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Description  |
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FIELD OF THE INVENTION
The present invention relates generally to medical equipment and more
particularly to a device which may be inserted into the body through an
existing orifice or small incision and subsequently utilized to pulverize,
granulate, smash, crush, shatter, grind, tear, shred, cut, mulch,
liquidize, or otherwise reduce the size of surgically excised tissues
(e.g. organs, tumors, adhesions), calculi (e.g. kidney stones, bladder
stones, gallstones) or other matter contained within a sac-like anatomical
structure or artificial containment bag positioned within the body.
BACKGROUND OF THE INVENTION
The development of modern endoscopic instrumentation has significantly
affected the manner in which many surgical procedures are performed.
Indeed, many procedures which have traditionally required large surgical
incisions (e.g. laparotomy) may now be performed endoscopically, by
inserting an endoscopic viewing device (e.g. a laparoscope, arthroscope,
bronchoscope, etc.) along with various surgical instruments through
natural body openings or small incisions.
The development of modern endoscopic surgical procedures has enabled
surgeons to perform major operative procedures at relatively low risk,
without the need for deep muscle relaxation and with minimal blood loss
and minimal post-operative discomfort.
In particular, recent advancements in laparoscopic technology have enabled
surgeons to perform various intra-abdominal surgical procedures through
one or more relatively small (e.g. 1 cm) laparoscopy incisions rather than
through the traditional, relatively large (e.g. 5-20 cm) laparotomy
incision. Although the laparoscopic technology is advanced enough to
permit surgeons to laparoscopically excise various tissues and/or organs
within a body cavity, (e.g. tumor removal, appendectomy, nephrectomy,
cholecystectomy, etc.) the ultimate success and feasibility of such
laparoscopic surgery is often confounded by the fact that the excised
tissue, organ or other matter may simply be too large to be extracted from
the body cavity through the relatively small (e.g. 1 cm) laparoscopy
incision. In such instance, it may be necessary to enlarge the laparoscopy
incision in order to effect extraction and removal of the excised tissue
or other matter. Such need for enlargement of the laparoscopy incision
partially negates the benefits of performing the procedure
laparoscopically because enlargement of the incision is likely to cause
additional post-operative discomfort and is likely to increase
post-operative recovery time.
Similar problems in extracting and removing tissue or organs may be
experienced in other contemporary endoscopic surgical procedures,
including those which are performed through natural body openings such as
the oral cavity, urethra, vagina, rectum, etc.
The present invention may be used with any type of endoscopic surgical
procedure wherein it is desired to remove a mass of tissue or other matter
from the body through a relatively small opening. Because the present
invention is particularly applicable to intra-abdominal laparoscopic
surgical procedures, the invention will be described herein with
particular reference thereto. The making of such particular reference to
laparoscopic surgical procedures shall not, however, constitute a
limitation on the overall description and intended application of the
present invention. In fact, in addition to intra-abdominal laparoscopic
procedures, the present invention may be usable in many other types of
procedures, including but not limited to transurethral removal of bladder
stones, standard cholecystotomy and a modified cholecystotomy procedure
known as "mini-cholecystostomy" wherein the gallbladder is, under
laparoscopic guidance, displaced and sutured onto the peritoneal wall with
subsequent formation of an incision or stoma through the abdominal wall,
directly into the stone-containing gallbladder. Furthermore, the device of
the present invention may be inserted into an organ to reduce and/or
remove the contents thereof without the need for initial excision of the
organ. For example, the device of the present invention may be inserted
directly through the abdominal wall and into the gallbladder, urinary
bladder or other sac-like structure wherein the device may be utilized to
reduce the size of and/or remove aberrant material (e.g. calculi)
contained within the organ, without the need for excision and removal
thereof.
i. The General Methodology of Laparoscopic Surgery
Laparoscopy has, for some time, been used in the treatment of gynecologic
diseases. More recently, and largely due to the development of highly
efficient laser cutting and coagulation devices, laparoscopy has shown
promise as a modality for performing various other general surgical
procedures which had heretofore been performed through relatively large
(e.g. 5-40 cm) laparotomy incisions. Indeed, frequently performed
intra-abdominal surgical procedures such as cholecystectomy and
appendectomy may now be approached with the laparoscope through a
relatively small (e.g. 1 cm) abdominal puncture. The feasibility of
performing such operations is, however, dependent upon the ability of the
surgeon to extract and remove the excised tissue or organ from the body.
In accordance with standard laparoscopic technique, an inflation needle is
initially inserted into the peritoneum and carbon dioxide is passed into
the peritoneum to create a distended pneumoperitoneum. Thereafter, a small
periumbilical incision is formed and a primary portal or trocar is
inserted, through such periumbilical incision, into the distended
peritoneum. The laparoscope is then inserted into the peritoneum through
the primary umbilical trocar. One or more secondary trocars or accessory
portals may also be inserted through one or more secondary incisions or
puncture wounds formed in the abdominal wall. Such secondary trocars or
accessory portals are generally used for passage of blunt forceps,
cannulas and other instruments into the abdomen. After such instruments
have been inserted through the accessory portals, the instruments are used
to carry out the desired surgical excision and/or manipulation of organs
and tissues within the abdomen while the surgeon views the operative site
through the previously inserted laparoscope. The surgically excised tissue
or other material which is to be removed during the surgical procedure
must then be extricated from the body, preferably by extraction through
one of the previously made laparoscopy portal incisions.
ii. A Specific Procedure for Laparoscopic Cholecystectomy
One particular laparoscopic surgical procedure which has become relatively
common in clinical application is the "laparoscopic cholecystectomy". The
laparoscopic cholecystectomy generally requires insertion of a laparoscope
through the primary periumbilical portal and various forceps and other
operative instruments through the secondary portals. The gallbladder is
then grasped with forceps, clips are placed on the cystic artery and bile
duct and the gallbladder is subsequently excised. Thereafter, the
laparoscope is extracted from the primary portal and relocated to a
secondary portal. Forceps are then utilized to move the gallbladder to a
position adjacent the periumbilical incision and to exteriorize the neck
of the gallbladder through the periumbilical incision. If possible, the
entire body of the gallbladder is then extracted through the periumbilical
incision. Such extraction of the gallbladder may be complicated, however,
in instances where the diseased stone-containing gallbladder is too large
to pass through the relatively small (e.g. 1 cm) periumbilical incision.
In such instances, it is current practice to insert forceps through the
exteriorized neck of the gallbladder to attempt to manually crush and
remove some or all of the gallstones. Such manual crushing of the
gallstones is time-consuming and may well result in perforation of the
gallbladder wall. Alternatively, the surgeon may elect to enlarge the
small (e.g. 1 cm) periumbilical incision in order to remove the entire
body of the stone-containing gallbladder. Such enlargement of the incision
is undesirable and may lead to increased post-operative discomfort.
In view of the problems associated with removing tissue, organs, or other
material through a relatively small (e.g. 1 cm) laparoscopy incision,
there exists a need in the art for an instrument which may be passed into
the peritoneum through the standard (e.g. 1 cm) laparoscopy incision to
liquidize and/or pulverize tissue or other material (e.g. gallstones) and
to aspirate such liquidized/pulverized material from the body cavity.
One instrument which has previously been devised for liquidizing tissue
during endoscopic surgical procedures is described in the literature. K.
T. Ison, M. J. Coptcoat, A. Timoney, and J. E. A. Wickham, "The
Development and Application of a Surgical Device-The Endoscopic Liquidizer
and Surgical Aspirator (ELSA)", Journal of Medical Engineering and
Technology, Vol. 13; No. 6 (November/December 1989), pg. 285-289. Such
instrument is intended to be inserted through the working channel of an
endoscope and incorporates an internal suction lumen along with a rotating
cutting head so as to access, liquidize and aspirate tissue through a
common instrument which is positioned in and inserted through the working
channel of the endoscope.
Various other instruments for fragmenting, pulverizing or reducing the size
of materials in situ have also been described. Examples of such
instruments are found in U.S. Pat. Nos. 4,823,793 (Angulo et al.),
4,681,106 (Kensey), 4,700,705 (Kensey), 4,631,052 (Kensey), 4,002,169
(Kulper).
SUMMARY OF THE INVENTION
The present invention overcomes some or all of the shortcomings of the
prior art by providing a device which is insertable through an existing
body orifice or small incision and which is usable to pulverize,
granulate, smash, crush, shatter, grind, tear, shred, cut, mulch,
liquidize or otherwise reduce the size of surgically excised tissues,
calculi or other matter contained within a sao-like anatomical structure
or intracorporeally positioned artificial containment bag.
In accordance with the invention, there is provided a device comprising an
elongate cutting tool having a distal cutting head such as a rotatable
cutting head or impactor, disposed thereon. In one embodiment, the
elongate cutting tool may optionally incorporate one or more
infusion/aspiration lumens running longitudinally therethrough. In another
embodiment, there may be provided an aspiration/infusion/guide cannula
which is separate from the elongate cutting tool. The separate
aspiration/infusion/guide cannula may be preinserted through a body
opening into the intracorporeally positioned organ or containment bag and
the elongate cutting tool may be inserted through the
aspiration/infusion/guide cannula, operated and subsequently extracted.
After the cutting tool has been employed to reduce the size of material
contained with the organ or sac, such material may be aspirated through
the separate aspiration/infusion/guide cannula prior to or after
extraction of the cutting tool therefrom.
In accordance with one embodiment of the invention, there is provided a
device comprising (a) an elongate cannula insertable through a body
opening into the intracorporeally positioned organ or artificial
containment bag, (b) an elongate cutting tool having a distal cutting head
mounted thereon, said elongate cutting tool being insertable through the
elongate cannula such that the cutting head will reside adjacent to the
distal end of said cannula, and (c) drive motor which is attachable to the
proximal end of the elongate cutting tool for driving the cutting head in
a manner that will effect size-reducing treatment of material contained
within the intracorporeally positioned organ or artificial containment
sao. The cannula portion of the device may further comprise a protective
assembly formed on the distal end of the elongate cannula to guard the
cutting head and to prevent the cutting head from inadvertently damaging
or puncturing the walls of the surrounding containment sac.
Various sizes and types of cutting heads may be provided for effecting
various types of applications including, but not limited to, pulverization
of kidney stones, pulverization of gallstones, pulverization of bladder
stones, liquidization of excised tissues or tumors, etc.
The rotatable cutting head or impactor deployed on the elongate cutting
tool may be specifically configured to create a circulatory fluid motion
and/or drawing effect so as to effectively pull matter into contact with
the rotating cutting head or impactor. Also, the leading edges of such
rotating cutting head or impactor may be bevelled or sharpened to
facilitate movement of the rotating head or impactor through the
surrounding fluid and/or to enhance the matter cutting or matter breaking
effect of the rotating head or impactor and/or to enhance the
above-described circulatory fluid motion such that matter will be pulled
or drawn into contact with the rotating head or impactor. In some
embodiments, the rotating head or impactor may comprise a plurality of
individual members which emanate outwardly from a central hub or shaft.
Such individual members may be twisted, bent or pitched in a manner that
will cause the formation of and/or enhancement of the above-described
circulatory fluid motion and/or drawing effect whereby matter is pulled or
drawn into contact with the rotating head or impactor.
In accordance with a further aspect of the invention, there is provided a
method for removing material from an intracorporeally positioned organ or
artificial containment sac. Such method comprises insertion of an elongate
cutting tool into an intracorporeally positioned organ or artificial
containment sac which may be partially exteriorized through a body opening
or small incision to contain a quantity of material to be removed
therefrom. A rotatable cutting head or impactor on the distal end of the
elongate cutting tool is then rotated so as to effect size-reducing
treatment of the material contained within the organ or containment sac.
Following the size-reducing treatment, the cutting tool is extracted from
the cannula and the material is aspirated from the sac through an
aspiration cannula which is no larger than the existing body opening or
small incision.
In accordance with a further aspect of the invention, there is provided a
pliable, intracorporeally positionable, artificial containment sac formed
of flexible material. The artificial containment sac is preferably sized
and configured so as to be insertable through an existing body orifice or
small incision, such as a 1 cm laparoscopy incision. In this respect, the
artificial containment sac may be constructed so as to be foldable,
compressible or otherwise collapsible to a small-diameter configuration
which is insertable through a body orifice or small (e.g. 1 cm)
laparoscopy incision. After the artificial containment sac has been
inserted into the body, through the body orifice or small laparoscopy
incision, it may be unfolded, decompressed or otherwise expanded to a
fully operative bag-like configuration. Thereafter, a quantity of tissue
or other material may be inserted into the containment sac and the sac may
be positioned adjacent to, or may be partially exteriorized through, a
body opening or incision. The device of the present invention or other
type of cutting tool may then be inserted through the body opening or
incision and into the containment sac to effect size-reducing treatment of
the material contained within the organ or containment sac. In one
preferred embodiment, the artificial containment sac comprises a simple
bag-like structure having a single open end. A purse string, compressible
closure, adhesive or other closure mechanism or closure means is provided
for closing off the open end of the bag-like structure after the tissue or
other material has been inserted thereinto. In another embodiment, the
containment sac may comprise a bag-like body having two or more
openings----e.g. one large sealable opening through which a bolus of
tissue, tumor, organ or other excised material may be inserted and a
second small neck opening or tube which may be at least partially
exteriorized through an existing body orifice or small laparoscopy
incision. The exteriorized neck portion or tube thus provides a convenient
passageway through which an elongate cutting device, such as the device of
the present invention, may be inserted into the sac to effect size
reducing treatment (e.g. liquidization, pulverization, etc.) and
subsequent aspiration of the tissue, tumor, organ or other material
contained within the sac.
Further objects and advantages of the present invention will become
apparent to those skilled in the art upon reading and understanding the
following detailed description and the accompanying drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a perspective view of a first embodiment of the present
invention.
FIG. 2 is a side elevational view of the distal portion of a first
embodiment of the present invention, wherein a plurality of distal
shielding members are disposed in a splayed "operative" configuration.
FIG. 3 is a distal end view of a first embodiment of the present invention
wherein a plurality of distal shielding members are disposed in a splayed
"operative" configuration.
FIG. 4 is a cross-sectional view through line 4--4 of FIG. 1.
FIG. 5 is a perspective view of a first embodiment of the present invention
attached to an alternate pistol-type, hand-held power drive unit.
FIG. 6 is a perspective view of a first example of a rotary impacting
member usable in the first embodiment of the present invention.
FIG. 7 is a perspective view of a second example of a rotary impacting
member usable in the first embodiment of the present invention.
FIG. 8 is a perspective view of a third example of a rotary impacting
member usable in the first embodiment of the present invention.
FIG. 9 is a schematic showing of a first step in the operation of the
device of FIGS. 1 or 5, whereby the distal end of the device of the first
embodiment of the present invention is about to be inserted into a
stone-containing gallbladder, the neck of the gall bladder having been
exteriorized through the laparoscopy incision.
FIG. 10 is a schematic showing of a second step in the operation of
the-device of FIGS. 1 or 5, whereby the distal end of the device of the
first embodiment of the present invention has been inserted into a
stone-containing gallbladder and the tip members thereof are disposed in a
splayed or open configuration.
FIG. 11 is a schematic showing of the gallbladder of FIG. 10 after the
stones contained therein have been fragmented and withdrawn such that the
gall bladder may be extracted through the laparoscopy incision.
FIG. 12 is a longitudinal sectional view of a second embodiment of the
present invention.
FIG. 13 is a perspective view of a second embodiment of the present
invention in its fully assembled "operative" configuration including: (a)
a motor/hand piece component, (b) an aspirator/guide cannula and
protective cage assembly component, (c) a bearing tube disposed within the
aspirator/guide cannula and protective cage assembly unit, d) a drive
shaft disposed within the bearing tube and (e) an impactor head disposed
on the distal end of the drive shaft.
FIG. 13a is an enlarged view of the cap member attached to the device shown
in FIG. 13.
FIG. 14 is a perspective view of the aspirator/guide cannula and protective
cage assembly component of the device shown in FIG. 13.
FIG. 15 is a perspective view of the bearing tube assembly component of the
device shown in FIG. 13.
FIG. 16 is a perspective view of the drive shaft and impactor head
components of the device shown in FIG. 13.
FIG. 17 is an enlarged perspective view of the distal tip of the device
shown in FIG. 13.
FIG. 18 is a longitudinal sectional view of the distal tip of the device
shown in FIG. 13.
FIG. 19 is an enlarged view of the distal tip portion of the
aspirator/guide cannula and protective cage assembly shown in FIG. 14.
FIG. 20 is a longitudinal sectional view of the distal tip portion of the
aspirator/guide cannula and protective cage assembly shown in FIG. 14.
FIG. 21 is an enlarged perspective view of the distal tip portion of the
bearing tube assembly component shown in FIG. 15.
FIG. 22 is a sectional view of the distal portion of the bearing tube
assembly of FIG. 21.
FIG. 23 is an enlarged view of the distal tip portion of the drive shaft
and the impactor head component of FIG. 16.
FIG. 24 is a longitudinal sectional view of the distal tip portion of FIG.
23 showing a preferred seal assembly which interfaces between the drive
shaft component of FIG. 16 and bearing tube component of FIG. 15.
FIG. 25 is a longitudinal sectional view of a portion of the bearing tube
component of FIG. 15, having the drive shaft component of FIG. 16 disposed
therein.
FIG. 26 is a schematic showing of a first step in the operation of the
device of FIG. 13, whereby the aspirator/guide cannula and protective cage
assembly has been inserted into a stone-containing gallbladder.
FIG. 27 is a schematic representation of a second step in the operation of
the device of FIG. 13 whereby the bearing tube, drive shaft and impactor
head assemblies have been advanced through the aspirator/guide cannula,
causing the protective cage assembly to open to a splayed "operative"
configuration.
FIG. 28a is a perspective view of a first embodiment of an artificial
containment sac of the present invention.
FIG. 28b is a perspective view of a second embodiment of an artificial
containment sac of the present invention.
DETAILED DESCRIPTION OF TWO PREFERRED EMBODIMENTS
The following detailed descriptions and the accompanying drawings are
provided for purposes of illustrating and describing a presently preferred
embodiment of the invention and are not intended to limit the scope of the
invention in any way.
i. A First Embodiment
Referring now to FIGS. 1-8, one presently preferred device 10 of the
present invention comprises an elongate cutting and aspiration device
which is detachably connectable to a hand-held drive unit 12a (FIG. 1),
12b (FIG. 5). The hand-held drive unit 12a, 12b may be formed in a
generally cylindrical handle type configuration 12a or may be formed as a
pistol grip type configuration 12b. Those skilled in the art will
recognize that other configurations are likewise suitable.
An elongate cylindrical shaft or housing 14 has a proximal end P and a
distal end D. The portion of the shaft 14 near the distal end D thereof
comprises a plurality of openable and closeable tip members 16a, 16b, 16c
and 16d (best shown in FIG. 3) which operate to form a protective assembly
or cage around the cutting head or impactor 26a, 26b, 26c. Such tip
members 16a, 16b, 16c and 16d are alternately deployable in a "closed"
configuration as shown in FIG. 1 or an "open" configuration as shown in
FIGS. 2 and 3.
A drive shaft 24 is rotatably disposed and supported within the elongate
cylindrical housing 14. A plurality of bearings or bushings 20 may be
disposed within the elongate housing 14 to support and/or facilitate
rotation of the drive shaft.
Upper and lower infusion and/or aspiration lumens 18a, 18b (FIG. 4) extend
longitudinally through the elongate shaft 14 of the device 10 so as to
provide passageways through which fluids may be infused (distally) and/or
air, fluids, debris or other matter may be aspirated (proximally) and
subsequently removed or discarded. Both infusion/aspiration lumens 18a,
18b may be separately accessible through separate side arm connectors 20
or, as in the embodiment shown, both lumens 18a, 18b may terminate in a
common internal collection manifold, reservoir or void formed within the
proximal portion P of the elongate shaft 14. In such embodiment a single
side arm connector 20 opens into such common manifold within the proximal
portion of shaft 14 to provide for concomitant infusion/withdrawal through
both lumens 18a, 18b. An ancillary infusion or aspiration apparatus, such
as a suction tube 22, infusion tube or syringe may be attached to side arm
connector 20 to effect the desired infusion or aspiration through lumens
18a, 18b.
When it is desired to aspirate material proximally through the lumens 18a,
18b the tube 22 may comprise a suction or vacuum tube attached to standard
wall suction, a dedicated suction pump or other suction means whereby the
operator may apply continuous and/or intermittent suction through the
lumens 18a and/or 18b.
Additionally, it will be appreciated that the device may be provided with
both a fluid supply lumen 18a or 18b and a separate aspiration lumen 18a
or 18b, so that fluid may be infused (distally) through one lumen into the
intracorporeal containment sac (e.g. natural organ or artificial sac)
while fluid/stone fragments/debris or other material is simultaneously or
intermittently aspirated (proximally) through a separate lumen. Such
concomitant infusion and aspiration may effect a lavage-like washing of
the interior of the organ or sac into which the device 10 has been
inserted so as to efficiently remove or extract fluid, debris, stone
fragments or other matter therefrom.
While it is preferable to incorporate one or more infusion and/or
aspiration lumens 18a, 18b within the elongate shaft 14 as shown, it will
be appreciated that such lumens 18a, 18b are optional features of the
device 10 and may be eliminated altogether.
Power unit 12a, 12b may be operatively connected to the proximal end P of
the elongate shaft 14 by any feasible mechanical, magnetic or other
connection means by which the power unit 12a, 12b may engage and rotatably
drive shaft 24 so as to cause resultant rotation of the impactor head 26a,
26b, 26c. The power unit 12a, 12b comprises an outer housing 28a, 28b
wherein a small electric or pneumatic motor is mounted. The electric or
pneumatic motor is sized and adapted to drive the drive shaft at a fixed
speed or may be capable of driving the drive shaft at variable speeds as
desired. The electric or pneumatic motor (not shown) is connected to a
drive assembly which mechanically, magnetically, or by other means, drives
shaft 24a (FIG. 2 and FIG. 6), 24b (FIG. 8), 24c (FIG. 7) in a rotary
fashion. An electrical power cord or pneumatic pressure line 30a, 30b is
connected to the power unit 12a, 12b so as to provide the necessary
pneumatic or electrical power to the motor disposed within housings 28a,
28b and on/off or variable speed control trigger 21a, 21b actuates the
motor.
The "pistol grip" power unit 12b shown in FIG. 5 incorporates an "enable
switch" 31 which must be closed in order for the motor disposed within
housing 28b to be actuated. As shown, the hand grip 33 may be pulled back
to depress enable switch 31, thereby closing the enable switch 31 and
allowing the motor to be actuated upon depression of trigger 21b. If the
enable switch 31 is not closed, compression of trigger 21b will be
ineffectual, and will not result in actuation of the motor.
In the first embodiment, the tip members 16a, 16b, 16c, and i6d are hinge
mounted or otherwise pivotally connected to the distal end D of the
elongate shaft 14 so as to be alternately deployable in a closed
configuration (FIG. 1) or an open configuration (FIGS. 2 and 3). When in
the closed configuration, the outer surfaces of the tip members 16a, 16b,
16c and 16d form a smooth, cylindrical surface which is generally
continuous with and emanates forward to the outer surface of the elongate
shaft 14 so as to permit smooth, unencumbered introduction of the distal
portion of the elongate shaft 14 into the gallbladder or other sac through
a small (e.g. 1 cm) incision or opening.
When the tip members 16a, 16b, 16c, 16d are deployed in their "open" or
splayed configuration they will form a protective cage around the rotating
head or impactor 26a, 26b, 26c to prevent the head or impactor from
damaging or puncturing a surrounding organ or artificial containment sac.
Also, it is preferable that the distal tip members 16a, 16b, 16c, 16d be
configured such that, when deployed in said open or splayed configuration,
will form an abutment means which, upon attempted proximal withdrawal of
the device, will abut against the neck of the organ or sac and/or the body
wall so as to prevent the device from being accidentally withdrawn during
use and also to maintain proper positioning of the cutting head (i.e. the
operator may purposely withdraw the instrument to a point where the open
tip members 16a-16d abut against the body wall thereby ensuring that the
cutting head is at or near the top of the organ or artificial sac and not
near the fundus or bottom wall thereof as may result in damage or puncture
of the organ or artificial sac.
The embodiment of the invention shown in FIGS. 1 and 5 may incorporate any
suitable means for controlling the opening and closing of the distal tip
members 16a-16d. For example, in the embodiment shown in FIG. 1 wherein
the generally cylindrical motor drive hand piece 12a is employed, a
rotatable dial member 23 may be attached to one or more
advanceable/retractable members 15 which extend through the elongate shaft
14 and are attached at their distal ends to the tip members 16a-16d. The
advanceable/retractable members 15 are connected to the dial member 23 by
gears or other mechanical transfer arrangement such that turning of the
dial member 23 in one direction (e.g. clockwise) will cause proximally
directed advancement of the members 15, thereby forcing the distal end
pieces 16a-16d to pivot on hinged connections to their open or splayed
configuration shown in FIGS. 2 and 3. Thereafter, turning of the dial 23
in its opposite direction (e.g. counter-clockwise) will cause the members
15 to retract in a distal direction, thereby pulling the distal end pieces
16a-16d back to their original closed configuration as shown in FIG. 1.
Alternately, in embodiments which incorporate a pistol grip-type hand piece
12b, a separate protective assembly trigger 33 may be employed. Such
trigger 33 may be connected by way of rack and pinion gears or other
mechanical interconnection to one or more members 15 extending
longitudinally through the elongate shaft 14 of the device such that, when
the trigger 33 is retracted against the hand piece the members 15 will
advance in the distal direction causing the distal end pieces to open into
their splayed configuration. Alternately, when the trigger 33 is allowed
to return to its resting position, as shown, the member(s) 15 will retract
within the elongate shaft 14 in a proximal direction, thereby allowing the
distal end member 16a-16d to return to their closed position.
As an alternative to the advanceable/retractable members 15 shown, the
hand-actuatable dial 23 or trigger 33 may be operatively connected to any
other suitable type of mechanism capable of opening and closing the tip
members 16a, 16b, 16c and 16d. Such other types of mechanism may include a
cable and pulley system having cable(s) running longitudinally through the
device 10 and attached to the dial 23 or trigger 33 to effectuate
alternate opening | | |
