A novel device for microsurgery

Abstract

Present invention discloses a novel surgical device suitable for bimanual microsurgery and in such applications as neurosurgery comprising a rigid tube, at least one semi-rigid conduit situated on top of said rigid tube wherein said rigid tube is configured to perform aspiration functions, and said at least one semi-rigid conduit comprises a semi-rigid annular channel comprising an image capturing means, the tip of said image capturing means being configured such that it is fixedly situated at an offset from the distal end of the said rigid tube, whereby a clear view of the distal end, the area immediately facing the distal end and around said distal end are provided at all times.

Description

[0001] A NOVEL DEVICE FOR MICROSURGERY

[0002] Technical Field of the Present Invention

[0003] The present disclosure generally relates to surgical devices and, more specifically, microsurgical devices typically utilized in neurosurgery. Micro and neurosurgical devices that are conducted bimanually, i.e. with the use of both hands of the operating physician, is the specific concentration of the present invention.

[0004] Background of the Present Invention

[0005] Brain surgery, and neurosurgery typically involve use of a specialized microscope for enhanced visualization and magnification, while exoscopes and other lenses are also found in place of imaging means. Typically, this microscope remains stationary, requiring the surgeon to physically adjust the position thereof via manipulating the handles provided. Once the operating physician achieves the desired microscope positioning, they proceed with the surgery while viewing the tissue with the help of the microscope. In this process, one hand holds a surgical instrument, while the other holds a second instrument, such as a dissecting or cutting tool, as needed for tissue manipulation. This is dubbed as bimanual operation, or two-handed operation.

[0006] The two instruments, namely the surgical suction device held in the left hand and the right-hand instrument, are used in tandem. The surgical suction serves two primary functions: clearing the surgical field of blood and offering counterpressure on the tissue to facilitate dissection with the right-hand instrument. This two-handed or bimanual approach is crucial for the surgical objective of separating abnormal tissue from healthy tissue. To manage bleeding during the procedure, the surgeon may employ bipolar cautery forceps when necessary, temporarily replacing the right-hand instrument. Throughout the operation, it may be necessary for the operating physician to reposition the microscope head multiple times to optimize visualization. This is accomplished by briefly handing the right-hand instrument to an assistant, using the microscope's handle to adjust its position, and then resuming surgery once satisfied with the new microscope placement. Additionally, small retractor blades may be employed to gently move tissue aside, creating a clear path for deeper brain surgery.

[0007] Certain brain surgeries can now be conducted using a minimally invasive approach. In these procedures, visualization and magnification are achieved with the utility of an endoscope. Since the endoscope is considerably smaller, it necessitates a smaller incision for the surgery, which calls for the term minimally invasive. Notably, the endoscope offers advantages such as improved illumination and magnification when compared to a microscope.

[0008] When performing surgery with an endoscope, there are two methods. In the first approach, the endoscope is introduced into the area of the brain where the surgery will take place with the help of a small incision. In conventional practices, the endoscope is usually affixed to a holder. An instrument is then inserted through a co-axial instrument channel within the endoscope shaft. Typically, this instrument is a flexible jaw capable of opening and closing or scissors designed for cutting. However, only one instrument can be introduced at a time. Manipulation with this instrument is limited to pulling or cutting, as it can only be moved in and out and not sideways for dissection. Occasionally, the surgeon may hold the endoscope in their left hand while introducing the instrument into the endoscope's channel with their right hand to perform the surgery. However, due to the presence of only one instrument in the surgical field, the ability to perform bimanual or two-handed fine dissection is restricted.

[0009] In the alternative approach to performing brain surgery with an endoscope, a relatively large port, approximately 1-1.5 cm in diameter, is inserted through the brain to create a pathway for the procedure. This method is akin to using small retractor blades to establish access to the target area when employing a microscope for surgery. Subsequently, the endoscope is secured onto a holder and inserted through the port to reach the target area. Within the remaining space in the port, two instruments are introduced, one held in the left hand and the other in the right hand, allowing for tissue dissection to occur using a two-handed bimanual technique.

[0010] However, the conventional approach to endoscopic brain surgery described above is fraught with significant issues. In the first method of endoscopic brain surgery, there are notable challenges. Firstly, there exists only a single instrument channel, limiting instrument movement to a single axis - specifically, in and out. This makes tissue dissection for surgery notably more challenging and time-consuming. Secondly, the endoscope's position is fixed by the holder, requiring the surgeon to halt the procedure, release the endoscope from the holder, and reposition it to access a different area of interest. This not only proves frustrating but also induces fatigue and consumes valuable time. Thirdly, only a small, flexible suction device can be inserted through the instrument channel to remove debris and blood. However, this can only be done intermittently because the channel serves other instruments used during surgery. This inefficiency prolongs the surgical process and increases the surgeon's workload. Moreover, the flexibility of the suction device limits its ability to provide sufficient counter-pressure to aid in tissue dissection. In the second approach to endoscopic brain surgery, issues also persist. A significant portion of the port's space is occupied by the endoscope itself, which makes it difficult and tedious to use two instruments within the remaining narrow space in the port for deep tissue dissection, often resulting in instrument interference. Secondly, since the endoscope is affixed to a holder, the surgeon must frequently pause to reposition the endoscope in order to visualize the area of interest. This elongates the surgery duration, fatigues the surgeon, and significantly ramps up the operation's risk.

[0011] In microsurgical interventions, especially in neurosurgery, mainly three surgical devices can be used for visualizing and handling the operation area. These are, surgical microscope, endoscopic systems, and exoscopic systems.

[0012] Surgical microscope is a device, located between the operation site and surgeon's eyes. By illuminating the surgical area, surgical microscope with a lens located at the distal site transfers the operation view to surgeon's eye with a binocular eye piece at its proximal parts. Under this view, the surgeon operates on the surgical area with microsurgical instruments bimanually, i.e., with both hands. Bimanual handling of operation site is exclusively comfortable and more enabling for the surgeon, directly increasing surgical success while decreasing the complication risks. The surgeon usually utilizes a surgical aspirator in one hand, mostly for cleaning the surgical site with suctioning, and one other microsurgical instrument in the other hand for different aims, such as; micro scissors for cutting, micro dissector for dissecting, bipolar forceps for coagulating, or bayonet pens for holding tissue, etc. It should be noted that the surgical aspirator is not only used for cleaning the surgical site but is also used in assisting other microinstruments such as (i) improving the view trajectory in deep site with gentle retraction of more superficial site by its proximal body, or (ii) retracting deep membranes or lesional parts with its tip for facilitation of cutting with micro scissors etc. This means that, surgical aspirator is used both as a leader in microsurgical approaches for disclosing the centerpiece of the operating site and as a facilitating tool supporting the handling of other instruments.

[0013] Surgical endoscope is a tube system either in flexible or rigid form. Mainly there is a lens at the tip of an endoscope with a light source for illuminating the surgical site. With this lens at the tip, it transmits surgical view under illumination to a camera system and screen, and the surgeon performs intervention under this view. There are different forms of endoscopic systems and some use guiding tubes with irrigation and suction channels in addition to channels (ports) for inserting the endoscopic surgical instruments to the surgical site. Endoscope, when directly inserted to deep tissue area, can transmit views beyond the scope of a surgical microscope providing panoramic views from different locations with its tip.

[0014] Exoscopic systems are recently developed and can be described in principle as a digital form of the surgical microscope. They can get view of surgical site from outside of the head (body) just like a microscope and transfer this view to a screen. The surgeon performs the operation while looking at the view at the screen. Some exoscopic systems provide additional features such as a robotic camera head with automatic angling and alignment or ability to automatically follow the surgical instruments while the surgeon uses them.

[0015] There are some limiting points in surgical intervention by microscope especially in the deep sites of the brain. When the surgeon operates deep structures through a superficial fissure or sulcus of the brain microsurgically, some cisterns, recesses are reached and spaces at the sides become blind to microscopic illumination and lens view. This situation can be tried to be eliminated by additional efforts of the surgeon such as retraction of more superficial parts of the brain tissue or positioning of microscope trajectory to these sites. However, either of these approaches might be ineffective from some points: more retraction may cause tissue injury or vascular tear, and microscopic alignment may not fit the blind recess parts to lens view. In such a situation, it is important to note that even a minute rotation of the surgeon's wrist would carry the tip of the microsurgical instrument to the areas of blind recess, and the lack of microscopic accompanying view to these blind sites would limit the success of the surgical intervention. These limitations, in turn, result in inadequate handling of pathologic tissue while increasing the risk of complications such as neural and vascular injuries. In summary, the surgical microscope offers the surgeon the comfort to work bimanually, but may encounter blind areas in deep concave sites.

[0016] On the other hand, during endoscopic surgery, when the tip of an endoscope is extended through the surgical trajectory to deep brain sites, different angled or wide angled lenses at its tip transmits view of all recess areas to the surgeon's view. In this sense, the endoscopic systems are superior to surgical microscope in imaging deep volumetric tissue areas. However, endoscopic surgery prohibits the comfort of bimanual surgical intervention in opposition to the surgical microscope. Endoscopic probes are either quite heavier than the microsurgical instruments or discordant to hand grip and hence are inharmonious to microsurgical manipulation according to routine microsurgical practice. In the usual practice, the surgeon holds the endoscopic probe with one hand and performs surgical manipulation with the other hand. This is incomparable to the capacity of bimanual working described above. Some endoscopic surgery systems provide additional facilitators such as distinct tubular systems accompanying endoscopic probe with different ports for insertion of different endoscopic surgical devices (endoscopic scissors, bipolar or dissector etc.). These instruments are not various enough as microsurgical instruments and bimanual working of a surgeon mostly requires fixation of this system in a stable point during manipulation. However, frequent repositioning and fixation of device would be unnatural during surgery because consecutive different positioning is generally needed. Another alternative to fixation of the system is the assistance of one surgeon in handling the endoscopic probe while another performs the operation bimanually but in deep restricted tissue area, cooperation would be difficult, and increase the risk of complications.

[0017] The main disadvantages of the exoscopic system are the same as the microscope. With robotic and automatic movements, the head containing the lens or the camera of the exoscope can align even excessive degrees but because of it is still getting images outside of the tissue, more superficial tissue parts would prevent imaging in deep sites. Hence, the exoscope does not change the limitations of the surgical microscope as mentioned above.

[0018] EP 2037794 Bl discloses a minimally invasive surgical system. According to the teaching contained therein, distal end of a surgical instrument is movable in all six Cartesian degrees of freedom independently of other components of a telemanipulated surgical system. The surgical instrument extends through a guide tube. The distal end is moved by actuators that are telemanipulatively controlled.

[0019] US 10842357 B2 discloses an apparatus, device or tool for performing endoscopic surgery. An exemplary embodiment of the invention includes a video endoscope whilst in another embodiment of the invention includes an endoscopic surgical tool which, when equipped with one of a suite of endoscopic surgical instruments, can be used by a surgeon to perform surgical procedures inside a body. Another embodiment of the present invention includes a suite of endoscopic surgical instruments designed to work cooperatively with the endoscopic surgical tool. In another embodiment of the present invention, a video-assisted endoscopic surgical tool system is provided. In one embodiment, the system includes the video-assisted endoscopic surgical tool and a suite of at least one endoscopic surgical instrument.

[0020] US 11660120 B2 provides a visualized surgical assembly, characterized in that the visualized surgical assembly includes a disposable drainage tube and a functional tube for providing visualization function, the disposable drainage tube and the functional tube are connected detachable along the axial of the tube body, and the functional tube is provided with a self-destructive part for cutting the disposable drainage tube. A corresponding endoscope is also provided. The visualized surgical assembly is a combination structure of the disposable drainage tube and the functional tube which can provide visualization function. The disposable drainage tube can removable connect with the functional tube, and the functional tube can be repeated disinfection, which can reduce the cost and avoid the risk of cross infection.

[0021] US 2018093021 Al teaches a handle for endoscopic surgery, in a microsurgical setting comprising a channel, a rigid suction and a suction control said handle. This handle comprises a suction tip which can be moved in relation to the endoscopy means.

[0022] Objects of the Present Invention

[0023] Primary object of the present invention is to provide a surgical device usable as a bimanual micro and neurosurgical device suitable for brain and neurosurgery applications.

[0024] Another object of the present invention is to provide a surgical device that displays additional advantages on top of classic surgical microscope, endoscope and exoscope type devices for image acquisition and site visualization.

[0025] Another object of the present invention is to provide a surgical device that improves the view trajectory in deep and superficial sites alike while offering comfortable tissue manipulation.

[0026] Another object of the present invention is to provide a surgical device that retains easy manipulation and handling by promoting operating physician comfort in a bimanual setting.

[0027] Another object of the present invention is to provide a surgical device that critically reduces the incision size required for bimanual surgical interventions.

[0028] Brief Description of the Present Invention

[0029] Disclosed invention aims to facilitate bimanual micro and neurosurgical approaches with a comfortable and compact multiplicity of surgical instruments and tools, based on an aspiration tube with at least an imaging means placed at an offset with a distal tip thereof. This aspect of the present disclosure enables the operating physician with greatly enhanced tissue manipulation capabilities in deep and shallow recesses alike, whilst never compromising clear visibility of a cavity.

[0030] Teaching of the present disclosure aspires to facilitate both bimanual and comfortable manipulation of microsurgical devices and viewing and handling of blind recess sites by the operating physician while performing microsurgical intervention either in superficial or deep tissue sites. With the aid of present invention, all the advantages of surgical microscope, endoscope, and exoscopes are retained while individual disadvantages thereof described above are greatly eliminated.

[0031] The surgeon would be able to perform microsurgical technique bimanually as with the surgical microscope and exoscope, and at the same time, view deep blind recess satisfactorily as with the endoscope. Present invention does not require any change or modification to the microsurgical instruments that are being used but it brings additional advantages of recess view and manipulation for every operation site, which in turn increase resectability of pathologic tissue, support surgeon's comfort and microsurgical manipulation capacity, as well as promoting patient health by decreasing risks complication.

[0032] Present disclosure has the potential to modify some surgical approaches especially in neurosurgery. For example, it has the potential to reduce the size of surgical opening and to alleviate the requirement of combined approaches. As such, the benefits of the invention are not exclusive to the area of bimanual surgery, since the novel aspects and features of the present disclosure also pave way for usage thereof in microscopic, endoscopic and exoscopic applications. Brief Description of the Figures of the Present Invention

[0033] Accompanying drawings are given solely for the purpose of exemplifying a bimanual micro and neurosurgical device, whose advantages over prior art were outlined above and will be explained in brief hereinafter.

[0034] The drawings are not meant to delimit the scope of protection as identified in the claims nor should they be referred to alone in an effort to interpret the scope identified in said claims without recourse to the technical disclosure in the description of the present invention.

[0035] Figure 1 demonstrates a side view of the surgical device according to the present disclosure.

[0036] Figure 2 demonstrates a longitudinal cross-section of a semi-rigid tube comprised by the surgical device according to the present disclosure.

[0037] Figure 3 demonstrates a side view of the surgical device as well as the intended movement according to at least one implementation of the present disclosure.

[0038] Figure 4 demonstrates a side view of the surgical device as well as a movement pattern according to at least one other implementation of the present disclosure.

[0039] Detailed Description of the Present Invention

[0040] 10 Aspiroscope

[0041] 11 Rigid aspiration tube

[0042] 12 Aspiroscope distal end

[0043] 13 Aspiroscope proximal end

[0044] 14 Semi-rigid conduit

[0045] 15 Irrigation means

[0046] 16 Image capturing means

[0047] 17 Semi-rigid annular channel

[0048] 18 Irrigation means tube

[0049] 19 Image capturing means tube

[0050] 20 Driving means

[0051] 21 Drivable tip

[0052] 22 Slot

[0053] 23 Rotatable tip

[0054] 24 Rotation joint

[0055] The invention according to the present disclosure is a device, that is mainly a surgical instrument. Said surgical instrument, dubbed aspiroscope (10) hereinafter, facilitates both (i) bimanual and comfortable manipulation of microsurgical devices and (ii) viewing and handling of blind recess sites by the surgeon while performing microsurgical intervention either in superficial or deep tissue sites. In short, this device displays all the advantages of individual surgical approaches and tools such as surgical microscope, endoscope, and exoscope while eliminating their individual disadvantages described above. The surgeon would be able to perform microsurgical technique bimanually as with the surgical microscope and exoscope, and at the same time, view deep blind recesses satisfactorily as with the endoscope. Disclosed aspiroscope (10) does not require any change or modification to the microsurgical instruments that are being used but it brings additional advantages of recess view and manipulation for every operation site, which in turn increase resectability of pathologic tissue, support surgeon's comfort and microsurgical manipulation capacity, and promote patient health by decreasing complication risks. Disclosed aspiroscope (10) has the potential to modify some surgical approaches especially in neurosurgery. For example, it has the potential to reduce the size of surgical opening and to alleviate the requirement of combined approaches, in addition to introducing better image acquisition based on potential applications using comparable types of image acquisition means, such as endoscopes, exoscopes and robotic surgical settings / devices enhancing site vision.

[0056] The main aspects of the aspiroscope (10) device according to the present disclosure is to attach (or append) an image capturing means (16) selectable from a group including cameras or lenses, to the distal end (12) of a surgical aspirator in the form of a rigid aspiration tube (11), which is preferentially similar to a Ya§argil suction tube. It is important to note that main body of the camera / lens is in contact with body of the aspiration tube (11) and location is not at the tip of the aspirator. It is located a few centimeters from the tip so that the surgeon can see the aspirator distal tip (12) during the operation. This is important because while using the aspiroscope (10) for cleaning the surgical area, the surgeon will have a better view of the surgical field and the exact position of the aspirator's distal end (12) in this field. Furthermore, the surgeon may use the tip to push away or hold back some of the tissues blocking the operation site and (s)he would need to see the tip of the aspirator to accomplish this. While the surgeon uses aspirator dynamically with his / her one hand, (s)he would get the view of surgical area would directly from the aspirator body without any additional effort. At the same time, the surgeon would perform more of the microsurgery with his other hand using additional microsurgical instruments needed as usual with the microsurgical approach. Such an intervention preserves the bimanual and comfortable routine in microsurgery under surgical microscope. On the other hand, the surgeon would be able to view blind sides of deep recesses due to the view capacity of this device and the fact that the lens will be able to see the deepest point that the aspirator tip can reach. This view capacity far surpasses that which is provided by the surgical microscope and is comparable to that of an endoscopic probe. The device weight and ergonomics are another novel characteristics of this device, which is specifically controlled for comfort as well as ease-of-use. Since device's weight is not much different than the routine suction / aspiration tube used in microsurgery and is harmonious for hand usage, bimanual working would be possible which is lacking in the endoscopic technique. Although not an essential feature, the camera or lens at distal body may also have an additional irrigation system that would help clean the lens system when needed. It should be noted that the lens or camera in this described device, in various embodiments, comprises an illumination means (such as a light source) for disclosing surgical area and might be designed internal or with external connections and different technologies could be preferred for this aim.

[0057] It might be thought that this aspiroscope (10) device is similar to an endoscopic probe because, some endoscopic probes have channels of irrigation and aspiration around the lens, but in this device, aspiration channel is configured to be distal enough from the lens or camera that mechanically aspirated area can be viewed better. To better explain the difference, it should be noted that in existing endoscopic systems, the lens and aspirating channel are at or around same level, in most cases being completely flush. Therefore, using the aspirating channel of this system to mechanically handle the surrounding tissue causes the lens to touch and sink into the tissue, blocking the view of the surgical area. On the other hand, in the disclosed invention, the lens is located sufficiently distant from the further end of the aspirating body. Hence, even when the aspirator is being used to mechanically manipulate the tissues, the lens still provides a clear view of the surgical area. Another advantage is that since the tip of the aspirator is within the view of the lens, the surgeon can see how (s)he is manipulating the surrounding tissues with the tip of the aspirator. These two advantages stem from a single innovative step that inspire the new device, it being the optimized location of the lens or camera attached to the aspirator in microsurgery. Furthermore, since in exoscope or surgical microscope the lens or camera is located at outside of the body, and in endoscope the lens or camera is positioned at the tip of the probe, disclosed invention conveniently positions it inside the body but away from the tip.

[0058] In short, the device set forth according to the present disclosure comprises a camera or lens which is optimally located on the body of a surgical aspirator (rigid aspiration tube, 11) that provides a clear view of the tip, around the tip, and farther points beyond the tip. Said system is also configured to be lightweight, comfortably steerable, and handy as a routine aspirator in microsurgery, while also comprising an irrigation channel for the lens when needed. Other characteristics may vary accordingly.

[0059] The lens or camera (image capturing means 16) and their more proximal connecting cables can be preferred as located along the body of the aspirator or can be designed as an external cover that is mountable to aspirator tubes (11) of different sizes. The camera can be connected to a device such as a screen or another platform via Bluetooth or with another wireless connector. An optional irrigating channel to clean the lens may be designed as an internal channel of the aspirator body or as a mountable external attachment or instead of irrigation different technologies may be used to clean lens or camera. Disclosed invention can even be realized as an adaptor to mount a thin snake endoscope to an aspirator. The distal part of the aspirator might be designed as flexible from one or more points to move the tip of the aspirator together with the camera or lens to see different angles. The lens or camera on aspirator body can be located on a sliding (skid) system for changing its location back and forth to enhance the view area or adjust the sharpness. An automatic zoom or focus system can be added.

[0060] Even with such modifications, the three statements mentioned above are the main part of the invention. Disclosed invention, while centrally being a visualization system to enhance microsurgery, also is a system that promises horizons for robotic surgery mainly in neurosurgery. In several different applications, a robotized arm with distally aspirating and viewing via a more proximally located camera or lens at the proximal body with additional arm could be comprised, and can be used to imitate surgeon maneuvers to a great degree in a robot-assisted surgery setting.

[0061] Disclosed invention is founded upon the premise of combining several micro and neurosurgical features in an optimal manner, such as surgical aspirator(s) and image acquisition means. The structural basis of the aspiroscope (10) device according to the disclosed invention is based on a rigid, or at least semirigid tube. According to multiple embodiments, said tube may be a suction tube, or a surgical aspirator such as a Yasargil tube known in the art. Said tube (11) is utilized for removing blood, fluids and foreign bodies that may obstruct the view of the surgical field, and is also configured to be sufficiently slender such that deep surgical exploration is promoted. Preferably, for the rigid aspiration tube (11), diameters in various embodiments are selected in a range from 1.5 mm to 3.5 mm, however, the diameter can also be up to 5 mm in other applications. In various embodiments, the tube (11) has a curved profile with an overall length that varies within the range from 130 to 220 mm, which permit reaching deep surgical targets, whereas in other embodiments the tube can be configured such that its length is up to 300 mm. Proximal end (13) of the tube (11) can feature a curved extension that serves the purpose of a connection site, itself preferably comprising a Luer Hub. From said hub, an external suction system can be attached so as to aspirate fluids and foreign materials out of the cavity. According to at least some embodiments, said tube can be manufactured from stainless steel, and can be configured to have a matte finish so that glare is reduced.

[0062] Some embodiments of the present invention comprise at least an imaging means. Said imaging means I image capturing means (16) may be in the form of a camera or a lens, configured to extend along at least one portion of said tube (11). A main body of said imaging means such as a camera or lens is in contact with body of the aspiroscope (10) and is preferably located towards a distal end (12) of the aspiration tube (11). In at least a preferred embodiment, said imaging means (16) is located at an offset from the distal end (12) of the aspirator tube, with the offset being fixed at a range. In an exemplary embodiment, said imaging means (16) is positioned such that it is set back from the distal end (12) between 2 cm and 7 cm (or even up to 10 cm) such that the imaging can be performed in a way to always show the aspirator distal end (12) during use. This is done such that when the aspiroscope (10) is used for cleaning and / or manipulating a target surgical area, the surgeon is always offered a sufficiently clear and open view of the surgical field in question with the exact position of the aspiroscope's distal end (12) in said field. Whilst manipulating the device, the surgeon is able to use the distal end (12) to push away or hold back some of the tissues blocking the operation site. As such, a clear view of the aspirator's distal end (12) would need to be seen to accomplish this. While the surgeon uses aspirator dynamically with his / her one hand, they would obtain the view of surgical area directly from the aspiration tube body (11) without any additional effort. At the same time, additional microsurgery actions can be performed with the surgeon's other hand using additional microsurgical instruments needed as usual with a bimanual microsurgical approach. Thus, this intervention preserves the bimanual and comfortable routine in microsurgery under surgical microscope. On the other hand, the surgeon would be able to view blind spots of deep recesses, since the view capacity offered by this device will facilitate viewing the deepest point reached by the distal tip (12) of the aspirator tube (11). This view capacity far surpasses that which is provided by surgical microscope approaches known in the art, and is comparable to that of an endoscopic probe.

[0063] According to multiple embodiments, the device offers a substantially similar weight and ergonomics characteristic comparable to a regular suction tube. Because device's weight is not much different than the routine suction tube used in microsurgery and is harmonious for hand usage, bimanual working would be possible which is something the established endoscopic technique lacks. Thus, the single-hand usage characteristics and feel of the aspiroscope (10) according to the present invention will be substantially identical to that of a suction tube.

[0064] According to various embodiments, the aspiroscope (10), in addition to the image capturing means (16) in the form of camera or lens towards the distal end (12) of the aspiration tube (11) may also comprise an additional irrigation means (15). Said irrigation means (15) may be configured to clean the image capturing means (16) when needed, and different embodiments may be arranged such that the spatial relationship between the image capturing means (16) and the irrigation means (15) is kept sufficiently close. One such embodiment may comprise the irrigation means (15) directly on top of the image capturing means (16) with the tip of said irrigation means (15) is completely flush with the image capturing means (16).

[0065] According to various embodiments, the image capturing means (16) in the form of a lens or camera in this described device comprises an illumination means, such as a light source for illuminating the surgical area directly facing the distal end (12) of the aspiration tube (11). Different embodiments may comprise connections structurally associated with the body of the aspiration tube (11) for the purpose of powering the illumination means.

[0066] In the art it is known that several endoscopic probes comprise dedicated channels for irrigation and aspiration around the lens. However, in the disclosed aspiroscope (10) the aspiration channel, which is the aspiration tube (11), is configured to be such that the distal end (12) thereof is extending ahead the lens or camera in the form of image capturing means (16), such that the mechanically aspirated area can be viewed clearly at all times. In the existing endoscopic systems and methods, the lens and aspirating channel are at or around a level described as being completely flush. This is a known problem since in the case of these approaches, using the aspirating channel for mechanically handling the surrounding tissue causes the lens to touch and sink into the tissue, in turn blocking the view of the surgical area. On the other hand, the lens (imaging means, image capturing means) found in the disclosed invention of aspiroscope (10) is located sufficiently distant from the distal tip (12) of the aspiration tube (11). Hence, even when the aspiroscope (10) is being used to mechanically manipulate the surrounding tissues, the imaging means still provides a clear view of the surgical area. Since the distal tip (12) of the aspiration tube (11) is always within the view of the image capturing means (16), the operator can continually see how their manipulation of the surrounding tissues is handled with the tip of the aspiration tube (11). In the established technique, exoscopes or surgical microscopes comprise lenses or cameras that are located at outside of the body, and in the case of endoscopes the lens or camera is positioned at the tip of the probe flush with said tip.

[0067] In various embodiments of the aspiroscope (10), the image capturing means (16), the illumination means and the irrigation means (15) can be comprised in the form of a single annular channel (17) or a lumen situated along the rigid aspiration tube body (11). Said single semi-rigid annular channel (17) is arranged to simultaneously accommodate lines for multiple surgical instruments, said surgical instruments being selectable from a group including an imaging lens, a camera, an illumination means like a light source, an irrigation means tube (18), an image capturing means tube (19). Said semirigid annular channel (17) may be in the form of a guide tube or an instrument tube. Said instrument tube or guide tube may be in the form of a semi-rigid channel set to be sufficiently flexible or bendable. Said semi-rigid channel (17) can be fully or partially enclosed that is configured to run from the proximal end (13) of the aspiration tube towards the distal end (12) of the rigid aspiration tube (11).

[0068] According to certain embodiments, said semi-rigid conduit (14) comprising an annular channel (17) with said instrument tube or guide tube may be deposited such that the multiplicity of imaging means, illumination means and irrigation means (15) can at least partially be retracted from the distal end (12) of the aspiration tube (11) body towards the proximal end (13) thereof. For this embodiment, at least one outer surface zone of the rigid aspiration tube (11) comprises a slot (22) whereon a drivable tip (21) corresponding to the end of the semi-rigid conduit comprising at least an image capturing means (16) can comfortably slide back and forth. This movement is limited to a distance towards the distal end (12) of the rigid aspiration tube (11) since a minimum distance between the tip of the instrument tube is maintained always at an offset with the distal tip of the aspiration tube body, meaning that a default position is arranged within a predetermined distance of said distal end (12) which is the forwardmost position of allowed by the slot (22). In a preferred embodiment, the slot (22) is arranged such that the tip of the instrument tube cannot exceed a distance of 2 cm to the distal end (12), and cannot be retracted to a distance more than 10 cm to the distal end (12), effectively meaning that the slot (22) allows movement of the drivable tip (21) to-and- from a distance of 2 cm and 10 cm to the distal end (12). This effectively means that in an embodiment the forwardmost position is still 2 cm away from the distal end (12). Movement of the drivable tip (21) is effectuated, according to an embodiment, by a driving means (20). Said driving means (20) is arranged to axially drive the instruments along the slot on command, towards the distal end (12) and away therefrom. Said driving means (20) is configured to be housed in the semi-rigid annular channel (17), at least comprising an image capturing means tube (19) therein, as well as an irrigation means tube (18) according to various embodiments. In preferred application of the present invention, a combination of various optical features of the image capturing means (16) comprised by the drivable tip (21), such as zooming, magnification and enhanced focusing can be used in combination with the movement of said drivable tip (21) effectuated by the driving means (20), allowing for a robustly controlled imaging medium.

[0069] According to certain embodiments, said rigid aspiration tube (11) may comprise a rotation joint (24), whereby at least one part of the rigid aspiration tube (11) is rotatable around at least one axis. Said rotation joint (24) is positioned towards the distal end (12) of the aspiroscope (10), and thus forms a section of said aspiration tube (11) with a rotatable tip (23). Said rotatable tip (23) is the most distal section of said semi-rigid conduit (14) comprising an annular channel (17) with said instrument tube or guide tube may be deposited such that the multiplicity of imaging means, illumination means and irrigation means (15) which comfortably rotate along with the part that rotates around the axis of the rotation joint (24) such that the imaging capabilities are retained to the utmost. Since the semi-rigid conduit (14) is bendable, movement of the rotatable tip (23) is configured to accommodate a sufficient range. According to various embodiments, rotation of the aspiration tube (11) section towards the distal tip (12) of the aspiroscope can be reversibly effectuated using a driving means (20).

Claims

CLAIMS1) A surgical device (10) suitable for bimanual microsurgery and in such applications as neurosurgery comprising a rigid tube (11), at least one semi-rigid conduit (14) situated on top of said rigid tube (11), characterized in that said rigid tube (11) is configured to perform aspiration functions, said at least one semi-rigid conduit (14) comprises a semi-rigid annular channel (17) comprising an image capturing means (16), the tip of said image capturing means (16) configured such that it is fixedly situated at an offset from the distal end (12) of the said rigid tube (11), whereby a clear view of the distal end (12), the area immediately facing the distal end (12) and around said distal end (12) are provided at all times.2) A surgical device (10) as set forth according to Claim 1, characterized in that said at least one semi-rigid conduit (14) comprises an irrigation means tube (18) for introducing liquid onto the image capturing means (16) to cleanse it from any obstruction,3) A surgical device (10) as set forth according to Claims 1 and 2, characterized in that said at least one semi-rigid conduit (14) is deposited on said rigid tube (11) such that the weight and handiness of the said rigid tube (11) is not significantly altered, and such that its single-hand use is arranged to be as close to a rigid tube (11).4) A surgical device (10) as set forth according to any preceding Claim, characterized in that the said image capturing means (16) is configured to augment the image captured by a microscope whereby information regarding the operation areas beyond the view or perspective ofthe microscope is provided.5) A surgical device (10) as set forth according to Claim 4, characterized in that the said image capturing means (16) is further configured to supply panoramic view of deep site of operation areas as in endoscopic surgery.6) Use of said surgical device (10) according to any preceding Claim as an endoscopic image acquisition means.7) Use of said surgical device (10) according to Claims 1 to 5 as a microscopic image acquisition means.8) Use of said surgical device (10) according to Claims 1 to 5 as an image acquisition means in a robot-assisted surgery setting.9) A visualization system comprising at least a rigid tube (11) configured to perform aspiration functions, and at least one semi-rigid conduit (14) comprising an annular channel (17) itself comprising an image capturing means, the tip of said image capturing means (16) configured such that it is fixedly situated at an offset from the distal end (12) of the said rigid tube (11), whereby a clear view of the area immediately facing the distal end (12) of said rigid tube as well as a clear view of the distal tip of the rigid tube and around it are provided at all times, characterized in that, said visualization system may comprise endoscopic and microscopic capabilities, in that the image capturing means (16) is configured to supply a level of magnification between 2-times to 40-times, and said visualization system is suitable for use in robotic surgery setting, and is configured to be manipulable in a robotic manner with the use of at leastone controller.

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