Unit-type blood vessel harvesting device and method of using same

Abstract

In one embodiment, the device includes an elongate body having a proximal end and a distal end, and a dissecting tip disposed at the distal end of the elongate body. The dissecting tip can include an integrated circuit for providing a camera, illumination, and data communication within the tip.

Description

[Technical field]

[0001] This application is based on U.S. Provisional Application No. 62 / 829990, filed April 5, 2019, and claims the benefit of priority to any and all of the contents of that provisional application which are common to this application, the contents of which are incorporated herein by reference in their entirety.

[0002] FIELD OF THE DISCLOSURE The present disclosure relates to a blood vessel harvesting device, and more particularly to a disposable blood vessel harvesting device with integrated imaging and illumination capabilities. [Background technology]

[0003] Generally, current EVH (endoscopic vessel harvesting) devices can utilize additional components and associated systems to perform various functions. For example, in one application, an EVH device uses a reusable, solid endoscope that is received within the cannula of the EVH device. Similarly, another conventional EVH device utilizes a reusable camera in combination with a separate light source. In a conventional example, a reusable camera is coupled to the proximal end of a solid endoscope. The EVH device and each of the reusable components have separate power and communication cords to communicate with separate processing components outside the sterile field. For example, a reusable camera has a power / video cable extending from it that connects to a camera processor. The camera processor processes image data from the camera and displays it on a monitor attached to the camera processor. Also, the endoscope typically has a fiber optic light cord attached to it that can transmit light from a separate light source attached to the light cord down the scope and to the distal tip of the EVH device. Summary of the Invention [Problem to be solved by the invention]

[0004] Traditional EVH device configurations have several drawbacks. For example, reusable components used with the EVH device must be sterilized separately before being used with the EVH device in the sterile field. This is time consuming and poses risks if any of the reusable components are not properly sterilized. Additionally, the addition of multiple different systems with power and communication cords makes the EVH device bulky and restricts movement, making the device less user-friendly.

[0005] There is a need for improved EVH devices. The present application is directed to further solutions to address this need, as well as other desirable attributes. Specifically, the present application provides a disposable vessel harvesting device that integrates illumination and visualization components. [Means for solving the problem]

[0006] According to an exemplary embodiment of the present invention, a surgical device is provided having an elongate body with a tip disposed at a distal end thereof capable of being advanced with minimal trauma to surrounding tissue, an integrated circuit having an imaging device, an illumination source, and communication circuitry disposed within the tip, and a cable connected to the communication circuitry of the integrated circuit, the cable being connected to a processing tower disposed remotely from the elongate body, the cable providing power and data lines to the surgical device, the imaging device, and the illumination source.

[0007] According to one aspect of the present invention, the surgical device further includes a cutting unit. The integrated circuit may further include at least one light emitting diode. The integrated circuit may further include a battery. The communication circuit may include a wireless transceiver. The integrated circuit may receive power from the battery and exchange data via the wireless transceiver. The communication circuit may include at least one of a conductive line and an optical line. The conductive line may include a small gauge wire extending from a housing of the surgical device through the elongate body and coupled to the integrated circuit. The integrated circuit may receive power and exchange data via the small gauge wire. The surgical device may be connected to the processing tower via a single cable. The surgical device may be disposable.

[0008] In accordance with an exemplary embodiment of the present invention, a system is provided that includes a surgical device and a processing tower having an electrosurgical generator. The surgical device has an elongated body with a tip disposed at a distal end thereof capable of minimizing trauma to surrounding tissue as the surgical device advances, an integrated circuit having an imaging device, an illumination source, and a communication circuit disposed within the tip, and a cable connecting the integrated circuit to the processing tower. The electrosurgical generator provides power to the imaging device, the illumination source, and the communication circuit via the cable.

[0009] According to one aspect of the invention, the processing tower may further include a video processor for processing signals received from the imaging device and a video monitor 156 for displaying the video. The system may further include a wireless transceiver for transmitting signal data from the camera to the processing tower. The surgical device may include a cutting device. The surgical device may be disposable.

[0010] According to an exemplary embodiment of the present invention, there is provided a method of harvesting a blood vessel, the method comprising: advancing an elongate body having a dissecting tip disposed at a distal end thereof along a main blood vessel to separate the main blood vessel and its branch blood vessels from surrounding tissue; illuminating the main blood vessel and its branch blood vessels within the dissecting tip using an illumination source; capturing and transmitting image signals by an imaging device within the dissecting tip to a video processor to display an image of the main blood vessel and its branch blood vessels to a user; moving the first cutting portion and the second cutting portion in a distal direction from a proximal position of the dissecting tip to capture the blood vessel between the first cutting portion and the second cutting portion using the image; and capturing the blood vessel between the first cutting portion and the second cutting portion using the image.

[0011] According to one aspect of the invention, the image signal is transmitted to the video processor via a single cable through wiring that runs through the elongated body. The single cable can provide power from the processing tower to the cutting section, the imaging device, and the illumination source. The image signal can be wirelessly transmitted to the video processor via a wireless transceiver built into the tip. [Brief description of the drawings]

[0012] The features of the present application will be better understood by reference to the following detailed description taken in conjunction with the accompanying drawings.

[0013] [Figure 1] FIG. 1 illustrates a conventional EVH setup that includes separate components coupled to an EVH device. [Diagram 2] FIG. 2 is a diagram showing an example of a blood vessel harvesting device according to the present application. [Diagram 3] 3A and 3B are diagrams showing an example of a dissection tip of a blood vessel harvesting device according to the present application. [Figure 4] FIG. 4 is a diagram showing an example of a dedicated integrated circuit of a dissection tip of the blood vessel harvesting device according to the present application. [Diagram 5] 5A and 5B are diagrams of an exemplary system for use with a blood vessel harvesting device in accordance with the present application. [Figure 6] 6A, 6B, and 6C are diagrams illustrating an example of a procedure that may be performed using a blood vessel harvesting device according to the present disclosure. [Figure 7] FIG. 7 illustrates a high level architecture for carrying out the process of the present invention. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0014] The following description provides exemplary embodiments only and is not intended to limit the scope, applicability, or configuration of the present disclosure. Rather, the following description of exemplary embodiments will provide those skilled in the art with an effective description for implementing one or more exemplary embodiments. Various changes may be made in the function and arrangement of elements without departing from the spirit and scope of the present invention as set forth in the claims.

[0015] In the following description, specific details are described to fully understand the embodiments. However, those skilled in the art can practice various embodiments without these specific details. For example, systems, processes, and other elements in the present invention are illustrated in block diagram form without going into unnecessary detail and obscuring the embodiments. For example, well-known processes, structures, and techniques may not be illustrated in unnecessary detail so as not to obscure the embodiments. Furthermore, like reference numbers and designations used in the drawings refer to like elements.

[0016] The present application provides a modular device for blood vessel harvesting that reduces the amount of clutter in the sterile field by simplifying the equipment required to perform the procedure. Additionally, the present application replaces traditional reusable components with disposable components that do not require resterilization. Specifically, the present application uses a unique combination of circuitry and wiring to eliminate the need for modular components to be paired with the blood vessel harvesting device for a medical procedure. The disposable blood vessel harvesting device includes an integrated camera and light source (i.e., light emitting diode (LED)) within the tip of the blood vessel harvesting device.

[0017] The disposable vessel harvesting device may include or be compatible with multiple other components for vessel harvesting. For example, the disposable vessel harvesting device may include a cutting component as described in U.S. Patent Nos. 9,119,900, 9,498,246, 9,814,481, and 9,943,328, the contents of which are incorporated herein by reference. In one embodiment, the disposable vessel harvesting device may be used to visualize and separate the main vessel from the surrounding tissue. The vessel may then be visualized and a tributary sealing instrument may be used to seal and cut the side branch. Once the side branch is sealed, another instrument may be used to harvest a portion of the main vessel for bypass grafting. The disposable vessel harvesting device of the present application may combine dissection, tributary sealing and cutting, and main vessel sealing and cutting functions, which may result in reduced manipulations in vascular surgery and improved ease of procedure. The present device may also be used to remove the sealed and cut main vessel from the patient.

[0018] 1-6C, in which like parts are designated with like reference numerals, illustrate an exemplary embodiment of an improved vessel harvesting device for harvesting vessels according to the present disclosure. Although the present disclosure is described with reference to the exemplary embodiment shown in the figures, many alternative forms may embody the present disclosure. Those skilled in the art will further appreciate various ways of modifying the parameters of the disclosed embodiments, such as the size, shape, and type of elements and materials, in a manner consistent with the scope and spirit of the present disclosure.

[0019] In FIG. 1, a representative conventional system 1 for performing an endoscopic harvesting procedure is shown. The system 1 generally includes a reusable endoscopic harvesting device 2, which includes a reusable endoscope 3 and a reusable camera 4, each of which is independently and removably connected to a central control tower 5. Traditionally, in order to be reused, the endoscopic harvesting device 2, endoscope 3, and camera 4 must each be separately sterilized, requiring separate power lines, data communication lines, and / or processing components running from the tower 5. As shown in FIG. 1, for example, the endoscopic harvesting device 2 has a power cable 12 connected to an electrosurgical generator 22, the endoscope 3 has another power cable 13 connected to a light source component 23, and the camera 4 has a cable 14 connected to a video processor 24 that relays information to a video monitor 25. Additionally, each cable 12, 13, 14 must have its own power source and power cable. In operation, each component 2, 3, 4 of the device 1 must be sterile when utilized within the sterile field 30 in which the procedure is performed.

[0020] FIG. 2 illustrates an example of a blood vessel harvesting device 100 according to the present disclosure. An embodiment of the device 100 includes a housing 102 that houses various components of the device 100, including internal wiring for providing power and communicating data to systems external to the housing 102. The housing 102 may also include buttons, switches, and the like for controlling the operation of the device 100. For example, the housing 102 may include a button for providing power to the cutting component of the device 100. The housing 102 may be constructed from any combination of materials using any combination of systems and methods known in the art. For example, the housing 102 may be constructed from biocompatible materials, such as plastic materials, elastomeric materials, metallic materials, shape memory materials, composite materials, or other materials having desired properties. In an embodiment, the device 100 and its components may be disposable.

[0021] In one embodiment, the housing 102 is coupled to wires or cabling 112 that are configured to provide power and / or data transfer between the device 100 and its subsystems. For example, the cable 112 can provide power to a combination of integrated circuits, imaging devices, illumination devices, transceivers, etc., as described in more detail herein. As will be appreciated by those skilled in the art, the cable 112 can also be configured to provide power to other systems known in the art, such as cutting systems as disclosed in U.S. Pat. Nos. 9,119,900; 9,498,246; 9,814,481; and 9,943,328, the contents of which are incorporated herein by reference. The cable 112 can provide a combination of different power and data wiring within a single shield, or it can be a combination of multiple wires woven together into a single line. The cable 112 can be provided as a single structure that can include any combination of various elements that provide physical connections to one or more devices within the tower 150.

[0022] In one embodiment, the cable 112 can include one or more conductive lines for providing power from an external source (e.g., the control tower 150) to the housing 102 to perform various functions. The power provided through the one or more conductive lines can be used to power any combination of components that are part of the device 100. For example, the components can include electrocautery leads, light sources, imaging devices, insufflation devices, computing devices, circuit boards, or any combination of devices or electronics that require power. The cable 112 can include a single conductive line to provide all power to the housing 102 and the components therein, or can include separate conductive lines to provide dedicated power to each of the components in the device, or can include combinations thereof. The cable 112 can include any combination of conductive lines and / or light transmitting lines (fiber optic lines) for any combination of devices. For example, the cable 112 may have three dedicated lines (e.g., positive, negative, signal) for the electrocautery components, two dedicated lines (e.g., signal, fiber optic) for the illumination source 208, and a dedicated line (e.g., signal) for the imaging device 204, all located within the device 100. In an embodiment, one or more of the conductive lines may be wires including any combination of wire gauges. Also, the cable 112 may include wires of different gauges to provide different levels of power to different components of the device 100.

[0023] In some embodiments, the cable 112 can include one or more optical fibers designed to carry light. The one or more optical fibers can be used to transmit light from a light source external to the device 100 (e.g., the tower 150) to an illumination source within the device 100 (e.g., the illumination source 208). In some embodiments, a combination of one or more conductive lines and one or more optical fibers (e.g., optical fibers) can be used to transmit data and / or signals between a computing device (e.g., the video processor 154) remote from the device 100 (e.g., from the tower 150) and a device within the device 100 (e.g., the integrated circuit 200). For example, one or more conductive lines and / or one or more optical fibers can be used to transmit a signal line from an imaging device 204 within the device 100 to a video processor 154 separate from the device 100.

[0024] In some embodiments, the cable 112 can include additional functional elements. For example, the cable 112 can include channels for providing CO2 (carbon dioxide) for pneumoperitoneum, fluids, saline for irrigation / irrigation, etc. The cable 112 can be connected to any portion of the device 100 using any combination of connection mechanisms. For example, the cable 112 can be a detachable cable 112 that is inserted into a port on the device 100, or a fixedly attached cable 112 that is connected to a contact point within the device 100.

[0025] In an embodiment, the elongate body 104 extends from the distal end of the housing 102. The elongate body 104 can be substantially solid or hollow and has a proximal end 106 and a distal end 108. The proximal end 106 is coupled to and / or within the housing 102, which may be accomplished using any suitable coupling mechanism. In an embodiment, the elongate body 103 can include an internal cavity extending from the proximal end 106 to the distal end 108, allowing for power and / or data transmission lines to extend between the proximal end 106 and the distal end 108 to the housing 102 and a cable 112 coupled to the housing 102. As will be appreciated by those skilled in the art, the elongate body 104 can house and / or be coupled to various other tools or components, such as cutting tools. In an embodiment, various components can be inserted on or around the device 100. For example, the trocar 110 can be removably slid onto the elongate body 104 of the device 100 .

[0026] In one embodiment, the longitudinal body 104 can be configured to enter through an incision, pass outside the blood vessel, and reach the site where the blood vessel is to be harvested. The longitudinal body 104 may have sufficient axial stiffness along its length to help guide the longitudinal body 104 to the harvest site. To provide such properties to the longitudinal body 104, in one embodiment, the longitudinal body 104 may be made from a biocompatible material, such as a plastic material, an elastomeric material, a metallic material, a shape memory material, a composite material, or other material having desired properties. Within the desired range, the longitudinal body 104 may have some flexibility to move radially or laterally, depending on the application.

[0027] In some embodiments, the elongate body 104 of the device 100 may be solid. In other embodiments, the device 100 has one or more lumens that house wires, power / data lines, or materials traveling therethrough. Also, in some embodiments, the device 100 may include conduits through which wires or cabling can be routed to provide power to and / or communicate with electrical components within the device 100.

[0028] In an embodiment, the elongate body 104 can terminate in a dissecting tip 120 or can have a dissecting tip 120 coupled to the distal end 108 of the elongate body 104. FIGS. 3A and 3B show an example of a dissecting tip 120. FIG. 3A shows a perspective view of an exemplary dissecting tip 120. In an embodiment, the dissecting tip 120 includes a tapered section 124 that terminates in a blunt end 126 to traumatically separate the vessel segment being harvested from the surrounding tissue while minimizing or preventing tearing or puncturing of nearby vessels or tissue as the device 100 is guided along the vessel segment. Although illustrated as blunt, the end 126 of the dissecting tip 120 can of course be relatively pointed to facilitate advancement of the distal end of the device 100, to the extent desired. Similarly, the tapered section 124 can be structurally configured differently to enhance maneuverability of the device 100.

[0029] In some embodiments, the dissection tip 120 may be radially flexible, flexible or deformable so as to flex slightly with forces applied to the dissection tip 120 to reduce the possibility of trauma during the dissection process. Also, in some embodiments, the dissection tip 120 may be radially compressible so that the walls of the dissection tip 120 may deform when a force perpendicular to the tip surface is applied. To this end, the dissection tip 120 may be made of a thin-walled plastic material to allow it to flex under load. Suitable materials include, but are not limited to, polycarbonate, polyethylene terephthalate glycol modified (PETG), polyethylene terephthalate (PET), and other materials that provide sufficient optical clarity while allowing the dissection tip to flex under load. At the same time, the dissection tip 120 may provide sufficient columnar strength in the axial or longitudinal direction to allow the blood vessel to be separated from the surrounding connective tissue. In other words, while the tip 120 is axially rigid so that it can advance through tissue, the tip 120 may be radially flexible, pliable, or deformable. The dissecting tip 120 may have other properties, such as variable strength, such as (1) variable axially vs. longitudinally, with the axial strength greater than the longitudinal strength, (2) variable longitudinally vs. axially, with the longitudinal strength greater than the axial strength, or (3) variable axially vs. longitudinally, with the axial strength similar to the longitudinal strength. The dissecting tip 120 may also include two or more materials, at least one of which may have different material properties, such as elasticity, hardness, tensile strength, etc.

[0030] 3A and 3B, in one embodiment, the dissecting tip 120 may be conical and may have its distal end 129 formed in such a manner as to minimize the adverse effects of visual distortion or blinding in the center of the visualization field when viewed through an imaging device (e.g., a camera) within the dissecting tip 120. The inner surface 121 of the dissecting tip 120 may be tapered with a relatively constant slope toward the distal end 126 of the dissecting tip 120, as shown in FIG. 3B, and terminates at an inner apex 123, which may be a sharp point. Also, the outer surface 125 of the dissecting tip 120 may be tapered with a constant slope toward the distal end 126 of the dissecting tip 120, but the distal end 126 may be formed with a relatively rounded, blunt end to minimize tissue damage during dissection. As shown, at the distal end 106, the outer surface 125 of the dissection tip 120 may fold back in a proximal direction and then terminate at an outer surface apex 127, maintaining a blunt outer surface and forming a recess at the distal end of the dissection tip 120.

[0031] In an embodiment, both the internal apex 123 and the external apex 127 may be collinear with the central longitudinal axis of the cannula 100. In other words, the centers of the internal apex 123 and the external apex 127 may be located on the central longitudinal axis of the longitudinal body 104. By providing each of the internal surface 121 and the external surface 125 of the dissection tip 120 with an apex that also coincides with the axis of any imaging device within the dissection tip 120, those surfaces that are perpendicular to the optical path (which is parallel to the axis of the longitudinal body 104) may be eliminated, which may eliminate refraction of light back to the camera from perpendicular surfaces. Thus, visual distortion or glare may be minimized or eliminated when looking through an internal imaging device with a light source and camera system.

[0032] Referring to FIG. 3B, in one embodiment, the dissection tip 120 may include an internal cavity in fluid communication with the internal cavity of the elongated body 104 to allow for power and data communication to be transmitted between the dissection tip 120 and the housing 102. This may include transmitting and receiving power and data between the dissection tip 120 and the cable 112 and to and from the tower 150. FIG. 3B is a cross-sectional view of the dissection 120 having a cavity therein. In one embodiment, a specialized integrated circuit 200 configured for illumination and / or electronic image processing is incorporated within the internal cavity of the dissection tip 120 to capture image data outside of the dissection tip 120. The specialized circuit 200 may be sized and dimensioned to fit within the dissection tip 120 of the device 100 and positioned to allow imaging from within the dissection tip 120. For example, the dissection tip 120 may have a circular cross-section with a diameter of about 2-10 mm and may be positioned at the distal end of the dissection tip 120.

[0033] 4 illustrates a block diagram of an exemplary dedicated circuit 200 for use within the dissection tip 120. In one embodiment, the dedicated circuit 200 includes a customized printed circuit board 202 with any combination of a wireless transceiver 212, an imaging device 204, a communication circuit 206, an illumination source 208, a battery 210, etc. mounted thereon. The imaging device 204, the communication circuit 206, the illumination source 208, the battery 210, and the wireless transceiver 212 may be embedded in or on the printed circuit board 202 in any combination manner known in the art.

[0034] In one embodiment, the imaging device 204 is any combination of digital imaging devices of a size and dimensions that can fit on the circuit board 202 and is located within the dissection tip 120. For example, the imaging device 204 is a camera designed to capture any combination of images and videos. The size and resolution of the imaging device 204 will affect the size of the dedicated circuitry 200. For example, the higher the resolution, the larger the imaging device 204 will be, and the larger the size of the dedicated circuitry 200 required. In one embodiment, the imaging device 204 can be designed to capture light, convert the captured light into a signal, and transmit the signal along the cable 112 to the intended device (e.g., the tower 150). In one embodiment, the imaging device 204 can include a lens and camera chip mounted on the circuit board 202 at the tip of the device 100. Ambient light passes through a glass lens, and early stage camera processing can be processed within the tip 120 of the device 100 (e.g., on the circuit board 202). This processing can be done without having to send the ambient light through optical fibers or the like in the handle for processing. The pre-processed electrical signal can be sent from the circuit board 202 along a transmission path on the cable 112 to the video processor 154, which may be built into the handle 102 or located in the external tower 150.

[0035] In an embodiment, the communication circuitry 206 includes any combination of electrical contacts, transceivers, plugs, wires, etc., that transmit data to or from the imaging device 204 through the wires of the cable 112 to transmit power and / or data between the device 100 and a remote source (e.g., tower 150). For example, the communication circuitry 206 can be any combination of hardwired buses, channels, pins, etc., that route data along a transmission line, such as a small gauge wire (or any wiring / conductive element known in the art) that runs through the elongated body 104 to the housing 102. In an embodiment, the communication circuitry 206 can be a different type of transmission line than that found in the cable 112.

[0036] In an embodiment, the printed circuit board 202 includes, directly or attachably, an illumination source 208, e.g., a light emitting diode(s) (LED), to illuminate the surrounding area near the tip 120 for image capture by the imaging device 204. The illumination source 208 may include any combination of light sources, such as LEDs, known in the art, and may be configured to illuminate the inside of a blood vessel. Because all components on the dedicated circuit 200 are located internally within the dissection tip 120, the device 100 does not require a separate endoscope, light source, camera, and their associated external cabling, etc. This is further described with reference to Figures 5A and 5B.

[0037] In an embodiment of the present application, the device 100 is sterile when removed from its packaging, eliminating the need to sterilize and attach separate components (e.g., endoscope, camera, light, etc.). Also, the entire device 100 can be disposed of after use. Conventional medical devices 1 utilize a separate reusable camera 4 that uses a conventional rigid rod lens when used as part of a medical procedure. The rigid rod lens is for sending images captured by a separate reusable endoscope 3 to the camera 4. The rigid rod lens is also part of a separate device, such as an endoscope 3 with a glass lens at its tip. External light entering the lens is collected and sent through optical fibers in the rod shaft to the eyepiece. The camera 4 is attached to the eyepiece, receives the light, processes the image, and sends the signal to a video process 24 over its own wiring and outputs it to a monitor 25.

[0038] Such a device 1 can also pass light from an endoscope 3, and is very expensive, so it is used as a reusable device 1. Reusable equipment must be sterilized before reuse, but the endoscope, camera, light source, etc. are sterilized separately. In particular, such a conventional device 1 uses a separate removable camera 4 that uses an expensive light source box 23 in a tower 5. Light from the light source box 23 is emitted from the tip along a separate cable 13 through a rod lens, and the reflected light is returned to the main body of the blood vessel harvesting device 2. During the procedure, light from inside the body returns through the rod lens to the expensive camera 4 attached to the front side of the rod lens, which processes the light to create an image and sends it to an expensive video processor 24.

[0039] In contrast, according to the present disclosure, the dedicated circuit 200 includes the imaging device 204 and one or more illumination sources 208 (e.g., LEDs), eliminating the need for a separate light box on the control tower 150. This combination of elements results in significant cost savings since the illumination source is internal and produces the light, and only a simple two wires are required to power the illumination source 208. Furthermore, the combination of the illumination source 208 and imaging device 204 eliminates the need for expensive components such as rod lenses to transmit the light generated in the light box to where it is needed, since the light is generated by the illumination source 208 in the dissection tip 120. Similarly, the device 100 of the present disclosure does not require expensive rod lenses to transmit the image back to the camera, since the imaging device 204 is located distally on the dedicated circuit board 200 in the dissection tip 120. By mounting cost-effective components such as an image sensor 204 and an illumination light source 208 on a dedicated circuit board 200 and combining them with cost-effective power and data lines in a cable 112, a compact device 100 suitable for disposable, one-time use is provided.

[0040] In one embodiment, the dissection tip 120 is transparent and configured to pass illumination light (e.g., illumination light from the illumination source 204) and receive reflected light (e.g., by the imaging device 204) during a procedure using the device 100. The dissection tip 120 in one embodiment may be of any shape, but should be shaped to facilitate imaging therethrough (e.g., imaging by the imaging device 204) to allow for the necessary control during dissection and separation of tissue. Similarly, the placement of the dedicated circuitry 200 within the dissection tip 120 should be in a position and orientation that can facilitate sufficient illumination and imaging therethrough to allow for the necessary control during dissection of tissue.

[0041] In an embodiment, the shape and material of the dissection tip 120 in combination with the location of the imaging device 204 and the illumination source 208 can facilitate the capture of sufficient quality image data with sufficient light for use during a procedure. The illumination source 208 can have one light source in a single location or multiple light sources in multiple locations to provide favorable illumination for image capture by the imager 204. For example, the illumination source 208 can include multiple light sources (e.g., 4-12 LEDs) that are distributed to ensure even light distribution and laid out in a symmetrical pattern (e.g., a circular ring pattern). In an embodiment, if there are multiple light sources in the illumination source 208, they can be wired to be controlled as a single unit or individually controlled. The same is true for the imaging device 204 and / or different types of imaging devices 204 in the dedicated circuit 200.

[0042] 4, in one embodiment, the dedicated circuitry 200, and components incorporated therein, can receive power and transmit data to a processing unit(s) (e.g., video processor 154) in a control or processing tower 150 via a single cable 112 coupled to the housing 102. In one embodiment, the cable 112 can connect directly or indirectly to a communication circuitry 206 to provide data communication and power to the circuitry 200. For example, the cable 112 can include one or more conductive and / or optical lines for transmitting signals, such as image data, from the imager 204 to the tower 150 for video processing and display. Power and data are transmitted from the cable 112 attached to the housing 102, through the elongated body 104, and to the dedicated circuitry 200. For example, a small gauge wire coupled to a cable 112 within the housing 102 and extending through the elongated body 104 between the dissecting tip 120 and the housing 102 can be used to provide power to the illumination source(s) 208 and to transmit control and video signals between the imaging device 204 and the external video processor 154.

[0043] In an embodiment, the dedicated circuitry 200 and / or the housing 102 can optionally include a battery 210 for powering the imaging element 204, the illumination source 208, and / or other components in the device 100. The battery 210 can be designed to power the dedicated circuitry 200 and the components / devices thereon (e.g., the imaging device 204, the illumination device 208, etc.). The battery 210 can be used to supplement or replace the power provided from the tower 150. In an embodiment, the battery 210 can be rechargeable, and the power provided via the cable 112 or another cable can be used to charge the battery 210 in the housing 102 of the device 100. The battery 210 can hold a charge to provide sufficient power to the device 100 and all components thereon during a medical procedure.

[0044] FIG. 5A illustrates an example of a system 300 having a dedicated circuit 200, which includes wiring for transmitting power and data from the device 100 to a location remote from the device 100. In one embodiment, the system 300 can include the device 100 as described with respect to FIG. 2 coupled to a processing tower 150 via a cable 112. The cable 112 can be configured to receive power from a power source in the tower 150 and share data with one or more processing units in the tower 150. The tower 150 can include a combination of processing units responsible for managing the various subsystems of the device 100. In one embodiment, the processing units can include an electrosurgical generator 152, a video processor 154, and a video monitor 156. The electrosurgical generator 152 can be configured to provide and control power to the device 100 to perform electrosurgical tasks such as imaging, lighting, cauterization, cutting, etc. The video processor 154 can be configured to receive, interpret, convert, and relay video signal data provided from the imaging device 204 in the device 100 (e.g., via the cable 112). The video processor 154 can also communicate the video signal in a displayable format to the video monitor 156 for display to the user. In one embodiment, the electrosurgical generator 152, video processor 154, and video monitor 156 can all be integrated into a single compact device.

[0045] In an embodiment, the cable 112 can include a wire that provides electrosurgical power to the device 100 and a separate wire for transmitting a video signal. For example, at or within the tower 150, the cable 112 can be split into two separate wires, one connected to the electrosurgical generator 152 and the other connected to the video processor 154. In other words, the combination of wires integrated into a single cable 112 can be bifurcated at the tower 150 and connected to different processing units, with only one cable 112 leaving the device 100 in the sterile field 130 for user convenience. This differs from the system 1 of FIG. 1, where multiple cables were required. In an embodiment, the video processor 154 can also provide power to the dedicated circuitry 200 and the illumination source 208 via separate video signal lines integrated into the single cable 112. This configuration can be used in addition to or instead of an electrosurgical generator. Furthermore, by mounting the image pickup element 204 on the dedicated circuit 200, there is no need to separately prepare a sturdy endoscope with wiring or a light source device with wiring.

[0046] 5B illustrates an exemplary system 350 in which the dedicated circuitry 200 is configured to provide wireless power and data transmission. In one embodiment, the system 350 can include the device 100 coupled to a processing tower 150 via a cable 112, similar to that described in FIG. 2. The cable 112 can be configured to receive power from an electrosurgical generator in the tower 150. The tower 150 can include a combination of processing units responsible for managing the various subsystems of the device 100. In one embodiment, the processing unit can include an electrosurgical generator 152, a video processor 154, and a video monitor 156. The electrosurgical generator 152 can be configured to power and control the device 100 to perform electrosurgical tasks, such as, for example, cauterizing, cutting, etc. The video processor 154 can be configured to receive, interpret, convert, and relay video signal data provided by the imaging device 204 in the device 100 (e.g., via the transceiver 116). Video processor 154 may also communicate the video signal in a displayable format to video monitor 156 for display to a user.

[0047] 5B, in an embodiment, the dedicated circuitry 200 and / or the housing 102 can include a wireless transceiver 212, which may be included within the communication circuitry 106 or otherwise coupled to the communication circuitry 106, and can communicate data with an external processor (e.g., video processor 154). Data from the imager 204 is sent to the tower 150 for processing and / or display using any combination of methods. The signal can be sent wirelessly from the wireless transceiver 212 and / or data lines in the cable 112 to the video processor 154 in the tower 150 and then output to the video monitor 156. In an embodiment, the wireless transceiver 212 can be powered by the battery 210 and / or via the cable 112 and can be configured to transmit data in any wireless format known in the art, such as, for example, Bluetooth, Wi-Fi, RF, etc. In one embodiment, the combination of the on-board battery 210 and transceiver 212 allows the dissection tip 120 to operate independently from the rest of the device 100 without additional wiring to the elongated body 104 of the cable 212. As will be appreciated by those skilled in the art, any combination of the illumination source(s) 208, the battery 210, and the transceiver 212 can be located on the dedicated circuit 200 or communicatively attached to the dedicated circuit 200 located elsewhere. For example, the battery 210 and / or the transceiver 212 can be located on a circuit board within the housing 102 and coupled to the dedicated circuit 200 via wires that run through the elongated body 104 of the device 100. In this example, the video signal from the imager 204 is sent from the dedicated circuit 200 via internal wiring to the circuit board within the housing 102.

[0048] In an embodiment, power for the on-board lighting device 208 for illumination, the imaging device 204, and the dedicated circuitry 200 can be provided via a battery 210, and image data (and other data signals) can be transmitted via a wireless transceiver 212. The video processor 154 can be configured with a corresponding transceiver to communicate with the transceiver 212 on the device 100. In an embodiment, the communication medium, frequency, etc. of the wireless data transmission are adjusted to avoid interference with other devices in the area.

[0049] By providing the dedicated circuitry 200 with an independent power supply and lighting, in any combination with wireless transmission of video signals, only one cable 112 can be used to isolate the device 100 in the sterile field 130, without requiring extra experience from the user, as would be the case with the multiple cables required to operate the system 1 of FIG. 1. In some embodiments, the cable 112 is not required if a power source is coupled to the device 100 to power the other components (e.g., battery 210). For example, the device 100 can be adapted for use without the cable 112 by providing a battery 210 with enough power to power the lighting device 208, the imaging device 204, and the communication means for exploratory procedures (transceiver 212 or communication path 206). In another example, the device 100 can utilize the additional power from the cable 212 to power components that require more power, such as an electrosurgical cutting tool. Also, the inclusion of the imaging element 204 in the dedicated circuitry 200 eliminates the need for a bulky endoscope with its associated wiring and light source. A battery 210 powers the lighting device 20 at the top of the device 100 and a transmitter that delivers a video signal to the video processor 154 in the tower 150. The features of the present disclosure combine to provide a simple system that can be adapted to a variety of procedures.

[0050] 6A to 6C, the blood vessel 600 is composed of a main blood vessel 610 and a branch blood vessel 620 that branches out from the main blood vessel 610, as shown in FIG. 6A. The blood vessel 600 and its branch blood vessel 610 are wrapped in subcutaneous fat connective tissue 630, so that the main blood vessel 600 needs to be cut away from the surrounding fat connective tissue 630 before being harvested. The subcutaneous fat 630 is softer than connective tissues such as skin, muscle, and fascia. Although the fat connective tissue 630 is attached to the blood vessel 600, it forms an interface 640, so that the blood vessel 600 can be dissected cleanly. In other words, a natural dissection plane exists between the outer layer (adventitia) of the blood vessel 600 and the surrounding subcutaneous fat 630.

[0051] FIG. 6B illustrates an exemplary dissection of a main vessel 610 of a blood vessel 600 along a natural dissection plane, where the dissection tip 120 of the device 100 advances along the adventitial surface of the blood vessel 600. Separating the blood vessel 600 from the surrounding fatty connective tissue 630 along this plane typically does not require high dissection force. Advancement of the dissection tip 120 can be performed with the aid of the imaging device 204 and the illumination source 208 in the dissection tip 120. For example, the illumination source 208 can provide sufficient illumination for the imaging device 204 to capture image data. The image data can then be transmitted to the housing 102 via the elongated body 104. For example, the image data can be transmitted from the imaging device 204 to the communication circuitry 206 and then transmitted via internal wiring through the elongated body 104. The image data can then be transmitted from the housing 102 to the tower 150 via the cable 112 for processing. Optionally, the image data can be transmitted from the wireless transceiver 212 to the tower 150. Within tower 150, the image data may be processed by a video processor 154 and displayed on a video monitor 156 for viewing by a user performing or assisting the procedure. In an embodiment, dissection tip 120 may provide sufficient axial strength to dissect blood vessel 600 from surrounding tissue 630 along natural dissection planes.

[0052] As shown in FIG. 6C, as the dissection tip 120 approaches the branch vessel 620, the dissection tip 120 can capture the branch vessel 620 at the bifurcation point 650 between the branch vessel 620 and the main vessel 600. Excessive force on the dissection tip 120 can dissect and sever the branch vessel 620 from the main vessel 610 or otherwise damage the main vessel 600. Therefore, in one embodiment, the dissection tip 120 has sufficient columnar strength to dissect the vessel 600 from the surrounding tissue 630 along the natural dissection plane, while being flexible enough to deform or deflect from the branch vessel 620 upon application of increased force to reduce the likelihood of trauma to the graft vessel during dissection around the branch vessel. Of course, it should be understood that the stiffness of the dissection tip 120 may be varied from fully flexible to semi-rigid to rigid, depending on the surgical requirements.

[0053] In an embodiment, the imaging device 204 and illumination source 208 described with respect to Figures 4-5B may be used to assist the user in the dissection process by conveying a viewable image proximate to the dissection tip 120, as described in more detail herein. In an embodiment, the device 100 may further include one or more end effectors for cauterizing or sealing and cutting blood vessels, either branch vessels or main vessels. The one or more end effectors may be powered by the cable 112. For example, the cable 112 may be connected to an electrosurgical generator 152 that provides power to the housing 102 via one or more conductive lines within the cable 112. In the housing 102, the cable 112 may transmit power to one or more lines within the housing 102 and provide it to the one or more end effectors via the elongated body 104. In one embodiment, the cable 112 can carry signals to one or more end effectors to supply or cut off power, or power supply or cut off can be performed locally on the device housing 102 (e.g., via a button on the housing 102).

[0054] In operation, the device 100 configured with the tip 120 in the system 300 or 350 can be utilized to perform various electrosurgical procedures, such as harvesting blood vessels. The blood vessels can be used for bypass grafts, such as the greater saphenous vein or radial artery, and can be harvested from the subcutaneous space below the surface of the skin. In an embodiment, an exemplary process for harvesting blood vessels can be performed using the device 100 discussed with respect to FIGS. 2-6C. This process can involve advancing the longitudinal body 104 having the dissecting tip 120 disposed at the distal end 108 of the longitudinal body 104 along the main blood vessel 600 to separate the main blood vessel 600 and its branch blood vessels 620 from the surrounding tissue 630 while illuminating the main blood vessel 600 and its branch blood vessels 620 with the illumination source 204 in the distal end 108 of the dissecting tip 120. The process may also include capturing and transmitting image signals by an imaging device 204 disposed within the dissecting tip 120 to a video processor 154 for displaying an image of the main vessel 600 and its branch vessels 620 to a user. The process may further include using the image to move a first cut and a second cut distally from a proximal position of the dissecting tip 120, and using the image to capture the vessel 600 between the first cut and the second cut.

[0055] In one embodiment, the image signals can be transmitted through wiring running inside the elongate body 104 to the video processor 154 via a single cable 112. The single cable 112 can provide power from the processing tower 150 to the cutting section, the imager 204, and the illumination source 208, and / or the image signals can be transmitted wirelessly to the video processor 154 via a wireless transceiver 212 provided on a dedicated circuit 200 in the distal tip 200.

[0056] Although preferred energy types for the various electrodes are given in this disclosure, the electrodes can be energized with a variety of energy sources, including but not limited to, resistive heating, ultrasonic heating, and bipolar or monopolar RF energy. In certain embodiments, the electrodes can be controlled independently of one another. Also, the electrodes can be insulated with an insulating coating or sheath, if desired.

[0057] Any suitable computing device may be used to implement the computing devices 152, 154 and methods / functions described herein. As will be appreciated by those skilled in the art, even a general-purpose computing device may be transformed into a specific system for performing the operations and functions described herein through extensively modified hardware, software, and firmware changes rather than simply running software. One illustrative example of such a computing device 700 is shown in FIG. 7. The computing device 700 is merely illustrative of a suitable computing environment and is not intended to limit the scope of the invention. The "computing device" shown in FIG. 7 includes computing devices such as "workstations," "servers," "laptops," "desktops," "handheld devices," "mobile devices," "tablet computers," and the like, as would be understood by one skilled in the art. The computing device 700 is shown for illustrative purposes, and various variations of embodiments of the invention may utilize any number of computing devices 700 in any number of different ways. Thus, embodiments of the invention are not limited to a single computing device 700, nor are they limited to a single type of implementation or configuration of the illustrated computing device 700, as will be appreciated by those skilled in the art.

[0058] Computing device 700 includes a bus 710 that may be coupled, directly or indirectly, to one or more of the following components: memory 712, one or more processors 714, one or more presentation components 716, input / output ports 718, input / output components 720, and a power supply 724. Those skilled in the art will appreciate that bus 710 may include one or more buses, such as an address bus, a data bus, or any combination thereof. Furthermore, those skilled in the art will appreciate that more than one of these components may be implemented in a single device, depending on the intended application and use of a particular embodiment. Likewise, a component may be implemented in more than one device. As such, FIG. 7 is merely illustrative of an exemplary computing device that may be used to implement one or more embodiments of the present invention, and is in no way intended to limit the invention.

[0059] Computing device 700 can include and interact with a variety of computer-readable media. For example, computer-readable media can include Random Access Memory (RAM); Read Only Memory (ROM); Electronically Erasable Programmable Read Only Memory (EEPROM); Flash memory or other memory technology; CD-ROM, Digital Versatile Disk (DVD) or other optical or holographic media; magnetic cassettes, magnetic tapes, magnetic disk storage or other magnetic storage devices that can be used to encode information and that can be accessed by computing device 700.

[0060] The memory 712 may include computer storage media in the form of volatile and / or non-volatile memory. The memory 712 may be removable, non-removable, or any combination thereof. Exemplary hardware devices are devices such as hard drives, solid state memories, optical disk drives, etc. The computing device 700 may include one or more processors that read data from components such as the memory 712, various I / O components 716, etc. The presentation component(s) 716 present a representation of the data to a user or other device. Exemplary presentation components include a display device, a speaker, a printing component, a vibrating component, etc.

[0061] I / O ports 718 allow computing device 700 to logically couple to other devices, such as I / O components 720, some of which may be internal to computing device 700. Examples of such I / O components 720 include microphones, joysticks, recording devices, game pads, satellite receivers, scanners, printers, wireless devices, network devices, etc.

[0062] All patents, patent applications, and published documents cited herein are incorporated herein by reference in their entirety. The above-described embodiments of the present disclosure are merely possible examples set forth for a clear understanding of the principles of the present disclosure. Many variations and modifications can be made to the above-described embodiments without substantially departing from the spirit and principles of the present disclosure. The various features and functions described above, or alternatives thereof, can be desirably combined into many other different systems and applications. All such modifications and variations are intended to be included within the scope of the appended claims and are intended to be within the scope of the disclosure herein.

[0063] The terms "configuration" and "including" as utilized herein are intended to be interpreted as inclusive rather than exclusive. As utilized herein, the terms "example," "exemplary," and "exemplary" are intended to mean "serve as an example, instance, or illustration," and should not be interpreted as indicating or not indicating a preferred or advantageous configuration compared to other configurations. As utilized herein, the terms "about," "generally," and "approximately" are intended to cover variations that may exist at the upper and lower limits of a range of subjective or objective values, e.g., variations in properties, parameters, sizes, and dimensions. In one non-limiting example, the terms "about," "generally," and "approximately" mean plus or minus 10% or less. In a non-limiting example, the terms "about," "generally," and "approximately" mean as close as would be determined to be included by one of ordinary skill in the relevant art. As utilized herein, the term "substantially" means a complete or nearly complete extension or extent of an action, property, quality, condition, structure, item, or result, to the extent that one of ordinary skill in the art would understand. For example, an object that is "substantially" circular means that it is perfectly circular to the limits that can be mathematically determined, or nearly so, as one of ordinary skill in the art would recognize and understand. The extent to which deviations from absolute perfection are acceptable may depend on the particular circumstances. In general, however, something that approaches perfection will produce results that are generally equivalent to those that would be obtained from something that is absolutely and completely perfect. The term "substantially" also applies when used in a negative sense, indicating a complete or nearly complete lack of an action, characteristic, property, state, structure, item, or result, as one of ordinary skill in the art would understand.

[0064] Numerous modifications and alternative embodiments of the present disclosure will be apparent to those skilled in the art in view of the foregoing description. This description is therefore to be construed as illustrative only, and is intended to teach those skilled in the art the best mode for carrying out the present disclosure. Details of construction may be varied considerably without departing from the spirit of the present disclosure, and all modifications that come within the scope of the appended claims may be used exclusively. Although the specification has been written and described herein with a degree of clarity and conciseness, it is intended that the embodiments may be combined or separated in various ways without departing from the invention. The present disclosure is limited to the extent required by the appended claims and the rules of applicable law.

[0065] Moreover, the following claims are intended to cover all the general and specific features of the invention described herein, and all statements of the scope of the invention that may be said to fall therebetween as a matter of language.

Claims

1. 1. A surgical device for visualizing blood vessels, comprising: an elongate body disposed at a distal end thereof such that a tapered tip terminates at an apex that can be advanced to minimize trauma to surrounding tissue; an integrated circuit disposed within the tip, the integrated circuit having an imager, an illumination source, and a communication circuit; a cable connecting communication circuitry of the integrated circuit to a processing tower remote from the elongated body, the cable providing power and data lines to the surgical device, the imaging device, and the illumination source; A surgical apparatus comprising:

2. 10. The surgical device of claim 1, further comprising an end effector for cauterizing or sealing and severing a blood vessel, the end effector being movable distally from a proximal position of the tapered tip to capture and cauterize or seal and sever a blood vessel.

3. The surgical apparatus of claim 1 , wherein the illumination source comprises at least one light emitting diode.

4. The surgical device of claim 1 , wherein the integrated circuit further comprises a battery.

5. The surgical device of claim 1 , wherein the communication circuitry comprises a wireless transceiver.

6. The surgical device of claim 5 , wherein the integrated circuit receives power from a battery and exchanges data via the wireless transceiver.

7. The surgical device of claim 1 , wherein the communication circuitry comprises at least one of a conductive line and an optical line.

8. The surgical device of claim 7 , wherein the conductive lines extend from a housing included with the surgical device, through the elongate body, and are coupled to the integrated circuit.

9. The surgical device of claim 8 , wherein the integrated circuit receives power and exchanges data via the conductive lines.

10. The surgical device of claim 1 , wherein the surgical device is connected to the processing tower via the single cable.

11. The surgical device of claim 1 , wherein the surgical device is disposable.

12. a treatment tower having an electrosurgical generator; a surgical device connected to a processing tower; A system comprising: The surgical device is an elongate body disposed at a distal end thereof such that a tapered tip terminates at an apex that can be advanced to minimize trauma to surrounding tissue; an integrated circuit disposed within the tip, the integrated circuit having an imager, an illumination source, and a communication circuit; a cable connecting said integrated circuit to a processing tower; having The electrosurgical generator provides power to the imaging device, the illumination source, and the communication circuitry via a single cable in the system.

13. 13. The system of claim 12, wherein the processing tower further comprises a video processor for processing signals received from the imaging device and a video monitor for displaying images.

14. 13. The system of claim 12, further comprising a wireless transceiver for transmitting signal data from the imaging device to a processing tower.

15. The system of claim 12 , wherein the surgical device further comprises an end effector for cauterizing or sealing and severing a blood vessel.

16. The system of claim 15 , wherein the surgical device is disposable.

Images