Cannula holder

Abstract

Disclosed herein are components, systems, and methods to secure a cannula being used during a surgical procedure such as an endoscopy. Specifically, embodiments of a cannula holder are disclosed that include a clamp, a piston, a spring, and an actuator. The clamp includes first and second jaws. The piston is movable toward and away from the first jaw, and the spring is positioned between the piston and the second jaw. The actuator is coupled to the piston such that rotation of the actuator in a first rotational direction moves the piston toward the first jaw, and rotation of the actuator in a second rotational direction moves the piston away from the first jaw. Rotation of the actuator varies the clamping force exerted against the cannula secured within the clamp. Also disclosed are methods of securing a cannula using the cannula holder and methods of assembly of the cannula holder.

Description

CANNULA HOLDERCROSS-REFERENCE TO RELATED APPLICATION

[0001] This patent application claims priority of U.S. Patent Application No. 63 / 575,533, filed on April 5, 2024, the entire disclosure of which is hereby incorporated by reference herein for all purposes.BACKGROUND

[0002] An endoscopy is a procedure that enables a surgeon to visualize an interior portion of a body. As part of endoscopic procedures, common practice involves the use of up to five fingers to hold an endoscope and a cannula at a desired position and depth. This is referred to as the “five finger technique,” during which a surgeon’s pinky is often used to maintain a relative depth between the endoscope and the cannula. Throughout the duration of endoscopic procedures, the surgeon may (manually) make many adjustments to this relative depth and may also rotate and angulate the cannula. Performing these movements and adjustments using the five finger technique may result in poor ergonomics and fatigue in the surgeon’s hand and / or wrist, which supports the weight of the endoscope and attached camera and light cable.

[0003] Traditionally, surgeons perform the procedures without employing an external fixation device. Instead, the surgeons rely on the tension of the surrounding tissue to hold the cannula in place. This technique has been found to increase the risk of unintended movement of the cannula (e.g., slipping further into the surgical site).

[0004] Even in view of conventional techniques and equipment, the need exists for devices that advantageously employ a fixation device that may exert a clamping force on a cannula thereby holding the cannula in a fixed location during an endoscopic surgical procedure.BRIEF SUMMARY

[0005] Embodiments described herein provide a cannula holder that may be used during endoscopy to clamp and secure the position of a cannula. Additional embodiments described herein include methods of use and assembly of the cannula holder.

[0006] Endoscopes typically include long flexible tubes with a camera and a light source at one end. In use, the endoscope is inserted into the body through a small opening. A cannula may be placed in the opening to maintain the opening and provide a rigid passageway for instruments, such as the endoscope, into the interior portion of the body.Preventing movement of the cannula once it is inserted may be beneficial to the surgeon. As noted above, this is conventionally handled via the five finger technique.

[0007] Accordingly, this disclosure relates to a cannula holder that comprises a clamp that is adjustable so as to exert a variable clamping force on the cannula. A first amount of the variable clamping force may be sufficient to allow the cannula to be held in place by the jaws of the clamp when no external force is applied to the cannula, but still be movable relative to the clamp if additional (e.g., manual) force is applied to the cannula. The cannula holder may define a lateral opening that allows the clamp to be secured to the cannula after the cannula is already inside the patient to provide flexibility to a surgeon regarding the order of operation within a surgical procedure.

[0008] In some cases, different procedures utilize cannulae of different sizes and may need different amounts of clamping force to hold the respective cannula in place. In some embodiments, the aforementioned clamp may comprise jaws that are shaped to receive and apply the variable clamping force to cannulae of different sizes and / or shapes.

[0009] As a result of this configuration, the disclosed devices, methods, and techniques enable a cannula to be held and adjusted during an endoscopic procedure, which beneficially improves ergonomics and enables the surgeon’s hands to remain available for other tasks.

[0010] According to one embodiment, a cannula holder includes a clamp, a piston, a spring, and an actuator. The clamp includes a first jaw having a first clamping surface, and a second jaw having a second clamping surface, wherein the second clamping surface faces the first clamping surface. The piston is movable toward and away from the first jaw, and the spring is positioned between the piston and the second jaw. The actuator is coupled to the piston such that rotation of the actuator in a first rotational direction moves the piston toward the first jaw, and rotation of the actuator in a second rotational direction moves the piston away from the first jaw.

[0011] According to one embodiment, a method of securing a cannula with a cannula holder includes exerting a clamping force on the cannula, when the cannula is secured between a first jaw and a second jaw of the cannula holder. The method further includes rotating an actuator of the cannula holder in a first rotational direction to increase the clamping force exerted on the cannula and rotating the actuator in a second rotational direction to decrease the clamping force exerted on the cannula.

[0012] According to one embodiment, a method of assembling a cannula holder includes positioning a piston within an inner chamber of a slotted, tubular member, and positioning the slotted, tubular member within a through hole of a sleeve. The method further includes inserting a first portion of a pin into a recess of the piston such that a secondportion of the pin is positioned within a slot of the slotted tubular member, and a third portion of the pin is positioned within a helical track defined by the sleeve, such that the sleeve is rotatable relative to the piston. The second portion of the pin is translatable within the slot, and the third portion of the pin is advanceable along the helical track. Additionally, the method includes securing a first end of a spring to the piston and a second end of the spring to a movable jaw, and securing a fixed jaw relative to the sleeve such that movement of the sleeve relative to the fixed jaw is limited to rotation about an axis.BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS

[0013] In the drawings, identical reference numbers identify similar elements or acts. The sizes and relative positions of elements in the drawings are not necessarily drawn to scale. For example, the shapes of various elements and angles are not necessarily drawn to scale, and some of these elements may be arbitrarily enlarged and positioned to improve drawing legibility. Further, the particular shapes of the elements as drawn, are not necessarily intended to convey any information regarding the actual shape of the particular elements and may have been solely selected for ease of recognition in the drawings. The headings and Abstract of the Disclosure provided herein are for convenience only and do not interpret the scope or meaning of the embodiments.

[0014] Figure 1 is an isometric view of a cannula holder.

[0015] Figure 2 is an isometric view of the cannula holder illustrated in Figure 1 with a cannula secured within a clamp of the cannula holder and the clamp exerting a clamping force on the cannula.

[0016] Figure 3 is an isometric view of the cannula holder and cannula illustrated in Figure 2 with the clamp exerting an increased clamping force on the cannula.

[0017] Figure 4 is an exploded, isometric view of the cannula holder illustrated in Figure 1.

[0018] Figure 5 is a top plan view of the cannula holder illustrated in Figure 1 in an open configuration.

[0019] Figure 6 is a cross-sectional view of the cannula holder illustrated in Figure6, taken along line 6-6.

[0020] Figure 7 is a top plan view of the cannula holder illustrated in Figure 1 in a closed configuration.

[0021] Figure 8 is a cross-sectional view of the cannula holder illustrated in Figure7, taken along line 8-8.

[0022] Figure 9 is a top plan view of the cannula holder illustrated in Figure 1 in a loaded configuration.

[0023] Figure 10 is a cross-sectional view of the cannula holder illustrated in Figure 9, taken along line 10-10.DETAILED DESCRIPTION

[0024] During an endoscopy a cannula may be inserted through an opening (e.g., an incision) in a patient’s body to provide access to an interior portion of the body. The cannula maintains the opening during the procedure and provides a stable passageway for instrumentation (e.g., endoscopes, drills, graspers, etc.). During the endoscopy there may be times where movement of the cannula (e.g., relative to the patient’s body, relative to the instrumentation, etc.) is desired, and other times where movement of the cannula is not desired.

[0025] In an embodiment the disclosure relates to a cannula holder that comprises a clamp with first and second jaws, a piston, a spring, and an actuator. The first jaw has a first clamping surface, and the second jaw has a second clamping surface that faces the first clamping surface. The piston is movable toward and away from the first jaw. The spring includes a first end coupled to the piston and a second end coupled to the second jaw such that the spring biases the second clamping surface toward the first clamping surface. The actuator is coupled to the piston such that rotation of the actuator in a first rotational direction moves the piston toward the first jaw, and rotation of the actuator in a second rotational direction moves the piston away from the first jaw.

[0026] The spring exerts a biasing force on the second jaw that biases the second clamping surface towards the first clamping surface. Rotation of the actuator in the first rotational direction compresses the spring (thereby increasing the biasing force), and rotation of the actuator in the second rotational direction decompresses the spring (thereby decreasing the biasing force). As a result, the cannula holder advantageously provides for improved fixation of the cannula, which allows for the aforementioned benefits (e.g., improved ergonomics and reduction of fatigue in the surgeon’s hand and / or wrist). In particular, when a first (i.e., lower) biasing force is applied to the cannula and when no external force (e.g., from the surgeon) is applied to the cannula, the adjustable biasing force of the cannula holder beneficially prevents movement of the cannula.

[0027] Also, the adjustable biasing force enables the cannula holder to secure cannulae of various sizes and shapes, and further provides options for securement of the cannula to the cannula holder that are not provided by known devices. There are a variety of different cannulae with different sizes and / or shapes that may be used depending on the specific procedure being performed. For example, a visualization may include the use of acannula with a smaller diameter compared to a procedure that includes the use and insertion of a robotic instrument through a larger diameter cannula.

[0028] For example, the cannula may be secured within the cannula holder such that the cannula does not “slip” further into the opening in the patient’s body (e.g., due to gravity or movement of the patient). However, the first biasing force may be low enough that the surgeon is able to move the cannula (e.g., rotate, angulate, etc.) relative to the cannula holder by applying a force to (e.g., physically manipulating) the cannula. During portions of the procedure when movement of the cannula is not needed / desired, the second (i.e. , higher or increased) biasing force may further secure the cannula relative to the cannula holder such that relative movement is prevented even when an external force is applied to the cannula.

[0029] Some embodiments of the cannula holder include a clamp with jaws shaped to accept and secure cannulae of various shapes and sizes, while still allowing for rotation of the cannulae relative to the clamp (e.g., when the first / lower biasing force is applied to the cannula secured within the clamp). The clamp and jaws as described enable the cannula holder to be used in a wider variety of procedures that involve the use of cannulae or various sizes, rather than needing dedicated cannula holders for each size / shape of cannula.

[0030] Some embodiments of the cannula holder include a lateral opening that provides entry for the cannula into the clamp. Thus, even if the cannula is already positioned within the opening of the patient’s body, the cannula holder may be used to better secure the cannula. This provides greater flexibility to surgeons and the order of operation in which they perform the endoscopy, rather than requiring insertion of the cannula through the cannula holder prior to insertion into the opening of the patient’s body.

[0031] With these configurations, endoscopy and similar surgical procedures may be beneficially performed with greater flexibility afforded to the surgeon while freeing up their hands for other tasks, other than maintaining the position of the cannula.

[0032] In some cases, the disclosure relates to a method of securing a cannula with a cannula holder. The method comprises exerting a clamping force on the cannula secured between a first jaw and a second jaw of the cannula holder, rotating an actuator of the cannula holder in a first rotational direction to increase the clamping force exerted on the cannula, and rotating the actuator in a second rotational direction to decrease the clamping force exerted on the cannula.

[0033] The method may further comprise compressing a spring of the cannula holder to increase the clamping force exerted on the cannula, and decompressing the spring of the cannula holder to decrease the clamping force exerted on the cannula. Some embodiments of the method include translating a piston of the cannula holder toward the firstjaw to compress the spring, and translating the piston of the cannula holder away from the first jaw to decompress the spring.

[0034] The actuator may be rotated in the first rotational direction to translate the piston toward the first jaw, and rotated in the second rotational direction to translate the piston away from the first jaw. Rotating the actuator in a first rotational direction may include rotating the actuator about an axis, and the second rotational direction may be opposite the first rotational direction. Translating the piston toward the first jaw and away from the first jaw includes translating the piston along the axis.

[0035] The method may further comprise advancing a follower along a helical track, and translating the follower along a longitudinal slot of a tubular member, wherein the follower includes a first portion positioned within the helical track, a second portion secured to the piston, and a third portion that is between the first portion and the second portion and extending through the longitudinal slot. Some embodiments of the method comprise rotating a sleeve relative to a tubular member thereby advancing the follower along the helical track and translating the piston within an inner chamber of the tubular member.

[0036] Decompressing the spring and translating the second jaw away from the first jaw opens a path into a pocket between the first jaw and the second jaw, according to some embodiments of the method. The cannula may be moved into the pocket via the path, the second jaw may be translated toward the first jaw thereby closing the path into the pocket, and the spring may be compressed to exert the clamping force on the cannula.

[0037] Referring now to the drawings, and specifically to Figures 1 to 4, some surgical procedures (e.g., endoscopies) involve the insertion of surgical instruments through an opening of a body to view and / or interact with an interior portion of a body. The opening may be maintained with a working tube (e.g., a cannula 17), that defines a passageway through the opening and into the interior portion of the body. A cannula holder 20 may be used to secure a position of the cannula 17 (e.g., relative to a fixed reference point such as the opening in the patient or an operating table upon which the patient is supported during the procedure).

[0038] According to one embodiment, the cannula holder 20 may be attachable to one or more commercially available support arms that have a first / fixed end securable to the operating table and a second / free end that is movable (e.g., via one or more articulated joints). The cannula holder 20 may be secured to the second / free end and the one or more articulated joints may then be locked to fix the secured cannula holder 17 in place relative to the first / fixed end and / or the operating table.

[0039] As shown in Figure 1 , the cannula holder 17 may include a clamp 22 including a first jaw 24 and a second jaw 26. The first jaw 24 may include a first clampingsurface 28, and the second jaw 26 may include a second clamping surface 30. As shown in Figures 2 and 3, the first and second clamping surfaces 28, 30 may face towards one another (e.g., so as to contact the cannula 17 when it is positioned between the first and second jaws 24, 26).

[0040] The cannula holder 20 may include a piston 32 (shown in Figure 4) that is movable (e.g., translatable) towards and away from the first jaw 24 (e.g., parallel to a first direction D1). The cannula holder 20 may include a biasing member (e.g., a spring 34) that, when compressed, exerts a biasing force F1 against the second jaw 26 in a direction that biases the second clamping surface 30 towards the first clamping surface 28. As shown in Figure 4, the spring 34 may include a first portion 36 coupled to (e.g., directly abutting) the piston 32 and a second portion 38 coupled to (e.g., directly abutting) the second jaw 26.

[0041] According to one embodiment, the cannula holder 17 may include an actuator 40. The actuator 40 may be coupled to the piston 32 such that rotation of the actuator 40 in a first rotational direction R1 (e.g., about an axis 42) moves the piston 32 toward the first jaw 24, and such that rotation of the actuator 40 in a second rotational direction R2 (e.g., opposite the first rotational direction R1 about the axis 42) moves the piston 32 away from the first jaw 24.

[0042] As will be described in greater detail below, rotation of the actuator 40 (e.g., relative to other components of the cannula holder 20, such as the spring 34) in the first rotational direction R1 may compress the spring 34, and rotation of the actuator 40 in the second rotational direction R2 may decompress the spring 34. Rotating the actuator 40 in the first rotational direction R1 thereby compressing the spring 34 may increase the biasing force F1 exerted against the second jaw 26 and rotating the actuator 40 in the second rotational direction R2 thereby decompressing the spring 34 may decrease the biasing force F1 exerted on the second jaw 26.

[0043] The clamp 22 (e.g., the first clamping surface 28 and the second clamping surface 30) may define a pocket 44 of the cannula holder 20 that is sized and shaped to receive cannulae of various sizes and / or shapes. The size of the pocket 44 may be measurable from the second clamping surface 30 to the first clamping surface 28 along the first direction D1. The size of the pocket 44 may be variable. For example, as the second jaw 26 moves towards the first jaw 24 the size of the pocket 44 may decrease, and as the second jaw 26 moves away from the first jaw 24 the size of the pocket 44 may increase.

[0044] The clamp 22 may define a first path 46 through the pocket 44 that is oriented perpendicular to a direction along which the second jaw 26 moves relative to the first jaw 24 (e.g., the first direction D1). According to one embodiment, the first path 46 may be parallel to a second direction D2. As shown in Figures 2 and 3, the cannula 17 may besecured within the clamp 22 (e.g., between the first clamping surface 28 and the second clamping surface 30) such that the cannula 17 is parallel to (e.g., aligned with) the first path 46.

[0045] Referring to Figures 1 to 3 and 6, the size of the pocket 44 may further be measurable from a first opening 48 to a second opening 50 along the second direction D2. According to one embodiment, the first opening 48 of the pocket 44 may be coplanar with a first outer sidewall 52 of the first jaw 24, a first sidewall 54 of the second jaw 26, or coplanar with both the first outer sidewall 52 and the first sidewall 54. The second opening 50 of the pocket 44 may similarly be coplanar with a second outer sidewall 56 of the first jaw 24, a second sidewall 58 of the second jaw 26, or coplanar with both the second outer sidewall 56 and the second sidewall 58. The first path 46 may extend through the first opening 48 to enter the pocket 44, extend through the pocket 44 (e.g., parallel to the second direction D2) to the second opening 50, and extend through the second opening 50 to exit the pocket 44.

[0046] Referring to Figures 1 to 3 and 5, the clamp 22 may define a second path 60 into the pocket 44 that is oriented perpendicular to both the direction along which the second jaw 26 moves relative to the first jaw 24 (e.g., the first direction D1) and the direction along which the first path 46 extends (e.g., the second direction D2). According to one embodiment, the second path 60 may be parallel to a third direction D3. As shown in Figures 2 and 3, the cannula 17 may be secured within the clamp 22 (e.g., between the first clamping surface 28 and the second clamping surface 30) such that the cannula 17 is perpendicular to the second path 60.

[0047] The size of the pocket 44 may further be measurable from a third opening 62 to a base surface 64 along the third direction D3. According to one embodiment, the third opening 62 of the pocket 44 may be coplanar with a third outer sidewall 66 of the first jaw 24. The third outer sidewall 66 may be perpendicular to both the first and second outer sidewalls 52, 56 of the first jaw 24 and the first and second sidewalls 54, 58 of the second jaw 26. The base surface 64 of the clamp 22 may be parallel to (e.g., facing in the same direction as) the third outer sidewall 66. The second path 60 may extend through the third opening 62 to enter the pocket 44, extend through the pocket 44 (e.g., parallel to the third direction D3), and terminate within the clamp 22 (e.g., at the base surface 64). As shown, the second path 62 may differ from the first path 46, as the second path 62 does not pass through the clamp 22 but terminates within the clamp 22.

[0048] Referring to Figures 1 to 6, the clamp 22 may be assembled such that the first jaw 24 is fixed (e.g., relative to other components of the cannula holder, such as the actuator 40) and the second jaw 26 is movable (e.g., relative to other components of the cannula holder, such as the first jaw 24 and the actuator 40), as shown in the illustratedembodiment. Alternatively, the first jaw 24 may be movable and the second jaw 26 may be fixed, or both the first jaw 24 and the second jaw 26 may be movable relative to one another. According to one embodiment, only translation along one axis (e.g., along the axis 42 and parallel to the first direction D1) of the second jaw 26 relative to the first jaw 24 is possible when the cannula holder 20 is fully assembled.

[0049] The clamp 22 (e.g., the first jaw 24 and the second jaw 26 may include corresponding features that enable the relative translational movement while restricting relative movement in all other degrees of freedom (rotational and translational). For example, the corresponding features may include one or more guide rails 68 and one or more recesses 70, with corresponding pairs of the guide rails 68 and recesses 70 having complementary shapes.

[0050] As shown, the first jaw 24 may include first and second guide rails 68 (e.g., formed by first and second inner sidewalls 72, 74 of the first jaw 24), and the second jaw 26 may define first and second recesses 70 (e.g., formed in third and fourth sidewalls 76, 78 of the second jaw 26). The first inner sidewall 72 face towards the second inner sidewall 74 (e.g., such that the first and second inner sidewalls 72, 74 are separated by a distance measured along the third direction D3. The third sidewall 76 may face away from (e.g., opposite) the fourth sidewall 78. According to one embodiment, when fully assembled, the guide rails 68 may each be received within a respective one of the recesses 70 such that all relative movement other than translation parallel to the first direction D1 is restricted and / or prevented. Additionally, the guide rails 68 and recesses 70 may be shaped such that (e.g., when the cannula holder 20 is fully assembled) the second jaw 26 is unable to disengage from the first jaw 24 (e.g., and be removed from the clamp 22).

[0051] Referring to Figures 1 to 3 and 5, the clamp 22 may include clamping surfaces (e.g., the first clamping surface 28 and the second clamping surface 30) shaped so as to secure and exert a clamping force C1 against a cannula (e.g., the cannula 17) that is positioned within the pocket 44. According to one embodiment, the first and second clamping surfaces 28, 30 may be shaped so as to provide multiple, discrete points of contact with the cannula 17. Pairs of the multiple, discrete points of contact may be opposite one another with respect to the first direction D1 such that the clamping force C1 is mostly / entirely applied parallel to the first direction D1.

[0052] The first clamping surface 28 may include a first portion 80 that lies in a first plane P1 that is oblique with respect to the axis 42 and / or the first direction D1. Similarly, the second clamping surface 30 may include a first portion 82 that lies in a second plane P2 that is oblique with respect to the axis 42 and / or the first direction D1. Additionally, the first clamping surface 28 may include a second portion 84 that lies in a third plane P3 that isoblique with respect to the axis 42 and / or the first direction D1 and that is also non-parallel with respect to the first plane P1. Similarly, the second clamping surface 30 may include a second portion 86 that lies in a fourth plane P4 that is oblique with respect to the axis 42 and / or the first direction D1 and that is also non-parallel with respect to the second plane P2. As shown in the illustrated embodiment, the first and second clamping surfaces 28, 30 may each be in the form of a shallow “V”. The first and second clamping surfaces 28, 30 may be the same, similar, or different (e.g., one may be in the form of a shallow “V” while the other is flat).

[0053] Referring to Figures 1 to 6, the cannula holder 20 may include a frame 100 having a first flange 102, a second flange 104, and a tubular member 106 extending between the first and second flanges 102, 104. The tubular member 106 may include an inner surface 108 defining an inner chamber 110 and an outer surface 112 opposite (e.g., radially with respect to the axis 42) the inner chamber 110.

[0054] The frame 100, according to one embodiment, supports one or more components of the actuator 40 and restricts movement of the actuator 40 relative to the first jaw 24 other than rotation in the first and second rotational directions R1 , R2. As shown, the frame 100 may support the piston 32 such that the piston 32 is received and slidable within the inner chamber 110 (e.g., toward and away from the first jaw 24). When the cannula holder 20 is fully assembled, the actuator 40 may be captured between the first flange 102 and the second flange 104 such that translation of the actuator 40 relative to the first jaw 24 is blocked (e.g., in all translational degrees of freedom, such as along D1 , D2, and D3).

[0055] The cannula holder 20 (e.g., the actuator 40) may include a sleeve 120, a helical track 122 extending through the sleeve 120 (e.g., radially with respect to the axis 42), and at least one follower 124. The follower(s) 124, which as shown may be in the form of a pin or rod, may include a first portion 126 positioned within the helical track 122 and a second portion 128 secured to (e.g., positioned within a recess 130 of) the piston 32. When fully assembled, rotation of the sleeve 120 relative to the piston 32 in the first rotational direction R1 may advance the follower 124 along the helical track 122 and translate the piston 32 toward the first jaw 24, and rotation of the sleeve 120 relative to the piston 32 in the second rotational direction R2 retreats the follower 124 along the helical track 122 and translates the piston 32 away from the first jaw 24. The helical track 122 may result in the clamping force C1 being adjustable (e.g., to allow / prevent movement / toggling of the clamped cannula 17) as described in further detail below.

[0056] The tubular member 106 may include one or more slots 132 extending between the first flange 102 and the second flange 104 (e.g., along the axis 42 and parallel to the first direction D1). As shown, the one or more slots 132 may extend through both theinner and outer surfaces 108, 112 forming a passage through the tubular member 106 and into the inner chamber 110. According to one embodiment, the tubular member 106 may define two slots 132 that are opposite one another (e.g., such that a single, straight line that perpendicularly intersects the axis 42 passes through the passages formed by both of the two slots 132).

[0057] The piston 32 may be supported by the frame 100 (e.g., positioned within the inner chamber 110) such that the piston 32 is slidable (e.g., within the inner chamber 110 along the axis 42) toward and away from the first jaw 24. The follower 24 may include a third portion 133 that is between the first portion 126 and the second portion 128, and that is positioned in the slot 132 when the cannula holder 20 is fully assembled.

[0058] According to one embodiment, the frame 100 may support the sleeve 120 such that the sleeve 120 is captured between the first flange 102 and the second flange 104 thereby restricting movement of the sleeve 120 relative to the first jaw 24 (and other components of the cannula holder 20) other than rotation in the first and second rotational directions R1, R2. For example, the sleeve 120 may have a tubular body 134 that defines a through hole 136 extending through the tubular body 134 (e.g., through an entire length of the tubular body 134 along the axis 42).

[0059] The through hole 136 may be formed by an inner surface 138 of the tubular body 134, and the inner surface 138 may face towards and slidingly engage with the outer surface 112 of the tubular member 106 when the sleeve 120 is captured between the first flange 102 and the second flange 104. The sleeve 120 may further include an outer surface 140 that is radially opposite the inner surface 138 with respect to the axis 42. The outer surface 140 may be textured, knurled, or otherwise formed so as to increase friction (and prevent slipping) with a user’s hand, which applies a rotational force to the sleeve 120 via contact with the outer surface 140.

[0060] When the cannula holder 20 is fully assembled (e.g., when the piston 32 is positioned within the inner chamber 110, the tubular member 106 is positioned within the through hole 136, the sleeve 120 is captured between the first flange 102 and the second flange 104, and the follower 124 is positioned such that the first portion 126 is within the helical track 122, the second portion 128 is within the recess 130 of the piston 32, and the third portion 133 is within the slot 132) rotation of the sleeve 120 relative to the piston 32 and the tubular member 106 in the first rotational direction R1 may translate the follower 124 along the slot 132 (e.g., parallel to the axis 42 and the first direction D1) and toward the first jaw 24. Similarly, rotation of the sleeve 120 relative to the piston 32 and the tubular member 106 in the second rotational direction R2 may translate the follower 124 along the slot 132 (e.g., parallel to the axis 42 and the first direction D1) and away from the first jaw 24.

[0061] The position of the follower 124 within (e.g., extending through) the slot 132 blocks movement of the follower 124 relative to the tubular member 106 except for translation along the axis 42 and the first direction D1. One or more components of the cannula holder 20 described herein may be radiolucent so as to prevent interference with radio imaging (e.g., x-rays) used during the endoscopy.

[0062] Referring to Figures 1 to 10, a method of securing the cannula 17 with the cannula holder 20 may include exerting the clamping force C1 on the cannula 17 when the cannula 17 is secured within the clamp 22 (e.g., between the first jaw 24 and the second jaw 26) of the cannula holder 20. As part of the method, actuating the actuator 40 (e.g., rotating the sleeve 120 in the first rotational direction R1 relative to the tubular member 106) may increase the clamping force C1 exerted on the cannula 17, and further actuation of the actuator 40 (e.g., rotating the sleeve 120 in the second rotational direction R2 relative to the tubular member 106) may decrease the clamping force C1 exerted on the cannula 17.

[0063] The method may include compressing the spring 34 (e.g., via actuation of the actuator 40) to increase the clamping force C1, and decompressing the spring 34 (e.g., via actuation of the actuator 40) to decrease the clamping force exerted on the cannula. According to one embodiment, the piston 32 may be translated toward the first jaw 24 to compress the spring 34, and translated away from the first jaw 24 to decompress the spring 34. As shown, the first portion 36 of the spring 34 may be coupled to the piston 32 (e.g., surrounding and thereby captured by a projection 142 extending from the piston 32 toward the first jaw 24), and the second portion 38 of the spring 34 may be coupled to the second jaw 26 (e.g., positioned within and thereby captured by a recess 144 defined by the second jaw 26).

[0064] With the spring 34 positioned between the piston 32 and the second jaw 26, the method may include rotating the sleeve 120 in the first rotational direction R1 (e.g., relative to the piston 32, the tubular member 106, or both), thereby translating the piston 32 toward the first jaw 24, and rotating the sleeve 120 in the second rotational direction R2 (e.g., relative to the piston 32, the tubular member 106, or both), thereby translating the piston 32 away from the first jaw 24. As shown, translating the piston 32 toward the first jaw 24 and away from the first jaw 24 may include translating the piston 32 along the axis 42.

[0065] The method may further include advancing the follower 124 along the helical track 122 of the sleeve 120, and translating the follower 124 along the slot 132 of the tubular member 106. The sleeve 120 may be rotated relative to the tubular member 106 thereby advancing the follower 124 along the helical track 122 and translating the piston 32 within the inner chamber 110 of the tubular member 106.

[0066] According to one embodiment, the method may include translating the second jaw 26 away from the first jaw 24 and toward the piston 32 without actuating the actuator 40 (e.g., by applying a force directly to the second jaw 26) thereby compressing the spring 34 and opening the second path 60 into the pocket 44 (e.g., such that a dimension of the second path 60 is greater than a dimension of the cannula 17). When the second path 60 is open, the method may include moving the cannula 17 into the pocket 44 via the second path 60. Once the cannula 17 is positioned within the pocket 44, the method may include translating the second jaw 26 toward the first jaw 24 and away from the piston 32 without actuating the actuator 40 (e.g., by releasing the force applied to the second jaw 26), thereby decompressing the spring 34, closing the second path 60 into the pocket 44, and exerting the clamping force C1 on the cannula 17.

[0067] Referring still to Figures 1 to 10, use of the cannula holder 20 according to one embodiment is described below. As shown in Figures 1 , 5 and 6, the cannula holder 20 may include an open configuration in which the cannula 17 may be inserted into the pocket 44 (e.g., via the first path 46, the second path 60, or both). In the open configuration, the second jaw 26 is withdrawn from the first jaw 24 and is closer to the second flange 104. The one or more followers 124 may be at or proximate to a first end 146 of the helical track 122. The first end 146 of the helical track 122 may include a portion of the helical track 122 that is closest to the first flange 102 and farthest from the second flange 104. Additionally, the one or more followers 124 may be at or proximate to a first end 148 of the slot 132. Similarly, the first end 148 of the slot 132 may include a portion of the slot 132 that is closest to the first flange 102 and farthest from the second flange 104.

[0068] When the cannula 17 is positioned within the pocket 44, the cannula holder 20 may be transitioned from the open configuration to a closed configuration as shown in Figures 2, 7, and 8. In the closed configuration, the clamp 22 exerts the clamping force C1 against the cannula 17. The clamping force C1 may be generated by compression of the spring 34 and exerted against the cannula 17 via the first and second clamping surfaces 28, 30.

[0069] To transition the cannula holder 20 from the open configuration to the closed configuration, the sleeve 120 may be rotated in the first rotational direction R1. Rotation of the sleeve 120 relative to the tubular member 106 advances the follower 124 along the helical track 122 away from the first end 146 and toward a second end 150 of the helical track 122, and also advances the follower 124 along the slot 132 away from the first end 148 and toward a second end 152 of the slot 132. As shown, the second end 150 of the helical track 122 may include a portion of the helical track 122 that is closest to the second flange 104 and farthest from the first flange 102, and the second end 152 of the slot 132 mayinclude a portion of the slot 132 that is closest to the second flange 104 and farthest from the first flange 102.

[0070] Prior to the first and second jaws 24, 26 contacting the cannula 17, rotation of the sleeve 120 may advance (e.g., translate along the axis 42) the piston 32, the spring 34, and the second jaw 26 toward the first jaw 24 without any compression of the spring 34. Once the first and second jaws 24, 26 are both in contact with the cannula 17, further rotation of the sleeve 120 may advance (e.g., translate along the axis 42) the piston 32 toward the second jaw 26 by compressing the spring 34 without further movement of the second jaw 26 toward the first jaw 24. Rotation of the sleeve 120 and compression of the spring 34 may continue until the clamping force C1 reaches a first desired value (e.g., that is sufficient to prevent movement of the cannula 17 relative to the clamp 22 in the absence of an external force applied to the cannula 17 by the surgeon). When the first desired value for the clamping force C1 is exerted against the cannula 17, rotation and / or angulation of the cannula 17 relative to the patient’s body may be possible, which provides visualization and access to different areas of the interior portion of the body.

[0071] As shown in Figures 3, 9, and 10, the cannula holder 20 may include a loaded configuration in which the clamping force C1 exerted on the cannula 17 is increased such that movement of the cannula 17 relative to the clamp 22 is prevented even when the external force is applied to the cannula 17 by the surgeon). To transition the cannula holder 20 from the closed configuration to the loaded configuration, the sleeve 120 may be rotated in the first rotational direction R1 relative to the tubular member 106 to advance the follower 124 further along the helical track 122 away from the first end 146 and toward the second end 150 (e.g., to the second end 150) of the helical track 122, and to advance the follower 124 further along the slot 132 away from the first end 148 and toward the second end 152 of the slot 132 (e.g., to the second end 152).

[0072] Rotation of the sleeve 120 to transition from the closed configuration to the loaded configuration may advance (e.g., translate along the axis 42) the piston 32 toward the second jaw 26 by further compressing the spring 34 without movement of the second jaw 26 toward the first jaw 24. Rotation of the sleeve 120 and further compression of the spring 34 may continue until the clamping force C1 reaches a second desired value that is greater than the first desired value.

[0073] Use of the cannula holder 20 may include transitioning the cannula holder 20 from the loaded configuration to the closed configuration and / or transitioning the cannula holder 20 from the closed configuration to the open configuration by reversing the transitions described above (e.g., rotating the sleeve 120 in the second rotational direction R2 to decompress the spring 34, thereby decreasing the clamping force C1. Once the clampingforce C1 is decreased to zero, further rotation of the sleeve 120 in the second rotational direction R2 may move the piston 32 away from the first jaw 24 and may result in movement of the second jaw 26 away from the first jaw 24 (e.g., due to the force of gravity) thereby releasing the cannula 17 from the clamp 22. One or more of the transitions (open to closed, closed to loaded, loaded to closed, loaded to open) may be repeated during use of the cannula holder 20.

[0074] Prior to or in between any of the transitions described above, use of the cannula holder 20 may include securing the cannula holder 20 to a support arm with a first / fixed end secured to an operating table and a second / free end that is movable (e.g., via one or more articulated joints). The cannula holder 20 may be secured to the second / free end and the one or more articulated joints may then be locked to fix the secured cannula holder 17 in place relative to the first / fixed end and / or the operating table.

[0075] The cannula holder 20 may be assembled by positioning the piston 32 within the inner chamber 110 of the tubular member 106 and positioning the tubular member 106 within the through hole 136 of the sleeve 120. The follower 124 (e.g., the second portion 128) may be inserted into the recess 130 of the piston 32 by passing the second portion 128 through the slot 132 of the tubular member 106 and into the recess 130, thereby positioning the first portion 126 within the helical track 122 and the third portion 133 within the slot 132. The follower 124 may thereby movably couple the piston 32 to the sleeve 120 such that rotation of the sleeve 120 advances the follower 124 along the helical track 122 and translates the follower 124 along the slot 132, thereby translating the piston 32 relative to the sleeve 120. Assembly of the cannula holder 20 may also include insertion of additional followers 124 in respective recesses 130, similarly to the follower 124 as described above.

[0076] The method of assembly may further include securing the first portion 36 of the spring 34 to the piston 32 (e.g., by capturing the first portion 36 of the spring 34 with the projection 142) and securing the second portion 38 of the spring 34 to the second jaw 26 (e.g., by capturing the second portion 38 of the spring 34 within the recess 144). During the method of assembly, the first jaw 24 may be secured relative to the sleeve 120 such that movement of the sleeve 120 relative to the first jaw 24 is limited to rotation about the axis 42 (e.g., in the first and second rotational directions R1 , R2).

[0077] According to one embodiment, the first jaw 24 may be secured relative to the sleeve 120 via one or more fasteners 160. At least one of the first and second flanges 102, 104 (e.g., the second flange 104 as shown) and the tubular member 106 may include one or more pairs of fastener receiving holes 162. Each of the respective one or more pairs of fastener receiving holes 162 may be aligned so as to receive a respective one of the fasteners 160. Other connections of the components (e.g., adhesives, threaded couplings,friction / snap fittings, etc.) are also options for connecting components of the cannula holder20.

[0078] The method of assembly may further include capturing the second jaw 26 between the guide rails 68 such that movement of the second jaw 26 relative to the first jaw 24 is only translational toward and away from the first jaw 24 along the axis 42.

[0079] The above description of illustrated embodiments, including what is described in the Abstract, is not intended to be exhaustive or to limit the embodiments to the precise forms disclosed. Although specific embodiments of and examples are described herein for illustrative purposes, various equivalent modifications can be made without departing from the spirit and scope of the disclosure, as will be recognized by those skilled in the relevant art. The various embodiments described above can be combined to provide further embodiments.

[0080] The methods described herein can be performed with variations. For example, many of the methods may include additional acts, omit some acts, and / or perform acts in a different order than as illustrated or described.

[0081] These and other changes can be made to the embodiments in light of the above-detailed description. In general, in the following claims, the terms used should not be construed to limit the claims to the specific embodiments disclosed in the specification and the claims but should be construed to include all possible embodiments along with the full scope of equivalents to which such claims are entitled. Accordingly, the claims are not limited by the disclosure.

Claims

CLAIMS1. A cannula holder comprising: a clamp comprising: a first jaw comprising a first clamping surface; and a second jaw comprising a second clamping surface facing the first clamping surface; a piston movable toward and away from the first jaw; a spring positioned between the piston and the second jaw; and an actuator coupled to the piston, wherein rotation of the actuator in a first rotational direction moves the piston toward the first jaw, and rotation of the actuator in a second rotational direction moves the piston away from the first jaw.

2. The cannula holder of claim 1 wherein rotation of the actuator in the first rotational direction compresses the spring, and rotation of the actuator in the second rotational direction decompresses the spring.

3. The cannula holder of claim 2 wherein the spring exerts a biasing force on the second jaw that biases the second clamping surface towards the first clamping surface.

4. The cannula holder of claim 3 wherein rotating the actuator in the first rotational direction thereby compressing the spring increases the biasing force exerted on the second jaw.

5. The cannula holder of any one of claims 3 and 4 wherein rotating the actuator in the second rotational direction thereby decompressing the spring decreases the biasing force exerted on the second jaw.

6. The cannula holder of any one of claims 1 to 5, further comprising: a pocket defined by the second clamping surface and the first clamping surface along a first direction, wherein the pocket defines a first path through the clamp, the first path oriented perpendicular to the first direction.

7. The cannula holder of claim 6 wherein: a first opening of the pocket is coplanar with a first sidewall of the first jaw, a first sidewall of the second jaw, or both; a second opening of the pocket is coplanar with a second sidewall of the first jaw that is opposite the first sidewall of the first jaw, a second sidewall of the second jaw that is opposite the first sidewall of the second jaw, or both; and the first path extends through the first opening to enter the pocket, through the pocket to the second opening, and through the second opening to exit the pocket.

8. The cannula holder of any one of claims 6 and 7 wherein rotation of the actuator in the first rotational direction moves the piston toward the first jaw and reduces a size of the pocket as measured in the first linear direction, and rotation of the actuator in the second rotational direction moves the piston away from the first jaw.

9. The cannula holder of any one of claims 6 to 8 wherein the cannula holder defines a second path into the pocket oriented perpendicular to the first path.

10. The cannula holder of claim 9, wherein the pocket defines a lateral opening, and the second path extends from the lateral opening to a base surface that partially defines the pocket.

11. The cannula holder of claim 10 wherein the lateral opening is coplanar with a third sidewall of the second jaw that is perpendicular to both the first and second sidewalls of the second jaw.

12. The cannula holder of any one of claims 2 to 11 wherein movement of the second jaw relative to the first jaw is only translational along an axis.

13. The cannula holder of claim 12 wherein: at least a portion of the first clamping surface lies in a first plane oblique with respect to the axis; at least a portion of the second clamping surface lies in a second plane oblique with respect to the axis; or at least a portion of the first clamping surface lies in the first plane and at least a portion of the second clamping surface lies in the second plane.

14. The cannula holder of claim 13 wherein: a first portion of the first clamping surface lies in the first plane, and a second portion of the first clamping surface lies in a third plane oblique with respect to the axis and nonparallel with the first plane; a first portion of the second clamping surface lies in the second plane, and a second portion of the second clamping surface lies in a fourth plane that is oblique with respect to the axis and non-parallel with the second plane; or the first portion of the first clamping surface lies in the first plane, the second portion of the first clamping surface lies in the third plane, the first portion of the second clamping surface lies in the second plane, and the second portion of the second clamping surface lies in the fourth plane.

15. The cannula holder of any one of claims 12 to 14 wherein translational movement of the second jaw relative to the first jaw in any direction other than along the axis is prevented, and rotational movement of the second jaw relative to the first jaw is prevented.

16. The cannula holder of any one of claims 12 to 15, further comprising: a guide rail extending from the actuator and toward the first jaw, the guide rail and at least a portion of the second jaw having corresponding shapes, the second jaw being slidable along the guide rail in a direction parallel to the axis.

17. The cannula holder of any one of claims 12 to 16 wherein the first rotational direction is about the axis, and the second rotational direction is opposite the first rotational direction.

18. The cannula holder of any one of claims 1 to 17, further comprising: a frame comprising: a first flange; a second flange; and a tubular member extending between the first and second flanges, the tubular member having an inner surface defining an inner chamber and an outer surface opposite the inner surface, wherein the frame supports the actuator and restricts movement of the actuator relative to the first jaw other than rotation in the first and second rotational directions, and wherein the frame supports the piston such that the piston is received and slidable within the inner chamber toward and away from the first jaw.

19. The cannula holder of claim 18 wherein the actuator is captured between the first flange and the second flange such that translation of the actuator relative to the first jaw is blocked.

20. The cannula holder of claim 1, further comprising: a sleeve, a helical track extending through the sleeve, and at least one follower, wherein the at least one follower includes a first portion positioned within the helical track and a second portion secured to the piston such that rotation of the sleeve relative to the piston in the first rotational direction advances the at least one follower along the helical track and translates the piston toward the first jaw, and such that rotation of the sleeve relative to the piston in the second rotational direction retreats the at least one follower along the helical track and translates the piston away from the first jaw.

21. The cannula holder of claim 20, further comprising: a frame comprising: a first flange; a second flange; and a slotted, tubular member extending between the first and second flanges, the slotted tubular member including an inner chamber defined by an inner surface of the slotted, tubular member, an outer surface opposite the inner surface, and a slot that extends through both the inner and outer surfaces forming a passage through the slotted, tubular member into the inner chamber, wherein the frame supports the sleeve such that the sleeve is captured between the first flange and the second flange thereby restricting movement of the sleeve relative to the first jaw other than rotation in the first and second rotational directions, wherein the frame supports the piston such that the piston is received and slidable within the inner chamber toward and away from the first jaw, and a third portion of the at least one follower between the first and second portions of the at least one follower extends through the slot, and wherein rotation of the sleeve relative to the piston in the first rotational direction translates the at least one follower along the slot and toward the first jaw.

22. The cannula holder of any one of claims 1 to 21 wherein at least a portion of the cannula holder is radiolucent.

23. A method of securing a cannula with a cannula holder, the method comprising: exerting a clamping force on the cannula secured between a first jaw and a second jaw of the cannula holder; rotating an actuator of the cannula holder in a first rotational direction to increase the clamping force exerted on the cannula; and rotating the actuator in a second rotational direction to decrease the clamping force exerted on the cannula.

24. The method of claim 23, further comprising: compressing a spring of the cannula holder to increase the clamping force exerted on the cannula; and decompressing the spring of the cannula holder to decrease the clamping force exerted on the cannula.

25. The method of claim 24, further comprising: translating a piston of the cannula holder toward the first jaw to compress the spring; and translating the piston of the cannula holder away from the first jaw to decompress the spring.

26. The method of claim 25 wherein rotating the actuator in the first rotational direction translates the piston toward the first jaw, and rotating the actuator in the second rotational direction translates the piston away from the first jaw.

27. The method of claim 26 wherein a first portion of the spring is proximate the piston and a second portion of the spring is proximate the second jaw.

28. The method of any one of claims 25 to 27 wherein: rotating the actuator in a first rotational direction includes rotating the actuator about an axis; the second rotational direction is opposite the first rotational direction; and translating the piston toward the first jaw and away from the first jaw includes translating the piston along the axis.

29. The method of any one of claims 25 to 28, further comprising: advancing a follower along a helical track; andtranslating the follower along a longitudinal slot of a tubular member, wherein the follower includes a first portion positioned within the helical track, a second portion secured to the piston, and a third portion that is between the first portion and the second portion and extending through the longitudinal slot.

30. The method of claim 29 , further comprising: rotating a sleeve relative to a tubular member thereby advancing the follower along the helical track and translating the piston within an inner chamber of the tubular member.

31. The method of claim 30 wherein rotating the actuator in the first rotational direction rotates the sleeve relative to the tubular member in the first rotational direction, and rotating the actuator in the second rotational direction rotates the sleeve relative to the tubular member in the second rotational direction.

32. The method of claim any one of claims 24 to 31 , further comprising: decompressing the spring and translating the second jaw away from the first jaw, thereby opening a path into a pocket between the first jaw and the second jaw; moving the cannula into the pocket via the path; translating the second jaw toward the first jaw thereby closing the path into the pocket; and compressing the spring thereby exerting the clamping force on the cannula.

33. The method of claim 32 wherein: opening the path into the pocket includes increasing a height of an opening to be greater than a cross-sectional dimension of the cannula; and closing the path into the pocket includes decreasing the height of the opening to be less than the cross-sectional dimension of the cannula.

34. A method of assembling a cannula holder, the method comprising: positioning a piston within an inner chamber of a slotted, tubular member; positioning the slotted, tubular member within a through hole of a sleeve; inserting a first portion of a follower into a recess of the piston such that a second portion of the follower is positioned within a slot of the slotted tubular member, and a third portion of the follower is positioned within a helical track defined by the sleeve, such that the sleeve is rotatable relative to the piston, the second portion of the follower is translatable within the slot, and the third portion of the follower is advanceable along the helical track;securing a first end of a spring to the piston and a second end of the spring to a movable jaw; and securing a fixed jaw relative to the sleeve such that movement of the sleeve relative to the fixed jaw is limited to rotation about an axis.

35. The method of claim 34, further comprising: capturing the movable jaw between opposing guide rails such that movement of the movable jaw relative to the fixed jaw is only translational toward and away from the fixed jaw along the axis.

36. The method of any one of claims 34 and 35 wherein the follower is a first follower, the recess is a first recess, and the slot is a first slot, the method further comprising: inserting a first portion of a second follower into a second recess of the piston such that a second portion of the second follower is positioned within a second slot of the slotted tubular member, and a third portion of the second follower is positioned within the helical track, wherein the first follower is offset from the second follower with respect to a direction parallel to the axis.