WO1996038197A1 - Seizing instrument - Google Patents

Seizing instrument Download PDF

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Publication number
WO1996038197A1
WO1996038197A1 PCT/US1996/007863 US9607863W WO9638197A1 WO 1996038197 A1 WO1996038197 A1 WO 1996038197A1 US 9607863 W US9607863 W US 9607863W WO 9638197 A1 WO9638197 A1 WO 9638197A1
Authority
WO
WIPO (PCT)
Prior art keywords
instrument
strips
funnel
cavity
instrument according
Prior art date
Application number
PCT/US1996/007863
Other languages
French (fr)
Inventor
Benny Gaber
Original Assignee
Helfgott & Karas, P.C.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Helfgott & Karas, P.C. filed Critical Helfgott & Karas, P.C.
Priority to JP8536605A priority Critical patent/JPH11506028A/en
Priority to US08/952,895 priority patent/US6027518A/en
Priority to AU59380/96A priority patent/AU5938096A/en
Priority to EP96916711A priority patent/EP0831953A4/en
Publication of WO1996038197A1 publication Critical patent/WO1996038197A1/en

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/02—Holding devices, e.g. on the body
    • A61M25/04—Holding devices, e.g. on the body in the body, e.g. expansible
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22031—Gripping instruments, e.g. forceps, for removing or smashing calculi
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/42—Gynaecological or obstetrical instruments or methods
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/0218—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421—Cannulas
    • A61B2017/3445—Cannulas used as instrument channel for multiple instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B2017/348—Means for supporting the trocar against the body or retaining the trocar inside the body
    • A61B2017/3482—Means for supporting the trocar against the body or retaining the trocar inside the body inside
    • A61B2017/3484—Anchoring means, e.g. spreading-out umbrella-like structure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/361—Image-producing devices, e.g. surgical cameras
    • A61B2090/3614—Image-producing devices, e.g. surgical cameras using optical fibre
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/02—Holding devices, e.g. on the body
    • A61M2025/0213—Holding devices, e.g. on the body where the catheter is attached by means specifically adapted to a part of the human body
    • A61M2025/0233—Holding devices, e.g. on the body where the catheter is attached by means specifically adapted to a part of the human body specifically adapted for attaching to a body wall by means which are on both sides of the wall, e.g. for attaching to an abdominal wall

Definitions

  • the present invention relates to medical in ⁇ struments generally, and particularly to seizing instru ⁇ ments inserted into body cavities.
  • the endocervix is typically seized with a type of sharp pincers called tenaculum.
  • the present invention seeks to provide a simple seizing instrument for inserting into a body cavity and seizing the inner walls of the cavity.
  • the present invention is described hereinbelow in detail with reference to preferred embodiments useful in seizing the inner wall of the lower uterine cavity (endocervix) .
  • Using the preferred embodiments to seize the endocervix does not require anesthesia and does not endanger the patient or cause pain, discomfort or bleed ⁇ ing thereto.
  • this is only one example of a possible use for the present invention and is not limiting.
  • the invention is raanufac- turable in a variety of sizes and shapes, and is readily adaptable for use in the rectum, urethra, esophagus, stomach or other bodily openings, as well as blood ves ⁇ sels.
  • the present invention comprises a pair of slender tubes, one disposed inside the other.
  • the outside diameter of the pair of tubes is chosen for easy inser ⁇ tion into the particular body cavity, without causing pain thereto or to tissue or sphincters surrounding the opening of the cavity.
  • the insertion end of the tubes is also smoothly tapered and shaped to facilitate insertion.
  • the insertion end of one of the tubes is caused to be deformed generally radially outwards inside the cavity.
  • this is accomplished by making the inner tube from a spring-like material and forming at its insertion end a plurality of axial strips. As long as the inner tube is disposed inside the outer tube, the strips remain constrained together inside the outer tube.
  • the outer tube is slid along the inner tube in a direction opposite the inser ⁇ tion direction, thereby exposing the strips of the inner tube and allowing them to spring radially outwards. The instrument can then be used to seize the inner walls of the cavity with the outwardly protruding strips.
  • the outer tube is formed at one end thereof with stiff axial strips, each formed with a rearwardly facing shoul ⁇ der.
  • the strips initially touch each other at the tip of the insertion end and do not protrude radially outwards beyond the chosen diameter. This ensures safe insertion into the particular body cavity.
  • the strips may even be weakly joined at their tips to prevent premature opening which could interfere with safe insertion.
  • the inner tube is slid axially along the outer tube in the insertion direction, thereby butting and pushing against the shoulders. This causes the strips to bend radially outwards. If the tips are weakly joined, the pushing force is sufficient to rupture the joint to allow the strips to bend outwards.
  • the instrument is then used to seize the inner walls of the cavity with the outwardly protruding strips.
  • the tubes may be bent or curved towards the insertion end to facilitate insertion into certain cavities.
  • Apertures may be provided at the bent or curved portion of the tubes to allow another path of insertion of devices and/or substances therethrough, in addition to the normal path through the insertion ends of the tubes.
  • the tubes may be tapered towards the insertion end.
  • the tapering provides the necessary relatively small diameter for insertion into the cavity, while providing a relatively larger diameter opposite to the insertion end which facilitates introduc ⁇ tion of instruments and/or materials through the inner tube.
  • the insertion end of the tapered tubes may be additionally formed with aligned axial slits which allow the tubes to expand radially outwards during insertion of instruments and/or materials, thereby further aiding in the introduction of such instruments and/or materials through the inner tube.
  • the preferred embodiments of the invention are each provided with handles reversibly attachable to each other.
  • a safety catch is provided to prevent premature opening of the strips which could hinder safe insertion of the instrument into the body cavity.
  • the invention may also be adapted to be used in conjunction with fiber optic and/or other devices.
  • Axial apertures may be formed in the tubes for passing there ⁇ through the optic filaments or other devices.
  • radial apertures may be formed in the tubes for passing therethrough substances and/or instruments.
  • the invention is provided with a slitted funnel guide to further aid safe insertion of the seizing instrument into the body cavity.
  • the guide is shaped somewhat like a sheet rolled into a cone-shaped funnel and is adapted to re ⁇ ceive the insertion end of the seizing instrument. After insertion of the funnel and seizing instrument into the body cavity, the funnel may be pulled transversely against the instrument, thereby unrolling and opening the funnel and allowing it to be slipped off the instrument. The seizing instrument is left inside the cavity where it can be used to seize the inner walls of the cavity as described above.
  • an instru ⁇ ment for seizing walls of a body cavity including a first portion and a second portion, the second portion being insertable into the cavity and to be reversibly deform ⁇ able from a first to a second configuration while inside the cavity, the first portion being operative to reversi ⁇ bly deform the second portion from the first to the second configuration, the second portion when in the second configuration being operative to seize the walls of the cavity.
  • the first portion of the instru ⁇ ment includes a first end of a pair of inner and outer tubes, the inner tube being disposed inside the outer tube and the outer tube being adapted to slide along the inner tube, and the second portion of the instrument includes a second end of the pair of the inner and the outer tubes, the second end of the inner tube having a plurality of axial slits which define a plurality of axial deformable strips, the strips being deformed radi ⁇ ally outwards when the outer tube is slid along the inner tube towards the first end of the inner tube.
  • the material of the strips is resilient and spring-like.
  • each of the plurali ⁇ ty of deformable strips is provided with a lip at an end thereof, wherein in the first configuration, the lips do not protrude radially outwards of the outer tube.
  • the lip is shaped to facilitate insertion into the body cavity.
  • the first end of the inner tube is fitted with a first handle and the first end of the outer tube is fitted with a second handle, the first handle being reversibly attachable to the second handle.
  • a safety catch to prevent unintentional axial movement of the inner tube and the outer tube with respect to each other.
  • the inner and the outer tubes each have an axial slit extending from their second ends towards their first ends, the axial slits being substan ⁇ tially aligned with each other.
  • the inner and the outer tubes are tapered.
  • the inner and the outer tubes may also have aligned axial slits extending from their second ends towards their first ends.
  • the first portion of the seiz ⁇ ing instrument includes a first end of a pair of inner and outer tubes, the inner tube being disposed inside the outer tube and the outer tube being adapted to slide along the inner tube, and the second portion of the instrument includes a second end of the pair of the inner and the outer tubes, the second end of the outer tube having a plurality of axial slits which define a plurali- ty of axial deformable strips, the strips being deformed radially outwards when the inner tube is slid along the outer tube towards the second end of the outer tube.
  • each deformable strip includes an inner shoulder, such that sliding the inner tube towards the second end of the outer tube causes the second end of the inner tube to butt and push against the shoulder, thereby causing the plurality of strips to deform radially outwards.
  • the plurality of strips are shaped to facilitate insertion into the body cavity.
  • the instrument further includes a safety sleeve which covers at least a portion of the strips in the first configuration and which is retract ⁇ able to expose the strips in the second configuration.
  • the instrument includes a guiding device which is attached to a distal end of the strips in the first configuration, the guiding device substantially preventing deformation of the plu ⁇ rality of strips radially outwards when in the first configuration, and wherein sliding of the inner tube towards the second end of the outer tube causes detach ⁇ ment of the guiding device from the strips, thereby permitting deformation of the plurality of strips radial ⁇ ly outwards, and wherein further sliding of the inner tube towards the second end of the outer tube causes the plurality of strips to deform radially outwards.
  • the guiding device preferably has a soft tip for guiding the seizing instrument through sharp bends and tight corners.
  • the plurality of strips are sub- stantially in contact with one another in the first configuration.
  • tips of the strips are joined together in the first configuration.
  • the seizing instrument includes a device for substantially preventing linear and rotational misalignment of the axial slits.
  • the seizing instrument includes a device for substantially preventing linear and rotational misalignment of the first and second tubes with respect to each other.
  • a slitted funnel guide for guiding insertion of an instrument, comprising a resiliently openable, conical coiled funnel, being adapted to receive an insertable end of the instru ⁇ ment and being retractable transversely from the instru ⁇ ment.
  • a method for seizing walls of a body cavity comprising the steps of providing an instrument comprising a first portion and a second portion, the second portion being insertable into the cavity and to be reversibly deformable from a first to a second configuration while inside the cavity, the first portion being operative to reversibly deform the second portion from the first to the second configu ⁇ ration, and the second portion when in the second config ⁇ uration being operative to seize the walls of the cavity, inserting the second portion of the instrument into the cavity, and deforming the second portion into the second configuration and seizing the walls of the cavity.
  • the step of inserting further comprises • the steps of providing a slitted funnel guide comprising a resiliently openable, conical coiled funnel, inserting the funnel into the cavity, inserting the second portion of the instrument into the funnel, re ⁇ tracting the funnel outwards from the cavity, transverse ⁇ ly pulling the funnel against the instrument, thereby causing the coiled funnel to split open and permitting removing the funnel from the instrument, leaving the instrument inside the cavity.
  • the step of inserting further comprises the steps of providing a slitted funnel guide comprising a resiliently openable, conical coiled funnel, inserting the funnel and the second portion of the instrument into the cavity, re ⁇ tracting the funnel outwards from the cavity, transverse ⁇ ly pulling the funnel against the instrument, thereby causing the coiled funnel to split open and permitting removing the funnel from the instrument, leaving the instrument inside the cavity.
  • a slitted funnel guide comprising a resiliently openable, conical coiled funnel
  • the step of providing further comprises the step of providing a guiding device for guiding the instrument through non- straight body cavities, the guiding device substantially preventing deformation of the second portion when in the first configuration and being removable so as to permit deformation of the second portion when in the second configuration, and wherein prior to the step of deform ⁇ ing, the guiding device is removed from the second por ⁇ tion to permit deformation of the second portion.
  • Fig. 1 is a simplified pictorial illustration of a seizing instrument constructed and operative in accordance with a preferred embodiment of the present invention, the seizing instrument being in a first con ⁇ figuration;
  • Fig. 2 is a frontal illustration of the seizing instrument of Fig. 1 as viewed along the arrow II in Fig. i;
  • Fig. 3 is a sectional illustration of a portion of the seizing instrument of Fig. 1, taken along lines III - III in Fig. 1;
  • Fig. 4 is simplified pictorial illustration of the seizing instrument of Fig. 1 in a second configura ⁇ tion;
  • Fig. 5A is a simplified sectional side view of the seizing instrument of Fig. 1 inserted in a cervix and in the first configuration;
  • Fig. 5B is a simplified sectional side view of the seizing instrument of Fig. 1 inserted in the cervix and in the second configuration;
  • Fig. 5C is a simplified sectional side view of the seizing instrument of Fig. 1 in the second configura ⁇ tion and positioned for seizing the cervix;
  • Fig. 6A is a simplified pictorial illustration of a seizing instrument constructed and operative in accordance with another preferred embodiment of the present invention, and wherein the inner and the outer tubes are bent;
  • Fig. 6B is a simplified pictorial illustration of a the seizing instrument of Fig. 6A and including radial apertures in the bent portion of the inner and outer tubes;
  • Fig. 7 is a simplified pictorial illustration of a seizing instrument constructed and operative in accordance with another preferred embodiment of the present invention, and wherein the inner and the outer tubes are tapered;
  • Fig. 8 is a simplified pictorial illustration of the seizing instrument of Fig. 7, and wherein the inner and the outer tubes have aligned axial slits;
  • Fig. 9 is a simplified pictorial illustration of a seizing instrument constructed and operative in accordance with another preferred embodiment of the present invention, the seizing instrument being in a first configuration;
  • Fig. 10 is a frontal illustration of the seiz ⁇ ing instrument of Fig. 9 as viewed along the arrow X in Fig. 9;
  • Fig. 11 is a sectional illustration of a por ⁇ tion of the seizing instrument of Fig. 9, taken along lines XI - XI in Fig. 9;
  • Fig. 12 is simplified pictorial illustration of the seizing instrument of Fig. 9 in a second configura ⁇ tion
  • Fig. 13 is a frontal illustration of the seiz ⁇ ing instrument of Fig. 12 as viewed along the arrow XIII in Fig. 12;
  • Fig. 14 is a sectional illustration of a por ⁇ tion of the seizing instrument of Fig. 12 taken along lines XIV - XIV in Fig. 12;
  • Fig. 15 is a simplified pictorial illustration of a seizing instrument provided with radial apertures constructed and operative in accordance with a preferred embodiment of the present invention
  • Fig. 16 is a simplified sectional illustration of a seizing instrument provided with axial apertures constructed and operative in accordance with a preferred embodiment of the present invention
  • Fig. 17 is a simplified pictorial illustration of a seizing instrument provided with roughened strips constructed and operative in accordance with a preferred embodiment of the present invention
  • Figs. 18 and 19 are simplified sectional illus ⁇ trations of a seizing instrument in a first configuration and provided with a retractable safety sleeve, construct ⁇ ed and operative in accordance with a preferred embodi ⁇ ment of the present invention, before and after retrac ⁇ tion of the safety sleeve, respectively;
  • Fig. 20 is a simplified sectional illustration of the seizing instrument of Figs. 18 and 19 in a second configuration for seizing a cervix;
  • Figs. 21 and 22 are enlarged illustrations of a portion of the seizing instrument shown in Figs. 18 and 20, respectively;
  • Figs. 23 and 24 are simplified sectional illus ⁇ trations of a seizing instrument in a first configuration and provided with a guiding device, constructed and operative in accordance with a preferred embodiment of the present invention, before and after removal of the guiding device, respectively;
  • Fig. 25 is a simplified sectional illustration of the seizing instrument of Figs. 23 and 24 in a second configuration for seizing a cervix;
  • Fig. 26 is a simplified pictorial illustration of a slitted funnel guide constructed and operative in accordance with a preferred embodiment of the present invention.
  • Figs. 27A - 27D are illustrations of the opera ⁇ tion of the funnel guide of Fig. 26.
  • Figs. 1 - 3 illustrate a seizing instrument 10 constructed and opera ⁇ tive in accordance with a preferred embodiment of the present invention.
  • the seizing instrument 10 comprises an inner tube 12 and an outer tube 14, the inner tube 12 being disposed inside the outer tube 14 and the outer tube 14 being adapted to slide along the inner tube 12.
  • the inner tube 12 preferably has a first handle 16 disposed at a first end 18 thereof.
  • the outer tube 14 preferably has a second handle 20 disposed at a first end 22 thereof.
  • the first handle 16 is preferable biased against the second handle 20 with a biasing device, such as a spring 24.
  • the first handle 16 is provided with one or more attachment devices 26, such as hooks, clips or snaps, which may be used to reversibly attach the first handle 16 to the second handle 20.
  • the first handle 16 is also preferably provided with a safety catch 28.
  • the safety catch 28 prevents unintentional axial movement of the first handle 16 and the second handle 20 with respect to each other, and thus also axial movement of the inner tube 12 and the outer tube 14 with respect to each other. The importance of the safety catch 28 is described further hereinbelow.
  • seizing instrument 10 has a provision for substantially preventing radial motion of inner tube 12 with respect to outer tube 14.
  • second handle 20 has a groove 29 which is engageable with attachment device 26 and safety catch 28. As long as either attachment device 26 or safety catch 28 is engaged with groove 29, radial motion of second handle 20 and outer tube 14 with respect to first handle 16 and inner tube 12, is substantially prevented. It is appreciated that other devices may be employed to substantially prevent radial motion of the tubes 12 and 14 with respect to each other.
  • the inner tube 12 has a plurality of axial slits 30 at a second end 32 thereof which define a plu ⁇ rality of axial deformable strips 34.
  • Each strip 34 is preferably provided with a lip 36 which is shaped, such as being rounded, to facilitate insertion of the seizing instrument 10 into a cervix.
  • the inner tube 12 and the outer tube 14 are preferably made of any durable, medically safe material.
  • the material of the strips 34, or optionally of the entire inner tube 12, further has the property of being resilient and spring-like.
  • the spring-like strips 34 are manufactured such that they protrude radially outwards when not stored inside the outer tube 14.
  • Figs. 1 - 3 illustrate a first configuration of the inner tube 12 and the outer tube 14, in which the strips 34 are held within the outer tube 14.
  • a second end 38 of the outer tube 14 is sub ⁇ stantially butted against the lips 36 of the strips 34 in the first configuration.
  • the lips 34 do not protrude radially outwards of the outer tube 14.
  • Fig. 4 which illus ⁇ trates the seizing instrument 10 in a second configura ⁇ tion in which the seizing instrument 10 is operative to seize the cervix.
  • the outer tube 14 is slid along the inner tube 12 in the direction of arrow 40, thereby exposing the strips 34.
  • the spring-like property of the strips 34 causes them return to their manufactured state and deform radially outwards.
  • the safety catch 28 is re ⁇ leased from the second handle 20 to allow axial movement of the outer tube 14. As long as the safety catch 28 is attached to the second handle 20, axial movement of the outer tube 14 is prevented and the strips 34 can not prematurely open which could hinder safe insertion into the cervix.
  • the at least one attachment device 26 fas ⁇ tens the first handle 16 to the second handle 20.
  • FIG. 5A illustrates the operation of the seizing instrument 10.
  • the seizing instrument 10 is inserted into the cervix in the first configuration described hereinabove with reference to Figs. 1 - 3.
  • Fig. 5C the seizing instrument 10 is pulled against and seizes the cervix.
  • Fig. 6A illustrates a seizing instrument 42 constructed and operative in ac ⁇ cordance with another preferred embodiment of the present invention, and comprising bent inner 44 and outer 46 tubes.
  • bent includes having a sharp bend or a bend with a radius of curvature. The bending of the tubes may be useful for insertion in certain body cavities.
  • apertures 47 may be formed in the bent portion of tubes 44 and 46.
  • devices and/or substances may be introduced into the cervix via apertures 47 in the direction of arrow 48 as well as through the end of tubes 44 and 46 in the direction of arrow 49.
  • Fig. 7 which illus ⁇ trates a seizing instrument 50 constructed and operative in accordance with yet another preferred embodiment of the present invention, and which comprises an inner tube 52 and an outer tube 54 which have a relatively larger diameter at a first end 56 and taper to a relatively smaller diameter at a second end 58.
  • the tapering pro ⁇ vides the necessary relatively small diameter for inser ⁇ tion into the cervix, while providing a relatively larger diameter at the first end 56 which facilitates introduc ⁇ tion of instruments and/or materials through the inner tube 52.
  • Fig. 8 shows that the inner 52 and the outer 54 tubes of seizing instrument 50, described hereinabove with reference to Fig. 7, may additionally be provided with axial slits 60 and 61 respectively which are substantially aligned with each other.
  • the slits 60 and 61 allow the second ends 58 of the inner 52 and the outer 54 tubes to expand radially outwards during insertion of instruments and/or materi ⁇ als, thereby further aiding in the introduction of such instruments and/or materials through the inner tube 52.
  • seizing instrument 50 is also provided with at least one attachment device 62, a safety catch 64 and a groove 66, which are respectively identi ⁇ cal with attachment device 26, safety catch 28 and groove 29 of seizing instrument 10 described hereinabove with reference to Figs. 1 - 5C.
  • attachment device 62 or safety catch 64 is engaged with groove 66, radial motion of outer tube 54 and slit 61 with respect to inner tube 52 and slit 60, is substantially prevented. It is appreciated that other devices may be employed to substantially prevent radial motion of the tubes 52 and 54, as well as slits 60 and 61, with respect to each other.
  • the seizing instrument 110 comprises an inner tube 112 and an outer tube 114, the inner tube 112 being disposed inside the outer tube 114 and the outer tube 114 being adapted to slide along the inner tube 112.
  • the inner tube 112 preferably has a first handle 116 disposed at a first end 118 thereof.
  • the outer tube 114 preferably has a second handle 120 disposed at a first end 122 thereof.
  • the first handle 116 is preferable biased against the second handle 120 with a biasing device, such as a spring 124.
  • the first handle 116 is provided with one or more attachment devices 126, such as hooks, clips or snaps, which are operative to reversibly attach the first handle 116 to the second handle 120.
  • the first handle 116 is also preferably provided with a safety catch 128.
  • the safety catch 128 prevents uninten ⁇ tional axial movement of the first handle 116 and the second handle 120 with respect to each other, and thus also axial movement of the inner tube 112 and the outer tube 114 with respect to each other.
  • seizing instrument 110 has a provision for substantially preventing radial motion of inner tube 112 with respect to outer tube 114.
  • second handle 120 has a groove 129 which is engageable with attachment device 126 and safety catch 128. As long as either attachment device 126 or safety catch 128 is engaged with groove 129, radial motion of second handle 120 and outer tube 114 with respect to first handle 116 and inner tube 112, is substantially prevented. It is appreciated that other devices may be employed to substantially prevent radial motion of the tubes 112 and 114 with respect to each other.
  • the outer tube 114 has a plurality of axial slits 130 at a second end 132 thereof which define a plurality of axial deformable strips 134. As seen in Fig. 11, each deformable strip 134 preferably includes an inner shoulder 136. Preferably slits 130 are formed in outer tube 114 with no sharp corners, but rather with rounded corners to prevent stress concentrations, as is known in the art.
  • Figs. 9 - 11 illustrate a first configuration of the inner tube 112 and the outer tube 114. It is noted that the strips 134 are substantially in contact with one another in the first configuration, which is important for safe insertion into the cervix. Optionally, the tips of strips 134 may be weakly joined together, such as by bonding, to ensure that the strips 134 contact one anoth- er in the first configuration. This is important to prevent the strips 134 from opening outwards prematurely which could interfere with safe insertion of the seizing instrument 110 into the cervix.
  • Figs. 12 - 14 illustrate the operation of the seizing instrument 110.
  • the inner tube 112 is slid along the inside of the outer tube 114 in the direction of arrow 140, such that an end 142 of the inner tube 112 butts against the inner shoulders 136 of the strips 134 of the outer tube 114. Further sliding of the inner tube 112 in the direction of the arrow 140 causes the end 142 to push against the shoulders 136, thereby causing the plurality of strips 134 to deform radially outwards as shown picto- rially in Fig. 13 and in section in Fig. 14. If the tips of the strips 134 are weakly joined, the pushing force is sufficient to rupture the joint to allow the strips 134 to bend outwards.
  • the seizing instrument 110 is then used to seize the cervical walls with the outwardly protruding strips 134.
  • seizing instrument 110 may be provided with a bend with apertures, may be ta ⁇ pered and/or may be provided with axial slits as de ⁇ scribed hereinabove for seizing instrument 10 with refer ⁇ ence to Figs. 6B, 7 and 8.
  • Fig. 15 which illus ⁇ trates seizing instrument 110 provided with substantially aligned radial apertures 150 and 152 formed in the inner 112 and the outer 114 tubes respectively. Apertures 150 and 152 may be used to pass therethrough instruments and/or substances into the cervix.
  • axial apertures 154 may be formed in the outer tube 114 for passing there ⁇ through devices, such as fiber optic and/or other de ⁇ vices. Apertures 154 are shown in section in Fig. 16. It is appreciated that radial and axial apertures may be formed in seizing instrument 10 as well.
  • Fig. 17 which illus ⁇ trates seizing instrument 110 with an outer surface of strips 134 roughened such as by forming grooves 156 thereon. Roughening may help in seizing certain tissues.
  • FIG. 18 - 22 illustrate a seizing instrument 200, constructed and operative in accordance with still another preferred embodiment of the present invention.
  • Seizing instrument 200 is preferably construct ⁇ ed substantially similarly to seizing instrument 110 described hereinabove, with like numerals designating like elements.
  • Seizing instrument 200 is preferably provided with a retractable safety sleeve 202 which initially substantially covers and envelops deformable strips 134, as seen in Figs. 18 and 21.
  • Safety sleeve 202 is preferably constructed of a thin pliable material, such as a thin plastic sheet fashioned to closely fit over outer tube 114 and deformable strips 134.
  • a third handle 204 (Fig. 18) is preferably attached to a proximal end 206 of safety sleeve 202.
  • first handle 116 may be provided with one or more attachment devices 208, such as hooks, clips or snaps, which may be used to reversibly attach first handle 116 to third handle 204.
  • second handle 120 is shown to be of smaller size than first handle 116 and third handle 204, however, second handle 120 may be any other convenient size.
  • a safety catch 210 may also be provided which prevents unintentional axial movement of first handle 116 and third handle 204 with respect to each other.
  • retract ⁇ able safety sleeve 202 is pulled towards its proximal end 206, thereby exposing deformable strips 134.
  • first handle 116 generally in the direction of an arrow 214
  • the plurality of strips 134 are deformed radially out ⁇ wards and are in a position to seize the inner walls of a body cavity (not shown) .
  • Seizing instrument 250 is preferably constructed substantially similarly to seizing instrument 110 described hereina ⁇ bove, with like numerals designating like elements.
  • Guiding device 252 is preferably constructed of a soft, resilient and flexible material, such as a soft rubber, so as to facilitate the insertion of seizing instrument 250 into a body cavity (not shown) , such as through sharp bends and tight corners. Guiding device 252 may have any suitable shape for facilitating entrance into a body cavity. Guiding device 252 is preferably fixedly attached to a rod 254 which passes through the first and second handles (not shown) of seizing instru ⁇ ment 250. In Fig. 23, guiding device 252 initially butts against a distal end of deformable strips 134, thereby substantially preventing deformation of strips 134 radi ⁇ ally outwards.
  • guiding device 252 By pushing rod 254 generally in the direction of an arrow 256, guiding device 252 is pushed away from strips 134, there ⁇ by permitting subsequent deformation of the strips 134.
  • Fig. 25 Sliding inner tube 112 generally in the direction of arrow 256 causes strips 134 to deform radially outwards, thereby bringing seizing instrument 250 into a configuration for seizing a cervix or other body cavity. Once strips 134 have been deformed, rod 254 may be used to retract guiding device 252 through seizing instrument 250. Guiding device 252 may then be disposed of, or may be sterilized for further use.
  • Fig. 26 which illus ⁇ trates a slitted funnel guide 160 constructed and opera ⁇ tive in accordance with a preferred embodiment of the present invention.
  • Guide 160 is constructed of resilient material and comprises an insertion portion 162 which is shaped somewhat like a sheet rolled into a cone-shaped funnel 164 with a generally axial slit 166.
  • Funnel 164 is adapted to receive the insertion end of any seizing instrument, such as instrument 10 or 110, constructed and operative in accordance with a preferred embodiment of the present invention.
  • Guide 160 preferably further comprises a handle 168.
  • Figs. 27A - 27D illustrate the operation of the funnel guide 160.
  • a user inserts the funnel guide 160 into the cervix. Since the funnel 164 tapers outwards from the cervix, a seizing instrument 170 is easily inserted through the funnel guide 160 into the cervix, as seen in Fig. 27B. Alternatively, seizing instrument 170 may be inserted together with funnel guide 160 into the cervix.
  • the funnel guide 160 may be pulled outwards from the cervix.
  • the slit 166 of the funnel 164 widens as the funnel 164 is pulled back somewhat transversely to the instrument 170, as seen in Fig. 27C. This allows the funnel guide 160 to slip off the instrument 170 and leaves the instrument 170 inside the cervix, as seen in Fig. 27D.
  • Instrument 170 can then be used to seize the endocervix as described above for seizing instrument 10 or 110.

Abstract

This invention is an instrument for seizing walls of a body cavity including a first portion (22) and a second portion (30), the second portion being insertable into the cavity and being reversibly deformable from a first (fig. 5A) to a second (fig. 5B) configuration while inside the cavity, the first portion being operative to reversibly deform the second portion from the first to the second configuration, the second portion when in the second configuration being operative to seize the walls of the cavity.

Description

SEIZING INSTRUMENT
The present invention relates to medical in¬ struments generally, and particularly to seizing instru¬ ments inserted into body cavities.
In certain medical procedures it is necessary to insert an instrument into a body cavity and seize the inner walls of the cavity. For example, in some gyneco¬ logical procedures, it is necessary to seize the endocer- vix while introducing instruments and/or substances through the vagina and the cervix into the uterus. In addition, for some procedures, such as embryo implanta¬ tions, it is necessary to hold the uterus fixed.
In the prior art, for example, the endocervix is typically seized with a type of sharp pincers called tenaculum.
The present invention seeks to provide a simple seizing instrument for inserting into a body cavity and seizing the inner walls of the cavity.
The present invention is described hereinbelow in detail with reference to preferred embodiments useful in seizing the inner wall of the lower uterine cavity (endocervix) . Using the preferred embodiments to seize the endocervix does not require anesthesia and does not endanger the patient or cause pain, discomfort or bleed¬ ing thereto. However, it should be emphasized that this is only one example of a possible use for the present invention and is not limiting. The invention is raanufac- turable in a variety of sizes and shapes, and is readily adaptable for use in the rectum, urethra, esophagus, stomach or other bodily openings, as well as blood ves¬ sels.
The present invention comprises a pair of slender tubes, one disposed inside the other. The outside diameter of the pair of tubes is chosen for easy inser¬ tion into the particular body cavity, without causing pain thereto or to tissue or sphincters surrounding the opening of the cavity. The insertion end of the tubes is also smoothly tapered and shaped to facilitate insertion.
Once safely inserted, the insertion end of one of the tubes is caused to be deformed generally radially outwards inside the cavity. In one embodiment of the present invention, this is accomplished by making the inner tube from a spring-like material and forming at its insertion end a plurality of axial strips. As long as the inner tube is disposed inside the outer tube, the strips remain constrained together inside the outer tube. After insertion into the body cavity, the outer tube is slid along the inner tube in a direction opposite the inser¬ tion direction, thereby exposing the strips of the inner tube and allowing them to spring radially outwards. The instrument can then be used to seize the inner walls of the cavity with the outwardly protruding strips.
In another embodiment of the present invention, the outer tube is formed at one end thereof with stiff axial strips, each formed with a rearwardly facing shoul¬ der. The strips initially touch each other at the tip of the insertion end and do not protrude radially outwards beyond the chosen diameter. This ensures safe insertion into the particular body cavity. The strips may even be weakly joined at their tips to prevent premature opening which could interfere with safe insertion.
The inner tube is slid axially along the outer tube in the insertion direction, thereby butting and pushing against the shoulders. This causes the strips to bend radially outwards. If the tips are weakly joined, the pushing force is sufficient to rupture the joint to allow the strips to bend outwards. The instrument is then used to seize the inner walls of the cavity with the outwardly protruding strips.
In accordance with another preferred embodiment of the present invention, the tubes may be bent or curved towards the insertion end to facilitate insertion into certain cavities. Apertures may be provided at the bent or curved portion of the tubes to allow another path of insertion of devices and/or substances therethrough, in addition to the normal path through the insertion ends of the tubes.
In accordance with yet another preferred embod¬ iment of the present invention, the tubes may be tapered towards the insertion end. The tapering provides the necessary relatively small diameter for insertion into the cavity, while providing a relatively larger diameter opposite to the insertion end which facilitates introduc¬ tion of instruments and/or materials through the inner tube.
The insertion end of the tapered tubes may be additionally formed with aligned axial slits which allow the tubes to expand radially outwards during insertion of instruments and/or materials, thereby further aiding in the introduction of such instruments and/or materials through the inner tube.
The preferred embodiments of the invention are each provided with handles reversibly attachable to each other. In addition, a safety catch is provided to prevent premature opening of the strips which could hinder safe insertion of the instrument into the body cavity.
The invention may also be adapted to be used in conjunction with fiber optic and/or other devices. Axial apertures may be formed in the tubes for passing there¬ through the optic filaments or other devices. Alterna¬ tively, or additionally, radial apertures may be formed in the tubes for passing therethrough substances and/or instruments.
In addition, the invention is provided with a slitted funnel guide to further aid safe insertion of the seizing instrument into the body cavity. In a preferred embodiment, the guide is shaped somewhat like a sheet rolled into a cone-shaped funnel and is adapted to re¬ ceive the insertion end of the seizing instrument. After insertion of the funnel and seizing instrument into the body cavity, the funnel may be pulled transversely against the instrument, thereby unrolling and opening the funnel and allowing it to be slipped off the instrument. The seizing instrument is left inside the cavity where it can be used to seize the inner walls of the cavity as described above.
There is thus provided in accordance with a preferred embodiment of the present invention an instru¬ ment for seizing walls of a body cavity including a first portion and a second portion, the second portion being insertable into the cavity and to be reversibly deform¬ able from a first to a second configuration while inside the cavity, the first portion being operative to reversi¬ bly deform the second portion from the first to the second configuration, the second portion when in the second configuration being operative to seize the walls of the cavity.
In accordance with a preferred embodiment of the present invention, the first portion of the instru¬ ment includes a first end of a pair of inner and outer tubes, the inner tube being disposed inside the outer tube and the outer tube being adapted to slide along the inner tube, and the second portion of the instrument includes a second end of the pair of the inner and the outer tubes, the second end of the inner tube having a plurality of axial slits which define a plurality of axial deformable strips, the strips being deformed radi¬ ally outwards when the outer tube is slid along the inner tube towards the first end of the inner tube.
Preferably, the material of the strips is resilient and spring-like.
Additionally in accordance with a preferred embodiment of the present invention, each of the plurali¬ ty of deformable strips is provided with a lip at an end thereof, wherein in the first configuration, the lips do not protrude radially outwards of the outer tube.
Further in accordance with a preferred embodi¬ ment of the present invention, the lip is shaped to facilitate insertion into the body cavity.
Preferably the first end of the inner tube is fitted with a first handle and the first end of the outer tube is fitted with a second handle, the first handle being reversibly attachable to the second handle.
Preferably there is provided a safety catch to prevent unintentional axial movement of the inner tube and the outer tube with respect to each other.
In accordance with another preferred embodiment of the present invention, the inner and the outer tubes each have an axial slit extending from their second ends towards their first ends, the axial slits being substan¬ tially aligned with each other.
Additionally in accordance with a preferred embodiment of the present invention, the inner and the outer tubes are tapered. In such an embodiment, the inner and the outer tubes may also have aligned axial slits extending from their second ends towards their first ends.
In accordance with another preferred embodiment of the present invention, the first portion of the seiz¬ ing instrument includes a first end of a pair of inner and outer tubes, the inner tube being disposed inside the outer tube and the outer tube being adapted to slide along the inner tube, and the second portion of the instrument includes a second end of the pair of the inner and the outer tubes, the second end of the outer tube having a plurality of axial slits which define a plurali- ty of axial deformable strips, the strips being deformed radially outwards when the inner tube is slid along the outer tube towards the second end of the outer tube.
Additionally in accordance with a preferred embodiment of the present invention, each deformable strip includes an inner shoulder, such that sliding the inner tube towards the second end of the outer tube causes the second end of the inner tube to butt and push against the shoulder, thereby causing the plurality of strips to deform radially outwards.
Further in accordance with a preferred embodi¬ ment of the present invention, the plurality of strips are shaped to facilitate insertion into the body cavity.
In accordance with a preferred embodiment of the present invention, the instrument further includes a safety sleeve which covers at least a portion of the strips in the first configuration and which is retract¬ able to expose the strips in the second configuration.
Additionally in accordance with a preferred embodiment of the present invention, the instrument includes a guiding device which is attached to a distal end of the strips in the first configuration, the guiding device substantially preventing deformation of the plu¬ rality of strips radially outwards when in the first configuration, and wherein sliding of the inner tube towards the second end of the outer tube causes detach¬ ment of the guiding device from the strips, thereby permitting deformation of the plurality of strips radial¬ ly outwards, and wherein further sliding of the inner tube towards the second end of the outer tube causes the plurality of strips to deform radially outwards.
The guiding device preferably has a soft tip for guiding the seizing instrument through sharp bends and tight corners.
In accordance with a preferred embodiment of the present invention, the plurality of strips are sub- stantially in contact with one another in the first configuration. In accordance with another preferred embodiment of the present invention, tips of the strips are joined together in the first configuration.
In accordance with a preferred embodiment of the present invention, the seizing instrument includes a device for substantially preventing linear and rotational misalignment of the axial slits.
In accordance with a preferred embodiment of the present invention, the seizing instrument includes a device for substantially preventing linear and rotational misalignment of the first and second tubes with respect to each other.
There is also provided in accordance with a preferred embodiment of the present invention, a slitted funnel guide for guiding insertion of an instrument, comprising a resiliently openable, conical coiled funnel, being adapted to receive an insertable end of the instru¬ ment and being retractable transversely from the instru¬ ment.
There is also provided in accordance with a preferred embodiment of the present invention, a method for seizing walls of a body cavity comprising the steps of providing an instrument comprising a first portion and a second portion, the second portion being insertable into the cavity and to be reversibly deformable from a first to a second configuration while inside the cavity, the first portion being operative to reversibly deform the second portion from the first to the second configu¬ ration, and the second portion when in the second config¬ uration being operative to seize the walls of the cavity, inserting the second portion of the instrument into the cavity, and deforming the second portion into the second configuration and seizing the walls of the cavity.
In accordance with a preferred embodiment of the present invention, the step of inserting further comprises • the steps of providing a slitted funnel guide comprising a resiliently openable, conical coiled funnel, inserting the funnel into the cavity, inserting the second portion of the instrument into the funnel, re¬ tracting the funnel outwards from the cavity, transverse¬ ly pulling the funnel against the instrument, thereby causing the coiled funnel to split open and permitting removing the funnel from the instrument, leaving the instrument inside the cavity.
Alternatively, in accordance with another preferred embodiment of the present invention, the step of inserting further comprises the steps of providing a slitted funnel guide comprising a resiliently openable, conical coiled funnel, inserting the funnel and the second portion of the instrument into the cavity, re¬ tracting the funnel outwards from the cavity, transverse¬ ly pulling the funnel against the instrument, thereby causing the coiled funnel to split open and permitting removing the funnel from the instrument, leaving the instrument inside the cavity.
Additionally in accordance with yet another preferred embodiment of the present invention, the step of providing further comprises the step of providing a guiding device for guiding the instrument through non- straight body cavities, the guiding device substantially preventing deformation of the second portion when in the first configuration and being removable so as to permit deformation of the second portion when in the second configuration, and wherein prior to the step of deform¬ ing, the guiding device is removed from the second por¬ tion to permit deformation of the second portion.
The present invention will be understood and appreciated from the following detailed description, taken in conjunction with the drawings in which:
Fig. 1 is a simplified pictorial illustration of a seizing instrument constructed and operative in accordance with a preferred embodiment of the present invention, the seizing instrument being in a first con¬ figuration;
Fig. 2 is a frontal illustration of the seizing instrument of Fig. 1 as viewed along the arrow II in Fig. i;
Fig. 3 is a sectional illustration of a portion of the seizing instrument of Fig. 1, taken along lines III - III in Fig. 1;
Fig. 4 is simplified pictorial illustration of the seizing instrument of Fig. 1 in a second configura¬ tion;
Fig. 5A is a simplified sectional side view of the seizing instrument of Fig. 1 inserted in a cervix and in the first configuration;
Fig. 5B is a simplified sectional side view of the seizing instrument of Fig. 1 inserted in the cervix and in the second configuration;
Fig. 5C is a simplified sectional side view of the seizing instrument of Fig. 1 in the second configura¬ tion and positioned for seizing the cervix;
Fig. 6A is a simplified pictorial illustration of a seizing instrument constructed and operative in accordance with another preferred embodiment of the present invention, and wherein the inner and the outer tubes are bent;
Fig. 6B is a simplified pictorial illustration of a the seizing instrument of Fig. 6A and including radial apertures in the bent portion of the inner and outer tubes;
Fig. 7 is a simplified pictorial illustration of a seizing instrument constructed and operative in accordance with another preferred embodiment of the present invention, and wherein the inner and the outer tubes are tapered;
Fig. 8 is a simplified pictorial illustration of the seizing instrument of Fig. 7, and wherein the inner and the outer tubes have aligned axial slits;
Fig. 9 is a simplified pictorial illustration of a seizing instrument constructed and operative in accordance with another preferred embodiment of the present invention, the seizing instrument being in a first configuration;
Fig. 10 is a frontal illustration of the seiz¬ ing instrument of Fig. 9 as viewed along the arrow X in Fig. 9;
Fig. 11 is a sectional illustration of a por¬ tion of the seizing instrument of Fig. 9, taken along lines XI - XI in Fig. 9;
Fig. 12 is simplified pictorial illustration of the seizing instrument of Fig. 9 in a second configura¬ tion;
Fig. 13 is a frontal illustration of the seiz¬ ing instrument of Fig. 12 as viewed along the arrow XIII in Fig. 12;
Fig. 14 is a sectional illustration of a por¬ tion of the seizing instrument of Fig. 12 taken along lines XIV - XIV in Fig. 12;
Fig. 15 is a simplified pictorial illustration of a seizing instrument provided with radial apertures constructed and operative in accordance with a preferred embodiment of the present invention;
Fig. 16 is a simplified sectional illustration of a seizing instrument provided with axial apertures constructed and operative in accordance with a preferred embodiment of the present invention;
Fig. 17 is a simplified pictorial illustration of a seizing instrument provided with roughened strips constructed and operative in accordance with a preferred embodiment of the present invention;
Figs. 18 and 19 are simplified sectional illus¬ trations of a seizing instrument in a first configuration and provided with a retractable safety sleeve, construct¬ ed and operative in accordance with a preferred embodi¬ ment of the present invention, before and after retrac¬ tion of the safety sleeve, respectively;
Fig. 20 is a simplified sectional illustration of the seizing instrument of Figs. 18 and 19 in a second configuration for seizing a cervix;
Figs. 21 and 22 are enlarged illustrations of a portion of the seizing instrument shown in Figs. 18 and 20, respectively;
Figs. 23 and 24 are simplified sectional illus¬ trations of a seizing instrument in a first configuration and provided with a guiding device, constructed and operative in accordance with a preferred embodiment of the present invention, before and after removal of the guiding device, respectively;
Fig. 25 is a simplified sectional illustration of the seizing instrument of Figs. 23 and 24 in a second configuration for seizing a cervix;
Fig. 26 is a simplified pictorial illustration of a slitted funnel guide constructed and operative in accordance with a preferred embodiment of the present invention; and
Figs. 27A - 27D are illustrations of the opera¬ tion of the funnel guide of Fig. 26.
Reference is now made to Figs. 1 - 3 which illustrate a seizing instrument 10 constructed and opera¬ tive in accordance with a preferred embodiment of the present invention. The seizing instrument 10 comprises an inner tube 12 and an outer tube 14, the inner tube 12 being disposed inside the outer tube 14 and the outer tube 14 being adapted to slide along the inner tube 12.
The inner tube 12 preferably has a first handle 16 disposed at a first end 18 thereof. The outer tube 14 preferably has a second handle 20 disposed at a first end 22 thereof. As seen in Fig. 1, the first handle 16 is preferable biased against the second handle 20 with a biasing device, such as a spring 24.
As seen in Fig. 1, the first handle 16 is provided with one or more attachment devices 26, such as hooks, clips or snaps, which may be used to reversibly attach the first handle 16 to the second handle 20. The first handle 16 is also preferably provided with a safety catch 28. The safety catch 28 prevents unintentional axial movement of the first handle 16 and the second handle 20 with respect to each other, and thus also axial movement of the inner tube 12 and the outer tube 14 with respect to each other. The importance of the safety catch 28 is described further hereinbelow.
In accordance with a preferred embodiment of the present invention, seizing instrument 10 has a provision for substantially preventing radial motion of inner tube 12 with respect to outer tube 14. In the embodiment illustrated in Fig. 1, second handle 20 has a groove 29 which is engageable with attachment device 26 and safety catch 28. As long as either attachment device 26 or safety catch 28 is engaged with groove 29, radial motion of second handle 20 and outer tube 14 with respect to first handle 16 and inner tube 12, is substantially prevented. It is appreciated that other devices may be employed to substantially prevent radial motion of the tubes 12 and 14 with respect to each other.
The inner tube 12 has a plurality of axial slits 30 at a second end 32 thereof which define a plu¬ rality of axial deformable strips 34. Each strip 34 is preferably provided with a lip 36 which is shaped, such as being rounded, to facilitate insertion of the seizing instrument 10 into a cervix.
The inner tube 12 and the outer tube 14 are preferably made of any durable, medically safe material. The material of the strips 34, or optionally of the entire inner tube 12, further has the property of being resilient and spring-like. The spring-like strips 34 are manufactured such that they protrude radially outwards when not stored inside the outer tube 14.
Figs. 1 - 3 illustrate a first configuration of the inner tube 12 and the outer tube 14, in which the strips 34 are held within the outer tube 14. As seen best in Fig. 3, a second end 38 of the outer tube 14 is sub¬ stantially butted against the lips 36 of the strips 34 in the first configuration. The lips 34 do not protrude radially outwards of the outer tube 14.
Reference is now made to Fig. 4 which illus¬ trates the seizing instrument 10 in a second configura¬ tion in which the seizing instrument 10 is operative to seize the cervix. The outer tube 14 is slid along the inner tube 12 in the direction of arrow 40, thereby exposing the strips 34. The spring-like property of the strips 34 causes them return to their manufactured state and deform radially outwards.
It is noted that the safety catch 28 is re¬ leased from the second handle 20 to allow axial movement of the outer tube 14. As long as the safety catch 28 is attached to the second handle 20, axial movement of the outer tube 14 is prevented and the strips 34 can not prematurely open which could hinder safe insertion into the cervix. The at least one attachment device 26 fas¬ tens the first handle 16 to the second handle 20.
Reference is now made to Figs. 5A - 5C which illustrate the operation of the seizing instrument 10. In Fig. 5A, the seizing instrument 10 is inserted into the cervix in the first configuration described hereinabove with reference to Figs. 1 - 3.
In Fig. 5B, the outer tube 14 is slid in the direction of arrow 40 along the inner tube 12, thereby exposing the strips 34 which deform radially outwards, and putting the seizing instrument 10 into the second configuration described hereinabove with reference to Fig. 4.
In Fig. 5C, the seizing instrument 10 is pulled against and seizes the cervix.
The inner tube 12 and the outer tube 14 of the embodiment described hereinabove with reference to Figs. 1 - 5C are generally straight along their entire length. Reference is now made to Fig. 6A which illustrates a seizing instrument 42 constructed and operative in ac¬ cordance with another preferred embodiment of the present invention, and comprising bent inner 44 and outer 46 tubes. Throughout the specification and claims, the term bent includes having a sharp bend or a bend with a radius of curvature. The bending of the tubes may be useful for insertion in certain body cavities.
Referring now to Fig. 6B, it is seen that apertures 47 may be formed in the bent portion of tubes 44 and 46. In this embodiment, devices and/or substances may be introduced into the cervix via apertures 47 in the direction of arrow 48 as well as through the end of tubes 44 and 46 in the direction of arrow 49.
Reference is now made to Fig. 7 which illus¬ trates a seizing instrument 50 constructed and operative in accordance with yet another preferred embodiment of the present invention, and which comprises an inner tube 52 and an outer tube 54 which have a relatively larger diameter at a first end 56 and taper to a relatively smaller diameter at a second end 58. The tapering pro¬ vides the necessary relatively small diameter for inser¬ tion into the cervix, while providing a relatively larger diameter at the first end 56 which facilitates introduc¬ tion of instruments and/or materials through the inner tube 52.
Reference is now made to Fig. 8 which shows that the inner 52 and the outer 54 tubes of seizing instrument 50, described hereinabove with reference to Fig. 7, may additionally be provided with axial slits 60 and 61 respectively which are substantially aligned with each other. The slits 60 and 61 allow the second ends 58 of the inner 52 and the outer 54 tubes to expand radially outwards during insertion of instruments and/or materi¬ als, thereby further aiding in the introduction of such instruments and/or materials through the inner tube 52.
Preferably, seizing instrument 50 is also provided with at least one attachment device 62, a safety catch 64 and a groove 66, which are respectively identi¬ cal with attachment device 26, safety catch 28 and groove 29 of seizing instrument 10 described hereinabove with reference to Figs. 1 - 5C. As long as either attachment device 62 or safety catch 64 is engaged with groove 66, radial motion of outer tube 54 and slit 61 with respect to inner tube 52 and slit 60, is substantially prevented. It is appreciated that other devices may be employed to substantially prevent radial motion of the tubes 52 and 54, as well as slits 60 and 61, with respect to each other.
Reference is now made to Figs. 9 - 11 which illustrate a seizing instrument 110 constructed and operative in accordance with another preferred embodiment of the present invention. The seizing instrument 110 comprises an inner tube 112 and an outer tube 114, the inner tube 112 being disposed inside the outer tube 114 and the outer tube 114 being adapted to slide along the inner tube 112.
The inner tube 112 preferably has a first handle 116 disposed at a first end 118 thereof. The outer tube 114 preferably has a second handle 120 disposed at a first end 122 thereof. As seen in Fig. 9, the first handle 116 is preferable biased against the second handle 120 with a biasing device, such as a spring 124.
As seen in Fig. 9, the first handle 116 is provided with one or more attachment devices 126, such as hooks, clips or snaps, which are operative to reversibly attach the first handle 116 to the second handle 120. The first handle 116 is also preferably provided with a safety catch 128. The safety catch 128 prevents uninten¬ tional axial movement of the first handle 116 and the second handle 120 with respect to each other, and thus also axial movement of the inner tube 112 and the outer tube 114 with respect to each other.
In accordance with a preferred embodiment of the present invention, seizing instrument 110 has a provision for substantially preventing radial motion of inner tube 112 with respect to outer tube 114. In the embodiment illustrated in Fig. 9, second handle 120 has a groove 129 which is engageable with attachment device 126 and safety catch 128. As long as either attachment device 126 or safety catch 128 is engaged with groove 129, radial motion of second handle 120 and outer tube 114 with respect to first handle 116 and inner tube 112, is substantially prevented. It is appreciated that other devices may be employed to substantially prevent radial motion of the tubes 112 and 114 with respect to each other.
The outer tube 114 has a plurality of axial slits 130 at a second end 132 thereof which define a plurality of axial deformable strips 134. As seen in Fig. 11, each deformable strip 134 preferably includes an inner shoulder 136. Preferably slits 130 are formed in outer tube 114 with no sharp corners, but rather with rounded corners to prevent stress concentrations, as is known in the art.
Figs. 9 - 11 illustrate a first configuration of the inner tube 112 and the outer tube 114. It is noted that the strips 134 are substantially in contact with one another in the first configuration, which is important for safe insertion into the cervix. Optionally, the tips of strips 134 may be weakly joined together, such as by bonding, to ensure that the strips 134 contact one anoth- er in the first configuration. This is important to prevent the strips 134 from opening outwards prematurely which could interfere with safe insertion of the seizing instrument 110 into the cervix.
Reference is now made to Figs. 12 - 14 which illustrate the operation of the seizing instrument 110. As shown in Fig. 12, the inner tube 112 is slid along the inside of the outer tube 114 in the direction of arrow 140, such that an end 142 of the inner tube 112 butts against the inner shoulders 136 of the strips 134 of the outer tube 114. Further sliding of the inner tube 112 in the direction of the arrow 140 causes the end 142 to push against the shoulders 136, thereby causing the plurality of strips 134 to deform radially outwards as shown picto- rially in Fig. 13 and in section in Fig. 14. If the tips of the strips 134 are weakly joined, the pushing force is sufficient to rupture the joint to allow the strips 134 to bend outwards. The seizing instrument 110 is then used to seize the cervical walls with the outwardly protruding strips 134.
It is appreciated that seizing instrument 110 may be provided with a bend with apertures, may be ta¬ pered and/or may be provided with axial slits as de¬ scribed hereinabove for seizing instrument 10 with refer¬ ence to Figs. 6B, 7 and 8.
Reference is now made to Fig. 15 which illus¬ trates seizing instrument 110 provided with substantially aligned radial apertures 150 and 152 formed in the inner 112 and the outer 114 tubes respectively. Apertures 150 and 152 may be used to pass therethrough instruments and/or substances into the cervix.
Reference is now made to Fig. 16 which shows that alternatively, or additionally, axial apertures 154 may be formed in the outer tube 114 for passing there¬ through devices, such as fiber optic and/or other de¬ vices. Apertures 154 are shown in section in Fig. 16. It is appreciated that radial and axial apertures may be formed in seizing instrument 10 as well.
Reference is now made to Fig. 17 which illus¬ trates seizing instrument 110 with an outer surface of strips 134 roughened such as by forming grooves 156 thereon. Roughening may help in seizing certain tissues.
Reference is now made to Figs. 18 - 22 which illustrate a seizing instrument 200, constructed and operative in accordance with still another preferred embodiment of the present invention.
Seizing instrument 200 is preferably construct¬ ed substantially similarly to seizing instrument 110 described hereinabove, with like numerals designating like elements. Seizing instrument 200 is preferably provided with a retractable safety sleeve 202 which initially substantially covers and envelops deformable strips 134, as seen in Figs. 18 and 21. Safety sleeve 202 is preferably constructed of a thin pliable material, such as a thin plastic sheet fashioned to closely fit over outer tube 114 and deformable strips 134. A third handle 204 (Fig. 18) is preferably attached to a proximal end 206 of safety sleeve 202.
As seen in Fig. 18, first handle 116 may be provided with one or more attachment devices 208, such as hooks, clips or snaps, which may be used to reversibly attach first handle 116 to third handle 204. It is noted that second handle 120 is shown to be of smaller size than first handle 116 and third handle 204, however, second handle 120 may be any other convenient size. A safety catch 210 may also be provided which prevents unintentional axial movement of first handle 116 and third handle 204 with respect to each other.
As seen in Fig. 19, by retracting third handle 204 generally in the direction of an arrow 212, retract¬ able safety sleeve 202 is pulled towards its proximal end 206, thereby exposing deformable strips 134. As seen in Figs. 20 and 22, by pushing first handle 116 generally in the direction of an arrow 214, the plurality of strips 134 are deformed radially out¬ wards and are in a position to seize the inner walls of a body cavity (not shown) .
Reference is now made to Figs. 23 - 25 which illustrate a seizing instrument 250 with a guiding device 252, constructed and operative in accordance with a preferred embodiment of the present invention. Seizing instrument 250 is preferably constructed substantially similarly to seizing instrument 110 described hereina¬ bove, with like numerals designating like elements.
Guiding device 252 is preferably constructed of a soft, resilient and flexible material, such as a soft rubber, so as to facilitate the insertion of seizing instrument 250 into a body cavity (not shown) , such as through sharp bends and tight corners. Guiding device 252 may have any suitable shape for facilitating entrance into a body cavity. Guiding device 252 is preferably fixedly attached to a rod 254 which passes through the first and second handles (not shown) of seizing instru¬ ment 250. In Fig. 23, guiding device 252 initially butts against a distal end of deformable strips 134, thereby substantially preventing deformation of strips 134 radi¬ ally outwards.
Reference is now made to Fig. 24. By pushing rod 254 generally in the direction of an arrow 256, guiding device 252 is pushed away from strips 134, there¬ by permitting subsequent deformation of the strips 134.
Reference is now made to Fig. 25. Sliding inner tube 112 generally in the direction of arrow 256 causes strips 134 to deform radially outwards, thereby bringing seizing instrument 250 into a configuration for seizing a cervix or other body cavity. Once strips 134 have been deformed, rod 254 may be used to retract guiding device 252 through seizing instrument 250. Guiding device 252 may then be disposed of, or may be sterilized for further use.
Reference is now made to Fig. 26 which illus¬ trates a slitted funnel guide 160 constructed and opera¬ tive in accordance with a preferred embodiment of the present invention. Guide 160 is constructed of resilient material and comprises an insertion portion 162 which is shaped somewhat like a sheet rolled into a cone-shaped funnel 164 with a generally axial slit 166. Funnel 164 is adapted to receive the insertion end of any seizing instrument, such as instrument 10 or 110, constructed and operative in accordance with a preferred embodiment of the present invention.
Guide 160 preferably further comprises a handle 168.
Reference is now made to Figs. 27A - 27D which illustrate the operation of the funnel guide 160. As seen in Fig. 27A, a user inserts the funnel guide 160 into the cervix. Since the funnel 164 tapers outwards from the cervix, a seizing instrument 170 is easily inserted through the funnel guide 160 into the cervix, as seen in Fig. 27B. Alternatively, seizing instrument 170 may be inserted together with funnel guide 160 into the cervix.
Once the instrument 170 is inserted in the cervix, the funnel guide 160 may be pulled outwards from the cervix. The slit 166 of the funnel 164 widens as the funnel 164 is pulled back somewhat transversely to the instrument 170, as seen in Fig. 27C. This allows the funnel guide 160 to slip off the instrument 170 and leaves the instrument 170 inside the cervix, as seen in Fig. 27D. Instrument 170 can then be used to seize the endocervix as described above for seizing instrument 10 or 110.
It will be appreciated by persons skilled in the art that the present invention is not limited to what has been particularly shown and described hereinabove. Rather, the scope of the present invention is defined only by the claims that follow:

Claims

1. An instrument for seizing walls of a body cavity comprising a first portion and a second portion, said second portion being insertable into said cavity and to be reversibly deformable from a first to a second configuration while inside said cavity, said first por¬ tion being operative to reversibly deform said second portion from said first to said second configuration, said second portion when in said second configuration being operative to seize said walls of said cavity.
2. An instrument according to claim 1 and wherein said first portion of said instrument comprises a first end of a pair of inner and outer tubes, said inner tube being disposed inside said outer tube and said outer tube being adapted to slide along said inner tube, and said second portion of said instrument comprises a second end of said pair of said inner and said outer tubes, said second end of said inner tube having a plurality of axial slits which define a plurality of axial deformable strips, said strips being deformed radially outwards when said outer tube is slid along said inner tube towards said first end of said inner tube.
3. An instrument according to claim 2 and wherein said strips are resilient and spring-like.
4. An instrument according to any of claims 1 - 3 and wherein each of said plurality of deformable strips is provided with a lip at an end thereof, wherein in said first configuration said lips do not protrude radially outwards of said outer tube.
5. An instrument according to claim 4 and wherein said lip is shaped to facilitate insertion into said body cavity.
6. An instrument according to claim 1 and wherein said first portion of said seizing instrument comprises a first end of a pair of inner and outer tubes, said inner tube being disposed inside said outer tube and said outer tube being adapted to slide along said inner tube, and said second portion of said instrument comprises a second end of said pair of said inner and said outer tubes, said second end of said outer tube having a plurality of axial slits which define a plurality of axial deformable strips, said strips being deformed radially outwards when said inner tube is slid along said outer tube towards said second end of said outer tube.
7. An instrument according to claim 6 and wherein each deformable strip comprises an inner shoulder, such that sliding said inner tube towards said second end of said outer tube causes said second end of said inner tube to butt and push against said shoulder, thereby causing said plurality of strips to deform radially outwards.
8. An instrument according to either of claims 6 and 7 and wherein said plurality of strips are shaped to facilitate insertion into said body cavity.
9. An instrument according to claim 8 and wherein said plurality of strips are substantially in contact with one another in said first configuration.
10. An instrument according to claim 8 and compris¬ ing a safety sleeve which covers at least a portion of said strips in said first configuration and which is retractable to expose said strips in said second configu¬ ration.
11. An instrument according to claim 8 and compris¬ ing a guiding device for guiding said seizing instrument through non-straight body cavities, said guiding device being attached to a distal end of said strips in said first configuration, and said guiding device substantial¬ ly preventing deformation of said plurality of strips radially outwards when in said first configuration, and wherein sliding of said inner tube towards said second end of said outer tube causes detachment of said guiding device from said strips, thereby permitting deformation of said plurality of strips radially outwards, and where¬ in further sliding of said inner tube towards said second end of said outer tube causes said plurality of strips to deform radially outwards.
12. An instrument according to claim 8 and wherein said plurality of strips are rupturably joined together in said first configuration.
13. An instrument according to claim 12 and wherein an outer surface of said strips is roughened.
14. An instrument according to any of claims 2 - 13 and wherein said first end of said inner tube is fitted with a first handle and said first end of said outer tube is fitted with a second handle, said first handle being reversibly attachable to said second handle.
15. An instrument according to any of claims 2 - 14 and further comprising a safety catch to prevent uninten¬ tional axial movement of said inner tube and said outer tube with respect to each other.
16. An instrument according to any of claims 2 - 15 and wherein said inner and said outer tubes are tapered.
17. An instrument according to any of claims 2 - 16 and wherein said inner and said outer tubes each have a radial aperture.
18. An instrument according to any of claims 2 - 17 and wherein said outer tube has an axial aperture.
19. An instrument according to any of claims 2 - 18 and wherein said inner and said outer tubes are each provided with a bend towards their second ends.
20. An instrument according to claim 19 and wherein said bends each have an aperture.
21. An instrument according to any of claims 2 - 20 and wherein said inner and said outer tubes each have an axial slit extending from their second ends towards their first ends, said axial slits being substantially aligned with each other.
22. An instrument according to claim 21 and com¬ prising a device for substantially preventing linear and rotational misalignment of said axial slits.
23. An instrument according to claim 21 and com¬ prising a device for substantially preventing linear and rotational misalignment of said first and said second tubes with respect to each other.
24. An instrument according to any of the previous claims and comprising a slitted funnel guide for guiding insertion of said instrument, comprising a resiliently openable, conical coiled funnel, being adapted to receive an insertable end of said instrument and being retract¬ able transversely from said instrument.
25. A method for seizing walls of a body cavity comprising the steps of: providing an instrument comprising a first portion and a second portion, said second portion being insertable into said cavity and to be reversibly deform¬ able from a first to a second configuration while inside said cavity, said first portion being operative to re¬ versibly deform said second portion from said first to said second configuration, and said second portion when in said second configuration being operative to seize said walls of said cavity; inserting said second portion of said instru¬ ment into said cavity; and deforming said second portion into said second configuration and seizing said walls of said cavity.
26. A method according to claim 25 and wherein the step of inserting further comprises the steps of: providing a slitted funnel guide comprising a resiliently openable, conical coiled funnel; inserting said funnel into said cavity; inserting said second portion of said instru¬ ment into said funnel; retracting said funnel outwards from said cavity; transversely pulling said funnel against said instrument, thereby causing said coiled funnel to split open and permitting removing said funnel from said in¬ strument, leaving said instrument inside said cavity.
27. A method according to claim 25 and wherein the step of inserting further comprises the steps of: providing a slitted funnel guide comprising a resiliently openable, conical coiled funnel; inserting said funnel and said second portion of said instrument into said cavity; retracting said funnel outwards from said cavity; transversely pulling said funnel against said instrument, thereby causing said coiled funnel to split open and permitting removing said funnel from said in¬ strument, leaving said instrument inside said cavity.
28. A method according to claim 25 and wherein the step of providing further comprises the step of: providing a guiding device for guiding said instrument through non-straight body cavities, said guiding device substantially preventing deformation of said second portion when in said first configuration and being removable so as to permit deformation of said second portion when in said second configuration; and wherein prior to the step of deforming, said guiding device is removed from said second portion to permit deformation of said second portion.
PCT/US1996/007863 1995-05-30 1996-05-29 Seizing instrument WO1996038197A1 (en)

Priority Applications (4)

Application Number Priority Date Filing Date Title
JP8536605A JPH11506028A (en) 1995-05-30 1996-05-29 Grabber
US08/952,895 US6027518A (en) 1995-05-30 1996-05-29 Seizing instrument
AU59380/96A AU5938096A (en) 1995-05-30 1996-05-29 Seizing instrument
EP96916711A EP0831953A4 (en) 1995-05-30 1996-05-29 Seizing instrument

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
IL11392295A IL113922A (en) 1995-05-30 1995-05-30 Seizing instrument
IL113922 1995-05-30

Publications (1)

Publication Number Publication Date
WO1996038197A1 true WO1996038197A1 (en) 1996-12-05

Family

ID=11067536

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1996/007863 WO1996038197A1 (en) 1995-05-30 1996-05-29 Seizing instrument

Country Status (6)

Country Link
EP (1) EP0831953A4 (en)
JP (1) JPH11506028A (en)
AU (1) AU5938096A (en)
CA (1) CA2222672A1 (en)
IL (1) IL113922A (en)
WO (1) WO1996038197A1 (en)

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WO2006101605A1 (en) * 2005-03-18 2006-09-28 Boston Scientific Scimed, Inc. Vacuum device for sealing an anatomical opening

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JP2002065845A (en) * 2000-09-04 2002-03-05 Shigenobu Takane Defacation device

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US6769161B2 (en) * 1997-10-16 2004-08-03 Scimed Life Systems, Inc. Radial stent crimper
WO2001021097A2 (en) * 1999-09-22 2001-03-29 Scimed Life Systems, Inc. Radial stent crimper
WO2001021097A3 (en) * 1999-09-22 2008-03-20 Scimed Life Systems Inc Radial stent crimper
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US8287552B2 (en) 2005-03-18 2012-10-16 Boston Scientific Scimed, Inc. Vacuum device for sealing an anatomical opening

Also Published As

Publication number Publication date
AU5938096A (en) 1996-12-18
IL113922A0 (en) 1995-08-31
CA2222672A1 (en) 1996-12-05
JPH11506028A (en) 1999-06-02
EP0831953A4 (en) 1999-12-01
EP0831953A1 (en) 1998-04-01
IL113922A (en) 1999-03-12

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