US20130217975A1 - Illuminated surgical access system including a surgical access device and integrated light emitter - Google Patents

Illuminated surgical access system including a surgical access device and integrated light emitter Download PDF

Info

Publication number
US20130217975A1
US20130217975A1 US13/855,496 US201313855496A US2013217975A1 US 20130217975 A1 US20130217975 A1 US 20130217975A1 US 201313855496 A US201313855496 A US 201313855496A US 2013217975 A1 US2013217975 A1 US 2013217975A1
Authority
US
United States
Prior art keywords
access device
light
surgical
light emitter
access
Prior art date
Legal status (The legal status 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 status listed.)
Abandoned
Application number
US13/855,496
Inventor
Sean Selover
Sara Dziedzic
Steve Connolly
Anita Barnick
Erin Dupak
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
DePuy Spine LLC
Original Assignee
DePuy Spine LLC
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 DePuy Spine LLC filed Critical DePuy Spine LLC
Priority to US13/855,496 priority Critical patent/US20130217975A1/en
Publication of US20130217975A1 publication Critical patent/US20130217975A1/en
Assigned to DEPUY SPINE, INC. reassignment DEPUY SPINE, INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: SELOVER, SEAN, BARNICK, ANITA, CONNOLLY, STEVE, DZIEDZIC, SARA, DUPAK, ERIN
Abandoned legal-status Critical Current

Links

Images

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/32Devices for opening or enlarging the visual field, e.g. of a tube of the body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00163Optical arrangements
    • A61B1/00165Optical arrangements with light-conductive means, e.g. fibre optics
    • A61B1/00167Details of optical fibre bundles, e.g. shape or fibre distribution
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/06Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/06Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements
    • A61B1/0607Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements for annular illumination
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/06Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements
    • A61B1/07Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements using light-conductive means, e.g. optical fibres
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/303Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the vagina, i.e. vaginoscopes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/313Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes
    • A61B1/3135Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes for examination of the epidural or the spinal space
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/0218Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for minimally invasive surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/0293Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors with ring member to support retractor elements
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3417Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421Cannulas
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, 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
    • A61B90/30Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3417Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421Cannulas
    • A61B17/3439Cannulas with means for changing the inner diameter of the cannula, e.g. expandable
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, 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
    • A61B90/30Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
    • A61B2090/306Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure using optical fibres
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, 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
    • A61B90/50Supports for surgical instruments, e.g. articulated arms

Definitions

  • the present invention relates to devices used in surgery. More particularly, the present invention relates to instrumentation and a method for the providing of access and illumination for surgical sites, implements and implants.
  • illumination of a working space may be required to facilitate use of surgical instruments.
  • access ports comprising generally tubular, open-ended structures, are often used to provide access to a surgical site.
  • the access ports may require illumination at the distal end thereof to facilitate the surgical procedure.
  • external light sources are used to provide illumination to access ports.
  • external light sources are unwieldy, and the link used to transmit the generated light to the access port can be cumbersome and block access by a surgeon to the port.
  • a surgeon may wear a head-mounted light in order to illuminate the working area at the base of an access port.
  • Head-mounted light sources may require the surgeon to constantly direct the light with his or her head at an optimal angle, into the access port in order to view the working area.
  • the light source is distant from the surgical site, increasing the likelihood of creating shadows and potentially obstructing the ability of the light to reach the working area when using surgical instruments inside the port.
  • fiber optic cables, attached to the light can encumber the surgeon and tether him or her to a light source.
  • the present invention provides an illuminated surgical access system including a light emitter coupled to a surgical access device.
  • the surgical access device defines a path or port to a surgical site and the light emitter emits and directs light into the path to illuminate a surgical site accessed by the surgical access device.
  • the light emitter is integrated into the distal end of the access device to provide illumination of the working site and provides circumferential light about an interior path via the side walls of the surgical access device.
  • the light emitter is offset from the very distal tip of the access device to prevent tissue or other biological matter from blocking the transmission of light.
  • the integrated light emitter may be comprised of a light transmission medium integrated into the sidewall which transfers light provided at the proximal end of the port to the surgical site. The integrated light emitter does not reduce the working area of the access device or hinder the surgeon, while providing superior illumination of a surgical site.
  • an illuminated surgical access system for creating access to a patient's bony anatomy during surgery.
  • the illuminated surgical access system includes a surgical access device including at least one sidewall and defines an interior path therethrough forming a port for accessing the patient, and a light emitter integrated into the sidewall in proximity to a distal end of the access device to illuminate a surgical site accessed by the surgical access device.
  • a method of accessing a surgical site in a patient comprises the steps of creating an incision in the patient, inserting a surgical access device into the incision in the patient.
  • the surgical access device comprises at least one sidewall and defines an interior path therethrough forming a port for accessing the patient; and a light emitter integrated into the sidewall in proximity to a distal end of the access device to illuminate a surgical site accessed by the surgical access device.
  • the surgical site may then be illuminated using the surgical access device.
  • an illuminated surgical access system for creating access to a surgical site of a patient during surgery.
  • the illuminated surgical access system including a retractor comprising one or more blades defining an interior path therethrough forming a path for accessing the surgical site, and an integrated light emitter in proximity to a distal end of the one or more blades of the retractor to illuminate a surgical site accessed by the retractor.
  • a method of accessing a surgical site in a patient includes the steps of creating an incision in the patient and inserting a retractor into the incision in the patient.
  • the surgical access device includes one or more blades defining an interior path therethrough forming a port for accessing the patient, and an integrated light emitter in proximity to a distal end of the one or more blades of the retractor to illuminate a surgical site accessed by the retractor. The surgical site may then be illuminated using the retractor.
  • FIG. 1A-1B illustrate an illuminated surgical access system including a light emitter coupled to a proximal end of an access device according to an embodiment of the invention.
  • FIGS. 2A-2C illustrate an illuminated surgical access system including a light emitter comprising a light transmission medium according to one embodiment of the invention.
  • FIG. 3 is flow diagram of one exemplary embodiment of a method or preparing a surgical site using the illuminated surgical access system of the present invention.
  • FIG. 4 illustrates one technique for inserting an access device according to the method of FIG. 3 .
  • FIGS. 5A-5B illustrate an embodiment of an access device for an illuminated surgical access system wherein the access device is a retractor having one or more blades incorporating a light emitter.
  • FIGS. 6A-6B illustrate another embodiment of an access device for an illuminated surgical access system wherein the access device is a retractor having one or more telescoping and rotatable blades incorporating a light emitter.
  • FIG. 7 is flow diagram of one exemplary embodiment of a method or preparing a surgical site using the illuminated surgical access system of the present invention.
  • the present invention provides an improved surgical access system for accessing a surgical site.
  • the surgical access system includes an integrated light emitter for illuminating the surgical site.
  • the present invention will be described below relative to certain illustrative embodiments. Those skilled in the art will appreciate that the present invention may be implemented in a number of different applications and embodiments and is not specifically limited in its application to the particular embodiments depicted herein.
  • the illuminated surgical access system of the illustrative embodiment of the invention may be used in spinal surgery, for example, during a discectomy or microdiscectomy procedure to remove damaged disc material from the spine.
  • spinal surgery for example, during a discectomy or microdiscectomy procedure to remove damaged disc material from the spine.
  • the invention can be used with other surgical instruments in other surgical procedures that require illumination.
  • surgical procedures suitable for employing the illuminated surgical access system of the present invention include, but are not limited to, insertion of interbody fusion devices, bone anchors, fixation devices, including rods, plates and cables, artificial disks, hip stems, artificial ligaments, trochars for gastro-intestinal work, or any procedure requiring access to a patient and visualization.
  • the surgical access system may be part of any suitable implant instrument used to provide access to a particular area of a patient's body where visualization is also needed.
  • the surgical access system can be used to position any suitable implant, instrument and/or other device in any suitable procedure where guidance of the implant, instrument and/or device is used.
  • the surgical access system may be used to dilate a surgical incision using a set of progressively larger cannulas or an expanding cannula to provide access to a surgical site.
  • An illustrative embodiment of the present invention provides lighted, minimally invasive access to a surgical site via a low profile port that used integrated light transmission and emission technology.
  • the invention facilitates access to a surgical site without decreasing a working space in the port or requiring extra equipment to be worn by the surgeon.
  • FIGS. 1A and 1B illustrate different perspective views of an illuminated surgical access system of an illustrative embodiment of the invention for providing both access and illumination of a surgical site during performance of a surgical procedure.
  • the illustrative illuminated surgical access system 110 includes a port, illustrated as an access device 120 comprising a substantially hollow tubular body, for accessing a surgical site, and a light emitter 130 integrated into the sidewall 124 in proximity to a distal end 123 of the surgical access device 120 for illuminating an a surgical site.
  • the illustrative access device 120 may be a standard access port, in the shape of a cannula comprising a hollow tubular body suitable for insertion in and/or placement adjacent to a patient's body.
  • the illustrative access device 120 has at least one hollow channel or lumen defining an interior path 122 extending from an open proximal end 121 of the access device to an open distal end 123 of the access device.
  • the path 122 may form a working channel or at least a portion of a working channel for accessing a surgical site adjacent to or in the vicinity of the distal end 123 of the tubular body.
  • the body of the access device 120 includes open proximal end 121 that forms a proximal port 125 of the interior path 122 , and the open distal end 123 forms a distal port 127 of the interior path 122 for allowing access to the surgical site.
  • the access device 120 may have any suitable configuration and size for providing access to an area of a body.
  • the illustrative access device may be used for retaining soft tissue away from a surgical site and/or guiding a surgical instrument, device and/or implant, though one skilled in the art will recognize that the access device may comprise any suitable device defining a path or channel requiring illumination.
  • the tubular body of the illustrative access device 110 is formed by a cylindrical sidewall 124 preferably having smooth inner and outer surfaces, though one skilled in the art will recognize that the tubular body can have any size, shape, configuration and number of sidewalls.
  • the access device can be any suitable device defining a port for providing access to a surgical site.
  • the access device can have any suitable cross-section and is not limited to the cylindrical cross-section shown in the illustrative embodiments.
  • the access device can be open or closed to define an open or closed path therethrough.
  • the surgical access device 120 can be formed of any suitable surgical material, such as, but not limited to, plastic, surgical stainless steel and other materials known in the art.
  • a suitable material is opaque PEEK or other opaque plastics, though other materials may also be used.
  • the surgical access device may also be made of a combination of suitable materials such as opaque PEEK and Surgical Stainless Steel.
  • the tubular body of the illustrative access device can be rigid, semi-rigid or flexible, and can have any suitable size, shape and configuration suitable for defining a working channel and/or access to a surgical site.
  • the tubular body is straight to define a straight channel therethrough, though one skilled in the art will recognize that the tubular body may define a shaped trajectory therethrough.
  • the tubular body is not limited to a tubular structure having closed sidewalls and can be any component that defines a path, including an open channel or a solid member.
  • the access device may also means 132 for attaching the access device 120 to an arm for securing the position of the access device 120 .
  • the path through the access device may also or alternatively form a working channel configured to receive selected surgical instruments, such as awls, bone taps, obturators, drills, guide wires, and/or implants, such as screws, fusion devices, artificial disks and hip stems, along the longitudinal axis thereof.
  • selected surgical instruments such as awls, bone taps, obturators, drills, guide wires, and/or implants, such as screws, fusion devices, artificial disks and hip stems, along the longitudinal axis thereof.
  • the illuminated access device 110 may be configured to guide instruments along the working channel.
  • the inner diameter of the tubular body may be slightly larger than the outer diameter of the instrument guided by the tubular body, so that the instrument can be inserted through the tubular body while the sidewalls of the tubular body maintain the instrument at a predetermined angle relative to the patient.
  • an instrument to be guided by the tubular body can be configured to slide over the tubular body, with the tubular body maintaining the orientation of the instrument as the instrument slides relative to the tubular body.
  • the tubular body can have an outer diameter that is slightly less than an inner diameter of an instrument.
  • the access device 110 need not form a trajectory or guide for instruments and can be any device suitable for providing access to a surgical site.
  • the proximal end 121 forming the proximal port 125 may be configured to minimize reflection of overhead light so as to reduce glare for the surgeon using the access device 110 .
  • the lip 128 of the proximal port 125 is chamfered to prevent overhead light from reflecting back into the surgeons eyes.
  • the surface of the proximal end may be treated to make the surface non-reflective.
  • the surface may be etched, coated with a non-reflective coating, or otherwise surfaced to reduce reflection. It will be understood that these are but some of the possible configurations and other implementation or combinations of the above are possible.
  • the light emitter 130 is integrated into the side wall 124 at the distal end 123 of the access device 120 .
  • the light emitter 130 emits circumferential light into the interior of the access device 120 directly inside and about the inner circumference of the distal end 123 , or about at least a substantial portion of the inner circumference.
  • the light emitter 130 may distribute light about perimeter of the side wall and may or may not distribute light where the side wall of the access device is open.
  • the inner circumference refers to the inner edge of the arc and is not required to be a full circle or loop.
  • the light emitted into the tube interior is directed through path 122 , out distal port 127 and into a working space adjacent to the distal port 127 .
  • the integrated light emitter 130 in the surgical access system of the illustrative embodiment of the invention can comprise any suitable means for producing light that may be directly integrated with the tubular body of an access device.
  • the integrated light emitter easily integrates illumination into a surgical access device, without requiring cumbersome cables, while allowing direction of light to an ideal location.
  • the integrated light emitter does not compromise or reduce the working area, as it is incorporates into the sidewall of the surgical access device and keeps the interior of the surgical access device clear.
  • the integrated light source provides superior illumination by providing even, circumferential light distributed about the periphery of a surgical access device, preferably in the interior of the surgical access device.
  • the light emitter 130 is offset or recessed from the distal tip 126 of the access device 120 .
  • the distal end 123 of the access device 120 is inserted into a patient and the side wall 124 is used to hold tissue away from the surgical site providing access for a surgeon. Since the distal end 123 is placed as the location for which access is desired, the distal tip 126 of the access device 120 may be in direct contact with tissue which may cover or other wise block illumination of a light emitter 130 located on the distal tip 126 .
  • Offsetting the light emitter 130 reduces the likelihood of tissue or other biological matter of blocking the transmission of light or otherwise interfering with the illumination.
  • the offset H is between approximately 1 and approximately 30, more preferably between approximately 10 and approximately 20 mm, and in one exemplary embodiment is approximately 15 mm. Other possible configurations will be apparent to one skilled in the art give the benefit of this disclosure.
  • the light emitter 130 may be configured to focus light at a particular point in the distal port 127 . In other embodiments, the light emitter 130 may be configured to provide defuse ambient light across the surgical site. Other possible implementations and configurations will be apparent to one skilled in the art given the benefit of this disclosure.
  • the light emitter 130 comprises a light transmission medium 230 for transmitting light, received for example via a coupler 135 , from the proximal end 121 of the access device 120 to the distal end 123 of the device.
  • the light transmission medium 230 is fiber optic cabling.
  • the light transmission medium 230 in this case fiber optics, is disposed between and inner surface 224 a and an outer surface 224 b of the side wall 124 of the access device 120 .
  • Disposing the transmission medium 230 between an inner 224 a and outer 224 b surface of the sidewall provides protection for the transmission medium.
  • a close-up of a cross-section of the access device depicting this can be seen in FIG. 2B .
  • the inner 224 a and outer 224 b surfaces may be made of different materials.
  • the outer surface 224 b may be made of metal for durability while the inner layer 224 a may be made of a non-conductive or non-reactive material such as a polymer.
  • the distal end 226 may be made of a different material. For example, since the distal end 226 is in contact with the surgical site it may be beneficial to have the distal end 226 made of a softer or non-reactive material.
  • the distal end is constructed from PEEK and or other suitable polymers.
  • the inner and outer surfaces 224 a and 224 b are constructed of surgical stainless steel or other suitable metals.
  • the distal end 226 of the exemplary embodiment can be manufactured separate from the inner and outer surfaces 224 a , 224 b and can be connected to the inner and outer surfaces 224 a , 224 b by for example, a snap fit, threads, bonding, or other conventional connection mechanisms.
  • FIG. 2C provides a view of the access device 120 showing the distribution of the transmission medium 230 , in this case fiber optics, around the periphery of the sidewall 124 so as to provide a circumferential light source 130 offset from the distal end 226 .
  • the transmission medium 230 is terminated within the inner path 122 so as provide a light emitter 130 at the distal end 123 of the access device.
  • the light emitter 130 may provide focused or defused. It should be understood that other transmission mediums and configurations are possible and will be apparent to one skilled in the art given the benefit of this disclosure.
  • the light transmission is configured at the proximal end 121 of the access device for receiving a light transferring cable (not shown) coupled to a light source (not shown).
  • a light transferring cable (not shown) coupled to a light source (not shown).
  • the fiber optics are bundled together 235 in a coupler 135 for connecting to a light source via a light transferring cable.
  • an external light source may be used to provide light to the coupler 135 of the access device which is transmitted from the proximal end 121 to the distal end 123 via the transmission medium.
  • the light source may be any suitable device for producing light, including, but not limited to, halogen light boxes, incandescent light boxes and other light sources readily available in most hospital settings, such as those available from Welch Allyn Medical Products of Skaneateles Falls, N.Y.
  • the light source may have any suitable power level.
  • the light source is a 300 Watt Halogen Light Box. Any other suitable light source capable of producing light that is transmitted to the light emitter 130 via the light transferring cable, which may be fiber optic cables or any other suitable light transmitter, may also be used.
  • the light emitter 130 emits white light. It will be understood that in some implementations it may be beneficial to provide other types of light.
  • the light emitter 130 may emit infrared (IR) light or ultraviolet (UV) light which may used to illuminate IR or UV markers or cure IR or UV reactive epoxies or adhesives.
  • IR infrared
  • UV ultraviolet
  • Other possible implementations or applications will be apparent to one skilled in the art given the benefit of this disclosure.
  • FIG. 3 depicts a flow chart 300 of an exemplary embodiment of a method of preparing a surgical site using the present invention.
  • the first step involves creating an incision in the patient (step 310 ). Once and incision has been created an access device of the present invention may be inserted into the incision (step 320 ). The surgical site may then be illuminated using the access device (step 330 ). These steps are discussed in more detail below.
  • the method includes making a first incision in the epidermis of the patient and then expanding the incision into a portion of the subdermal tissue to create a pathway in any conventional manner.
  • the incision can be expanded by dilation to the desired shape, and orientation by using a plurality of dilators. Once the incision has been expanded to the desire size, shape, and orientation the retractor may be inserted.
  • serial dilation is used to prepare the incision for the insertion of the access device 120 .
  • a series of dilators 405 a , 405 b may be inserted into the patient through the incision (not shown).
  • the access device 120 may then be inserted into the patient over the dilators 405 a , 405 b .
  • the dilatators 405 a , 405 b passing though the access device 120 serve as a guide for the insertion of the access device 120 .
  • the surgical site may then be illuminated. In some embodiments this may involve connecting the access device to an external light source 152 via a light transferring cable 150 and transmitting light from the external source 152 from the light emitter 130 incorporated into the sidewall as depicted in FIGS. 1 and 2 .
  • the access device 510 may be a retractor 520 as shown in FIG. 5A .
  • the retractor 520 comprises one or more adjustable blades 520 defining an interior path 522 therethrough forming a port for accessing the surgical site; and a light emitter 530 integrated into a distal end of the one or more adjustable blades 520 of the retractor to illuminate a surgical site accessed by the retractor.
  • the retractor 520 of FIG. 5A has an interior path 522 extending from an open proximal end 521 of the retractor 520 to an open distal end 523 of the retractor 520 .
  • the path 522 may form a working channel or at least a portion of a working channel for accessing a surgical site adjacent to or in the vicinity of the distal end 523 of the tubular body.
  • the body of the retractor 520 includes open proximal end 521 that forms a proximal port 525 of the interior path 522 , and the open distal end 523 forms a distal port 527 of the interior path 522 for allowing access to the surgical site.
  • the retractor 520 may have any suitable configuration and size for providing access to an area of a body.
  • the light emitter 530 is integrated into the blade 524 at the distal end 523 of the retractor 520 .
  • the light emitter 530 emits light into the interior of the retractor 520 directly inside and about the inner circumference of the distal end 523 , or about at least a substantial portion of the inner circumference.
  • the light emitted into the interior is directed through path 522 , out distal port 527 and into a working space adjacent to the distal port 527 .
  • the light emitter 530 is offset or recessed from the distal tip 526 of the retractor 520 .
  • the distal end 523 of the retractor 520 is inserted into a patient and the blades 524 are used to hold tissue away from the surgical site providing access for a surgeon. Since the distal end 523 is placed as the location for which access is desired, the distal tip 526 of the access device 520 may be in direct contact with tissue which may cover or other wise block illumination of a light emitter 530 located on the distal tip 526 .
  • Offsetting the light emitter 530 reduces the likelihood of tissue or other biological matter of blocking the transmission of light or otherwise interfering with the illumination.
  • the offset is between approximately 1 and approximately 30 mm, more preferably between approximately 10 and approximately 20 mm, and in one exemplary embodiment is approximately 15 mm. Other possible configurations will be apparent to one skilled in the art give the benefit of this disclosure.
  • FIG. 5B depict one embodiment of a blade 524 of the retractor 520 .
  • the blade 524 comprises an inner surface 524 a and an outer surface 524 b having a transmission medium 532 , such as fiber optic cabling, providing a light transmission path.
  • the transmission medium 532 further comprises connection 535 at the proximal end 521 for connecting the blade to an external light source such as shown in FIG. 1 .
  • the light transition medium 532 terminates at the distal end 523 in a light emitter 530 .
  • the light emitter 530 can be seen to be offset from the distal tip 526 of the blade 524 .
  • FIG. 6A depicts another embodiment of a retractor 620 wherein the adjustable blades 624 are telescoping and can rotate about an access.
  • the retractor 620 of FIG. 6A has an interior path 622 extending from an open proximal end 621 of the retractor 620 to an open distal end 623 of the retractor 620 .
  • the path 622 may form a working channel or at least a portion of a working channel for accessing a surgical site adjacent to or in the vicinity of the distal end 623 of the tubular body.
  • the adjustable blades 624 of the retractor have been rotated outward, or “toed-in”, as the adjustable blades 624 might be deployed in a patient to create a larger work area.
  • the adjustable blades in the present example are telescoping such that the distal end 626 of the adjustable blades 624 may be extended or retracted allowing for adjustable blade depth.
  • the retractor 620 may have any suitable configuration and size for providing access to an area of a body.
  • the light emitter 630 is integrated into the blade 624 at the distal end 623 of the retractor 620 .
  • the light emitter 630 emits light into the interior of the retractor 620 directly inside and about the inner circumference of the distal end 623 , or about at least a substantial portion of the inner circumference into a working space defined by the retractor blades 624 .
  • the light emitter 630 is offset or recessed from the distal tip 626 of a retractor blade 624 .
  • the distal end 623 of the retractor 620 is inserted into a patient and the blades 624 are used to hold tissue away from the surgical site providing access for a surgeon. Since the distal end 623 is placed as the location for which access is desired, the distal tip 626 of the access device 620 may be in direct contact with tissue which may cover or other wise block illumination of a light emitter 630 located on the distal tip 626 .
  • Offsetting the light emitter 630 reduces the likelihood of tissue or other biological matter of blocking the transmission of light or otherwise interfering with the illumination.
  • the offset is between approximately land approximately 30 mm, more preferably between approximately 10 and approximately 20 mm, and in one exemplary embodiment is approximately 15 mm. Other possible configurations will be apparent to one skilled in the art give the benefit of this disclosure.
  • FIG. 6B depict one embodiment of a telescoping blade 624 of the retractor 620 .
  • the blade 624 comprises an inner surface 624 a and an outer surface 624 b having a transmission medium 632 , such as fiber optic cabling, providing a light transmission path.
  • the transmission medium 632 further comprises a connection such as coupler 635 at the proximal end 621 for connecting the blade 624 to an external light source.
  • the light transition medium 632 terminates at the distal end 623 in a light emitter 630 .
  • the light emitter 630 can be seen to be offset from the distal tip 626 of the blade 624 .
  • the exemplary blade 624 of FIG. 6B further includes configurations 640 for engaging surface configuration 642 on the retractor assembly 620 allowing the blade 624 to adjustably telescope when attached to the retractor assembly 620 .
  • the transmission medium 630 is terminated so as provide a light emitter 130 at the distal end 123 of the access device.
  • the light emitter 130 may provide focused or defused light. It should be understood that other transmission mediums and configurations are possible and will be apparent to one skilled in the art given the benefit of this disclosure.
  • FIGS. 5A , 5 B, 6 A, and 6 B are but some examples of any number of possible configurations for a retractor. Other possible configurations incorporating integrated light emitters will be apparent to one skilled in the art, given the benefit of this disclosure.
  • FIG. 7 depicts a flow chart 700 of an exemplary embodiment of a method of preparing a surgical site using the present invention.
  • the method involves the steps of creating and incision in the patient 710 , inserting a retractor of the present invention into the incision 720 , and illuminating the surgical site with the retractor 730 .
  • retractor The techniques for incision and serial dilation discussed above in regard to using and access device apply equally as well to the use of a retractor.
  • the advantage of retractor is that after insertion, the retractor can be used to further dilate the incision and retract the tissue providing greater access to the surgical site.

Abstract

A surgical access system for providing access to a surgical site in a patient includes a surgical access device defining a working channel for accessing a surgical site and an integrated light emitter for illuminating the surgical site. The light emitter is integrated in proximity to a distal end of the surgical access device. In some embodiments, the light emitter is offset from the distal end. In certain embodiments, the integrated light emitter includes a light transmission medium for transmitting light from a proximal end of the access device to the distal end.

Description

    FIELD OF THE INVENTION
  • The present invention relates to devices used in surgery. More particularly, the present invention relates to instrumentation and a method for the providing of access and illumination for surgical sites, implements and implants.
  • BACKGROUND OF THE INVENTION
  • In minimally invasive surgical procedures, illumination of a working space may be required to facilitate use of surgical instruments. For example, in spinal surgery, access ports, comprising generally tubular, open-ended structures, are often used to provide access to a surgical site. The access ports may require illumination at the distal end thereof to facilitate the surgical procedure.
  • Achieving proper illumination of a surgical site during minimally invasive surgery can be difficult. In the current state of the art, external light sources are used to provide illumination to access ports. However, external light sources are unwieldy, and the link used to transmit the generated light to the access port can be cumbersome and block access by a surgeon to the port. For example, a surgeon may wear a head-mounted light in order to illuminate the working area at the base of an access port. Head-mounted light sources may require the surgeon to constantly direct the light with his or her head at an optimal angle, into the access port in order to view the working area. Also the light source is distant from the surgical site, increasing the likelihood of creating shadows and potentially obstructing the ability of the light to reach the working area when using surgical instruments inside the port. In addition, fiber optic cables, attached to the light, can encumber the surgeon and tether him or her to a light source.
  • Another option currently used by surgeons involves lights mounted on an overhead microscope. Though offering an un-tethered light source that can be positioned accurately above the port, one main limitation still exists in that the light source is still distant from the surgical site. Again this increases the likelihood of creating shadows and potentially obstructing the ability of the light to reach the working area.
  • Other alternatives for lighting a surgical site attach light sources into the interior of an access port to illuminate the work space. However, the use of a light source within the access port can reduce the available working area in the port and may hinder the use of instruments that enter and exit the port during surgery.
  • SUMMARY OF THE INVENTION
  • The present invention provides an illuminated surgical access system including a light emitter coupled to a surgical access device. The surgical access device defines a path or port to a surgical site and the light emitter emits and directs light into the path to illuminate a surgical site accessed by the surgical access device. The light emitter is integrated into the distal end of the access device to provide illumination of the working site and provides circumferential light about an interior path via the side walls of the surgical access device. Preferably the light emitter is offset from the very distal tip of the access device to prevent tissue or other biological matter from blocking the transmission of light. The integrated light emitter may be comprised of a light transmission medium integrated into the sidewall which transfers light provided at the proximal end of the port to the surgical site. The integrated light emitter does not reduce the working area of the access device or hinder the surgeon, while providing superior illumination of a surgical site.
  • According to a first aspect of the invention, an illuminated surgical access system is provided for creating access to a patient's bony anatomy during surgery. The illuminated surgical access system includes a surgical access device including at least one sidewall and defines an interior path therethrough forming a port for accessing the patient, and a light emitter integrated into the sidewall in proximity to a distal end of the access device to illuminate a surgical site accessed by the surgical access device.
  • According to another aspect of the invention, a method of accessing a surgical site in a patient is provided. The method comprises the steps of creating an incision in the patient, inserting a surgical access device into the incision in the patient. The surgical access device comprises at least one sidewall and defines an interior path therethrough forming a port for accessing the patient; and a light emitter integrated into the sidewall in proximity to a distal end of the access device to illuminate a surgical site accessed by the surgical access device. The surgical site may then be illuminated using the surgical access device.
  • According to another aspect of the invention, an illuminated surgical access system is provided for creating access to a surgical site of a patient during surgery. The illuminated surgical access system including a retractor comprising one or more blades defining an interior path therethrough forming a path for accessing the surgical site, and an integrated light emitter in proximity to a distal end of the one or more blades of the retractor to illuminate a surgical site accessed by the retractor.
  • According to another aspect of the invention, a method of accessing a surgical site in a patient is provided. The method includes the steps of creating an incision in the patient and inserting a retractor into the incision in the patient. The surgical access device includes one or more blades defining an interior path therethrough forming a port for accessing the patient, and an integrated light emitter in proximity to a distal end of the one or more blades of the retractor to illuminate a surgical site accessed by the retractor. The surgical site may then be illuminated using the retractor.
  • BRIEF DESCRIPTION OF THE FIGURES
  • These and other features and advantages of the present invention will be more fully understood by reference to the following detailed description in conjunction with the attached drawings in which like reference numerals refer to like elements through the different views. The drawings illustrate principles of the invention and, although not to scale, show relative dimensions.
  • FIG. 1A-1B illustrate an illuminated surgical access system including a light emitter coupled to a proximal end of an access device according to an embodiment of the invention.
  • FIGS. 2A-2C illustrate an illuminated surgical access system including a light emitter comprising a light transmission medium according to one embodiment of the invention.
  • FIG. 3 is flow diagram of one exemplary embodiment of a method or preparing a surgical site using the illuminated surgical access system of the present invention.
  • FIG. 4 illustrates one technique for inserting an access device according to the method of FIG. 3.
  • FIGS. 5A-5B illustrate an embodiment of an access device for an illuminated surgical access system wherein the access device is a retractor having one or more blades incorporating a light emitter.
  • FIGS. 6A-6B illustrate another embodiment of an access device for an illuminated surgical access system wherein the access device is a retractor having one or more telescoping and rotatable blades incorporating a light emitter.
  • FIG. 7 is flow diagram of one exemplary embodiment of a method or preparing a surgical site using the illuminated surgical access system of the present invention.
  • DETAILED DESCRIPTION OF THE INVENTION
  • The present invention provides an improved surgical access system for accessing a surgical site. The surgical access system includes an integrated light emitter for illuminating the surgical site. The present invention will be described below relative to certain illustrative embodiments. Those skilled in the art will appreciate that the present invention may be implemented in a number of different applications and embodiments and is not specifically limited in its application to the particular embodiments depicted herein.
  • The illuminated surgical access system of the illustrative embodiment of the invention may be used in spinal surgery, for example, during a discectomy or microdiscectomy procedure to remove damaged disc material from the spine. One skilled in the art will recognize that the invention can be used with other surgical instruments in other surgical procedures that require illumination. Examples of surgical procedures suitable for employing the illuminated surgical access system of the present invention include, but are not limited to, insertion of interbody fusion devices, bone anchors, fixation devices, including rods, plates and cables, artificial disks, hip stems, artificial ligaments, trochars for gastro-intestinal work, or any procedure requiring access to a patient and visualization. The surgical access system may be part of any suitable implant instrument used to provide access to a particular area of a patient's body where visualization is also needed. The surgical access system can be used to position any suitable implant, instrument and/or other device in any suitable procedure where guidance of the implant, instrument and/or device is used. Alternatively, or in addition to providing guidance, the surgical access system may be used to dilate a surgical incision using a set of progressively larger cannulas or an expanding cannula to provide access to a surgical site.
  • An illustrative embodiment of the present invention provides lighted, minimally invasive access to a surgical site via a low profile port that used integrated light transmission and emission technology. The invention facilitates access to a surgical site without decreasing a working space in the port or requiring extra equipment to be worn by the surgeon.
  • FIGS. 1A and 1B illustrate different perspective views of an illuminated surgical access system of an illustrative embodiment of the invention for providing both access and illumination of a surgical site during performance of a surgical procedure. The illustrative illuminated surgical access system 110 includes a port, illustrated as an access device 120 comprising a substantially hollow tubular body, for accessing a surgical site, and a light emitter 130 integrated into the sidewall 124 in proximity to a distal end 123 of the surgical access device 120 for illuminating an a surgical site.
  • The illustrative access device 120 may be a standard access port, in the shape of a cannula comprising a hollow tubular body suitable for insertion in and/or placement adjacent to a patient's body. The illustrative access device 120 has at least one hollow channel or lumen defining an interior path 122 extending from an open proximal end 121 of the access device to an open distal end 123 of the access device. The path 122 may form a working channel or at least a portion of a working channel for accessing a surgical site adjacent to or in the vicinity of the distal end 123 of the tubular body. In the illustrative embodiment, the body of the access device 120 includes open proximal end 121 that forms a proximal port 125 of the interior path 122, and the open distal end 123 forms a distal port 127 of the interior path 122 for allowing access to the surgical site. One skilled in the art will recognize that the access device 120 may have any suitable configuration and size for providing access to an area of a body. The illustrative access device may be used for retaining soft tissue away from a surgical site and/or guiding a surgical instrument, device and/or implant, though one skilled in the art will recognize that the access device may comprise any suitable device defining a path or channel requiring illumination.
  • As shown, the tubular body of the illustrative access device 110 is formed by a cylindrical sidewall 124 preferably having smooth inner and outer surfaces, though one skilled in the art will recognize that the tubular body can have any size, shape, configuration and number of sidewalls. The access device can be any suitable device defining a port for providing access to a surgical site. The access device can have any suitable cross-section and is not limited to the cylindrical cross-section shown in the illustrative embodiments. The access device can be open or closed to define an open or closed path therethrough.
  • The surgical access device 120 can be formed of any suitable surgical material, such as, but not limited to, plastic, surgical stainless steel and other materials known in the art. An example of a suitable material is opaque PEEK or other opaque plastics, though other materials may also be used. The surgical access device may also be made of a combination of suitable materials such as opaque PEEK and Surgical Stainless Steel.
  • The tubular body of the illustrative access device can be rigid, semi-rigid or flexible, and can have any suitable size, shape and configuration suitable for defining a working channel and/or access to a surgical site. In the illustrative embodiment, the tubular body is straight to define a straight channel therethrough, though one skilled in the art will recognize that the tubular body may define a shaped trajectory therethrough. The tubular body is not limited to a tubular structure having closed sidewalls and can be any component that defines a path, including an open channel or a solid member. In some embodiments, the access device may also means 132 for attaching the access device 120 to an arm for securing the position of the access device 120.
  • The path through the access device may also or alternatively form a working channel configured to receive selected surgical instruments, such as awls, bone taps, obturators, drills, guide wires, and/or implants, such as screws, fusion devices, artificial disks and hip stems, along the longitudinal axis thereof.
  • In one embodiment, the illuminated access device 110 may be configured to guide instruments along the working channel. In such an embodiment, the inner diameter of the tubular body may be slightly larger than the outer diameter of the instrument guided by the tubular body, so that the instrument can be inserted through the tubular body while the sidewalls of the tubular body maintain the instrument at a predetermined angle relative to the patient. Alternatively, an instrument to be guided by the tubular body can be configured to slide over the tubular body, with the tubular body maintaining the orientation of the instrument as the instrument slides relative to the tubular body. In this embodiment, the tubular body can have an outer diameter that is slightly less than an inner diameter of an instrument. However, the access device 110 need not form a trajectory or guide for instruments and can be any device suitable for providing access to a surgical site.
  • In certain embodiments, the proximal end 121 forming the proximal port 125 may be configured to minimize reflection of overhead light so as to reduce glare for the surgeon using the access device 110. In one example, as seen in FIG. 1A, the lip 128 of the proximal port 125 is chamfered to prevent overhead light from reflecting back into the surgeons eyes. In another embodiment, the surface of the proximal end may be treated to make the surface non-reflective. For example, the surface may be etched, coated with a non-reflective coating, or otherwise surfaced to reduce reflection. It will be understood that these are but some of the possible configurations and other implementation or combinations of the above are possible.
  • The light emitter 130 is integrated into the side wall 124 at the distal end 123 of the access device 120. Preferably, the light emitter 130 emits circumferential light into the interior of the access device 120 directly inside and about the inner circumference of the distal end 123, or about at least a substantial portion of the inner circumference. For example, for an access device that has an open side, the light emitter 130 may distribute light about perimeter of the side wall and may or may not distribute light where the side wall of the access device is open. Similarly, for an arc-shaped access device, the inner circumference refers to the inner edge of the arc and is not required to be a full circle or loop. The light emitted into the tube interior is directed through path 122, out distal port 127 and into a working space adjacent to the distal port 127.
  • The integrated light emitter 130 in the surgical access system of the illustrative embodiment of the invention can comprise any suitable means for producing light that may be directly integrated with the tubular body of an access device. The integrated light emitter easily integrates illumination into a surgical access device, without requiring cumbersome cables, while allowing direction of light to an ideal location. The integrated light emitter does not compromise or reduce the working area, as it is incorporates into the sidewall of the surgical access device and keeps the interior of the surgical access device clear. The integrated light source provides superior illumination by providing even, circumferential light distributed about the periphery of a surgical access device, preferably in the interior of the surgical access device.
  • Preferably the light emitter 130 is offset or recessed from the distal tip 126 of the access device 120. The distal end 123 of the access device 120 is inserted into a patient and the side wall 124 is used to hold tissue away from the surgical site providing access for a surgeon. Since the distal end 123 is placed as the location for which access is desired, the distal tip 126 of the access device 120 may be in direct contact with tissue which may cover or other wise block illumination of a light emitter 130 located on the distal tip 126. Offsetting the light emitter 130 reduces the likelihood of tissue or other biological matter of blocking the transmission of light or otherwise interfering with the illumination. The offset H is between approximately 1 and approximately 30, more preferably between approximately 10 and approximately 20 mm, and in one exemplary embodiment is approximately 15 mm. Other possible configurations will be apparent to one skilled in the art give the benefit of this disclosure.
  • In some embodiments the light emitter 130 may be configured to focus light at a particular point in the distal port 127. In other embodiments, the light emitter 130 may be configured to provide defuse ambient light across the surgical site. Other possible implementations and configurations will be apparent to one skilled in the art given the benefit of this disclosure.
  • In certain embodiments, the light emitter 130 comprises a light transmission medium 230 for transmitting light, received for example via a coupler 135, from the proximal end 121 of the access device 120 to the distal end 123 of the device. In one example, as shown in FIG. 2A, the light transmission medium 230 is fiber optic cabling. In this embodiment, the light transmission medium 230, in this case fiber optics, is disposed between and inner surface 224 a and an outer surface 224 b of the side wall 124 of the access device 120.
  • Disposing the transmission medium 230 between an inner 224 a and outer 224 b surface of the sidewall provides protection for the transmission medium. A close-up of a cross-section of the access device depicting this can be seen in FIG. 2B. In certain embodiments the inner 224 a and outer 224 b surfaces may be made of different materials. For example, the outer surface 224 b may be made of metal for durability while the inner layer 224 a may be made of a non-conductive or non-reactive material such as a polymer. Likewise the distal end 226 may be made of a different material. For example, since the distal end 226 is in contact with the surgical site it may be beneficial to have the distal end 226 made of a softer or non-reactive material. Examples of suitable materials have been set forth above and other embodiments will be apparent to one skilled in the art given the benefit of this disclosure. In one exemplary embodiment, the distal end is constructed from PEEK and or other suitable polymers. The inner and outer surfaces 224 a and 224 b are constructed of surgical stainless steel or other suitable metals. The distal end 226 of the exemplary embodiment can be manufactured separate from the inner and outer surfaces 224 a, 224 b and can be connected to the inner and outer surfaces 224 a, 224 b by for example, a snap fit, threads, bonding, or other conventional connection mechanisms.
  • FIG. 2C provides a view of the access device 120 showing the distribution of the transmission medium 230, in this case fiber optics, around the periphery of the sidewall 124 so as to provide a circumferential light source 130 offset from the distal end 226. Here, the transmission medium 230 is terminated within the inner path 122 so as provide a light emitter 130 at the distal end 123 of the access device. Depending on how the transmission medium 230, in this case the fiber optics, is terminated, the light emitter 130 may provide focused or defused. It should be understood that other transmission mediums and configurations are possible and will be apparent to one skilled in the art given the benefit of this disclosure.
  • The light transmission is configured at the proximal end 121 of the access device for receiving a light transferring cable (not shown) coupled to a light source (not shown). In the example of FIGS. 2A and 2C the fiber optics are bundled together 235 in a coupler 135 for connecting to a light source via a light transferring cable. In such embodiments, an external light source may be used to provide light to the coupler 135 of the access device which is transmitted from the proximal end 121 to the distal end 123 via the transmission medium. The light source may be any suitable device for producing light, including, but not limited to, halogen light boxes, incandescent light boxes and other light sources readily available in most hospital settings, such as those available from Welch Allyn Medical Products of Skaneateles Falls, N.Y. The light source may have any suitable power level. In an illustrative embodiment, the light source is a 300 Watt Halogen Light Box. Any other suitable light source capable of producing light that is transmitted to the light emitter 130 via the light transferring cable, which may be fiber optic cables or any other suitable light transmitter, may also be used.
  • In the above examples, the light emitter 130 emits white light. It will be understood that in some implementations it may be beneficial to provide other types of light. For example, in one embodiment, the light emitter 130 may emit infrared (IR) light or ultraviolet (UV) light which may used to illuminate IR or UV markers or cure IR or UV reactive epoxies or adhesives. Other possible implementations or applications will be apparent to one skilled in the art given the benefit of this disclosure.
  • FIG. 3 depicts a flow chart 300 of an exemplary embodiment of a method of preparing a surgical site using the present invention. The first step involves creating an incision in the patient (step 310). Once and incision has been created an access device of the present invention may be inserted into the incision (step 320). The surgical site may then be illuminated using the access device (step 330). These steps are discussed in more detail below.
  • In some embodiments, the method includes making a first incision in the epidermis of the patient and then expanding the incision into a portion of the subdermal tissue to create a pathway in any conventional manner. For example, the incision can be expanded by dilation to the desired shape, and orientation by using a plurality of dilators. Once the incision has been expanded to the desire size, shape, and orientation the retractor may be inserted.
  • In the embodiment of FIG. 4, serial dilation is used to prepare the incision for the insertion of the access device 120. As such a series of dilators 405 a, 405 b may be inserted into the patient through the incision (not shown). The access device 120 may then be inserted into the patient over the dilators 405 a, 405 b. The dilatators 405 a, 405 b passing though the access device 120 serve as a guide for the insertion of the access device 120.
  • It should be understood that the above embodiments are exemplary. Other possible insertion techniques with or without insertion instruments as well as different insertion instruments are possible. Other implementations and configurations will be apparent to one skilled in the art given the benefit of this disclosure.
  • Once the access device 120 has been inserted the surgical site may then be illuminated. In some embodiments this may involve connecting the access device to an external light source 152 via a light transferring cable 150 and transmitting light from the external source 152 from the light emitter 130 incorporated into the sidewall as depicted in FIGS. 1 and 2.
  • In another example, the access device 510 may be a retractor 520 as shown in FIG. 5A. Here the retractor 520 comprises one or more adjustable blades 520 defining an interior path 522 therethrough forming a port for accessing the surgical site; and a light emitter 530 integrated into a distal end of the one or more adjustable blades 520 of the retractor to illuminate a surgical site accessed by the retractor.
  • The retractor 520 of FIG. 5A has an interior path 522 extending from an open proximal end 521 of the retractor 520 to an open distal end 523 of the retractor 520. The path 522 may form a working channel or at least a portion of a working channel for accessing a surgical site adjacent to or in the vicinity of the distal end 523 of the tubular body. In the illustrative embodiment, the body of the retractor 520 includes open proximal end 521 that forms a proximal port 525 of the interior path 522, and the open distal end 523 forms a distal port 527 of the interior path 522 for allowing access to the surgical site. One skilled in the art will recognize that the retractor 520 may have any suitable configuration and size for providing access to an area of a body.
  • The light emitter 530 is integrated into the blade 524 at the distal end 523 of the retractor 520. Preferably, the light emitter 530 emits light into the interior of the retractor 520 directly inside and about the inner circumference of the distal end 523, or about at least a substantial portion of the inner circumference. The light emitted into the interior is directed through path 522, out distal port 527 and into a working space adjacent to the distal port 527.
  • Preferably the light emitter 530 is offset or recessed from the distal tip 526 of the retractor 520. The distal end 523 of the retractor 520 is inserted into a patient and the blades 524 are used to hold tissue away from the surgical site providing access for a surgeon. Since the distal end 523 is placed as the location for which access is desired, the distal tip 526 of the access device 520 may be in direct contact with tissue which may cover or other wise block illumination of a light emitter 530 located on the distal tip 526. Offsetting the light emitter 530 reduces the likelihood of tissue or other biological matter of blocking the transmission of light or otherwise interfering with the illumination. The offset is between approximately 1 and approximately 30 mm, more preferably between approximately 10 and approximately 20 mm, and in one exemplary embodiment is approximately 15 mm. Other possible configurations will be apparent to one skilled in the art give the benefit of this disclosure.
  • FIG. 5B depict one embodiment of a blade 524 of the retractor 520. In this example the blade 524 comprises an inner surface 524 a and an outer surface 524 b having a transmission medium 532, such as fiber optic cabling, providing a light transmission path. The transmission medium 532 further comprises connection 535 at the proximal end 521 for connecting the blade to an external light source such as shown in FIG. 1. The light transition medium 532 terminates at the distal end 523 in a light emitter 530. In this embodiment the light emitter 530 can be seen to be offset from the distal tip 526 of the blade 524.
  • FIG. 6A depicts another embodiment of a retractor 620 wherein the adjustable blades 624 are telescoping and can rotate about an access. As with the retractor 520 of FIG. 5A, the retractor 620 of FIG. 6A has an interior path 622 extending from an open proximal end 621 of the retractor 620 to an open distal end 623 of the retractor 620. The path 622 may form a working channel or at least a portion of a working channel for accessing a surgical site adjacent to or in the vicinity of the distal end 623 of the tubular body. In the illustrative embodiment, the adjustable blades 624 of the retractor have been rotated outward, or “toed-in”, as the adjustable blades 624 might be deployed in a patient to create a larger work area. In addition to being able to rotate, the adjustable blades in the present example are telescoping such that the distal end 626 of the adjustable blades 624 may be extended or retracted allowing for adjustable blade depth. One skilled in the art will recognize that the retractor 620 may have any suitable configuration and size for providing access to an area of a body.
  • The light emitter 630 is integrated into the blade 624 at the distal end 623 of the retractor 620. Preferably, the light emitter 630 emits light into the interior of the retractor 620 directly inside and about the inner circumference of the distal end 623, or about at least a substantial portion of the inner circumference into a working space defined by the retractor blades 624.
  • Preferably the light emitter 630 is offset or recessed from the distal tip 626 of a retractor blade 624. The distal end 623 of the retractor 620 is inserted into a patient and the blades 624 are used to hold tissue away from the surgical site providing access for a surgeon. Since the distal end 623 is placed as the location for which access is desired, the distal tip 626 of the access device 620 may be in direct contact with tissue which may cover or other wise block illumination of a light emitter 630 located on the distal tip 626. Offsetting the light emitter 630 reduces the likelihood of tissue or other biological matter of blocking the transmission of light or otherwise interfering with the illumination. The offset is between approximately land approximately 30 mm, more preferably between approximately 10 and approximately 20 mm, and in one exemplary embodiment is approximately 15 mm. Other possible configurations will be apparent to one skilled in the art give the benefit of this disclosure.
  • FIG. 6B depict one embodiment of a telescoping blade 624 of the retractor 620. In this example the blade 624 comprises an inner surface 624 a and an outer surface 624 b having a transmission medium 632, such as fiber optic cabling, providing a light transmission path. The transmission medium 632 further comprises a connection such as coupler 635 at the proximal end 621 for connecting the blade 624 to an external light source. The light transition medium 632 terminates at the distal end 623 in a light emitter 630. In this embodiment the light emitter 630 can be seen to be offset from the distal tip 626 of the blade 624. The exemplary blade 624 of FIG. 6B further includes configurations 640 for engaging surface configuration 642 on the retractor assembly 620 allowing the blade 624 to adjustably telescope when attached to the retractor assembly 620.
  • In the example, the transmission medium 630 is terminated so as provide a light emitter 130 at the distal end 123 of the access device. Depending on how the transmission medium 230, in this case the fiber optics, is terminated, the light emitter 130 may provide focused or defused light. It should be understood that other transmission mediums and configurations are possible and will be apparent to one skilled in the art given the benefit of this disclosure.
  • It should be understood that the retractors depicted in FIGS. 5A, 5B, 6A, and 6B are but some examples of any number of possible configurations for a retractor. Other possible configurations incorporating integrated light emitters will be apparent to one skilled in the art, given the benefit of this disclosure.
  • FIG. 7 depicts a flow chart 700 of an exemplary embodiment of a method of preparing a surgical site using the present invention. The method involves the steps of creating and incision in the patient 710, inserting a retractor of the present invention into the incision 720, and illuminating the surgical site with the retractor 730.
  • The techniques for incision and serial dilation discussed above in regard to using and access device apply equally as well to the use of a retractor. The advantage of retractor is that after insertion, the retractor can be used to further dilate the incision and retract the tissue providing greater access to the surgical site.
  • The present invention has been described relative to an illustrative embodiment. Since certain changes may be made in the above constructions without departing from the scope of the invention, it is intended that all matter contained in the above description or shown in the accompanying drawings be interpreted as illustrative and not in a limiting sense.
  • It is also to be understood that the following claims are to cover all generic and specific features of the invention described herein, and all statements of the scope of the invention which, as a matter of language, might be said to fall therebetween.

Claims (1)

1. An illuminated surgical access system for providing access to a patient during surgery, comprising:
a surgical access device comprising at least one sidewall and defining an interior path therethrough forming a port for accessing the patient; and
a light emitter integrated into the sidewall in proximity to a distal end of the access device to illuminate a surgical site accessed by the surgical access device.
US13/855,496 2006-05-26 2013-04-02 Illuminated surgical access system including a surgical access device and integrated light emitter Abandoned US20130217975A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
US13/855,496 US20130217975A1 (en) 2006-05-26 2013-04-02 Illuminated surgical access system including a surgical access device and integrated light emitter

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US11/441,753 US8430813B2 (en) 2006-05-26 2006-05-26 Illuminated surgical access system including a surgical access device and integrated light emitter
US13/855,496 US20130217975A1 (en) 2006-05-26 2013-04-02 Illuminated surgical access system including a surgical access device and integrated light emitter

Related Parent Applications (1)

Application Number Title Priority Date Filing Date
US11/441,753 Continuation US8430813B2 (en) 2006-05-26 2006-05-26 Illuminated surgical access system including a surgical access device and integrated light emitter

Publications (1)

Publication Number Publication Date
US20130217975A1 true US20130217975A1 (en) 2013-08-22

Family

ID=38750367

Family Applications (2)

Application Number Title Priority Date Filing Date
US11/441,753 Active 2027-11-08 US8430813B2 (en) 2006-05-26 2006-05-26 Illuminated surgical access system including a surgical access device and integrated light emitter
US13/855,496 Abandoned US20130217975A1 (en) 2006-05-26 2013-04-02 Illuminated surgical access system including a surgical access device and integrated light emitter

Family Applications Before (1)

Application Number Title Priority Date Filing Date
US11/441,753 Active 2027-11-08 US8430813B2 (en) 2006-05-26 2006-05-26 Illuminated surgical access system including a surgical access device and integrated light emitter

Country Status (6)

Country Link
US (2) US8430813B2 (en)
EP (2) EP2020903A4 (en)
JP (1) JP2009538196A (en)
AU (1) AU2007267794B2 (en)
CA (1) CA2653713C (en)
WO (1) WO2007139993A2 (en)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10299882B2 (en) * 2012-03-14 2019-05-28 Armour Technologies, Inc. Sterile site apparatus, system, and method of using the same

Families Citing this family (60)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9186175B2 (en) * 2004-10-28 2015-11-17 Nico Corporation Surgical access assembly and method of using same
US9770261B2 (en) 2004-10-28 2017-09-26 Nico Corporation Surgical access assembly and method of using same
US9161820B2 (en) 2004-10-28 2015-10-20 Nico Corporation Surgical access assembly and method of using same
US9387010B2 (en) * 2004-10-28 2016-07-12 Nico Corporation Surgical access assembly and method of using same
US9265523B2 (en) 2011-10-24 2016-02-23 Nico Corporation Surgical access system with navigation element and method of using same
US9005115B2 (en) 2005-04-04 2015-04-14 Invuity, Inc. Illuminated telescoping cannula
US7510524B2 (en) * 2005-04-04 2009-03-31 Invuity, Inc. Optical waveguide sheath
US8251902B2 (en) * 2005-10-17 2012-08-28 Lanx, Inc. Pedicle guided retractor system
US8062217B2 (en) 2007-01-26 2011-11-22 Theken Spine, Llc Surgical retractor with removable blades and method of use
EP2142116A4 (en) * 2007-04-17 2013-07-17 Covidien Lp Visual obturator with handle
US20080319432A1 (en) * 2007-06-20 2008-12-25 Scott Ely Surgical illumination system and method
US8192353B2 (en) * 2007-10-05 2012-06-05 Tyco Healthcare Group Lp Visual obturator
US9072446B2 (en) 2008-06-23 2015-07-07 Intubrite, Llc Laryngoscope and method of use
US8152719B2 (en) * 2008-06-23 2012-04-10 Intubrite, Llc Laryngoscope and method of use
US8012087B2 (en) * 2008-06-23 2011-09-06 Intubrite, Llc Laryngoscope blade and method of use
US8257250B2 (en) * 2008-06-23 2012-09-04 Intubrite, Llc Laryngoscope and method of use
USRE48598E1 (en) 2008-06-23 2021-06-22 Salter Labs Laryngoscope and method of use
US20090318768A1 (en) * 2008-06-23 2009-12-24 Tenger James P Laryngoscope and Method of Use
US8968186B2 (en) 2008-06-23 2015-03-03 Intubrite, Llc Handle for fiber optic device
US9095298B2 (en) 2008-06-23 2015-08-04 Intubrite, Llc Adjustable display mechanism and method
US20100114147A1 (en) * 2008-10-30 2010-05-06 The University Of Toledo Directional soft tissue dilator and docking pin with integrated light source for optimization of retractor placement in minimally invasive spine surgery
US8992558B2 (en) 2008-12-18 2015-03-31 Osteomed, Llc Lateral access system for the lumbar spine
US20130032628A1 (en) * 2009-10-26 2013-02-07 B. J. Zh. F. Panther Medical Equipment Co., Ltd. Anorectal surgical instrument and anal dilator
US8747309B2 (en) * 2010-11-09 2014-06-10 Covidien Lp Suspension system for minimally invasive surgery
JP5535611B2 (en) * 2009-12-22 2014-07-02 日本コヴィディエン株式会社 Endoscope cover fixing tool
DE102010022403B4 (en) * 2010-06-01 2018-12-06 Geuder Aktiengesellschaft Device for introducing a medium or an instrument into the human body
CN103079457A (en) 2010-06-01 2013-05-01 小利兰斯坦福大学理事会 System for illuminating a body orifice
US9289114B2 (en) * 2010-07-30 2016-03-22 Nilesh R. Vasan Disposable, self-contained laryngoscope and method of using same
CN102100542A (en) * 2010-12-10 2011-06-22 广州宝胆医疗器械科技有限公司 Integrated infrared heat-scanning cholecystoscope system
CN102100529B (en) * 2010-12-10 2013-04-24 广州宝胆医疗器械科技有限公司 Integrated infrared thermally scanning esophagoscope system
CN102100539B (en) * 2010-12-10 2013-04-24 广州宝胆医疗器械科技有限公司 Integrated anorectaloscope system with infrared thermal scanning function
CN102100528A (en) * 2010-12-10 2011-06-22 广州宝胆医疗器械科技有限公司 Integrated thermal-infrared scanning gastroscope system
US9757109B2 (en) 2010-12-10 2017-09-12 Illumix Surgical Canada Inc. Organic light emitting diode illuminated surgical retractor
US20120321259A1 (en) * 2011-06-14 2012-12-20 Luke Lu Light-transmittable composite tube
US10722318B2 (en) * 2011-08-24 2020-07-28 Mako Surgical Corp. Surgical tools for selectively illuminating a surgical volume
IL215106A0 (en) * 2011-09-12 2012-02-29 Daniel Sherwin Laparoscopic device
US9757147B2 (en) 2012-04-11 2017-09-12 Nico Corporation Surgical access system with navigation element and method of using same
US9480855B2 (en) * 2012-09-26 2016-11-01 DePuy Synthes Products, Inc. NIR/red light for lateral neuroprotection
US9084591B2 (en) 2012-10-23 2015-07-21 Neurostructures, Inc. Retractor
US20140121467A1 (en) * 2012-10-31 2014-05-01 Invuity, Inc. Methods and apparatus for simultaneous retraction and distraction of bone and soft tissue
CN103126751B (en) * 2013-01-31 2015-10-07 毛克亚 The expansible channel system of novel high polymer material built-in fiber vertebral column minimally invasive
CN103126752B (en) * 2013-01-31 2015-10-07 毛克亚 The expansible channel system of novel high polymer material built-in LED light source vertebral column minimally invasive
EP3005669B1 (en) * 2013-06-06 2019-04-17 Dolby Laboratories Licensing Corporation Lighting for audio devices
AU2015227273A1 (en) * 2014-03-05 2016-05-05 Nico Corporation Surgical access system with navigation element
US10068173B2 (en) * 2014-05-22 2018-09-04 Invuity, Inc. Medical device featuring cladded waveguide
US10258228B2 (en) 2014-08-08 2019-04-16 K2M, Inc. Retraction devices, systems, and methods for minimally invasive spinal surgery
CN104257344B (en) * 2014-09-25 2016-09-21 李晓萍 Gynecological examination device
CA2963283C (en) * 2014-12-23 2017-08-08 Synaptive Medical (Barbados) Inc. System for illumination during a corridor based procedure
KR101616122B1 (en) * 2015-03-10 2016-04-28 김현성 Taylor tubular retractor
EP3457950B8 (en) * 2016-05-20 2023-07-26 Choice Spine, LLC Access instruments to extend a surgical working channel
US11166709B2 (en) 2016-08-23 2021-11-09 Stryker European Operations Holdings Llc Instrumentation and methods for the implantation of spinal implants
EP3668414B1 (en) 2017-08-17 2023-04-05 Stryker European Operations Holdings LLC Lateral access bridges, shims and lighting including rod lighting
EP3545857B1 (en) 2018-03-30 2024-01-03 Stryker European Operations Holdings LLC Lateral access retractor and core insertion
USD876625S1 (en) 2018-08-07 2020-02-25 Adroit Surgical, Llc Laryngoscope
US11413029B2 (en) 2018-10-24 2022-08-16 Stryker European Operations Holdings Llc Anterior to psoas instrumentation
JP2022519213A (en) * 2019-02-08 2022-03-22 リバウンド セラピュティクス コーポレーション Illuminated cannula system
WO2021021777A1 (en) * 2019-07-31 2021-02-04 Nico Corporation Surgical access device with integrated illumination
US11844504B2 (en) 2019-09-20 2023-12-19 Axis Spine Technologies Ltd. Radiolucent surgical retractor
US11564674B2 (en) 2019-11-27 2023-01-31 K2M, Inc. Lateral access system and method of use
WO2023163702A1 (en) * 2022-02-24 2023-08-31 Intersect ENT International GmbH Illumination assembly for handheld medical devices and instruments

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5928139A (en) * 1998-04-24 1999-07-27 Koros; Tibor B. Retractor with adjustable length blades and light pipe guides
US20020055670A1 (en) * 2000-10-17 2002-05-09 Sol Weiss Surgical instrument
US20090018399A1 (en) * 2004-10-08 2009-01-15 Scot Martinelli Surgical access system and related methods
US8137284B2 (en) * 2002-10-08 2012-03-20 Nuvasive, Inc. Surgical access system and related methods

Family Cites Families (142)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US559192A (en) * 1896-04-28 Steam log loader and turner
US1326300A (en) 1919-12-30 Iighi ibanshiiting subglcal device
US2235979A (en) 1940-06-03 1941-03-25 Albert L Brown Surgical and diagnostic instrument
US2553004A (en) * 1949-03-11 1951-05-15 Rabatine Michael Dividing protractor
US3075516A (en) 1960-05-23 1963-01-29 Clauss B Strauch Apparatus for auto-vaginoscopy
US3261350A (en) 1963-09-16 1966-07-19 American Cystoscope Makers Inc Endoscope
FR1394945A (en) 1964-02-26 1965-04-09 Comp Generale Electricite Circular section waveguide for transmission of light or infrared waves
US3441143A (en) * 1967-02-10 1969-04-29 Marvel Eng Co Plural element filter assembly
US3590232A (en) 1968-03-27 1971-06-29 Radioptics Inc Annular illuminator for dental tools or the like
US3664330A (en) 1969-09-12 1972-05-23 Harold L Deutsch Fiber optic medical tool
USRE32089E (en) * 1970-08-25 1986-03-04 Amicon Corporation Blood fractionating process and apparatus for carrying out same
US3785549A (en) * 1972-07-31 1974-01-15 Haemonetics Corp Centrifuge chuck for disposable, snap-in centrifuge rotor
US3935113A (en) * 1974-02-27 1976-01-27 Becton, Dickinson And Company Serum/plasma separator with centrifugal valve
US3951801A (en) * 1974-02-27 1976-04-20 Becton, Dickinson And Company Serum/plasma separator-strut stop type
US3941699A (en) * 1974-02-27 1976-03-02 Becton, Dickinson And Company Plasma separator with centrifugal valve
US3931010A (en) * 1974-02-27 1976-01-06 Becton, Dickinson And Company Serum/plasma separators with centrifugal valves
US4204537A (en) * 1974-08-15 1980-05-27 Haemonetics Corporation Process for pheresis procedure and disposable plasma
US4088582A (en) * 1976-01-16 1978-05-09 Sherwood Medical Industries Inc. Blood phase separation means
DE2636510C3 (en) 1976-08-13 1980-01-24 Heine Optotechnik Gmbh & Co Kg, 8036 Herrsching Endoscope, in particular rectoscope, with a detachable, light-guiding tube
US4173392A (en) 1977-07-20 1979-11-06 American Hospital Supply Corporation Glass fiber light guide and method of making the same
US4146172A (en) * 1977-10-18 1979-03-27 Baxter Travenol Laboratories, Inc. Centrifugal liquid processing system
US4300541A (en) 1979-02-09 1981-11-17 Kermit Burgin Speculum lens structure
AT359653B (en) * 1979-02-15 1980-11-25 Immuno Ag METHOD FOR PRODUCING A TISSUE ADHESIVE
US4314823A (en) * 1979-03-05 1982-02-09 Dionex Corporation Combination apparatus and method for chromatographic separation and quantitative analysis of multiple ionic species
US4424132A (en) * 1981-02-05 1984-01-03 Asahi Kasei Kogyo Kabushiki Kaisha Apparatus and method for separating blood components
JPS5810033A (en) 1981-05-26 1983-01-20 オリンパス光学工業株式会社 Illumination optical system for endoscope
US4442655A (en) * 1981-06-25 1984-04-17 Serapharm Michael Stroetmann Fibrinogen-containing dry preparation, manufacture and use thereof
ATE13810T1 (en) * 1981-06-25 1985-07-15 Serapharm Gmbh & Co Kg ENRICHED PLASMA DERIVES TO ASSIST WOUND CLOSURE AND COVERAGE.
ATE20824T1 (en) * 1981-06-25 1986-08-15 Serapharm Gmbh & Co Kg ENRICHED PLASMA DERIVES TO SUPPORT WOUND CLOSURE AND HEALING.
US4735726A (en) * 1981-07-22 1988-04-05 E. I. Du Pont De Nemours And Company Plasmapheresis by reciprocatory pulsatile filtration
GB2104401B (en) * 1981-08-25 1985-03-20 Krauss Maffei Ag Support plate for centrifuges
DE3203775A1 (en) * 1982-02-04 1983-08-11 Behringwerke Ag, 3550 Marburg FIBRINOGEN PREPARATION, METHOD FOR THEIR PRODUCTION AND THEIR USE
DE3301890C2 (en) 1983-01-21 1986-04-10 W.C. Heraeus Gmbh, 6450 Hanau Retractor
CH665565A5 (en) * 1983-10-22 1988-05-31 Mitsui Toatsu Chemicals METHOD FOR CONTROLLING THE CONCENTRATION OF AN AQUEOUS SOLUTION OR EMULSION CONTAINING A MACROMOLECULAR CONNECTION.
US4562832A (en) 1984-01-21 1986-01-07 Wilder Joseph R Medical instrument and light pipe illumination assembly
DE3419324C1 (en) 1984-05-24 1985-08-22 Josef 6090 Rüsselsheim Laaber Method of producing a fibre-optical ring lamp
JPS6144825A (en) * 1984-08-09 1986-03-04 Unitika Ltd Hemostatic agent
US4928603A (en) * 1984-09-07 1990-05-29 The Trustees Of Columbia University In The City Of New York Method of preparing a cryoprecipitated suspension and use thereof
US4639316A (en) * 1984-12-14 1987-01-27 Becton, Dickinson And Company Automatic liquid component separator
US4597030A (en) 1985-01-31 1986-06-24 American Hospital Supply Corporation Surgical illuminator
AT382783B (en) * 1985-06-20 1987-04-10 Immuno Ag DEVICE FOR APPLICATING A TISSUE ADHESIVE
US4805984A (en) 1985-11-21 1989-02-21 Minnesota Mining And Manufacturing Company Totally internally reflecting light conduit
US5112490A (en) * 1986-02-19 1992-05-12 Jon Turpen Sample filtration, separation and dispensing device
JPS62287215A (en) 1986-06-06 1987-12-14 Olympus Optical Co Ltd Optical system device for endoscope lighting
US4983158A (en) * 1986-07-22 1991-01-08 Haemonetics Corporation Plasmapheresis centrifuge bowl
CH673117A5 (en) * 1986-12-10 1990-02-15 Ajinomoto Kk
US4832851A (en) * 1987-02-02 1989-05-23 W. R. Grace & Co. Centrifugal force-enhanced filtration of fluids
US4983157A (en) * 1987-03-23 1991-01-08 Ceramics Process Systems Corp. Centrifugation system using static layer
US4905082A (en) 1987-05-06 1990-02-27 Olympus Optical Co., Ltd. Rigid video endoscope having a detachable imaging unit
US4907132A (en) 1988-03-22 1990-03-06 Lumitex, Inc. Light emitting panel assemblies and method of making same
US5290552A (en) * 1988-05-02 1994-03-01 Matrix Pharmaceutical, Inc./Project Hear Surgical adhesive material
AT397203B (en) * 1988-05-31 1994-02-25 Immuno Ag FABRIC ADHESIVE
AU617265B2 (en) * 1988-06-23 1991-11-21 Asahi Medical Co. Ltd. Method for separating blood into blood components, and blood components separator unit
US4902281A (en) * 1988-08-16 1990-02-20 Corus Medical Corporation Fibrinogen dispensing kit
DE8900469U1 (en) * 1989-01-17 1990-05-23 Espe Stiftung & Co Produktions- Und Vertriebs Kg, 8031 Seefeld, De
US5002571A (en) * 1989-02-06 1991-03-26 Donnell Jr Francis E O Intraocular lens implant and method of locating and adhering within the posterior chamber
SE8900586L (en) * 1989-02-21 1990-08-22 Pharmacia Ab COMPOSITION AND PROCEDURES TO PREVENT ADHESION BETWEEN BODY TISSUE
US5226877A (en) * 1989-06-23 1993-07-13 Epstein Gordon H Method and apparatus for preparing fibrinogen adhesive from whole blood
US5000970A (en) * 1989-06-30 1991-03-19 Horizons International Foods, Inc. Process for preparing reheatable french fried potatoes
US5039198A (en) 1989-08-02 1991-08-13 Vanbeek Allen L Stereoscopic microsurgery system
US5100564A (en) * 1990-11-06 1992-03-31 Pall Corporation Blood collection and processing system
US5316674A (en) * 1989-09-12 1994-05-31 Pall Corporation Device for processing blood for human transfusion
US5104375A (en) * 1989-10-16 1992-04-14 Johnson & Johnson Medical, Inc. Locking holder for a pair of syringes and method of use
US5163949A (en) 1990-03-02 1992-11-17 Bonutti Peter M Fluid operated retractors
US5204537A (en) * 1990-03-30 1993-04-20 Recognition Equipment Incorporated Thickness sensor comprising a leaf spring means, and a light sensor
US5420250A (en) * 1990-08-06 1995-05-30 Fibrin Corporation Phase transfer process for producing native plasma protein concentrates
US5173295A (en) * 1990-10-05 1992-12-22 Advance Biofactures Of Curacao, N.V. Method of enhancing the regeneration of injured nerves and adhesive pharamaceutical formulation therefor
US5112484A (en) * 1990-10-11 1992-05-12 Zuk, Inc. Filtration apparatus
US5486359A (en) * 1990-11-16 1996-01-23 Osiris Therapeutics, Inc. Human mesenchymal stem cells
US5206023A (en) * 1991-01-31 1993-04-27 Robert F. Shaw Method and compositions for the treatment and repair of defects or lesions in cartilage
US5165387A (en) 1991-02-04 1992-11-24 Transidyne General Corporation Endoscope with disposable light
FR2679251B1 (en) * 1991-07-18 1993-11-12 Nord Assoc Essor Transfusion San PROCESS FOR THE PREPARATION OF A HUMAN THROMBIN CONCENTRATE FOR THERAPEUTIC USE.
DE4220701C2 (en) 1991-08-02 2001-02-08 Olympus Optical Co Endoscope cleaning device
DE4126341C1 (en) * 1991-08-09 1993-01-28 Fresenius Ag, 6380 Bad Homburg, De
DE4129516C2 (en) * 1991-09-06 2000-03-09 Fresenius Ag Method and device for separating blood into its components
US5190057A (en) * 1991-12-13 1993-03-02 Faezeh Sarfarazi Sarfarazi method of closing a corneal incision
US5353786A (en) 1992-01-24 1994-10-11 Wilk Peter J Surgical lighting method
EP0639980A1 (en) * 1992-02-26 1995-03-01 Allergan, Inc. Use of platelet derived growth factor in ophthalmic wound healing
US5298016A (en) * 1992-03-02 1994-03-29 Advanced Haemotechnologies Apparatus for separating plasma and other wastes from blood
US5261392A (en) 1992-04-03 1993-11-16 Achi Corporation Laryngoscope with interchangeable fiberoptic assembly
AU661131B2 (en) 1992-04-14 1995-07-13 Ethicon Inc. Illuminated surgical cannula
FR2691911B1 (en) * 1992-06-05 1994-11-25 Delmas Olivier Device for obtaining a supernatant of activated thrombocytes, process using the device and obtained supernatant.
US5354302A (en) 1992-11-06 1994-10-11 Ko Sung Tao Medical device and method for facilitating intra-tissue visual observation and manipulation of distensible tissues
US5562696A (en) 1992-11-12 1996-10-08 Cordis Innovasive Systems, Inc. Visualization trocar
US5334150A (en) 1992-11-17 1994-08-02 Kaali Steven G Visually directed trocar for laparoscopic surgical procedures and method of using same
US5400773A (en) 1993-01-19 1995-03-28 Loma Linda University Medical Center Inflatable endoscopic retractor
US5290918A (en) * 1993-02-23 1994-03-01 Haemacure Biotech Inc. Process for the obtention of a biological adhesive made of concentrated coagulation factors by acidic precipitation
US5395923A (en) * 1993-02-23 1995-03-07 Haemacure-Biotech, Inc. Process for the obtention of a biological adhesive made of concentrated coagulation factors by "salting-out"
US5441041A (en) 1993-09-13 1995-08-15 United States Surgical Corporation Optical trocar
US5957832A (en) * 1993-10-08 1999-09-28 Heartport, Inc. Stereoscopic percutaneous visualization system
US5588949A (en) 1993-10-08 1996-12-31 Heartport, Inc. Stereoscopic percutaneous visualization system
US5411885A (en) * 1993-12-17 1995-05-02 New York Blood Center, Inc. Methods for tissue embedding and tissue culturing
US5437598A (en) * 1994-01-21 1995-08-01 Cobe Laboratories, Inc. Automation of plasma sequestration
US5448990A (en) 1994-02-15 1995-09-12 Very Inventive Physicians, Inc. Endoscope viewing cannula and surgical techniques
US5445142A (en) 1994-03-15 1995-08-29 Ethicon Endo-Surgery, Inc. Surgical trocars having optical tips defining one or more viewing ports
US5723331A (en) * 1994-05-05 1998-03-03 Genzyme Corporation Methods and compositions for the repair of articular cartilage defects in mammals
US5584796A (en) 1994-08-10 1996-12-17 Cohen; Barry J. Apparatus and method for retracting and viewing bodily tissues on remote display device
US5510102A (en) * 1995-01-23 1996-04-23 The Regents Of The University Of California Plasma and polymer containing surgical hemostatic adhesives
US5591192A (en) 1995-02-01 1997-01-07 Ethicon Endo-Surgery, Inc. Surgical penetration instrument including an imaging element
US5733545A (en) * 1995-03-03 1998-03-31 Quantic Biomedical Partners Platelet glue wound sealant
US5716616A (en) * 1995-03-28 1998-02-10 Thomas Jefferson University Isolated stromal cells for treating diseases, disorders or conditions characterized by bone defects
USRE38730E1 (en) * 1995-05-05 2005-04-26 Harvest Technologies Corporation Automatic multiple-decanting centrifuge and method of treating physiological fluids
EP0836487A1 (en) * 1995-06-06 1998-04-22 Quantic Biomedical Partners Device and method for concentrating plasma
US6185356B1 (en) 1995-06-27 2001-02-06 Lumitex, Inc. Protective cover for a lighting device
US5759150A (en) 1995-07-07 1998-06-02 Olympus Optical Co., Ltd. System for evulsing subcutaneous tissue
US6200606B1 (en) * 1996-01-16 2001-03-13 Depuy Orthopaedics, Inc. Isolation of precursor cells from hematopoietic and nonhematopoietic tissues and their use in vivo bone and cartilage regeneration
US5891013A (en) 1996-02-07 1999-04-06 Pinotage, Llc System for single-puncture endoscopic surgery
US5865785A (en) * 1996-02-23 1999-02-02 Baxter International Inc. Systems and methods for on line finishing of cellular blood products like platelets harvested for therapeutic purposes
US6129662A (en) 1996-06-03 2000-10-10 Cogent Light Technologies, Inc. Surgical tool with surgical field illuminator
US5785648A (en) 1996-10-09 1998-07-28 David Min, M.D., Inc. Speculum
US6176824B1 (en) 1996-10-29 2001-01-23 James M. Davis Fiberoptically illuminated appliances
US5902435A (en) 1996-12-31 1999-05-11 Minnesota Mining And Manufacturing Company Flexible optical circuit appliques
US5889584A (en) * 1997-03-10 1999-03-30 Robert A. Levine Assembly for rapid measurement of cell layers
WO1998048938A1 (en) * 1997-04-25 1998-11-05 Washington State University Research Foundation Semi-continuous, small volume centrifugal blood separator
US5860937A (en) * 1997-04-30 1999-01-19 Becton, Dickinson & Company Evacuated sample collection tube with aqueous additive
US6196968B1 (en) 1997-06-02 2001-03-06 General Surgical Innovations, Inc. Direct vision subcutaneous tissue retractor and method for use
DE19732785C2 (en) 1997-07-30 2001-06-28 Aesculap Ag & Co Kg Instrument guide tube for the introduction of surgical instruments
CA2307743A1 (en) * 1997-10-30 1999-05-14 The General Hospital Corporation Bonding of cartilaginous matrices using isolated chondrocytes
US6304712B1 (en) 1997-11-06 2001-10-16 James M. Davis Bendable illuminating appliance
US6982740B2 (en) 1997-11-24 2006-01-03 Micro-Medical Devices, Inc. Reduced area imaging devices utilizing selected charge integration periods
US5967971A (en) 1998-04-14 1999-10-19 Bolser; Jeffrey William Surgical instrument
US6139493A (en) * 1998-07-08 2000-10-31 Koros; Tibor B. Retractor with adjustable length blades and light pipe guides
US6210325B1 (en) 1998-10-02 2001-04-03 Minnesota Scientific, Inc. Cam-activated adjustable arm and illuminated tubular retractor
US6551346B2 (en) 2000-05-17 2003-04-22 Kent Crossley Method and apparatus to prevent infections
JP4197157B2 (en) * 2001-07-16 2008-12-17 デピュイ・プロダクツ・インコーポレイテッド Cartilage repair and reproduction apparatus and method
US20030163030A1 (en) 2002-02-25 2003-08-28 Arriaga Moises A. Hollow endoscopy
US7179391B2 (en) * 2002-05-24 2007-02-20 Biomet Manufacturing Corp. Apparatus and method for separating and concentrating fluids containing multiple components
US7223233B2 (en) * 2002-08-02 2007-05-29 Warsaw Orthopedic, Inc. Systems and techniques for illuminating a surgical space
CA2494011A1 (en) * 2002-08-02 2004-02-12 Sdgi Holdings, Inc. Systems and techniques for illuminating a surgical space
EP2284266B1 (en) 2002-11-14 2013-11-06 Thermo Fisher Scientific Biosciences Inc. siRNA targeting tp53
AU2003294336A1 (en) 2002-11-19 2004-06-15 Den-Mat Corporation Dental light guide
US6880948B2 (en) 2002-12-16 2005-04-19 Zeolux Corporation Illuminant and method
US7481766B2 (en) * 2003-08-14 2009-01-27 Synthes (U.S.A.) Multiple-blade retractor
WO2005027726A2 (en) * 2003-09-18 2005-03-31 Howmedica Osteonics Corp. Surgical retractor with removable scissor arms
JP4463819B2 (en) * 2003-09-25 2010-05-19 ヌヴァシヴ インコーポレイテッド Surgical access system
EP2332468B1 (en) * 2003-12-18 2016-11-09 DePuy Spine, Inc. Surgical retractor systems
US7708688B2 (en) 2004-03-15 2010-05-04 Paradigm Optics, Incorporated Polymer endoscopic shaft
WO2005115223A2 (en) 2004-05-25 2005-12-08 Innovative Gynecological Solutions, Inc. Speculum
US7150714B2 (en) * 2004-06-14 2006-12-19 Ebi, L.P. Minimally invasive surgical spinal exposure system
US8480566B2 (en) 2004-09-24 2013-07-09 Vivid Medical, Inc. Solid state illumination for endoscopy
US20060069313A1 (en) 2004-09-30 2006-03-30 Couvillon Lucien A Jr Medical devices with light emitting regions
US20060224045A1 (en) * 2005-03-31 2006-10-05 Depuy Spine, Inc. Integrated access device and light source for surgical procedures

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5928139A (en) * 1998-04-24 1999-07-27 Koros; Tibor B. Retractor with adjustable length blades and light pipe guides
US20020055670A1 (en) * 2000-10-17 2002-05-09 Sol Weiss Surgical instrument
US8137284B2 (en) * 2002-10-08 2012-03-20 Nuvasive, Inc. Surgical access system and related methods
US20090018399A1 (en) * 2004-10-08 2009-01-15 Scot Martinelli Surgical access system and related methods

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10299882B2 (en) * 2012-03-14 2019-05-28 Armour Technologies, Inc. Sterile site apparatus, system, and method of using the same
US11147650B2 (en) * 2012-03-14 2021-10-19 Armour Technologies, Inc. Sterile site apparatus, system, and method of using the same

Also Published As

Publication number Publication date
EP2020903A2 (en) 2009-02-11
AU2007267794B2 (en) 2012-08-02
WO2007139993A2 (en) 2007-12-06
EP2959825A1 (en) 2015-12-30
JP2009538196A (en) 2009-11-05
WO2007139993A3 (en) 2008-07-24
AU2007267794A1 (en) 2007-12-06
US20070276191A1 (en) 2007-11-29
US8430813B2 (en) 2013-04-30
CA2653713A1 (en) 2007-12-06
EP2020903A4 (en) 2010-12-29
CA2653713C (en) 2014-11-04

Similar Documents

Publication Publication Date Title
US8430813B2 (en) Illuminated surgical access system including a surgical access device and integrated light emitter
US7874982B2 (en) Illuminated surgical access system including a surgical access device and coupled light emitter
US20060224045A1 (en) Integrated access device and light source for surgical procedures
US20070100210A1 (en) Illuminated surgical access system including a surgical access device and coupled light emitter
ES2232206T3 (en) DEVICES FOR PERCUTANEOUS SURGERY.
EP2243435B1 (en) Visual veress needle assembly
US9675235B2 (en) Multi-purpose surgical instrument with removable component
US7959651B2 (en) Systems and techniques for illuminating a surgical space
JP4361864B2 (en) Surgical lighting fixture
US8012146B2 (en) Extending small-gauge illuminator
US20080319432A1 (en) Surgical illumination system and method
CA2441482A1 (en) Devices and methods for percutaneous surgery
CN216455275U (en) Guide structure for surgical ablation device
EP1951142B1 (en) Extending small-gauge illuminator

Legal Events

Date Code Title Description
AS Assignment

Owner name: DEPUY SPINE, INC., MASSACHUSETTS

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:SELOVER, SEAN;DZIEDZIC, SARA;CONNOLLY, STEVE;AND OTHERS;SIGNING DATES FROM 20060814 TO 20060906;REEL/FRAME:031364/0081

STCB Information on status: application discontinuation

Free format text: ABANDONED -- FAILURE TO RESPOND TO AN OFFICE ACTION