GB2465615A

GB2465615A - Surgical device for grasping tissue

Info

Publication number: GB2465615A
Application number: GB0821097A
Authority: GB
Inventors: Chris Spencer; Philip Robarts
Original assignee: MID ESSEX HOSPITAL SERVICES NHS TRUST
Current assignee: MID ESSEX HOSPITAL SERVICES NHS TRUST
Priority date: 2008-11-19
Filing date: 2008-11-19
Publication date: 2010-06-02
Also published as: GB0821097D0

Abstract

A surgical device for grasping human or animal tissue within a body cavity, comprises a first2and second3user-actuated members moveably connected via elongated shaft members4to a clamping portion comprising first6and second7jaw members, the jaw members6,7being moveable between an open position and a closed grasping position, and characterised in that the first and second jaw members6, 7comprise interlocking serrations8. Further disclosed is a surgical device as described having an aperture9in at least one of the jaw members6, 7and the surgical device having means 10 for locking the jaw members6, 7. The device may be surgical forceps which may be used for removing endometrial polyps or fibroids from the uterus of a patient.

Description

SURGICAL DEVICE

The invention relates to a surgical device for grasping tissue inside a body cavity S of a human or animal. In particular but not exclusively the invention relates to the use of such a device in the removal of endometrial polyps or fibroids from inside the uterus of a patient.

Endometrial polyps and fibroids are growths of tissue originating in the lining of the uterus. In those cases where troublesome symptoms result, a common form of treatment is to surgically remove the tissue. Although a laproscopic approach is possible in these instances, the preferred method is to use a hysterscopic procedure as this is less invasive and poses a lower risk to the patient. Due to the difficulty of accessing the tissue within the cavity of the uterus, special surgical instruments are needed to perform the procedure. The forceps currently used are not specifically designed for the purpose and have a number of disadvantages. In particular, they do not allow efficient gripping of the tissue resulting in potentially incomplete removal of the growth, which is an undesirable outcome. Moreover, the arrangement of the handles of the forceps is not suited to comfortable use by the surgeon rendering the procedure more difficult than necessary.

According to a first aspect of the invention there is provided a surgical device for grasping human or animal tissue within a body cavity, comprising first and second user-actuated members moveably connected via elongated shaft members to a clamping portion comprising first and second jaw members, said jaw members being moveable between an open position and a closed grasping position, and characterised in that the first and second jaw members comprise interlocking serrations.

This aspect of the invention is designed to allow a surgeon to more effectively grip tissue within a body cavity of a patient. One example of a use of the invention is in the removal of endometrial polyps. Instruments used in such procedures require a balance between a large clamping portion to ensure effective grasping of the tissue and a small clamping portion to aid insertion of the device into the uterus. The serrated interlocking teeth in the clamping portion of the present invention allow a piece of tissue to be very effectively gripped, preventing slippage and ensuring complete avulsion of the pathological tissue. As a result of this improvement, the size of the clamping portion can be reduced, facilitating passage through the cervix into the uterus.

According to a second aspect of the invention there is provided a surgical device for grasping human or animal tissue within a body cavity, comprising first and second user-actuated members moveably connected via elongated shaft members to a clamping portion comprising first and second jaw members, said jaw members being moveable between an open position and a closed grasping position, and characterised in that at least one of said jaw members comprises an aperture.

This aspect of the invention is designed to allow a surgeon to more effectively grip tissue within a body cavity of a patient. One example of a use of the invention is in the removal of endometrial polyps. Instruments used in such procedures require a balance between a large clamping portion to ensure effective grasping of the tissue and a small clamping portion to aid insertion of the device into the uterus. The aperture in one or both jaw members of the clamping portion of the present invention allows a piece of tissue to be effectively grasped. Rather than the tissue being completely compressed by the jaw members, the presence of one or more apertures allows some of the tissue to expand and evert through the aperture while still being gripped. A larger sample of tissue can therefore be accommodated than with jaw members lacking apertures. As a result of this improvement, the size of the clamping portion can be reduced, facilitating passage through the cervix into the uterus.

In one embodiment both jaw members comprise an aperture. This has the advantage of increasing the extra volume of tissue that can be grasped within the jaw members.

In another embodiment the position of the apertures is identical in each jaw member, such that a continuous aperture in the clamping portion is formed when the jaw members are in a closed position. This continuous aperture represents a larger volume than two individual apertures, and can therefore accommodate a larger sample of tissue.

In a further embodiment the apertures are located in a central position within the jaw members. This has the advantage of creating a uniform thickness of material surrounding the aperture resulting in greater structural rigidity of each jaw member.

In one embodiment, the jaw members have substantially the same external dimensions as the shaft members. As described above, one of the advantages of having jaw members with interlocking serrations is that their size can be kept to a minimum. By way of a general example, the height of the jaw members may therefore be equal to the height of the shaft members and the width may be in the range of 80% to 200% (e.g. 140% -160%) of the width of the shaft members. By way of a specific example, a possible set of dimensions could be: height of shaft and jaw members, 7mm; width of shaft members, 6mm and width of jaw members, 10mm.

In another embodiment the jaw members, when closed, form a linear continuation of the elongated shaft members. Regardless of which point the device is viewed from, the jaw members therefore lie in the same plane as the shaft members and the surgeon can accurately judge their position with respect to the rest of the instrument.

In yet another embodiment the jaw members can be opened to a maximum angle of 90 degrees or less.

According to a further aspect of the invention, there is provided a surgical device for grasping human or animal tissue within a body cavity, comprising first and second user-actuated members moveably connected via elongated shaft members to a clamping portion comprising first and second jaw members, said jaw members being moveable between an open position and a closed grasping position, and characterised in that the user-actuated members comprise a means of locking the jaw members into any one of a number of differing positions.

This aspect of the invention is designed to allow a surgeon to more effectively grip tissue within a body cavity of a patient. One example of a use of the invention is in the removal of endometrial polyps. One means of simplifying the procedure for the surgeon is to allow the clamping device to be locked into position, so the clamping effect can be maintained while the surgeon operates other instruments. This will ensure that the tissue sample is not lost if the degree of pressure manually applied to the device is inadvertently reduced momentarily.

Once the device is locked into position, the surgeon can be confident that it will continue to grip the sample of interest until the lock is released. It will be appreciated by the skilled person that it is possible to lock the device into a range of positions which will close the jaw members to a range of varying degrees.

In one embodiment, the locking means comprise a ratchet mechanism. Such a mechanism has the advantage of automatically locking the jaw members into position in gradual increments. If necessary, the locking action can be released by simply manually disengaging the teeth of the ratchet from the pawl. This arrangement gives the surgeon enhanced control over the clamping action of the device.

In another embodiment, the locking means comprise a ratchet mechanism configured to lock upon closure of the jaw members. As the jaws members are moved towards the closed grasping position, they are locked into place in gradual increments by the ratchet. Once the desired degree of clamp has been reached, the user-actuated members can be released without losing any of the grasping action.

In a further embodiment the user-actuated members comprise handle members.

An example of this are handles which allow the surgeon to operate the device with one hand while using the other hand to operate other instruments such as an endoscope.

In another embodiment the handle members are positioned at a substantially 45 degree angle with respect to the elongated shaft members. In the case of the endometrial polyp removal example cited above, this allows the surgeon to access the interior of the uterus while comfortable holding the device. The ergonomic angle of the handle takes account of the position of the surgeon with respect to the patient. It therefore allows the hand of the surgeon to adopt a natural position when performing the procedure, making the latter safer and quicker. It will be appreciated by the skilled person that the angle between the handle members and shaft members can be within the range of 40 to 50 degrees.

In yet another embodiment, the clamping portion of the device is rounded in shape. This feature results in more effective grasping of the tissue as the clamping portion is similar in shape to the polyp it is intended to grip.

In a further embodiment, the device is a surgical forceps. An example of such a device is given in the accompanying figures.

According to another aspect of the invention, there is provided the use of the device for removing endometrial poiyps or fibroids. This will bring a particular advantage in the treatment of pedunculated fibroid poiyps. The method of removing these types of growth traditionally used endometrial resection, which is a time consuming and expensive procedure, needs a highly skilled surgeon and carries greater risks to the patient e.g. fluid overload, uterine perforation and bleeding. Using the device, surgeons will be able to remove such growths hysteroscopically in a manner similar to the removal of endometrial polyps. As a result, a treatment that currently takes 30 minutes (endometrial resection) will be shortened to 5 minutes (using the device), with all the benefits this brings to the patient, for example: greater proportion of day case treatment, less disruptive to other commitments and lower overall risk.

It will be appreciated by the skilled person that all aspects of the invention hereinbefore described can be combined in several ways to produce alternative embodiments of the invention. Three examples are: A device having jaw members comprising interlocking serrations and apertures, additionally having user-actuated members comprising locking means.

A device having jaw members comprising interlocking serrations and user-actuated members comprising locking means, additionally having at least one jaw member comprising an aperture.

A device having jaw members comprising apertures and having user-actuated members comprising locking means, additionally having jaw members comprising interlocking serrations.

The invention will now be described, by way of example only, with reference to the accompanying figures, in which: Figure 1A shows a side view of a surgical forceps embodiment of the invention with the jaw members in an open position; Figure lB shows a magnified view of the jaw members of the surgical forceps shown in Figure 1A; Figure 2 shows a side view of a surgical forceps embodiment of the invention with the jaw members in a closed grasping position; and Figure 3 shows a top view of a surgical forceps embodiment of the invention with the jaw members in a closed grasping position.

Referring first to Figure 1A, a surgical forceps is shown generally as 1, which comprises user-actuated members 2 and 3 (which in this embodiment comprise handle members), shaft members 4 and a clamping portion 5. The clamping portion comprises first and second jaw members, 6 and 7 which are in an open position and comprise interlocking serrations 8. The user-actuated members are equipped with a locking mechanism which in this embodiment is a ratchet 10.

A magnified view of the clamping portion 5 in an open position can be seen in Figure lB. First and second jaw members 6 and 7 are shown, comprising interlocking serrations 8. It can also be seen that in this embodiment, the jaw members 6 and 7 each comprise a central aperture 9.

Figure 2 shows a surgical forceps embodiment of the invention in the same view as described in Figure 1A. In this case however, the jaw members 6 and 7 are in a closed grasping position. It can also be seen that in this embodiment, the height of the jaw members is equal to that of the shaft members.

The same embodiment of the device is shown from a top view in Figure 3. From this viewpoint it can be seen that in this embodiment, the jaw members 6 and 7 comprise central apertures 9 which are in identical positions in each member.

These apertures 9 combine, when the jaw members 6 and 7 are in a closed position, to produce a continuous aperture 9 penetrating through the whole of the clamping portion 5. It can also be seen that in this embodiment, the width of the jaw members 6 and 7 is slightly greater than that of the shaft members 4.

In use, the device is inserted into the uterus of a patient in the closed position as shown in Figure 2. Once the device is inside the uterus and the pathological growth has been identified, the jaw members 6 and 7 are opened by releasing the ratchet 10 (as in Figure 1A) in preparation for grasping the tissue.

The jaw members 6 and 7 are then brought to a closed position over the tissue by moving the handle members 2 and 3 together, which are locked into position in regular increments by the teeth of the ratchet 10. With the jaw members 6 and 7 clamped onto the tissue by means of the ratchet 10, the device can be withdrawn from the patient, removing the pathological tissue.

Claims

CLAIMS1. A surgical device for grasping human or animal tissue within a body cavity, comprising first and second user-actuated members moveably connected via elongated shaft members to a clamping portion comprising first and second jaw members, said jaw members being moveable between an open position and a closed grasping position, and characterised in that the first and second jaw members comprise interlocking serrations.
2. A surgical device for grasping human or animal tissue within a body cavity, comprising first and second user-actuated members moveably connected via elongated shaft members to a clamping portion comprising first and second jaw members, said jaw members being moveable between an open position and a closed grasping position, and characterised in that at least one of said jaw members comprises an aperture.
3. A device as defined in claim 2 wherein both jaw members comprise an aperture.
4. A device as defined in claim 3 wherein the position of the apertures is identical in each jaw member, such that a continuous aperture in the clamping portion is formed when the jaw members are in a closed position.
5. A device as defined in claim 4 wherein the apertures are located in a central position within the jaw members.
6. A device as defined in any preceding claim wherein the jaw members have substantially the same external dimensions as the shaft members.
7. A device as defined in any preceding claim wherein the jaw members, when closed, form a linear continuation of the elongated shaft members.
8. A device as defined in any preceding claim wherein the jaw members can be opened to a maximum angle of 90 degrees or less.
9. A surgical device for grasping human or animal tissue within a body cavity, comprising first and second user-actuated members moveably connected via elongated shaft members to a clamping portion comprising first and second jaw members, said jaw members being moveable between an open position and a closed grasping position, and characterised in that the user-actuated members comprise a means of locking the jaw members into any one of a number of differing positions.
10. A device as defined in claim 9 wherein the locking means comprise a ratchet mechanism.
11. A device as defined in claim 10 wherein the ratchet mechanism is configured to lock upon closure of the jaw members.
12. A device as defined in any preceding claim wherein the user-actuated members comprise handle members.
13. A device as defined in claim 12 wherein the handle members are positioned at a substantially 45 degree angle with respect to the elongated shaft members.
14. A device as defined in any preceding claim wherein the clamping portion is rounded in shape.
15. A device as defined in any preceding claim, which is a surgical forceps.
16. Use of a device as defined in any preceding claim, for grasping tissue inside a body cavity of a human or animal.
17. Use of a device as defined in any preceding claim, for grasping tissue within the uterus of a patient.
18. Use of a device as defined in any preceding claim, for removing endometrial poiyps or fibroids from the uterus of a patient.
19. A device as defined in claims 1 to 5 which additionally comprises locking means as defined in claims 9 to 11.
20. A device as defined in claim 1 and claims 9 to 11, wherein at least one of the jaw members comprises and aperture as defined in claims 2 to 5.
21. A device as defined in claims 2 to 5 and claims 9 to 11, wherein the jaw members comprise interlocking serrations as defined in claim 1.
22. A device substantially as hereinbefore defined with reference to the accompanying figures.