical trocars and practicing laparoscopic techniques and approaches to minimize entry-related injuries.
Systems and methods for preventing the seeding of cancerous cells during morcellation of a tissue specimen inside a patient's body and removal of the tissue specimen from inside the patient through a minimally-invasive body opening to outside the patient are provided. One system includes a cut-resistant tissue guard removably insertable into a containment bag. The tissue specimen is isolated and contained within the containment bag and the guard is configured to protect the containment bag and surrounding tissue from incidental contact with sharp instrumentation used during morcellation and extraction of the tissue specimen. The guard is adjustable for easy insertion and removal and configured to securely anchor to the body opening. Protection-focused and containment-based systems for tissue removal are provided that enable minimally invasive procedures to be performed safely and efficiently.
A61B 17/02 - Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
A simulated dissectible tissue model for practicing surgical skills is provided. The simulated tissue comprises a simulated anatomical structure, such as or a simulated rectum or one or more artificial vessels, embedded with a silicone gel layer between two silicone layers. The simulated dissectible tissue, with or without a simulated anatomical structure, is connected to one or more artificial organ via a fiberfill layer. The fiberfill layer includes a plurality of entangled fibers embedded between two adjacent silicone layers. The fiberfill layer creates a dissection plane that permits the one or more artificial organ to be removed by spreading apart and selectively dissecting the chains of entangled fibers. Artificial nerves may be included in fiberfill layer.
A retractor/protector suitable for use in a surgical incision or a natural orifice comprises a longitudinal axis defining an instrument access channel extending from a proximal end to a distal end; a flexible outer ring; an inner ring; a flexible sheath extending between the outer ring and the inner ring; and at least one rigid segment adapted to attach to the flexible outer ring to thereby increase the rigidity of the outer ring. Embodiments of the retractor/protector are described that have interlocking and non-interlocking rigid segments. Embodiments are also described that have bases that insert into or under the flexible outer ring in addition to or in lieu of rigid segments to increase rigidity and/or provide support for a detachable cap.
A surgical simulator for surgical training is provided. The simulator includes a frame defining an enclosure and a simulated tissue model located inside the enclosure. The simulated tissue model is adapted for practicing a number of surgical procedures including but not limited to transanal excisions and transvaginal hysterectomies. The simulated tissue model includes one more components and is interchangeably connected to the frame with fasteners configured to pass through apertures in the frame to suspend the simulated tissue model within the frame. The enclosure of the frame is increasingly laterally constricted along the longitudinal axis to progressively increase the confinement of the components of the simulated tissue model.
Pressure conditioning systems for supplying insufflation gas to an open-ended body conduit such as a rectal cavity during a transanal minimally invasive surgery (TAMIS) procedure can reduce billowing of walls of the body conduit. A pressure conditioning system can include a pressure storage component, an accumulator, and a flow restrictor. The pressure storage component can include a variable volume reservoir that is biased to a relatively low volume state. The flow restrictor can include insufflation tubing with a restrictor plate having a relatively low diameter orifice. The pressure storage component, accumulator, and flow restrictor can be fluidly connected in various orders in series or as side branches from a gas flow conduit. Despite a pulsed or otherwise discontinuous insufflation gas flow and leakage and absorption from the body conduit, the pressure conditioning system can maintain a constant pressure within the body conduit.
The surgical robotic access system provides access for robotic instruments and/or actuators including the introduction, operation and withdrawal of such robotic manipulators into a body cavity without permitting the escape of pressurized fluid or gas. The surgical robotic access system also provides a multi-faceted range of movement without touching or effecting pressure on the opening in the patient's body cavity.
A laparoscopic suturing device is provided. The suturing device can pass a suturing needle back and forth between jaws of a jaw assembly to suture tissue at a surgical site in a minimally invasive procedure. The jaw assembly can have a pivotable jaw member in each jaw to position the jaw assembly and needle in a low-profile stowed configuration for insertion through a low diameter surgical port. The jaw assembly can be actuated by a handle assembly that provides simultaneous needle passing from a driving jaw to a receiving jaw and latching the needle within the receiving jaw in a single trigger cycle.
A retractor/protector suitable for use in a surgical incision or a natural orifice comprises a longitudinal axis defining an instrument access channel extending from a proximal end to a distal end; an outer ring; an inner ring; and a flexible sheath extending between the outer ring and the inner ring, wherein the instrument access channel extends through the outer ring, the inner ring, and the sheath, and the inner ring is non- circular, non-coplanar and/or non-parallel. Embodiments of the retractor/protector are described that have inner rings of a variety of non-circular or non-coplanar shapes that are insertable through small incisions or orifices, minimize space occupied and maintain a strong anchor and effective retraction.
A61B 17/02 - Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
55.
SURGICAL STAPLER HAVING LOCKING ARTICULATION JOINT
A laparoscopic surgical stapler can include an articulation joint between an elongate shaft and a jaw assembly. The articulation joint can include a latch mechanism allowing a user to selectively allow the jaw assembly to be freely pivotable with respect to the elongate shaft in an unlatched configuration and positionable in an aligned position or one of several predetermined articulated positions in a latched configuration. The latch mechanism of the articulation joint is biased to the latched configuration and is operable in a 'push-to-release' manner.
An appendectomy model for surgical training is provided. The model includes a simulated large intestine with a central lumen interconnected with a lumen of an artificial appendix. The model also includes a simulated appendiceal artery, simulated mesoappendix and a simulated ileum. The simulated ileum made of white silicone is embedded between a first layer of pink silicone and a second layer of pink silicone to create a realistic anatomical landmark particularly suitable for laparoscopic appendectomy training.
A simulated tissue structure for surgical training is provided. It includes a first layer made of silicone and a second layer made of silicone interconnected by a third layer made of polyester fiber that is embedded in part in the first layer and in part in the second layer to create a mechanical linkage between the first layer and the second layer. Part of the third layer that is adjacent to the first layer and part of the third layer that is adjacent to the second layer includes fiber strands coated in silicone. An inclusion that mimics an anatomical structure is located between the first layer and the second layer. The third layer of polyester fibers provides a realistic dissection plane for the practice of the surgical excision of the inclusion.
A surgical simulator for surgical training is provided. The simulator includes a frame defining an enclosure and a simulated tissue model located inside an enclosure. The simulated tissue model is adapted for practicing hysterectomies and includes at least a simulated uterus and a simulated vagina. The simulated tissue model is suspending inside the enclosure with two planar sheets of silicone such that the tissue model is located between the two sheets each of which form a fold and are in turn connected to the frame. The frame may be shaped like a cylinder and located inside a cavity of a larger laparoscopic trainer having a penetrable simulated abdominal wall. The tissue model is interchangeable and accessible laterally through an aperture provided in a support leg of the trainer.
A surgical training device including a model for practicing the passage of needle and suture. The model includes a base with a plurality of openings configured to receive a plurality of suture tabs. The suture tabs are made of elastomeric material. Some suture tabs includes pre-formed tab apertures for the passage of a suture. Other suture tabs include a penetrable area through which a suture needle may penetrate for passing a suture. The suture tabs are movable with respect to the base to orientate them at different angles with respect to the base. The base itself may include portions that are angled with respect to each other. The suture tabs are movable with respect to the base to pull, expose or open the tab apertures and surfaces. Some of the tab apertures are slits that open upon being pulled relative to the base requiring the user to practice holding the tab while passing the needle through the tab.
A surgical simulator for electrosurgical training and simulation is provided. The surgical simulator includes one or more simulated tissue structures made substantially of a hydrogel comprising a dual interpenetrating network of ionically cross-linked alginate and covalently cross-linked acrylamide. Combinations of different simulated tissue structures define procedural-based models for the practice of various electrosurgical procedures including laparoscopic total mesorectal excision, transanal total mesorectal excision, cholecystectomy and transanal minimally invasive surgery. Methods of making the simulated tissue structures are also provided.
A61B 18/12 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
G09B 23/28 - Models for scientific, medical, or mathematical purposes, e.g. full-sized device for demonstration purposes for medicine
A guard for providing a cut-resistant pathway through a body orifice or incision to circumferentially protect tissue at the margin is provided. The guard is made of flexible, cut-resistant mesh material having a plurality of interwoven thermosetting filaments. The guard has a central lumen and at least one flared end. The flared end, which serves to anchor the guard in the body opening, is deformable into a reduced configuration to facilitate its insertion and removal. The layer of mesh stretches laterally to increase the diameter of the central lumen. The flexibility and expandability of the guard allows the guard to conform to body openings of different sizes. The guard may include a drawstring to cinch the flared distal end from the proximal end. The guard is thermoset with the flared distal end that is biased to spring back to its normal, undeformed configuration when released from a deformed configuration.
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
Simulated tissue structures (10) and methods of manufacturing are provided. The simulated tissue structures (10) are particularly useful for placement inside abdominal simulators for practicing laparoscopic surgical techniques. One simulated tissue structure (10) includes a combination of two materials that are attached together wherein one of the materials forms a hollow anatomical structure configured to contain the other material. The two materials are attached in an anatomically advantageous manner such that the inner surface of the outer material closely conforms to the outer surface of the inner material. Another simulated tissue structure includes a plurality of layers wherein at least one layer is applied by printing the layer with at least one stencil to impart one or more functional characteristic to the simulated tissue structure.
B29C 41/20 - Shaping by coating a mould, core or other substrate, i.e. by depositing material and stripping-off the shaped article; Apparatus therefor for making articles of definite length, i.e. discrete articles incorporating preformed parts or layers, e.g. moulding around inserts or for coating articles
G09B 23/34 - Anatomical models with removable parts
G09B 23/28 - Models for scientific, medical, or mathematical purposes, e.g. full-sized device for demonstration purposes for medicine
An electrosurgical instrument is provided that captures, compresses, fuses and cuts tissue between upper and lower jaws connected to pivotably movable handles. The instrument includes a force and over compression regulation mechanism that is configured such that in a clamped configuration, the jaws delivers a gripping force between the first jaw and the second jaw between a predetermined minimum force and a predetermined maximum force.
Embodiments of a circumferential retractor having an attached supporting, manipulating or positioning tool are described. The retractor optionally includes a sealing member associated with an external member of the retractor and an external support structure that may be used with the retractor and positioning tool as needed.
Systems and methods for preventing the seeding of cancerous cells during morcellation of a tissue specimen inside a patient's body and removal of the tissue specimen from inside the patient through a minimally-invasive body opening to outside the patient are provided. One system includes a cut-resistant tissue guard removably insertable into a containment bag. The tissue specimen is isolated and contained within the containment bag and the guard is configured to protect the containment bag and surrounding tissue from incidental contact with sharp instrumentation used during morcellation and extraction of the tissue specimen. The guard is adjustable for easy insertion and removal and configured to securely anchor to the body opening. Protection-focused and containment-based systems for tissue removal are provided that enable minimally invasive procedures to be performed safely and efficiently.
Simulated tissue structures for practicing surgical techniques and methods of manufacturing those structures are provided. In particular, a realistic organ model or simulated tissue portion for practicing the removal of a tumor or other undesired tissue followed by suturing a remnant defect as part of the same surgical procedure is provided. The simulated tissue structures include a polyp simulation having a suturable mesh layer that is separable from a defect layer. A simulated colon model with interchangeable and suturable tissue pods is also provided as is a fully suturable rectum model and a rectum model with integrative suturable and removable polyp zones.
A surgical stapler is provided that includes a spring loaded lift that automatically adjusts a staple cartridge and/or staple formation between a range of sizes. The lift is automatically released as the staple firing mechanism begins its forward translation of the firing sequence. The automatic one-way adjustment also adjusts the staple cartridge while maintaining the cartridge parallel to the anvil to provide consistent staple formations.
Systems and methods for tissue containment and retrieval are disclosed. The containment system includes a primary chamber interconnected with a secondary channel extending from the primary chamber. A tissue specimen is mobilized inside a body cavity and placed into the primary chamber through a first opening. The first opening is pulled through a first incision or orifice and the narrower secondary channel is placed at a second incision or orifice. A second opening at the end of the secondary channel permits observation via a scope inserted through the second opening of the tissue specimen in the primary chamber undergoing morcellation via the first opening. Other systems and methods for deployment, containment, debulking and sealing of the second opening to create a closed system for the safe retrieval of the tissue specimen are provided.
A wound retractor comprising an outer ring, an inner ring, and a flexible sheath extending therebetween is described, wherein the inner ring has the strength, rigidity and bounce back characteristics of a solid injection-molded ring yet is manufactured by extrusion techniques described herein with a 20-30% reduction in materials, resulting in reduced manufacturing costs.
B29C 47/00 - Extrusion moulding, i.e. expressing the moulding material through a die or nozzle which imparts the desired form; Apparatus therefor (extrusion blow-moulding B29C 49/04)
Embodiments of a surgical access port system that comprises a retractor that is adapted for being coupled to a cap and that is particularly useful in natural orifice surgery are described. The retractor comprises an outer ring, wherein the outer ring is configured to be disposed proximate the natural orifice of the patient and substantially surround the orifice; a tubular body; and various stabilizing mechanisms surrounding the tubular body, sized and configured to stabilize and retain the retractor within the orifice. The stabilizing embodiments described herein are useful in all natural orifices and are of particular use in the vaginal surgery.
The present invention is directed to tack-free gels and to methods for manufacturing a tack-free gel pad, in which a discontinuous layer of fluorinated ultrahigh molecular weight polyethylene is permanently bonded to the gel pad to provide a tack-free coating. The gel pad may be incorporated into a gel cap to provide a surgical access device having a tack-free surface.
B29C 69/00 - Combinations of shaping techniques not provided for in a single one of main groups , e.g. associations of moulding and joining techniques; Apparatus therefor
B29C 39/02 - Shaping by casting, i.e. introducing the moulding material into a mould or between confining surfaces without significant moulding pressure; Apparatus therefor for making articles of definite length, i.e. discrete articles
B29C 33/62 - Releasing, lubricating or separating agents based on polymers or oligomers
A surgical access port (10) for passage through body tissue to provide access to an underlying tissue site is provided. The access port has a working channel (13) dimensioned for receiving a surgical instrument and a seal assembly for providing a substantial seal before, during and after insertion of a surgical instrument. The seal assembly includes an instrument seal (22) and a zero seal (24). The instrument seal (22) includes a proximal base that is interconnected to a distal instrument engaging portion by an elongate supporting portion. The engaging portion has a lateral dimension larger than the lateral dimension of the supporting portion forming a bulbous, mushroom-like head. The lateral dimension of the engaging portion decreases toward a distal opening of the instrument seal such that the distal end of the engaging portion is substantially perpendicular to the seal axis. The supporting portion closely conforms to an inserted instrument and serves to align the distal end of the seal.
A surgical stapler is provided. The stapler employs circumferential channels through which staples are deployed along an arc pathway against an anvil surface. The curved channels allow staples with relatively longer legs to be used in the stapler having a smaller diameter at the jaws. Also, by utilizing a curved path, a much larger staple can be placed in the same diameter device. Specialized curved staples for use with the stapler of the present invention are also provided. To further enable the benefits of the stapler with circumferential channels and method of staple deployment, novel jaw reinforcement structures are provided in the present invention. The jaw reinforcement structures are located towards the center or bladeline of the device instead of around the circumference as in conventional staplers, thereby clearing the outer area near the circumference of the device to provide room for longer staples and staple firing components.
A bipolar electrosurgical fusion/sealer and dissector instrument (20) is provided that is arranged to simultaneously fuse and cut tissue captured between jaws of the instrument. The jaws include particularly positioned, shaped and/or oriented electrodes along with a compressible landing pad to perform the simultaneous fusion and cutting of tissue. An electrosurgical generator (10) is arranged to supply RF energy through the instrument and to monitor a phase angle of the supplied RF energy; the generator is further arranged to adjust the supplied RF energy or to terminate the supply based on the monitored phase angle to optimally fuse and dissect the tissue.
A61B 18/12 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
An electrosurgical generator arranged to supply radio frequency (RF) energy to fuse tissue is provided. The generator is arranged to supply RF energy through a removably coupled electrosurgical instrument to fuse tissue grasped by the instrument. The generator monitors a phase angle of the supplied RF energy and adjusts or terminates the supplied RF energy based on the monitored phase angle in comparison to predetermined thresholds and conditions to optimally fuse the tissue. The electrosurgical instrument conducts radio frequency energy to fuse tissue captured between the jaws and a blade to mechanically cut tissue between the jaws. A conductive post positioned on the jaw adjacent to the blade.
A61B 18/12 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
Systems and methods for preventing the seeding of cancerous cells during morcellation of a tissue specimen inside a patient's body and removal of the tissue specimen from inside the patient through a minimally-invasive body opening to outside the patient are provided. One system includes a cut-resistant tissue guard removably insertable into a containment bag. The tissue specimen is isolated and contained within the containment bag and the guard is configured to protect the containment bag and surrounding tissue from incidental contact with sharp instrumentation used during morcellation and extraction of the tissue specimen. The guard is adjustable for easy insertion and removal and configured to securely anchor to the body opening. Protection-focused and containment-based systems for tissue removal are provided that enable minimally invasive procedures to be performed safely and efficiently.
A simulated dissectible tissue for surgical training is provided. The simulated tissue comprises a silicone gel layer encapsulated within a silicone shell. A simulated anatomical structure is embedded together with the silicone gel layer within the sealed shell. The silicone shell as well as the silicone gel layer may include a deadening agent. Further processing of the silicone gel layer may include adding alcohol and, optionally, heating the mixture. The simulated dissectible tissue may be formed into a specific tissue or organ model for practicing surgical skills. The user practices incising through the outer layer and separating the shell layer along a dissection plane defined by the silicone gel layer to gain visibility of the embedded simulated anatomical structures. The silicone gel layer simulates dissectible tissue and has glossy and elastic properties that provide a realistic dissectible tissue layer for emulating skeletonization of the simulated anatomical structures contained therein.
The present invention provides a surgical training device for training laparoscopic first entry surgical techniques. The training device includes a simulated abdominal wall that is penetrable with an optical trocar. A receptacle containing a tissue simulation is located inside the receptacle. The tissue simulation is observable via scope placed inside the optical trocar. Upon penetration of the one or more of the simulated abdominal wall and receptacle, the tissue simulation appears to translate distally relative to the simulated abdominal wall. The distal translation is effected by a variety of ways including the release of negative pressure inside the receptacle upon penetration and the expansion of an elastic wall of the receptacle with the introduction of fluid under pressure into the receptacle.
Embodiments of a natural orifice access device that is adapted for being coupled to a cap and that may be adjusted in length to accommodate variations in patient body types and variations in the location of surgical sites within the natural orifices of patients are described.
A simulated abdominal wall model that is ideal for practicing laparoscopic first entry surgical techniques is provided. The model includes a simulated abdominal wall portion captured between two frame elements of a support. The support is connectable to a surgical trainer. When connected to the trainer, the model provides a penetrable abdominal tissue portion for accessing an internal cavity of the trainer. The simulated abdominal wall includes a plurality of layers including a skin layer, a fabric posterior rectus sheath layer, a simulated fat layer of low-resilience polyurethane foam and at least two layers that provide distinctive haptic feedback upon penetration of the simulated transversalis fascia and muscle layers. The simulated abdominal wall includes a simulated umbilicus across several layers of simulated tissue.
An anatomical model for surgical training includes a first layer simulating a liver and a second layer including a simulated gallbladder. A third layer having an inner surface and an outer surface is provided between the first and second layer. The outer surface of the third layer is adhered to the first layer at location around the simulated gallbladder and the simulated gallbladder is adhered to the inner surface of the third layer. A fourth layer is provided that overlays both the second layer and the simulated gallbladder. A frame is embedded within the first layer and is connectable to a support. The model provides a substantially upright projection of a simulated gallbladder and liver in a retracted orientation ideally suited for practicing laparoscopic cholecystectomy when inserted inside a simulated insufflated cavity of laparoscopic trainer.
A model for practicing transabdominal pre-peritoneal (TAPP) and total extraperitoneal (TEP) approaches for laparoscopic hernia repairs is provided. The model simulates an insufflated space between the abdominal muscles and peritoneum. A spring layer may be incorporated to provide a realistic resiliency to the model while in the simulated insufflated configuration. At least one hole is provided in the model from which synthetic tissue protrudes to simulate a hernia. The model is used to selectively simulate direct, indirect and femoral inguinal hernias as well as incisional hernias by removably placing the protruding simulated tissue into any one of several openings. The model contains all important anatomical structures and sits on a base frame or is connected to a rigid simulated pelvis. When located inside a laparoscopic trainer with an angled top cover, the model provides an ideal simulation for teaching and practicing laparoscopic hernia repair.
A cannula assembly having a retention member and a method of manufacture of the cannula assembly is provided. The cannula assembly includes a cannula and a sleeve disposed around the cannula from a proximal end to a distal end. The sleeve can include a balloon formed by a stretch blow molding process following local heating once advanced over the cannula. Once formed, the balloon can be conditioned to constrict against the cannula. A conditioning aid can be advanced over the balloon when it is still formable to constrict the balloon against the cannula.
A surgical stapler includes a jaw assembly at a distal end connected to a handle assembly that is configured to control the stapler and actuate the deployment of staples. The surgical stapler successfully eliminates intermediate caming portions commonly known as pushers that are located between the staples and a translating slider. The staples are located in pockets at an angle such that the base of the staple is parallel to an angled caming surface of the slider. The translating slider comes into direct contact with staples during deployment as the slider moves through each staple pocket where staples are partially supported by recesses along the slider pathway. The staples are deployed at an angle against the anvil surface. Because there are no pushers, a great deal of space is saved resulting in a much smaller diameter surgical stapler that is particularly suitable for laparoscopic stapling applications.
A handle assembly for a surgical stapler can comprise a rotatable actuation shaft. The actuation shaft can have a first rotational orientation in which it can actuate a jaw assembly in a repeatable open and close mode, a second rotational orientation in which it can actuate a jaw assembly in a staple firing mode, and a third rotational orientation in which it can actuate a jaw assembly in a reversing mode. The handle assembly can include a rotational mechanism arranged to discretely position the rotatable actuation shaft in one of the rotational orientations. The rotational mechanism can be arranged for single handed operation such as by including a slideable switch or selector to rotate the actuation shaft.
A trocar surgical seal or surgical access device is provided. The trocar surgical seal comprises first and second supports coupled together by a film passageway. The trocar surgical seal provides an instrument seal for instruments inserted therethrough. The trocar surgical seal occupies minimal surgical space.
A mechanical cap ring/gel pad assembly useful in surgical access devices and methods for making the same, wherein the cap ring and the gel pad are formed separately and then mechanically attached to form a strong seal without the need for heating, solvents or adhesives.
Jaw assemblies for a surgical stapler are provided. The jaw assemblies comprise a first jaw having a first clamping surface and a plurality of staples disposed therein and second jaw assembly having a second clamping surface. The jaw assemblies can be actuated from a closed configuration in which the first clamping surface contacts or is adjacent to the second clamping surface to an open configuration in which the second jaw is pivoted away from the first jaw to a stapling position in which the second clamping surface is parallel to the first clamping surface and spaced apart from the first clamping surface. A pivoting link or sliding pivot joint can couple the second jaw to the first jaw to facilitate motion between the closed position, the open position, and the stapling position.
A surgical simulation system is provided. The system includes at least one simulated body organ placed upon the base of an organ tray and at least one covering layer placed over the simulated body organ. At least one of the simulated body organ and covering layer includes electro-conductive gel that is operably severable under application of electrical current to simulate electrosurgery in a training environment. The training environment comprises a top cover connected to and spaced apart from a base to define an internal cavity that is partially obstructed from direct observation by a practitioner. The tray, simulated body organs and covering layer are placed inside the internal cavity for the practice of laparoscopic surgical procedures.
A surgical training model that includes a simulated tissue having a tubular shape that is connected to a tissue holder is provided. A portion of the simulated tissue overhangs the distal end of the tissue holder to simulate a cuff-like entry to the vaginal vault or resected intestine suitable for practicing laparoscopic closure of the vaginal vault, intestine or other organ via suturing or stapling. Two concentric tubular structures are also arranged over the same tissue holder. A second model includes two portions of simulated tissue that are held by two holders such that the simulated tissues are adjacent making the model suitable for practicing different types of anastomosis procedures. A third model includes two holders with a single or double tubular simulated tissue structure connected to and spanning a gap between the holders. The model isolates the step of closing a cylindrical opening for the purpose of repeated practice.
A surgical training device is provided. The training device includes a practice model comprising a base with a plurality of eyelets connected to the outer surface of the base. The plurality of eyelets defines at least one predetermined pathway for practicing the passing of at least one needle and suture through the eyelets of the predetermined pathway. Various eyelets are described including angled, flexible, deflectable, interchangeable, retractable, rotatable and ones having apertures of various shapes and sizes. The predetermined pathway is marked with markings on the outer surface of base or with color-coded eyelets. Suture pathways define anatomical pathways as well as differing skill levels. The model provides a platform for practicing hand-to-hand transfer and depth perception among other skills required in laparoscopic procedures.
A model for practicing laparoscopic surgical skills is provided. The model includes a base having a plurality of practice stations at the upper surface. The practice stations include a cover having a first closed position in which a cavity is concealed beneath the cover and a second open position in which the cover is moved to uncover the cavity. The covers are connected to the surface in a number of ways to provide a variety of haptic responses useful in fine-tuning laparoscopic surgical skills. The cover is configured as a door hinged with or without a bias, a flexible flap, a sliding cover, a lid, and a penetrable sheet. An object for removal is hidden inside the cavity underneath the cover for practicing hand-to-hand transfer of instruments, use of both hands, switching instruments and determining and visualizing tissue planes in a laparoscopic environment.
A surgical training device includes a model comprising a simulated tissue portion mounted in selectable tension onto a plurality of posts connected to a base. Each post includes at least one notch configured for retaining the simulated tissue portion. Mounting the simulated tissue portion that is in the form of a sheet in notches of different heights creates an angled installation of simulated tissue upon which surgical techniques such as cutting and suturing can be practiced in a simulated laparoscopic environment. More than one sheet can be mounted and each sheet can be mounted with selectable tension by pulling the sheet more or less as desired onto the posts. One variation includes a simulated tumor disposed between sheets, angled or wobbly posts and textured and imprinted simulated tissue surfaces to provide various levels of dynamism and difficulty for surgical skills training in a laparoscopic environment.
A model for practicing laparoscopic surgical skills is provided. The model comprises a body having an elongate lumen and a plurality of eyelets connected to an inner surface of the lumen. The plurality of eyelets defines at least one pathway for practicing the passing of at least one needle and suture through the eyelets. The model further includes a staging area with removable objects having apertures configured to be placed onto hook-like eyelets. The model provides a platform for practicing hand-to- hand transfer, depth perception among other skills required in laparoscopic procedures within a confined tubular space. The model may be placed inside a laparoscopic trainer in which the practice is performed in a simulated laparoscopic environment and observed on a video display.
An inexpensive and practical surgical training system to train practitioners in the use of surgical stapling and energy-based ligation instruments and procedures is provided. The system comprises a modified or simulated surgical instrument such as linear surgical stapling device having a fixed anvil and an opposed, movable jaw sized and configured to be closed upon a simulated tissue structure. A marking or inking element is associated with the jaw and anvil of the stapling device and configured to impose a visible pattern on the surfaces of simulated tissue placed between the anvil and jaw. A pressure sensitive adhesive or other adhesive is associated with the inner surfaces of the simulated tissue that is activated upon compression between the anvil and jaw to simulate surgical occlusion.
Embodiments of a surgical access port system that comprises a retractor that is adapted for being coupled to a cap and that is particularly useful in natural orifice surgery are described. The retractor comprises an outer ring, wherein the outer ring is configured to be disposed proximate the natural orifice of the patient and substantially surround the orifice; a tubular body; a funnel segment extending between and coupling the outer ring and the tubular body, wherein the funnel segment provides a diametric reduction between the relatively large diameter of the outer ring and the relatively smaller diameter of the tubular body, which is sized to fit within a natural orifice with minimal distention of the orifice; and an inflatable member disposed around the distal end of the tubular body, the inflatable member sized and configured to fit snugly around the tubular body in the deflated condition and to expand against the wall of the natural orifice in the inflated state to thereby stabilize and retain the retractor within the orifice.
Surgical access systems and obturators for or used in surgical access systems are provided. The obturator is configured to operate or accommodate the use of at least two different sized trocars. The outer diameter of the adaptable obturator when inserted into a trocar compresses from an initial condition to a compressed condition to match the inner diameter of the trocar.
A system for training a clinician in energy-based surgical techniques that advantageously does not require the simulated tissue to be electrically conductive is provided. The simulated tissue comprises at least two materials. A heat generator is configured in the shape of a medical instrument typically encountered in energy-based surgical procedures such as electrosurgery or electrocautery. The instrument delivers sufficient heat to melt at least one of the materials in order to simulate energy-based surgical techniques such as excising target material. The at least two materials are configured in the simulated tissue such that their relative thermoplasticity defines a predetermined surgical pathway of a desired clinical outcome.
A simulated tissue structure for practicing surgical techniques is provided. In particular, a realistic organ model or tissue portion for practicing the removal of a tumor or other undesired tissue followed by suturing a remnant defect as part of the same surgical procedure is provided. The simulated tissue structure includes an artificial tumor disposed between layers of elastomeric material and mounted on a simulated organ wall or tissue portion. The simulated tissue structure is modular and interchangeable. At least one of the layers includes a mesh reinforcement. A defect comprising two juxtapositioned surfaces defining a gap between the surfaces is created in the simulated tissue structure and the trainee practices tumor removal and closure of the gap by suturing in a laparoscopic environment.
A retraction device for retracting an incision in a body wall includes a sheath that traverses through the incision from outside the body to a body cavity inside the body. The retraction device may include a deployable, adjustable frame that supports the sheath and that, together with the sheath, retracts the incision. The retraction device may include an outer ring and an inner ring coupled to opposing ends of the sheath and further include means to place the sheath in tension between the inner and outer rings, thereby retracting the incision.
patents
