GB2268883A

GB2268883A - Endoscope

Info

Publication number: GB2268883A
Application number: GB9215640A
Authority: GB
Inventors: Terence John Morgan
Original assignee: PENNINE HEALTHCARE Ltd
Current assignee: PENNINE HEALTHCARE Ltd
Priority date: 1992-07-23
Filing date: 1992-07-23
Publication date: 1994-01-26
Also published as: GB9215640D0

Abstract

A surgical apparatus 10 for use in minimally invasive surgery comprises an endoscope 12 with a seal 20 provided on the outer end thereof. An operating device 22 extends through the seal 20 into the endoscope. The device comprises a length of tube 24 connectible to a suction pump. A branch 26 extends from the tube and mounts on its end an inverted Y-shaped connector 28 to permit manual control of the suction. Another seal 32 is provided across the outer end of the tube. Operating means such as a lithotripter can extend through the tube and seal. The device finds use in the removal of stones from e.g. the kidney, ureter, bladder or bile duct wherein the stone is located by the endoscope, held in position by suction and broken up by the lithotripter. <IMAGE>

Description

Surgical Apparatus This invention concerns improvements in or relating to apparatus for use in surgery, and particularly but not exclusively apparatus for use in minimally invasive surgery.

In minimally invasive surgery as small as possible an opening is made in the patient and surgery is carried out normally using elongate tools extending through the opening. This means that the surgeon does not actually place his hands in the patient's body but normally works with the aid of an endoscope. A significant advantage with this type of surgery is that a patient's body is not disturbed as much as in conventional surgery and thus much shorter recovery times are generally achieved.

One such technique is the removal of stones from e.g. the kidney, ureter, bladder or bile duct. In this technique the stone is located with an endoscope. A lithotripter is then used to break the stone. The lithotripter may operate using pneumatic shock waves.

The broken bits of stone are removed from the body using micro forceps or other mechanical means acting through the endoscope.

According to the present invention there is provided a surgical device, the device comprising tubular means locatable extending through an endoscope for providing suction at the operating end of the endoscope to remove material from a patient's body, the tubular means permitting operating means to also extend through the endoscope.

The tubular means is preferably formed so as to permit the operating means to extend therethrough.

Seal means are preferably provided on an exterior part of the tubular means through which the operating means can extend and can be moved into and out of the tubular means and hence endoscope, whilst permitting suction to be maintained. The seal means may comprise a puncturable latex membrane.

The device preferably permits suction to be selectively applied, and desirably the selective application is manually operable. An external opening may be provided on the device which is manually closable by an operator's finger or thumb to provide suction.

The apparatus is preferably removably connectable to a suction pump.

The operating end of the tubular member is preferably engageable with an object in a body so as to hold the object thereagainst by suction, thereby permitting the operating means to engage with the object.

The tubular member may be selectively connectible to a supply of irrigant to supply same into the body.

The tubular member is preferably flexible, and may be sufficiently flexible to be usable in a flexible endoscope.

Also according to the present invention there is provided surgical apparatus, the apparatus comprising an endoscope, a surgical device according to any of the preceding seven paragraphs locatable in the endoscope, and operating means also locatable in the endoscope.

The operating means is preferably a lithotripter, which may operate by producing pneumatic shock waves.

Means are preferably provided on the endoscope for providing irrigant to the operating end thereof, the irrigant preferably passing over the outside of the tubular means.

The endoscope may be flexible.

An embodiment of the present invention will now be described by way of example only with reference to the accompanying drawings, in which: Fig. 1 is a diagrammatic side view of surgical apparatus according to the present invention; and Fig. 2 is a side view of part of the apparatus of Fig. 1.

The drawings shown surgical apparatus 10 suitable for destroying and removing stones from a human body, from e.g. the kidney, ureter or bladder. The apparatus 10 comprises a conventional endoscope 12. The endoscope 12 comprises an eye piece 14 from which extends an optical fibre 16. An irrigant inlet 18 is provided with a suitable tap (not shown). The inlet 18 permits irrigant to enter the endoscope, with the optical fibre 16 being isolated from the irrigant.

A rubber seal 20 is provided on the outer end of the endoscope 12. An operating device 22 according to the invention extends through the seal 20 into the endoscope 12. The device 22 comprises a length of tube 24 which extends for the whole length of the endoscope and out of each end thereof. A branch 26 extends from the tube 24 towards the end thereof beyond the outer end of the endoscope 12. The branch 26 connects with one limb of an inverted "Y" shape connector 28. The base of the "Y" connects to a suction pump (not shown) and the other limb of the "Y" is open to atmosphere and presents an angled opening 30. A suitable collector (not shown) may be provided between the connector 28 and suction pump.

Provided on the outer end of the main part of the tube 24 is a cylindrical latex seal 32. Extending through the seal 32 and the tube 24 is the probe of a lithotripter which operates by pneumatic shock waves.

The end of the probe which extends through the seal 32 connects with a suitable source of shock waves which may be produced using a conventional hospital supply of compressed air.

In use, the endoscope 12 is inserted into a human body in the conventional way. A stone to be removed is located using the endoscope 12. Suction is applied to the tube 24 by closing the opening 30 with the operator's hand. The endoscope is manouvered such that the stone becomes held on the tube 24 by suction. The lithotripter is now operated to break the stone. The broken particles of stone plus irrigant and any other materials are removed from the body through the tube 24 by suction. If required, and particularly in the case where a narrow endoscope is being used, the probe 34 of the lithotripter is withdrawn such that its operating end is beyond the branch 26 prior to materials being removed from the body. It is to be realised that the suction pump will usually be operating all the time but suction is only produced in the tube 24 when required by closing the opening 30.

There is thus described surgical apparatus which permits a lithotripter to be efficiently used and also permits ready removal of broken stones and other material from the body. Removal of this material by suction rather than by convention mechanical means is much quicker and easier to operate and less likely to damage any delicate tissue in the patient. The feature of holding the stone on the end of the tube by suction during breaking thereof obviously provides for considerably increased efficiency. This will particularly be the case in parts of the body where stones are relatively free to move. The fact that the stone is held during breaking also greatly reduces the likelihood of damage to the body during breakage of the stone.

The apparatus, and particularly the suction device incorporated, is of relatively simple construction and can thus be inexpensively made. The operating device can readily be made in a sterile condition and disposed of after use, rather than require expensive cleaning and sterilisation. #Simple operation of suction by covering and uncovering the opening eases use of the apparatus and permits suction to be readily applied only when required. Apparatus according to the invention is usable for many conditions and can be made in many different sizes and to very small dimensions as is required.

Various modifications may be made without departing from the scope of the invention. For example, the supply of irrigant may be connected so as to be delivered through the operating device when suction is not applied. This could be provided by a further branch on the tube and any suitable tap means. This would be particularly useful with small endoscopes.

Whilst endeavouring in the foregoing specification to draw attention to those features of the invention believed to be of particular importance it should be understood that the Applicant claims protection in respect of any patentable feature or combination of features hereinbefore referred to and/or shown in the drawings whether or not particular emphasis has been placed thereon.

Claims

Claims:

1. A surgical device, the device comprising tubular means locatable extending through an endoscope for providing suction at the operating end of the endoscope to remove material from a patient's body, the tubular means permitting operating means to also extend through the endoscope.

2. A device according to claim 1, in which the tubular means is formed so as to permit the operating means to extend therethrough.

3. A device according to claim 2, in which seal means are provided on an exterior part of the tubular means through which the operating means can extend and can be moved into and out of the tubular means and hence endoscope, whilst permitting suction to be maintained.

4. A device according to claim 3, in which the seal means comprises a puncturable latex membrane.

5. A device according to any of claims 2 to 4, in which the operating end of the tubular member is engageable with an object in a body so as to hold the object thereagainst by suction, thereby permitting the operating means to engage with the object.

6. A device according to any of the preceding claims, in which the device permits suction to be selectively applied.

7. A device according to claim 6, in which the selective application of the device is manually operable.

8. A device according to claim 7, in which an external opening is provided on the device which is manually closable by an operator's finger or thumb to provide suction.

9. A device according to any of the preceding claims, in which the apparatus is removably connectable to a suction pump.

10. A device according to any of the preceding claims, in which the tubular member is selectively connectable to a supply of irrigant to supply same into the body.

11. A device according to any of the preceding claims, in which the tubular member is flexible.

12. A device according to claim 11, in which the tubular member is sufficiently flexible to be usable in a flexible endoscope.

13. Surgical apparatus, the apparatus comprising an endoscope, a surgical device according to any of claims 1 to 12 locatable in the endoscope, and operating means also locatable in the endoscope.

14. Apparatus according to claim 13, in which the operating means is a lithotripter.

15. Apparatus according to claim 14, in which the lithotripter is operated by producing pneumatic shock waves.

16. Apparatus according to any of claims 13 to 15, in which means are provided on the endoscope for providing irrigant to the operating end thereof.

17. Apparatus according to claim 16, in which the irrigant passes over the outside of the tubular means.

18. Apparatus according to any of claims 13 to 17, in which the endoscope is flexible.

19. A surgical device substantially as hereinbefore described with reference to Fig. 2 of the accompanying drawings.

20. Surgical apparatus substantially as hereinbefore described with reference to Fig. 1 of the accompanying drawings.

21. Any novel subject matter or combination including novel subject matter disclosed in the foregoing specification or claims and/or shown in the drawings, whether or not within the scope of or relating to the same invention as any of the preceding claims.