WO2007089631A2 - Ciseaux medicaux adaptes pour des operations chirurgicales de césarienne et procedes relatifs - Google Patents

Ciseaux medicaux adaptes pour des operations chirurgicales de césarienne et procedes relatifs Download PDF

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Publication number
WO2007089631A2
WO2007089631A2 PCT/US2007/002250 US2007002250W WO2007089631A2 WO 2007089631 A2 WO2007089631 A2 WO 2007089631A2 US 2007002250 W US2007002250 W US 2007002250W WO 2007089631 A2 WO2007089631 A2 WO 2007089631A2
Authority
WO
WIPO (PCT)
Prior art keywords
surgical scissors
elongate members
scissors according
surgical
elongate
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.)
Ceased
Application number
PCT/US2007/002250
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English (en)
Other versions
WO2007089631A3 (fr
Inventor
Julius Mallette
Iv John Bossick
Thomas J. Rassau
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.)
East Carolina University
Original Assignee
East Carolina University
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 East Carolina University filed Critical East Carolina University
Publication of WO2007089631A2 publication Critical patent/WO2007089631A2/fr
Publication of WO2007089631A3 publication Critical patent/WO2007089631A3/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B17/3201—Scissors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/08—Accessories or related features not otherwise provided for
    • A61B2090/0801—Prevention of accidental cutting or pricking
    • A61B2090/08021—Prevention of accidental cutting or pricking of the patient or his organs

Definitions

  • the invention relates to surgical tools that are particularly suitable for cesarean section ("C-section") procedures.
  • Embodiments of the invention provide for medical scissors having enhanced safety features.
  • Embodiments of the present invention are directed to surgical scissors that can inhibit fetal lacerations and inadvertent trans-sections of a uterine artery during cesarean section.
  • the scissors may allow for clean incision edges facilitating closure of a uterine incision after delivery.
  • surgical scissors include first and second elongate cooperating members that close to cut target tissue.
  • Each of the first and second elongate members include a rounded forward edge portion.
  • the surgical scissors may optionally have cooperating laterally extending (typically rounded) projections and recesses configured to trap tissue.
  • the recesses may have a tissue contacting surface configured with an anti-slip texture and/or coating.
  • the scissors may be particularly useful for a cesarean-section surgery.
  • the scissors may also be useful for other medical situations, such as EMT applications.
  • Other embodiments are directed to surgical scissors that include first and second elongate cooperating members that close to cut target tissue.
  • Each of the first and second elongate members include at least one cooperating laterally outwardly extending tissue stabilizing projection on a respective inner perimeter surface thereof. In operation, the projections travel closer together to trap tissue and inhibit slippage.
  • Some embodiments are directed toward methods of facilitating a cesarean section.
  • the methods include: (a) trapping tissue between first and second laterally extending stabilizing projections disposed across from each other on elongate members of surgical scissors to inhibit slipping; and (b) cutting tissue with the elongate members of the surgical scissors while the tissue is trapped.
  • the methods may optionally include making a complete uterine incision using the scissors without manual pressure to extend the incision thereby providing clean incision edges whereby closure of the uterine after surgery is facilitated, wherein the scissors have rounded tips that are sized and configured sufficiently large to keep a sharp portion of a blade of the scissors away from a uterine artery while making the uterine incision.
  • Figure l is a top view of exemplary surgical scissors according to embodiments of the present invention.
  • Figure 2 is an enlarged side perspective view of surgical scissors similar to • that shown in Figure 1 according to embodiments of the present invention.
  • Figure 3 is an enlarged opposing side perspective view of the scissors shown in Figure 2.
  • Figure 4 is a greatly enlarged top perspective view of the scissors shown in Figure 2.
  • Figure 5 is a side perspective view of another embodiment of scissors according to embodiments of the present invention.
  • Figure 6 A is a bottom view of one elongate member of medical scissors and
  • Figure 6B is a bottom view of the other elongate member of the scissors according to embodiments of the present invention.
  • Figure 6C is an enlarged view of the lower portion of the member shown in Figure 6A according to embodiments of the present invention.
  • Figure 7 is a schematic illustration of surgical scissors in a protective sterile package according to embodiments of the present invention.
  • Figures 8A-8C are partial top views of different exemplary tip configurations for surgical scissors according to embodiments of the present invention.
  • Figure 9 A is an exploded top perspective view of an elongate member for surgical scissors having weights enclosed therein according to embodiments of the present invention.
  • Figure 9B is a cross sectional view along the lines B-B of Figure 9 A.
  • Figure 1OA is an exploded top perspective view of an elongate member for surgical scissors having weights enclosed therein according to embodiments of the present invention.
  • Figure 1OB is a cross sectional view along the lines B-B of Figure 1OA.
  • Figure HA is a top view of exemplary surgical scissors with a releasably attached handle and/or blade set according to embodiments of the present invention.
  • Figure HB is a top view of another exemplary surgical scissors with a releasably attached handle and/or blade set according to embodiments of the present invention.
  • Figure 12 is a perspective view of the handle portion of the surgical scissors of Figure HB.
  • Figure 13 is a partial cross sectional view of a portion of the blade and the handle portion of the surgical scissors of Figure HB.
  • Figure 14 is a side perspective view of the blade set of the surgical scissors of Figure HB.
  • phrases such as “between X and Y” and “between about X and Y” should be interpreted to include X and Y.
  • phrases such as “between about X and Y” mean “between about X and about Y.”
  • phrases such as “from about X to Y” mean “from about X to about Y.” Unless otherwise defined, all terms (including technical and scientific terms) used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs.
  • first, second, etc. may be used herein to describe various elements, components, regions, layers and/or sections, these elements, components, regions, layers and/or sections should not be limited by these terms. These terms are only used to distinguish one element, component, region, layer or section from another region, layer or section. Thus, a first element, component, region, layer or section discussed below could be termed a second element, component, region, layer or section without departing from the teachings of the present invention.
  • the sequence of operations (or steps) is not limited to the order presented in the claims or figures unless specifically indicated otherwise.
  • Figure 1 illustrates one embodiment of medical (surgical) scissors 10.
  • the scissors 10 include a cooperating pair of elongate members 20, 30, respectively.
  • the tip or forward edge portion 2Oe, 3Oe of each member 20, 30, respectively, can have a lobe that has a rounded shape 2Or, 30r.
  • the terms "lobe” means a rounded projecting part.
  • the terms "rounded” and “rounded shape” means that there are no sharp points.
  • the inner perimeter (blade side) of each member 21, 31, can have a curvilinear shape and the outer perimeter 22, 32 may have a generally straight edge.
  • the outer perimeter 22, 33 may have alternative shapes, such as substantially the same curvilinear shape as the inner perimeter 21, 31.
  • the scissors 10 can have a relatively short length to allow for better surgeon "feel” as well as an increased control of a cut of target tissue during a surgical procedure.
  • the scissors 10 can have a length of between about 13 cm to about 20 cm, and more typically is between about 14-15 cm.
  • the scissors 10 include a pivot joint 12.
  • the elongate members 20, 30 can have a length L that extends from a medial portion of the pivot joint 12 to the forwardmost end of the rounded tips 2Or, 3Or of between about 3 cm to about 6 cm, and is typically between about 4.5 cm to about 5.5 cm.
  • the pivot joint 12 can be disposed closer to the rounded tips 2Or, 3Or than the opposing handle end 24, 34 of the scissors 10.
  • the pivot joint 12 can be configured to provide increased cutting force without requiring that excess pressure be applied to the handles 24, 34.
  • At least a subportion of the length of the inner perimeter 21, 31 defines the cutting blade portion of the scissors 10. That is, the cutting edge 23, 33 may reside closer to the pivot joint 12 spaced apart from the rounded forward edge 2Or, 3Or and is typically spaced back from a forwardmost edge of the elongate members 20, 30 forming the scissors body. In other embodiments, the blade 23, 33 can extend substantially the entire length of the inner perimeter of the elongate members 20, 30 below the pivot 12 and typically rearward of the forwarmost edge a suitable distance.
  • a blood field of view with limited visualization can exist, such as, for example, upon surgical entry into the uterine cavity to deliver a newborn baby.
  • the rounded edges 20r, 3Or can be substantially bulbous and configured to allow closure of the scissors 10 without the risk of a sharp edge of the blade contacting the uterine artery or the baby during incision with the scissors 10.
  • the radius of the tip 2Or (shown as member 20 but can apply to member 30 as well) can be such that it defines a perimeter (outermost or forwardmost) portion 2Op which is blunt or dull.
  • the sharp edge 20s is rearward a distance Ls.
  • the distance Ls is sufficient to place the point of contact with the sharp edge at least about 0.5 cm from the forwardmost edge, and typically at least about 0. 8 cm. In the latter, this dimension will place the point of contact at least about 0.8 cm from a baby's face and also at least about 0.8 cm from the uterine wall edge. This distance Ls can allow for tissue compression without contact to sensitive regions thereby preventing the sharp edge from touching the baby's face or uterine artery inadvertently.
  • the scissors 10 has a handle end 24, 34 with respective finger holes or apertures 20a.
  • the inner perimeter of the handle defining the apertures 24a, 34a can be radiused for comfort.
  • the outer perimeter of the neck portion 25, 35 of the elongate members 20, 30 may also be radiused to cradle a surgeon's index finger for increased control and feel.
  • a finger resting projection 38 may be formed on the neck portion of one or more of the members (see, e.g., Figure 6B) to define a finger rest recess 39 between the radiused neck 35 and the projection 38.
  • Figure 2 illustrates that the elongate members 20, 30 may have a curvature 25, 35 so that at least a lower portion of each of the first and second elongate members 20, 30 curve upwardly relative to the direction of the scissors' stroke.
  • the radius of curvature "ri" can be between about 19.3 cm to about 19.5 cm.
  • the enlarged views of the scissors 10 shown in Figures 3 and 4 illustrate the rounded edge portions 2Or, 3Or and the curvilinear shape of the inner perimeters 21, 31.
  • the rounded edge portion 2Or, 3Or can be configured to inhibit (typically prevent) inadvertent tissue damage and/or damage to a baby's skull during incision in a C-section procedure.
  • the scissors 10 can be configured to allow a complete uterine incision using the scissors 10 without manual pressure to extend the incision, thereby providing clean incision edges to facilitate closure of the uterine after surgery. This can require less upper body strength than conventional procedures.
  • the scissors 10 have rounded edges 2Or, 3Or that can be sized and configured sufficiently large to keep a sharp portion of a blade of the scissors away from a uterine artery while making the uterine incision. As shown in Figures 3, 5 and 8A-8C, the rounded forward edge portion 2Or,
  • each of the first and second members can have various rounded shapes, each having at least a portion with an arcuate shape.
  • the radius of the arcuate segment or shape "r 2 " can be between about 3 mm to about 10 mm, and is typically between about 8 mm to about 10 mm.
  • Figure 8C also illustrates that the outermost edge of the rounded shape 2Or, 30r may be scalloped or may otherwise vary in radius of curvature.
  • the rounded forward edge portions 2Or, 3Or are substantially circular and configured so that the substantially circular (i.e., substantially completely rounded) forward edges merge into a narrower adjacent neck portion 2On, 3On, respectively, then flare transversely outward to define a projection 29, 39, respectively, along the inner perimeter surface 21, 31.
  • substantially circular refers to a substantially circular circumferential perimeter shape that extends for at least about 270 degrees.
  • Figure 5 illustrates that the forward edge 2Or', 30r* can be semi-circular, with at least a forward and outer portion of the tip comprising a semi-circular perimeter shape.
  • the semi-circular shape has a radius of between about 3 mm to about 10mm, and typically between about 4 mm to about 8 mm.
  • the semicircular shape can be at least a half-circle (typically at least three-fourths of a circle).
  • the projections 29, 39 can be intermediate two recesses 129i, 1292 and 139i, 139 2 , respectively.
  • Figure 8C illustrates that at least one of the recesses 129i, 139i can include an anti-slip surface 200 formed of an embossed, notched, or textured surface and/or a coating or anti-slip material.
  • the curvilinear inner perimeter 21, 31 of the first and second members 20, 30, respectively can have substantially the same perimeter shape. However, each may have a different shape as well (not shown).
  • the projections 29, 39 are a substantially arcuate laterally extending projection.
  • the respective projections 29, 30 are typically substantially axially aligned to face each other such that in a closed configuration the projection 39 of one member 30 resides above the projection 29 of the other member 20.
  • the curvilinear perimeter 21, 31 includes at least one substantially arcuate recess disposed closer to the handle than the at least one projection.
  • the dimensions of the lobes (projections) 29, 39 and recesses 129i, 129 2 and 139i, 139 2 can vary.
  • a recess radius of between about 0.5 cm to about 10 cm may be suitable, with a typically recess radius of about 0.8 cm, so as to be sufficiently deep to hold the target tissue in place.
  • a lobe projection radius of between about 0.5 cm to about 1.0 cm, typically between about 0.8 cm to about 1.0 cm, can allow the lobes 29, 39 to project sufficiently without extending too far over the edge of the opposing blade when the scissors are closed, which may be desirable in some embodiments.
  • FIG. 7 illustrates the scissors 10 in a sterile package 250. That is, the scissors 10 can be sterilized and placed in a sterile sealant ready for use during a medical procedure.
  • the scissors 10 can be configured to be re-sterilized and re-used or may be single-use disposable.
  • the scissors 10 and/or elongate members 20, 30 can be metallic. In other embodiments, scissors 10 (at least the elongate members 20, 30 thereof) are substantially rigid and non-metallic.
  • the scissors 10 and/or elongate members 20, 30 can comprise a rigid polymer, ceramic or composite.
  • the scissors 10 comprise an elastomeric material, for example, a polymer, copolymer or derivatives thereof.
  • the scissors and/or the elongate members comprise a composite (resin reinforced fiber) material.
  • the scissors comprise a ceramic material.
  • the elongate members forming the scissors can be a unitary member molded or otherwise formed or may include different components of different or the same materials attached together.
  • at least a portion of the forward edge 2Or, 3Or may be flexible or resiliency configured with, for example, a compressible forward edge coating, cap or other configuration to inhibit tissue damage.
  • the scissors 10 can be formed of at least two materials.
  • at least one portion of the scissors 10 is single-use disposable. Accordingly, portions of the scissors 10 likely to come in contact with tissue or bodily fluids can be formed a single-use disposable material, and a reusable portion of the scissors 10 can be used to provide additional weight, for example, to accommodate surgeons who may desire surgical instruments that are heavier than typical disposable materials.
  • the scissors 10 can include a single-use disposable portion with high density inserts.
  • the scissors 10 can include a disposable outer housing or casing and may be matable and be formed as portions which may be formed of different materials and/or different weights.
  • the disposable outer casing can be configured to enclose one or more weighted elements that are formed of the material that is heavier than the outer housing or casing.
  • the weighted elements may be reusable, sterilizable and/or provide additional weight to the disposable outer casing so that the total weight of the scissors is approximately of a standard stainless steel surgical instrument.
  • the weight of the scissors can be between 75 to 100 grams.
  • the weighted elements may be formed of metal, such as stainless steel
  • the disposable outer casing can be formed of an elastomeric material, such as polymer, copolymer or derivatives thereof or of a composite (resin reinforced fiber)
  • the blade or elongate members can be formed of a single-use disposable material (e.g., elastomeric or composite materials), and can be releasably attached to reusable handles.
  • the handles can be formed of metal, such as stainless steel, and may be sterilizable.
  • an elongate member 300 includes a body 310 with a base 310a and a cover 310b.
  • the base 310a includes recesses 315 that are configured to receive weights 316 therein.
  • the cover 310b is secured to the base 310a, and can seal the weights 316 in the body 310 to reduce (and typically prevent) contact between the weights 316 and bodily fluids and/or tissue during use.
  • the cover 310b can be secured to the base 310a by a mechanical seal (such as a snap fit or tongue and groove seal) and/or an adhesive may be used.
  • the recesses 315 can be sized and configured so that the corresponding weights 316 create an appropriate weight distribution for ease of use, and in some instances, to mimic conventional stainless steel surgical instruments.
  • Alternative embodiments with different weight distributions are shown in Figures 10A-10B.
  • the elongate member 400 includes a body 410 with a base 410a and a cover 410b.
  • the base 410a includes recesses 415 that are configured to receive the weights 416 therein.
  • the cover 410b is secured to the base 410a, and can seal the weights 416 in the body 410.
  • elongate members 300, 400 may be combined with a corresponding elongate member (not shown) to form a scissors, such as with the two elongate members 20, 30 shown, for example, in Figure 1.
  • Figure HA illustrates scissors 500, which includes a blade set 504 having to cooperating elongate members 504A, 504B and releasably attachable handle members 502.
  • the elongate members 504 A, 504B extend to the finger openings on the handle members 502.
  • the elongate members 504 A, 504B can be disposable and formed of a polymeric and/or composite material, and the handle members 502 can be reusable and/or sterilizable.
  • the elongate members 504A, 504B can extend any suitable distance along the length of the handle members 502.
  • the elongate members 504A, 504B generally prevent or inhibit contact between the handle members 502 and bodily fluids and/or tissue.
  • FIGS 11B-14 illustrate a scissors 50Oi that includes releasably attachable handle members 502 and a blade set 504i.
  • the blade set 504i includes two cooperating elongate members 504Ai, 504Bi.
  • the handle members 502 can be formed of a re-usable material, such as metal ⁇ e.g., stainless steel) and the blade set 504i can be single-use disposable, for example, formed of an elastomeric material.
  • the handle members 502 may be formed of a material that is heavier than the blade set 504i-
  • the handle members 502 can be releasably attached to the blade set elongate members 504Ai, 504Bi-
  • the elongate members 504Ai, 504Bi include apertures 506 for receiving a portion of the handle members 502.
  • the handle members 502 can include a notch 506, and, as is shown in Figure 13, the elongate members 504Ai, 504Bi can include a corresponding aperture 510 for receiving the notch 506 therein.
  • a sealing member (not shown) can be used to seal the blade set 504i and the handle members 502 so as to inhibit or prevent blood or other bodily fluids or tissue from contacting the handle members 502 via the apertures 506 during use.
  • elongate members 300, 400 and the scissors 500, 50Oi may incorporate the features of the scissors 10 of Figures 1-5, 6A-6C, 7 and 8A-8C.

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Pathology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

La présente invention concerne des ciseaux de chirurgie comprenant des premier et second éléments allongés coopérants se fermant pour couper les tissus ciblés. Chacun des premier et second éléments allongés comprend une partie de bord avant arrondie et/ou un périmètre intérieur curvilinéaire (le côté de lame des éléments allongés).
PCT/US2007/002250 2006-01-26 2007-01-26 Ciseaux medicaux adaptes pour des operations chirurgicales de césarienne et procedes relatifs Ceased WO2007089631A2 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US76230606P 2006-01-26 2006-01-26
US60/762,306 2006-01-26

Publications (2)

Publication Number Publication Date
WO2007089631A2 true WO2007089631A2 (fr) 2007-08-09
WO2007089631A3 WO2007089631A3 (fr) 2007-12-13

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PCT/US2007/002250 Ceased WO2007089631A2 (fr) 2006-01-26 2007-01-26 Ciseaux medicaux adaptes pour des operations chirurgicales de césarienne et procedes relatifs

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN107898493A (zh) * 2017-12-29 2018-04-13 沙洋县人民医院 一种阴式碎宫器

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Publication number Priority date Publication date Assignee Title
US3003236A (en) * 1961-03-31 1961-10-10 Johnson & Johnson Cutter
FI48988C (fi) * 1973-11-28 1975-03-10 Fiskars Ab Oy Keittiösakset.
US4807364A (en) * 1987-03-27 1989-02-28 Michael Porat Medical scissors
US5047042A (en) * 1990-02-09 1991-09-10 Ravinder Jerath Cervical conization method and instrument
US5752972A (en) * 1995-11-09 1998-05-19 Hoogeboom; Thomas J. Modular endoscopic surgical instrument
US20030171747A1 (en) * 1999-01-25 2003-09-11 Olympus Optical Co., Ltd. Medical treatment instrument
CN1452538A (zh) * 2000-03-29 2003-10-29 足立工业株式会社 剪刀
US6785968B1 (en) * 2002-07-05 2004-09-07 Mary M. Stevens Fabric-cutting scissors

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN107898493A (zh) * 2017-12-29 2018-04-13 沙洋县人民医院 一种阴式碎宫器

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Publication number Publication date
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