WO2004054626A2

WO2004054626A2 - Lighted cautery knife

Info

Publication number: WO2004054626A2
Application number: PCT/US2003/039871
Authority: WO
Inventors: Kenneth S. Solovay; James H. Layer; Thomas P. Jacobs; Gregory Madden; William Gregory
Original assignee: Gmp Surgical Solutions, Inc.
Priority date: 2002-12-13
Filing date: 2003-12-15
Publication date: 2004-07-01
Also published as: AU2003300931A1; WO2004054626A3; AU2003300931A8

Abstract

The present invention relates to a lighting accessory system using fiberoptic illumination (914). In certain embodiments, the lighting accessory system of the present invention is combinable with a hand tool, for example a cautery knife (902), to illuminate the distal end of the tool. The lighting accessory system provides an illuminable tool whereby an object may be illuminated without obstruction by the illumination mechanism.

Description

LIGHTED CAUTERY KNIFE

BACKGROUND OF THE INVENTION Field of the Invention

The present invention relates to a lighting accessory system for providing an illuminable tool. More particularly, the present invention relates to a fiber-optic lighting accessory attachable to a surgical cautery knife. Description of the Related Art

Practitioners in the surgical arts frequently find themselves with a need for enhanced visualization of a body tissue or other workpieces disposed within body cavities. A variety of illumination systems have been devised to address this need. One option is overhead lighting. Overhead illumination in an operating room is directable, and in some cases focusable, so that a surgeon may use this lighting better to visualize the surgical field. Overhead light sources, however, provide a more general and diffuse type of illumination. Another option involves the use of illuminated devices held in a person's hand. To direct light towards a specific target, surgeons and other operating room personnel may employ handheld lighting instruments, such as lighted retractors or flexible surgical flashlights. If such tools are held by the surgeon, however, they tie up a hand that the surgeon may need for other manipulations. If such tools are held by other members of the surgical team, the person holding the light may not be able to direct it accurately towards what the surgeon wants to have illuminated. To overcome some of the limitations of the aforesaid lighting systems, surgeons may elect to wear conventional surgical headlights. These devices, however, have limitations as well. Surgical headlights commonly are heavy, uncomfortable and hot. The light may require periodic or and possibly frequent redirection so that it is properly aimed along the line of the surgeon's sight. Other members of the operating team may need to exercise caution so that they do not block or strike the surgeon's light, especially when procedures are being undertaken in deep body cavities. The light itself may generate sufficient heat that it can bum tissues if it comes in contact with them. Furthermore, the headlight and all related apparatus is unsterile, so the surgeon and the operating team must be cautious so as to avoid contamination of the surgical field. A need therefore remains in the art to provide an easy to use lighting system that may be directed specifically at a surgical site or other workpiece being manipulated. There is a further need in the art for such a system adapted for single use disposability. Advantageously, such a system would avoid interference with the actual performance of the operation, including the motions and maneuvers carried out by the entire surgical team to carry out the surgery safely.

An example of lighted tools consistent with the present invention is disclosed in U.S. Patent No. 6,648,902, filed July 20, 2001, the contents of whish are incorporated herein by reference. There is a need for a tool that can illuminate the region that is being cut by a surgical cautery knife.

BRIEF SUMMARY OF THE INVENTION [01] In one aspect, the present invention provides a lighting accessory system that comprises an anchoring base attachable to a proximal end of the tool, a lightguide using an optical fiber whose proximal end is attached to the anchoring base and whose distal end extends distally along a face of the tool to illuminate a distal surface of the tool, and a fiberoptic cable assembly connected to the proximal end of the fiber-optic fiber that conveys light energy thereto. The lighting accessory system may also include an attachment clip that attaches the lightguide to the face of the tool. In certain embodiments, the anchoring base may cover the proximal end of the tool. In certain embodiments, the lightguide may comprise a hyporube. The hyporube may be adjustable. The lightguide may be centered on the tool. In certain embodiments, the anchoring base may include an attachment device. In some embodiments, the attachment device may be selected from a group consisting of friction fit, set screws, ratchets, cable ties, adhesives, spring clams, roller clamps, can more lever locks, elastic material, hook and loop fasteners, welding, rivets, tight friction fit, or chemical bonding. The attachment device may comprise an elastomeric polymer. The tool may be a cautery knife. In certain embodiments, the lighting accessory system may further include a light adapter for attaching a light pipe on the fiber-optic cable to a light source, the light adapter comprising a body having a lumen, a proximal end for connection to a light source, and a distal end for connection to a fiber-optic cable, and also having a light transmitting insulator positioned in the proximal end, and further having a means for anchoring the fiber-optic cable. In certain embodiments, the light transmitting insulator is glass. In certain embodiments, the means for anchoring the fiber-optic cable comprises at least one of the following: an iris, set screws, ratchets, adhesives, spring clamps, trumpet valve clamps, roller clamps, cam or lever locks. In certain embodiments, the iris may be an elastomeric iris. In certain embodiments, the light adapter may further include a visual indicator to indicate insertion of the light pipe. In certain embodiments, the light adapter may be molded or bonded to the fiber-optic cable.

[02] In another aspect, the present invention provides for an illuminable tool and/or lighting accessory system coupled with an electrocautery knife. In an embodiment, a tool such as an electrocautery knife could also provide suction. The suction could facilitate the removal of smoke and liquid that can be generated at a surgical site. In an embodiment, the lightguide or tube could include a malleable or ductile material that would facilitate positioning, aiming, or directing the lightguide or light emitted from the lightguide.

Objectives, advantages, and applications of the present invention will be made apparent by the following detailed description of embodiments of the invention.

BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS

Figure 1 is a partial perspective view of one embodiment of the present invention.

Figure 2 is a partial perspective view of another embodiment of the present invention.

Figures 3-4 are cross-sectional views illustrating two different embodiments for the attachment of the lightguide to the electrocautery knife.

Figure 5 is a partial perspective view of attachment of the lightguide to the electrocautery knife blade.

Figures 6-10 are various views illustrating embodiments for incorporating the lightguide into the electrocautery knife.

Figures 11-12 are perspective views illustrating two embodiments of the distal region of a lighted cautery knife of the present invention.

Figure 13 is a perspective view of another embodiment for attachment of the lightguide to the electrocautery knife.

Figures 14-15 are perspective views of alternate embodiments for attachment of the lightguide to the electrocautery knife.

Figures 16-18 are representative cross-sectional view of various embodiments of the attachment mechanism illustrated in Fig. 15.

Figure 19 is a perspective view of another embodiment for an attachment clip for attaching the lightguide to the electrocautery knife.

Figure 20 is a perspective view of an embodiment for inco orating the lightguide into the electrocautery knife blade. Figures 21-22 are perspective views of alternate embodiments for incorporating the lightguide into the electrocautery knife blade.

Figure 23 is a perspective view of another embodiment for attachment of the lightguide to the electrocautery knife.

Figure 24 is a perspective view of an embodiment for incorporating a light source in the electrocautery knife blade.

Figure 25 is a perspective view of an embodiment for attachment of the lightguide to the electrocautery knife.

DETAILED DESCRIPTION OF THE INVENTION [03] Fig. 1 depicts an exemplary embodiment of an illuminable tool and/or lighting accessory system coupled to electrocautery knife 902. An electrocautery knife can be used to cut, burn, seal, dissect or otherwise manipulate tissue by delivering electric current to the tissue. The electrocautery knife 902 may have a shaft 904, a distal region 908, a switch 910, and a blade 912. The blade 912 can have an insert portion 924 by which the blade 912 can be inserted into or removed from the knife 902. A mounting clip 918 may be attached to the knife 902, at a variety of locations including but not limited to the shaft 904, a proximal region (as shown in Fig. 25), the distal region 908, the insert 924, and the blade 912. In an embodiment, the mounting clip 918 can be positioned distal to the switch 910 in order to be clear of an operator's hand gripping the knife 902 in the vicinity of the switch 910. By way of example, Fig. 1 shows the mounting clip 918 attached to the insert 924, and Fig. 2 shows the mounting clip 918 attached to the distal region 908 of the knife 902. The mounting clip 918 can have a bore 920 that can receive a lightguide 914, such as an optical fiber. The mounting clip 918 can also have a fastener 922 that attaches the clip 918 to the knife 902. The fastener may have a "C" shape in cross-section, as depicted in Figs. 1 and 3, which could facilitate snapping the mounting clip 918 onto and/or off of the knife 902. As the mounting clip 918 is pressed against or pulled away from the knife 902, the mounting clip 918 can deform to admit or release the knife 902 to the space 924 inside the fastener 922. In an embodiment, the bore 920 could have a "C" shape in cross-section, which could facilitate attachment and removal of the lightguide 914. In an embodiment, the clip 918 could be a wrap. The clip could be positioned at a variety of places on the knife 902, the blade 912, or therebetween by sliding the clip 912 onto the position such that the blade 912 and optionally a portion of the knife 902 protrudes through.

[04] Fig. 4 shows another exemplary embodiment, in which a fastener 922' has a circular or annular shape in cross-section. A clip 918' according to this embodiment could be attached to the knife 902 by, e.g., sliding the clip 918' onto the knife 902. The clip 918' could be removed from the knife by, e.g., sliding it off the knife 902. The fastener 922, 922' and/or space 924 and the bore 920 may be given other shapes in cross-section, such as triangular, oval, elliptical, diamond, slot, other quadrilateral, higher order polygon, or other shape known to one of skill in the art. In another exemplary embodiment (not shown), the fastener could have two jaws, at least one of which can be rotated at a pivot point between the bore and the fastener. The jaw or jaws could be oriented in an open position to facilitate placing the knife within the space 924. Subsequently, the jaw or jaws could be oriented to a second position to attach the fastener to the knife. The jaw or jaws could be returned to the first position to facilitate removal of the clip from the knife. In another embodiment, a mounting clip could be inserted between the knife 902 and the blade 912. The mounting clip could be fixed in place by the attachment of the blade 912 to the knife 902. [05] Fig. 5 depicts another exemplary embodiment, in which an insert 924' of a blade 912' could include the bore 920' to receive the lightguide 914. Lightguide 914 could be, for example, snapped or slid into the bore 920'. The blade 912' having the insert 924' and the bore 920' could be manufactured as a single unit, and/or be disposable and/or sterilizable. [06] Figs. 6-9 depict other embodiments in which the bore can be incorporated into the knife 902 itself. Fig. 6 depicts a perspective view of an electrocautery knife 902 having a bore 920" running in or along one of the surfaces of the knife 902. Figs. 7, 8, and 9 depict exemplary embodiments showing alternative dispositions of the bore 920". As shown in Fig. 7, the bore 920" can be attached to the surface of the knife 902. The bore 920" can be attached to the knife 902 by the attachment mechanisms described herein. The bore 920" could also be molded as part of the knife 902. As shown in Fig. 8, the bore 920" can be under the surface of the knife 902. Fig. 11 depicts a projection view of the exemplary embodiment of Fig. 8 to show detail of an embodiment of the front end of the knife 902. The bore 920" can pass through the knife 902 to emit light in the vicinity of the blade 912. In an exemplary embodiment depicted in Fig. 12, light can be directed through the lightguide (not shown) in the knife 902 to be emitted through an annular aperture 950 around blade 912. The bore 920", in the embodiments depicted in Figs. 7 and 8, can have a circular shape (or other shape as described above) cross-section. A lightguide (not shown) can be inserted into the bore 920" by threading it through an aperture, for example aperture 940 in Fig. 6. As shown in Fig. 9, the bore 920"' can have a "C" shape and form a portion of the surface of the knife 902. A lightguide (not shown) can be snapped or slid into the bore 920'". The bore 920'" could have a rim at a proximal end of the bore 920'" (not shown) to prevent the lightguide from advancing beyond a predetermined position. In another embodiment depicted in Fig. 10, the lightguide 914 could be provided with a circumferential ridge or indent 942 that could preferentially fit into a complementary indent or ridge 944 in the bore 920'". The lightguide 914 could be snapped into the bore 920'" or slid into the bore 920'", stopping when the ridge or indent 942 seats into the complementary indent or ridge 944. [07] The mounting clip 918 can hold the lightguide 914 firmly in position relative to the knife 902 to prevent slipping of the lightguide 914 during use of the knife 902. The lightguide 914 may be held in position, for example, by closely approximating the inner diameter to the bore 920 to the outer diameter of the lightguide 914 to facilitate a friction fit. The lightguide 914 could also be held in position by being attached to the mounting clip 918 by friction, set screws, ratchets, cable ties, adhesives, spring clamps, roller clamps, cam or lever locks, elastic bands or hook and loop fasteners. In addition, the mounting clip 918 could permit the lightguide 914 to be attached thereto through a variety of mechanisms, including mechanisms that provide a snap-on connection such as compressible polymer foam, set screws, elastically deformed prongs to provide friction, and a range of latches, clasps, clamps and other affixation mechanisms familiar to those of ordinary skill in the art. The lightguide could be permanently attached to the mounting clip by, for example, welding, rivets, tight friction fit or chemical bonding. The lightguide 914 may be affixed to the mounting clip 918 in the bore 920 or to the surface of mounting clip 918. The bore 920 may adopt shapes as described above for the fastener 922, 922'.

[08] Fig. 13 shows another exemplary embodiment in which the lightguide 914 can be attached to the electrocautery knife 902 by a mounting clip 1118 that may attach to a cautery wire 930 or a proximal end 928 of the knife 902. The cautery wire 930 can supply power to the knife 902, which power is typically directed through the blade (912 for example in Fig. 1) to a local area of tissue. The mounting clip 1118 can have a bore 1120 to receive the lightguide 914. The bore 1120 may be approximately triangular in cross-section, as shown in Fig. 13, or may adopt any of the shapes described about for the bore 920 or fastener 922, 922'. The mounting clip 1118 can also have a fastener 1122 to receive the cautery wire 930 or another part of the knife 902, such as the proximal end 928 of the knife 902. [09] A mounting clip according to the depicted embodiment could be positioned by sliding it along the cautery wire 930, or, alternatively, by sliding it over the distal end (not shown) of the knife 902. In such an instance, the mounting clip 1118 could be made of an elastic material capable of stretching sufficiently to fit over the knife 902 and still have a fastener 1122 appropriately sized to grip the wire 930, the proximal end 928, or some other portion of the knife 902. The fastener 1122 may also adopt a configuration such as depicted in Fig. 3, in which it has a "C" shape and can snap onto and off of the cautery wire 930, proximal end 928, or other portion of the knife 902. The mounting clip 1118 may have a grip surface 1102 to facilitate manipulation of the mounting clip 1118. Other embodiments of the mounting clip, such as mounting clip 918, 918' may also have a grip surface. [10] Fig. 14 shows an exemplary embodiment in which the mounting clip 1118 can be attached to the proximal end 928 of the knife 902 by sliding it onto the proximal end 928 of the knife 902. The mounting clip 1118 may be slid along the cautery wire 930. Alternatively, the cautery wire 930 can be detached from the knife 902, the mounting clip 1118 attached to the proximal end 928, and the cautery wire 930 reattached to the knife 902. [11] Fig. 15 shows another exemplary embodiment in which the mounting clip 1118 can have a longitudinal cut 1130 to facilitate attachment to and removal from the knife 902 or a portion thereof, including but not limited to the cautery wire 930, the proximal portion 928, the shaft (not shown), distal portion (not shown), the insert (not shown), and the blade (not shown). The mounting clip, in particular the fastener 1122, can deform when pressure is applied to attach or remove the mounting clip 1118. A bore 1120 can adopt the properties described above for bores. As shown in Fig. 16-18 in cross-section, respectively, the bore 1120 may be attached to the surface of the mounting clip 1118, under the surface of the mounting clip 1118, or form part of the surface of the mounting clip 1118. [12] Fig. 19 depicts a mounting clip 1218 having a fastener 1222 and a bore 1220 as described above that can be mounted to a knife 1202 having a distal portion 1208 and a blade 1212 including an insert 1224. The bore 1220 may have an extended length to determine a set distance between the blade 1212 and a lightguide or optical fiber (not shown) when disposed in the bore 1220. Blades of a variety of lengths and shapes are employed, e.g., in the surgical arts, to facilitate selective manipulation of structures that may positioned deep within a surgical site. A bore 1220 can be sized to provide an appropriate distance between the location of light output from the lightguide and the blade 1220. An appropriately sized bore 1220 can also facilitate keeping the lightguide in a fixed position relative to the blade 1212 by contacting the lightguide near its distal end (not shown).

[13] Fig. 20 depicts an exemplary embodiment in which the lightguide can be incorporated into the blade. The blade 1312 can attach to the knife 1302 as described elsewhere. The blade can include a center conductor 1352 to deliver cauterizing energy disposed within a lightguide 1314 through which light can be transmitted. In an embodiment (not shown), the blade can have a hollow conductor for transmitting energy, through which light may be transmitted. Thus, the blade can be the lightguide. [14] In an embodiment, a tool such as knife 1302 could also provide suction. The suction could facilitate the removal of smoke and liquid that can be generated at a surgical site. The distal end of the knife 1302 can include an aperture 1356 to which a suction system is attached. An exemplary suction system is described in U.S. Patent No. 5,800,431 to Brown, the contents of which are incorporated herein by reference. Analogously, a lightguide could be attached to a suction tool according to a variety of embodiments described herein. [15] Fig. 21 depicts an exemplary embodiment in which a lightguide 1314' is integrated in the blade 1312'. The blade 1312' may be attached to a knife (not shown) as described elsewhere. The lightguide 1314' could attach to a lightguide on the knife (not shown) that could transmit light from a light source. The lightguide 1314' could be disposed on the surface of the blade 1312', or could be disposed within the blade 1312', as depicted in cross- section by way of example in Fig. 22.

[16] Fig. 23 depicts an exemplary embodiment in which a lightguide 1414 can be attached to a knife 1402 by a proximal mounting clip 1419 and a distal mounting clip 1418. The mounting clips 1418, 1419 may have respective bores, 1420a, 1420b. The bores may be aligned to admit a lightguide 1414 therethrough. The bores 1420a, 1420b could also receive a tube through which an optical fiber may be inserted. The bores 1420a, 1420b may be axially aligned to admit a straight lightguide 1414, or may arranged otherwise to admit, for example, a curved or bent lightguide (not shown). Supporting the lightguide 1414 by two mounting clips 1418, 1419 may facilitate stability of the lightguide 1414 by providing two points of attachment to the knife 1402. Mounting the lightguide 1414 on the two mounting clips 1418, 1419 may also facilitate adjustment of the lightguide 1414, e.g., by sliding the lightguide 1414 along, e.g., the long axis of the knife 1402 to optimize the distance between the lightguide 1414 and the blade 1412. The distal mounting clip 1418 may be attached to, e.g., the shaft 1404, the distal portion 1408 of the knife 1402, the insert 1424, the blade 1412, or some other portion of the knife 1402. The proximal mounting clip 1419 may be attached to the knife 1402 at, e.g., the proximal portion 1428, the cautery wire 1430, the shaft 1404, or some other portion of the knife 1402. The lightguide 1414 could also be attached to the knife 1402 by a series or plurality of mounting clips (not shown) deployed at a variety of positions along, e.g., the knife, the blade, and the cautery wire.

[17] In an embodiment, the lightguide or tube could include a malleable or ductile material that would facilitate positioning, aiming, or directing the lightguide or light emitted from the lightguide. Light from the lightguide could also be directed into a plurality of fibers, as disclosed, e.g. in U.S. Patent No. 4,597,030 to Brody et al.

[18] Fig. 24 shows an exemplary embodiment in which a light source is integrated into the blade. Blade 1512 can include a light 1554 that may be, e.g., a light emitting diode (LED). The light 1554 could draw power from a conduit (not shown) from the knife, or from energy being delivered through the blade 1512, from a battery disposed on the knife or on the blade 1512, or in another way known in the art. The LED could be shaped and/or oriented to promote projection of light toward the area where the blade 1512 is being used. In an embodiment, the blade itself could include an iridescent or light-emitting material, such as those described, e.g., in U.S. Patent No. 6,310,364 to Uemura, in U.S. PatentNo. 6,285,130 to Nakagawa et al, or in U.S. Patent No. 5,932,363 to Hu et al., or to others known in the art. [19] Fig. 25 illustrates attachment of the lightguide 914 to knife 902 via mounting clip 918, which in this embodiment is a resilient member shown in cross-section in Fig. 4. Mounting clip 918 is somewhat stretchable and slips over knife shaft 904 and is retained in firmly position. Lightguide 914 can be held in place in bore 920 by friction. Mounting clip 918 can be contoured to fit comfortably in the hand of a user of knife 902.

[20] It will be understood that the embodiments described above are illustrative of some of the applications and principles of the present invention. Various modifications may be made by those skilled in the art without departing from the spirit and scope of the invention. For example, different materials and shapes can be employed for forming the different elements of the lighting system. As another example, additional distal clips could be used to attach the lightguide to the leg or legs of the forceps closer to the forceps tip. The light guide could surface mounted or could be incorporated into the body of the clip. Or, for example, the anchor base could be made in a variety of different geometries and configurations to permit proper fixation of the anchor base to differently sized or shaped knives. Alternative configurations could include single piece or multi-piece anchor bases. Multi-piece bases could include the use of a separate outer shell that mounts over an inner shell in which the outer shell would work in connection with the inner shell to hold the lightguide onto the instrument. Such outer shell could take the form of a cap, with or without pinch points, a sliding sleeve, or wedge shapes. Optionally, the inner shell would be of a softer material than the outer shell. Such alternative anchor base configurations, in addition to friction fit, could further include one or more locking mechanisms for mounting the base to the knife, such as: set screws, ratchets, cable ties, adhesives, spring clamps, roller clamps, cam or lever locks, elastic bands or hook and loop fasteners. In addition, the anchor base could permit the lightguide to be attached thereto through a variety of mechanisms, including mechanisms that provide a snap on connection such as compressible polymer foam, set screws, elastically deformed prongs to provide friction, and a range of latches, clasps, clamps and other affixation mechanisms familiar to those of ordinary skill in the art. Devices desiring permanent attachment of the base or lightguide could utilize welding, rivets, tight friction fit or chemical bonding as a means of attachment the base and/or lightguide to the tool. [21] Furthermore, the lightguide as used in the present invention may be either rigid or flexible. A flexible lightguide may be formed, for example, from a pliable polymer tube that has a metal wire inside. In such an embodiment, the polymer light tube may be manipulated into a particular geometric configuration to focus the light properly on the target. The result of this manipulation would then be firmly retained by the metal wire. [22] The fiber optic cable assembly as used herein may of any suitable thickness or material including but not limited to glass or acrylics. Most preferred is a 1.5 mm acrylic material.

The embodiments depicted and described provide illustrations of adjustable or flexible light sources according to the present invention. Other embodiments demonstrating this principle and other principles of the present invention may also be produced using no more than routine experimentation. Other modifications, substitutions and additions can be also made without departing from the scope of the invention.

It is to be understood that variations and modifications of the present invention can be made without departing from the scope of the invention. It is also to be understood that the scope of the invention is not to be interpreted as limited to the specific embodiments disclosed herein, but only in accordance with the appended claims when read in light of the forgoing disclosure.

Claims

CLAIMS What is claimed is:

1. A lighting accessory for an electrocautery knife, the knife having a distal end for connection to a blade and a proximal end for coimection to a source of electrical power, comprising: a lightguide having a distal end for directing light and a proximal end for attachment to a light source; and, a retaining member having means for retaining said lightguide and means for attachment to the electrocautery knife wherein said lightguide directs light toward a blade of the knife.

2. The lighting accessory of claim 1 wherein said means for attachment to the electrocautery knife comprises a resilient material adapted to be manually expanded and slipped over at least a portion of the knife and when released in a preselected position the resilient material gripping the portion of the knife and staying relatively fixed in place relative to the knife.

3. The lighting accessory of claim 2 wherein said retaining member being adapted for easy removal from the knife by manually expanding said resilient material and slipping said material from said knife.

4. The lighting accessory of claim 1 wherein said means for retaining said lightguide comprises said retaining member having a portion that defines at least a portion of an aperature adapted to grip and retain said lightguide in a relatively fixed orientation in relation to said knife.

5. The lighting accessory of claim 4 wherein said lightguide is slidable in said aperature for adjustment of the light being directed to the blade from said lightguide.

6. The lighting accessory of claim 1 wherein said retaining member attaches to the blade of the knife.

7. The lighting accessory of claim 1 comprising a plurality of retaining members.

8. The lighting accessory of claim 1 wherein said means for attachment to the electrocautery knife comprises a relatively rigid C-shaped clip for clipping onto at least a portion of the knife.

9. The lighting accessory of claim 1 wherein said means for attachment to the electrocautery knife comprises a member having a circular cross-section for slipping over at least a portion of the knife.

10. The lighting accessory of claim 1 wherein said retaining member being integrally formed with said knife.