CA2091271A1 - Percutaneously insertable, needle-sized tissue retractor and system - Google Patents
Percutaneously insertable, needle-sized tissue retractor and systemInfo
- Publication number
- CA2091271A1 CA2091271A1 CA002091271A CA2091271A CA2091271A1 CA 2091271 A1 CA2091271 A1 CA 2091271A1 CA 002091271 A CA002091271 A CA 002091271A CA 2091271 A CA2091271 A CA 2091271A CA 2091271 A1 CA2091271 A1 CA 2091271A1
- Authority
- CA
- Canada
- Prior art keywords
- retractor
- sheath
- passage
- distal end
- tissue
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/0218—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for minimally invasive surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/50—Supports for surgical instruments, e.g. articulated arms
Abstract
Abstract of the Disclosure A percutaneously insertable, needle-sized retractor and system for grasping and retracting tissue in a cavity of a patient. The system comprises a needle-sized trocar sheath having an outside diameter in a range from 10 to 22 gauge, a pointed distal end stylet insertable into the trocar sheath, and a tissue-grasping retractor also insertable through the trocar sheath. The stylet is inserted through the trocar sheath with the pointed distal end extending therefrom. The trocar sheath and stylet are then inserted through a patient's skin and subtending tissue and organs into a desired cavity. When the trocar sheath is inserted, the stylet is removed and the tissue grasping retractor inserted through the sheath and into the cavity. A
retaining cap at the proximal end of the sheath fixedly positions the retractor with respect to the trocar sheath while a retention flange positioned around the outside surface of the sheath fixedly positions the sheath with respect to the patient. Thus, the tissue grasping retractor and system grasps and retracts tissue during a minimally invasive procedure with minimal trauma to the patient.
retaining cap at the proximal end of the sheath fixedly positions the retractor with respect to the trocar sheath while a retention flange positioned around the outside surface of the sheath fixedly positions the sheath with respect to the patient. Thus, the tissue grasping retractor and system grasps and retracts tissue during a minimally invasive procedure with minimal trauma to the patient.
Description
Edward Duane Ping ~on, Paul Guy Thomson 6-8 (~ 5050~
r PERCUTANEOUSLY INSERTABLE, NEEDL~-SIZED
TISSUE RETRACTOR AN~ SYSTEM
Technical Field This invention relates to suxgical instruments and particularly to a needle-sized tissue retractor and system that are percutaneously inserted into a cavity of a subject.
' Backaround of the Invention Minimally invasive endoscopic surgery is performed using two or more trocar sheaths for gaining access to a cavity of a patient. These trocar sheaths provide access to the surgical site for various medical instruments such as forceps, scissors, and scopes. The advantages of endoscopic surgery over traditional, open surgery include decreased trauma for the patient, smaller wounds and less scarring, faster healing and recovery time, and decreased risk of infection.
A prohlem presented by endoscopic surgical procedures is that a surgeon has no direct visualization of the surgical site. Instead, visualization of the surgical site is by a video camera and monitor. The surgeon uses medical devices inserted through access sheaths to manipulate tissue adjacent the surgical site for lifting tissue out of the line of sight. A solution to this problem is the use of an EXPRESS MAIL CERTIFICATE
"Express Mailing" label number ~B ~3~ ~c/s Date of Deposit ~lay ~, /qq~
I hereby certify that this paper is being deposited l~ith the United States Postal Service "Express Mail Post Office to Addressee" service under 37 CFR 1.10 on the date indicated above and is addressed to the Commissioner of Patents and Trademarks, Washington, D.C. 20231.
~ ~ .J ~f s ~
(Typed or printed name of person mailing paper or fee ~Signature of per n mailing paper or fee) _ : ,., ;' ' ': ' i -Edward Duane Pingl on, Paul Guy Thomson 6-8 (~ 5050~ 0 9 ~ 2 71 additional access sheath for inserting forceps or a grasper to the surgical site for retracting tissue. A limitation of using these sheaths, however, is that the trocar sheaths normally range in size from 3 to 10 mm and leave deep, cylindrical wounds where a significant bulk of tissue is removed. As a result, surgeons tend to use as few access sheaths as possible.
In endoscopic surgical procedures, the surgeon does not directly manipulate tissue as in traditional, open surgery.
To perform the task of moving tissue aside and away from the surgical site, the surgeon or surgical assistants must insert forceps or a grasper through an access sheath, grasp the desired tissue, move the tissue aside, and then manually maintain the position of the grasper and tissue for the duration of a surgical procedure. A problem with manually stabilizing medical devices such as a grasper is that the surgeon or surgical assistants lack control over the grasper and tissue due to muscle fatiyue or inadvertent movement over the duration of the procedure. ~nother problem with the use of these known medical devices for repositioning tissue is that one or both hands of each surgeon or surgical assistant are occupied. When the surgeon or surgical assistant must release a device prematurely to perform a more urgent task, as often happens during surgery, the tissue returns to its original position. As a result, the surgeon's line of sight or access to the surgical site is obstructed, and operative time is extended.
Summarv of the Invention The foregoing problems are solved and a technical advance is achieved in an illustrative tissue retractor that is percutaneously inserted into a cavity of a patient through a needle-sized trocar sheath. The retractor comprises an elongated member and a tissue grasper positioned about the distal end of the elongated member.
The grasper has open and closed positions for engaging and " ::
Edward Duane Pingl ~on, Paul Guy Thomson 6-8 (1 5050) 20~1~71 releasin~ tissue. The grasper in the closed position and the elongated member are sized for insertion through a needle-sized trocar sheath having an outside diameter in a range of 10 to 22 gauge. The needle-sized trocar sheath and retractor advantageously minimize trauma to the patient and the bulk associated with commonly used trocar sheaths ranging in size from 3 to 10 mm. The retractor also includes an easily operated handle that is positioned about the proximal end of the elongated member for operating the grasper between the open and closed positions.
The elongated member of the retractor includes an outer cannula and an inner rod extending through the passage of the outer cannula. The grasper includes pivotedly interconnected jaws operable between the open and closed positions with the first jaw connected to the distal end of the outer cannula and the second jaw conn~cted to the distal end of the inner rod. The handle includes an enclosure having a cavity therein and a piston slidably positioned in the cavity for operating the grasper between the open and closed positions. The proximal end of the outer cannula is connected to the enclosure, whereas the piston is connected to the proximal end of the inner rod. Retaining tubes are positioned on the outer cannula to advantageously fixedly position the cannula with respect to the enclosure. The handle further includes a spring positioned in the cavity - that engages both the enclosure and the piston for maintaining the grasper in one of the open and closed position. The elongated member of the retractor further includes an outer sheath of, for example, nylon. The outer cannula and inner rod are inserted in the passage of the outer sheath. The outer sheath is connected to the handle for easy percutaneous insertion of the elongated retractor member into the cavity of a patient.
The retractor system includes the tissue retractor and the needle-sized trocar sheath through which the tissue retractor is extended therethrough. The retractor system ' - . . .
:
Edward Duane Pingl~_on, Paul Guy Thomson 6-8 (~. 5050) 209~2~1 further comprises a trocar stylet insertable through the passaye of the trocar sheath and stylet into the cavity of the patient. The trocar stylet includes a pointed distal end that extends from the distal end of the sheath when the stylet is inserted through the passage of the sheath. The sheath further includes a retention cap positioned about the proximal end of the sheath. The cap includes a second passage extending therethrough that communicates with the passage of the sheath. The cap also includes a seal positioned about the passage of the cap for fixedly positioning the retractor when inserted through the passage of the cap and sheath. This advantageously allows the physician to percutaneously grasp and retract tissue and fixedly position the retractor and tissue in a desirable position so as not to interfere with the line of sight during a minimally invasive endoscopic procedure. The retractor system further comprises a retention flange that is positioned around the outside surface of the sheath and is movable and fixedly positionable therealong. The retention flange is utilized to advantageously fixedly position the sheath and retractor with respect to the surface tissue of the patient.
Brief DescriPtion of the Drawinq FIG. 1 depicts an illustrative percutaneously - insertable, needle-sized retractor and system of the present invention; and FIG. 2 depicts an enlarge~, partially sectioned, side view of the retractor o~ FIG. 1.
Detailed Description Depicted in FIG. 1 is an illustrative percutaneous retractor system 100 comprising needle-sized trocar sheath 101, tissue retractor 102, and trocar stylet 103 for percutaneous insertion into the cavity of a patient. The trocar sheath comprises a polytetrafluoroethylene radiopaque material tube 104 having passage 105 extending , ~ , :., :: . ::, :;
Edward Duane Pingl_~on, Paul Guy Thomson 6-8 (~ -5050) longitudinally therethrough. Tube 104 has an outside diameter in a range of 10 to 22 gauge (.028" to .134") and is approximately 13 cm in length. Preferably, tube 104 has an 8 French (.105") outside diameter and a wall 106 thickness of approximately .016". Fixedly attached using, for example, medical grade adhesive about proximal end 107 of the tube are well-known male and female Luer lock connector adapters 108 and 109. Also positioned about the proximal end of the tube is retention cap llO threadably engaging female connector adapter 109. Passage 111 extends through the retention cap and connector adapters to communicate with passage 105 of the polytetrafluoroethylene tube. Trocar stylet 103 is inserted through passages 105 and 111 of the tube and retention cap. When the trocar stylet is fully inserted in tube 104, pointed distal end 112 of the stylet extends distally from passage 105 of the tube.
The trocar sheath with the pointed distal end of the stylet extending therefrom is then percutaneously inserted into the cavity of a patient through the skin and subtending tissue and organs. The trocar stylet stiffens the sheath for advancement through the skin and subtending tissues and organs. A well-known connector cap 113 is fixedly positioned about a proximal end 114 of the stylet with, for example, medical grade adhesive for positioning and manipulating the stylet with respect to the trocar sheath.
The trocar stylet preferably comprises a stainless steel material rod approximately 17 cm in length ttith an outer diameter of approximately .068". The distal end of the rod is ground to a point for easy insertion into the cavity of a patient.
When the trocar stylet and sheath are inserted into the cavity of a patient, the stylet is removed from the passage of the sheath. Tissue retractor 102 is then inserted through the passage of the trocar sheath and into the cavity of the patient. The retractor includes grasper 115 positioned at distal end 116 of elongated member 117.
s Edward Duane Pingi_~on, P~ul Guy Thomson 6-8 ~ 5050~
Tissue retractor 102 also comprises push-button handle 118 attached about proximal end 119 of elongated member 117.
Handle 118 is grasped by the middle and inde~ fingers along with the thumb of the physician to operate pivotedly interconnected jaws 120 and 121 of grasper 115 between open and closed positions. Jaws 120 and 121 have well-known alligator teeth for grasping tissue or, alternatively, a well-known hounds tooth configuration. Normally, the grasper is maintained in the closed position with jaws 120 and 121 engaging one another. The jaws of the grasper are operated to the open position by the physician pressing push-button piston 122 of the handle which slidably moves in enclosure 123 of the handle. Retaining cap 110 of the trocar sheath includes seal 124 positioned about passageway 15 111, which is compressed to engage elongated member 117 of the retractor. This is accomplished by the physician turning retention cap 110, compressing the seal, and fixedly positioning the retractor in passages 105 and 111 of the trocar sheath and retention cap.
The retractor system further comprises a well-known retention flanye 125, such as the Molnar retention disk commercially available from Cook Urological, Incorporated, Spencer, Indiana. The disk includes passage 126 of which trocar sheath tube 104 is inserted therethrough. Tha disk is moved along the length of the tube to engage the surface of the skin and fixedly position the trocar sheath with respect to the cavity. With the retention cap fixedly positioning the grasper, and the retention flange fixedly positioning the trocar sheath with respect to the surfa~e tissue of the patient, the grasper can effectively grasp, retract, and fixedly position tissue during a minimally invasive endoscopic procedure.
Depicted in FIG. 2 is an enlarged, partially sectioned, side view of tissue retractor 102. Tissue retractor 102 includes needle-sized elongated member 117 with tissue grasper 115 positioned about distal end 116 and handle 118 :.-: '"' ` :: -:
Edward Duane Pin(~l _on, Paul Guy Thomson 6-8 (~ 5050) positioned about distal end 119 thereof. Jaws 120 and 121 of the grasper are depicted in this figure in the open position with alligator teeth 127 positioned on opposing faces of the jaws. Elongated member 117 comprises an outer 5 cannula lZ8, inner rod 129, and outer sheath 130. Outer cannula 128 comprises a 12.125" length of an 18.5 gauge regular wall tube with an outside diameter of approximately .046" and passage 131 extending longitudinally therethrough with an inside diameter of .030". Distal end 116 of the 10 outer cannula is connected to stationary jaw 121. Proximal end 119 of the outer cannula is connected to handle enclosure 123 through passage 134 with proximal and distal retaining tubes 132 and 133 on opposite sides of enclosure wall 135, as shown.
Inner rod 129 comprises a 22 gauge thin-wall stainless steel tube with an outside diameter of approximately .028"
and an inside diameter of approximately .014". A mandrel of stainless steel wire is inserted through the passage of the thin-wall tube and soldered about the proximal and distal 20 ends thereof. Distal end 116 of the inner rod is connected to movable jaw 120 via interconnecting link 136 in a well-known manner. The proximal end of the inner rod is connected to push button piston 122 via passage 137 thereof and fixed thsreto with a well-known set screw 138, as shown.
Handle 118 comprises machined, vinyl material enclosure 123 with cavity 139 formed therein, as shown. The handle further comprises machined, vinyl material push button piston 122 slidably positioned in cavity 139. Push button piston 122 also includes cavity 140 communicating with 30 enclosure cavity 139. Positioned in cavity 139 of the enclosure and cavity 140 of the piston around outer cannula 128 and inner rod 129 is spring 141 engaging opposite facing walls 135 and 14Z and providing expansion tension thereon.
Spring 141 is commercially available as model number LC-35 0380-8 from Lee Spring, Inc., Des Plaines, Illinois.
" :. : : ' , .: . . : . ~
. ., .;
.. : ~ . : .
Edward Duane PingL ,on, Paul Guy Thomson 6-8 (~ -5050) ~; 2091271 H~ndle enclosure 123 also includes outer shoulder 143 extending distally therefrom about proximal end 119 of elongated member 119. Passage 134 extends therethrough of which proximal and distal retaining tubes 132 and 133 are friction welded on outer cannula 128 on opposite sides of enclosure wall 13 5, as shown.
Elongated member 117 also includes outer sheath 130 comprising, for example, a nylon material tube having an outside dimension of .065" and an inside dimension of . 050" .
Proximal end 119 of the nylon material outer sheath is glued to shoulder 143 of the handle enclosure next to distal retaining tube 133.
Handle enclosure 123 comprises a machined, vinyl material cylindrical cup with a length of approximately .750" and an overall length with outer shoulder 143 of approximately 1.000". The depth of enclosure cavity 139 is approximately .650". The outside diameter of the handle enclosure is approximately . 750" . The diameter of the cavity is approximately .650". Shoulder 143 has an outermost diameter of .250" with 15 degree tapered sides.
Passage 134 is approximately . 052" in diameter. The distal end of the shoulder is countersunk to accept 17 gauge thin-wall, stainless steel, distal retaining tube 133, which is approximately .04" in length. Proximal retaining tube 132 25 is a 17 gauge thin-wall, stainless steel tube approximately .300" in length. Outer sheath nylon tube 130 is approximately 5 French (.066") in diameter.
Handle 11~ assumes operated and relaxed states corxesponding to the open and closed positions of grasper 115. With spring 141 engagincl the push button and handle enclosure, the handle assumes the relaxed state with the grasper in the closed position. To operate the handle to the operated state, the physician grasps handle enclosure 123 with the middle and index fingers and depresses push button 122 with the thumb. As a result, spring 141 is compressed and tissue grasper 115 and jaws 120 and 121 are ... ~ . :
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~ Edward Duane Pingl ~on, Paul Guy Thomson 6-8 (~ 5050) -' -, 2091271 operated to the open position. This is accomplished by inner rod 121. To operate the retractor to the closed position, the physician simply releases the push button.
spring 141 separates the push button and handle enclosure, causing jaws 120 and 121 to close. It is to be understood that the above-described percutaneously insertable needle-sized retractor and system is merely an illustrative embodiment of the principles of this invention and that other needle-sized retractors and systems may be devised by those skilled in the art without departing from the spirit and scope of this invention. It is contemplated that the tissue grasper at the distal end of the retractor may comprise other configurations such as a biopsy punch, normally opened rather than closed jaws, cutting blades, and the like. It is further contemplated that the handle may take on other shapes of which to operate the tissue grasper between open and closed positions. It is also contemplated that the materials of the grasper may comprise other well-known and commercially available materials.
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: : . ; . . . .. :,: . :. :~: ., , :. : : .. .:
r PERCUTANEOUSLY INSERTABLE, NEEDL~-SIZED
TISSUE RETRACTOR AN~ SYSTEM
Technical Field This invention relates to suxgical instruments and particularly to a needle-sized tissue retractor and system that are percutaneously inserted into a cavity of a subject.
' Backaround of the Invention Minimally invasive endoscopic surgery is performed using two or more trocar sheaths for gaining access to a cavity of a patient. These trocar sheaths provide access to the surgical site for various medical instruments such as forceps, scissors, and scopes. The advantages of endoscopic surgery over traditional, open surgery include decreased trauma for the patient, smaller wounds and less scarring, faster healing and recovery time, and decreased risk of infection.
A prohlem presented by endoscopic surgical procedures is that a surgeon has no direct visualization of the surgical site. Instead, visualization of the surgical site is by a video camera and monitor. The surgeon uses medical devices inserted through access sheaths to manipulate tissue adjacent the surgical site for lifting tissue out of the line of sight. A solution to this problem is the use of an EXPRESS MAIL CERTIFICATE
"Express Mailing" label number ~B ~3~ ~c/s Date of Deposit ~lay ~, /qq~
I hereby certify that this paper is being deposited l~ith the United States Postal Service "Express Mail Post Office to Addressee" service under 37 CFR 1.10 on the date indicated above and is addressed to the Commissioner of Patents and Trademarks, Washington, D.C. 20231.
~ ~ .J ~f s ~
(Typed or printed name of person mailing paper or fee ~Signature of per n mailing paper or fee) _ : ,., ;' ' ': ' i -Edward Duane Pingl on, Paul Guy Thomson 6-8 (~ 5050~ 0 9 ~ 2 71 additional access sheath for inserting forceps or a grasper to the surgical site for retracting tissue. A limitation of using these sheaths, however, is that the trocar sheaths normally range in size from 3 to 10 mm and leave deep, cylindrical wounds where a significant bulk of tissue is removed. As a result, surgeons tend to use as few access sheaths as possible.
In endoscopic surgical procedures, the surgeon does not directly manipulate tissue as in traditional, open surgery.
To perform the task of moving tissue aside and away from the surgical site, the surgeon or surgical assistants must insert forceps or a grasper through an access sheath, grasp the desired tissue, move the tissue aside, and then manually maintain the position of the grasper and tissue for the duration of a surgical procedure. A problem with manually stabilizing medical devices such as a grasper is that the surgeon or surgical assistants lack control over the grasper and tissue due to muscle fatiyue or inadvertent movement over the duration of the procedure. ~nother problem with the use of these known medical devices for repositioning tissue is that one or both hands of each surgeon or surgical assistant are occupied. When the surgeon or surgical assistant must release a device prematurely to perform a more urgent task, as often happens during surgery, the tissue returns to its original position. As a result, the surgeon's line of sight or access to the surgical site is obstructed, and operative time is extended.
Summarv of the Invention The foregoing problems are solved and a technical advance is achieved in an illustrative tissue retractor that is percutaneously inserted into a cavity of a patient through a needle-sized trocar sheath. The retractor comprises an elongated member and a tissue grasper positioned about the distal end of the elongated member.
The grasper has open and closed positions for engaging and " ::
Edward Duane Pingl ~on, Paul Guy Thomson 6-8 (1 5050) 20~1~71 releasin~ tissue. The grasper in the closed position and the elongated member are sized for insertion through a needle-sized trocar sheath having an outside diameter in a range of 10 to 22 gauge. The needle-sized trocar sheath and retractor advantageously minimize trauma to the patient and the bulk associated with commonly used trocar sheaths ranging in size from 3 to 10 mm. The retractor also includes an easily operated handle that is positioned about the proximal end of the elongated member for operating the grasper between the open and closed positions.
The elongated member of the retractor includes an outer cannula and an inner rod extending through the passage of the outer cannula. The grasper includes pivotedly interconnected jaws operable between the open and closed positions with the first jaw connected to the distal end of the outer cannula and the second jaw conn~cted to the distal end of the inner rod. The handle includes an enclosure having a cavity therein and a piston slidably positioned in the cavity for operating the grasper between the open and closed positions. The proximal end of the outer cannula is connected to the enclosure, whereas the piston is connected to the proximal end of the inner rod. Retaining tubes are positioned on the outer cannula to advantageously fixedly position the cannula with respect to the enclosure. The handle further includes a spring positioned in the cavity - that engages both the enclosure and the piston for maintaining the grasper in one of the open and closed position. The elongated member of the retractor further includes an outer sheath of, for example, nylon. The outer cannula and inner rod are inserted in the passage of the outer sheath. The outer sheath is connected to the handle for easy percutaneous insertion of the elongated retractor member into the cavity of a patient.
The retractor system includes the tissue retractor and the needle-sized trocar sheath through which the tissue retractor is extended therethrough. The retractor system ' - . . .
:
Edward Duane Pingl~_on, Paul Guy Thomson 6-8 (~. 5050) 209~2~1 further comprises a trocar stylet insertable through the passaye of the trocar sheath and stylet into the cavity of the patient. The trocar stylet includes a pointed distal end that extends from the distal end of the sheath when the stylet is inserted through the passage of the sheath. The sheath further includes a retention cap positioned about the proximal end of the sheath. The cap includes a second passage extending therethrough that communicates with the passage of the sheath. The cap also includes a seal positioned about the passage of the cap for fixedly positioning the retractor when inserted through the passage of the cap and sheath. This advantageously allows the physician to percutaneously grasp and retract tissue and fixedly position the retractor and tissue in a desirable position so as not to interfere with the line of sight during a minimally invasive endoscopic procedure. The retractor system further comprises a retention flange that is positioned around the outside surface of the sheath and is movable and fixedly positionable therealong. The retention flange is utilized to advantageously fixedly position the sheath and retractor with respect to the surface tissue of the patient.
Brief DescriPtion of the Drawinq FIG. 1 depicts an illustrative percutaneously - insertable, needle-sized retractor and system of the present invention; and FIG. 2 depicts an enlarge~, partially sectioned, side view of the retractor o~ FIG. 1.
Detailed Description Depicted in FIG. 1 is an illustrative percutaneous retractor system 100 comprising needle-sized trocar sheath 101, tissue retractor 102, and trocar stylet 103 for percutaneous insertion into the cavity of a patient. The trocar sheath comprises a polytetrafluoroethylene radiopaque material tube 104 having passage 105 extending , ~ , :., :: . ::, :;
Edward Duane Pingl_~on, Paul Guy Thomson 6-8 (~ -5050) longitudinally therethrough. Tube 104 has an outside diameter in a range of 10 to 22 gauge (.028" to .134") and is approximately 13 cm in length. Preferably, tube 104 has an 8 French (.105") outside diameter and a wall 106 thickness of approximately .016". Fixedly attached using, for example, medical grade adhesive about proximal end 107 of the tube are well-known male and female Luer lock connector adapters 108 and 109. Also positioned about the proximal end of the tube is retention cap llO threadably engaging female connector adapter 109. Passage 111 extends through the retention cap and connector adapters to communicate with passage 105 of the polytetrafluoroethylene tube. Trocar stylet 103 is inserted through passages 105 and 111 of the tube and retention cap. When the trocar stylet is fully inserted in tube 104, pointed distal end 112 of the stylet extends distally from passage 105 of the tube.
The trocar sheath with the pointed distal end of the stylet extending therefrom is then percutaneously inserted into the cavity of a patient through the skin and subtending tissue and organs. The trocar stylet stiffens the sheath for advancement through the skin and subtending tissues and organs. A well-known connector cap 113 is fixedly positioned about a proximal end 114 of the stylet with, for example, medical grade adhesive for positioning and manipulating the stylet with respect to the trocar sheath.
The trocar stylet preferably comprises a stainless steel material rod approximately 17 cm in length ttith an outer diameter of approximately .068". The distal end of the rod is ground to a point for easy insertion into the cavity of a patient.
When the trocar stylet and sheath are inserted into the cavity of a patient, the stylet is removed from the passage of the sheath. Tissue retractor 102 is then inserted through the passage of the trocar sheath and into the cavity of the patient. The retractor includes grasper 115 positioned at distal end 116 of elongated member 117.
s Edward Duane Pingi_~on, P~ul Guy Thomson 6-8 ~ 5050~
Tissue retractor 102 also comprises push-button handle 118 attached about proximal end 119 of elongated member 117.
Handle 118 is grasped by the middle and inde~ fingers along with the thumb of the physician to operate pivotedly interconnected jaws 120 and 121 of grasper 115 between open and closed positions. Jaws 120 and 121 have well-known alligator teeth for grasping tissue or, alternatively, a well-known hounds tooth configuration. Normally, the grasper is maintained in the closed position with jaws 120 and 121 engaging one another. The jaws of the grasper are operated to the open position by the physician pressing push-button piston 122 of the handle which slidably moves in enclosure 123 of the handle. Retaining cap 110 of the trocar sheath includes seal 124 positioned about passageway 15 111, which is compressed to engage elongated member 117 of the retractor. This is accomplished by the physician turning retention cap 110, compressing the seal, and fixedly positioning the retractor in passages 105 and 111 of the trocar sheath and retention cap.
The retractor system further comprises a well-known retention flanye 125, such as the Molnar retention disk commercially available from Cook Urological, Incorporated, Spencer, Indiana. The disk includes passage 126 of which trocar sheath tube 104 is inserted therethrough. Tha disk is moved along the length of the tube to engage the surface of the skin and fixedly position the trocar sheath with respect to the cavity. With the retention cap fixedly positioning the grasper, and the retention flange fixedly positioning the trocar sheath with respect to the surfa~e tissue of the patient, the grasper can effectively grasp, retract, and fixedly position tissue during a minimally invasive endoscopic procedure.
Depicted in FIG. 2 is an enlarged, partially sectioned, side view of tissue retractor 102. Tissue retractor 102 includes needle-sized elongated member 117 with tissue grasper 115 positioned about distal end 116 and handle 118 :.-: '"' ` :: -:
Edward Duane Pin(~l _on, Paul Guy Thomson 6-8 (~ 5050) positioned about distal end 119 thereof. Jaws 120 and 121 of the grasper are depicted in this figure in the open position with alligator teeth 127 positioned on opposing faces of the jaws. Elongated member 117 comprises an outer 5 cannula lZ8, inner rod 129, and outer sheath 130. Outer cannula 128 comprises a 12.125" length of an 18.5 gauge regular wall tube with an outside diameter of approximately .046" and passage 131 extending longitudinally therethrough with an inside diameter of .030". Distal end 116 of the 10 outer cannula is connected to stationary jaw 121. Proximal end 119 of the outer cannula is connected to handle enclosure 123 through passage 134 with proximal and distal retaining tubes 132 and 133 on opposite sides of enclosure wall 135, as shown.
Inner rod 129 comprises a 22 gauge thin-wall stainless steel tube with an outside diameter of approximately .028"
and an inside diameter of approximately .014". A mandrel of stainless steel wire is inserted through the passage of the thin-wall tube and soldered about the proximal and distal 20 ends thereof. Distal end 116 of the inner rod is connected to movable jaw 120 via interconnecting link 136 in a well-known manner. The proximal end of the inner rod is connected to push button piston 122 via passage 137 thereof and fixed thsreto with a well-known set screw 138, as shown.
Handle 118 comprises machined, vinyl material enclosure 123 with cavity 139 formed therein, as shown. The handle further comprises machined, vinyl material push button piston 122 slidably positioned in cavity 139. Push button piston 122 also includes cavity 140 communicating with 30 enclosure cavity 139. Positioned in cavity 139 of the enclosure and cavity 140 of the piston around outer cannula 128 and inner rod 129 is spring 141 engaging opposite facing walls 135 and 14Z and providing expansion tension thereon.
Spring 141 is commercially available as model number LC-35 0380-8 from Lee Spring, Inc., Des Plaines, Illinois.
" :. : : ' , .: . . : . ~
. ., .;
.. : ~ . : .
Edward Duane PingL ,on, Paul Guy Thomson 6-8 (~ -5050) ~; 2091271 H~ndle enclosure 123 also includes outer shoulder 143 extending distally therefrom about proximal end 119 of elongated member 119. Passage 134 extends therethrough of which proximal and distal retaining tubes 132 and 133 are friction welded on outer cannula 128 on opposite sides of enclosure wall 13 5, as shown.
Elongated member 117 also includes outer sheath 130 comprising, for example, a nylon material tube having an outside dimension of .065" and an inside dimension of . 050" .
Proximal end 119 of the nylon material outer sheath is glued to shoulder 143 of the handle enclosure next to distal retaining tube 133.
Handle enclosure 123 comprises a machined, vinyl material cylindrical cup with a length of approximately .750" and an overall length with outer shoulder 143 of approximately 1.000". The depth of enclosure cavity 139 is approximately .650". The outside diameter of the handle enclosure is approximately . 750" . The diameter of the cavity is approximately .650". Shoulder 143 has an outermost diameter of .250" with 15 degree tapered sides.
Passage 134 is approximately . 052" in diameter. The distal end of the shoulder is countersunk to accept 17 gauge thin-wall, stainless steel, distal retaining tube 133, which is approximately .04" in length. Proximal retaining tube 132 25 is a 17 gauge thin-wall, stainless steel tube approximately .300" in length. Outer sheath nylon tube 130 is approximately 5 French (.066") in diameter.
Handle 11~ assumes operated and relaxed states corxesponding to the open and closed positions of grasper 115. With spring 141 engagincl the push button and handle enclosure, the handle assumes the relaxed state with the grasper in the closed position. To operate the handle to the operated state, the physician grasps handle enclosure 123 with the middle and index fingers and depresses push button 122 with the thumb. As a result, spring 141 is compressed and tissue grasper 115 and jaws 120 and 121 are ... ~ . :
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~ Edward Duane Pingl ~on, Paul Guy Thomson 6-8 (~ 5050) -' -, 2091271 operated to the open position. This is accomplished by inner rod 121. To operate the retractor to the closed position, the physician simply releases the push button.
spring 141 separates the push button and handle enclosure, causing jaws 120 and 121 to close. It is to be understood that the above-described percutaneously insertable needle-sized retractor and system is merely an illustrative embodiment of the principles of this invention and that other needle-sized retractors and systems may be devised by those skilled in the art without departing from the spirit and scope of this invention. It is contemplated that the tissue grasper at the distal end of the retractor may comprise other configurations such as a biopsy punch, normally opened rather than closed jaws, cutting blades, and the like. It is further contemplated that the handle may take on other shapes of which to operate the tissue grasper between open and closed positions. It is also contemplated that the materials of the grasper may comprise other well-known and commercially available materials.
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Claims (30)
1. A percutaneously insertable retractor system comprising:
a needle-sized trocar sheath having an outside diameter in a range of 10 to 22 gauge, a distal end, a proximal end, and a passage extending longitudinally therethrough, and a tissue retractor insertable through said passage and extendable from said distal end of said trocar sheath.
a needle-sized trocar sheath having an outside diameter in a range of 10 to 22 gauge, a distal end, a proximal end, and a passage extending longitudinally therethrough, and a tissue retractor insertable through said passage and extendable from said distal end of said trocar sheath.
2. The retractor system of claim 1 further comprising a trocar stylet having an outside diameter sized for insertion through said passage of said sheath.
3. The retractor system of claim 2 wherein said trocar stylet includes a pointed distal end that extends from said distal end of said sheath when said stylet is inserted through said passage of said sheath.
4. The retractor system of claim 4 wherein said sheath further comprises a retention cap positioned about said proximal end of said sheath and having a second passage extending longitudinally therethrough and communicating with said passage of said sheath and also having a seal positioned about said second passage for fixedly positioning said retractor relative to said sheath when said retractor is inserted through said second passage of said cap and in said passage of said sheath.
5. The retractor system of claim 4 further comprising a retention flange having a third passage therein for insertion of said sheath therethrough, said flange being movably and fixedly positionable about and along an outer surface of said sheath.
6. The retractor system of claim 1 wherein said tissue retractor includes an elongated member and a tissue grasper positioned about a distal end of said member insertable through said passage of said sheath.
7. The retractor system of claim 6 wherein said tissue retractor further includes a handle positioned about a proximal end of said member having first and second states for operating said grasper between open and closed positions, respectively.
8. The retractor system of claim 7 wherein said elongated member includes an outer cannula having a fourth passage extending longitudinally therethrough and an inner rod passing through said passage of said outer cannula, each of said rod and said outer cannula having a distal end connected to said grasper and a proximal end connected to said handle.
9. The retractor system of claim 8 wherein said grasper includes first and second pivotedly interconnected jaws operable between said open and closed positions, said first jaw connected to said distal end of said outer cannula, said second jaw connected to said inner rod.
10. The retractor system of claim 8 wherein said handle includes an enclosure having a cavity therein and connected to said proximal end of said outer cannula and a piston slidably positioned in said cavity and connected to said proximal end of said inner rod.
11. The retractor system of claim 10 wherein said handle further includes a spring positioned in said cavity engaging said enclosure and said piston.
12. The retractor system of claim 11 wherein said elongated member further includes an outer sheath connected to said handle and having a passage extending therethrough of which said outer cannula is positioned therein.
13. A percutaneously insertable tissue retractor comprising:
an elongated member;
a tissue grasper positioned about a distal end of said member and having open and closed positions, both of said elongated member and said grasper in said closed position being sized for insertion through a needle-sized trocar sheath having an outside diameter in a range of 10 to 22 gauge;
and a handle positioned about a proximal end of said member and having first and second states for operation of said grasper between said open and closed positions, respectively.
an elongated member;
a tissue grasper positioned about a distal end of said member and having open and closed positions, both of said elongated member and said grasper in said closed position being sized for insertion through a needle-sized trocar sheath having an outside diameter in a range of 10 to 22 gauge;
and a handle positioned about a proximal end of said member and having first and second states for operation of said grasper between said open and closed positions, respectively.
14. The retractor of claim 13 wherein said elongated member includes an outer cannula having a second passage extending longitudinally therethrough and an inner rod passing through said second passage of said outer cannula, each of said rod and said outer cannula having a distal end connected to said grasper and a proximal end connected to said handle.
15. The retractor of claim 13 wherein said grasper includes first and second pivotedly interconnected jaws operable between said open and closed positions, said first jaw connected to said distal end of said outer cannula, said second jaw connected to said distal end of said inner rod.
16. The retractor of claim 13 wherein said handle includes an enclosure connected to said proximal end of said outer cannula having a cavity therein and a piston slidably positioned in said cavity and connected to said proximal end of said inner rod.
17. The retractor of claim 17 further comprising a first retaining tube positioned on said outer cannula in said cavity of said enclosure and a second retaining tube on said outer cannula outside of said cavity of said enclosure.
18. The retractor of claim 17 wherein said handle further includes a spring positioned in said cavity engaging said enclosure and said piston.
19. The retractor system of claim 18 wherein said elongated member further includes an outer sheath connected to said handle and having a passage extending therethrough of which said outer cannula is positioned therein.
20. A percutaneously insertable retractor system comprising:
a needle-sized trocar sheath having an outside diameter in a range of 10 to 22 gauge, a first distal end, a first proximal end, and a first passage extending longitudinally therethrough, said sheath comprising a retention cap positioned about said first proximal end of said sheath and having a second passage extending longitudinally therethrough and communicating with said first passage of said sheath, said retention cap also having a seal positioned about said second passage for fixedly positioning said stylet relative to said sheath when said stylet is inserted through said second passage of said cap and in said first passage of said sheath;
a retention flange having a third passage therein for insertion of said sheath therethrough, said flange being movably and fixedly positionable about and along an outer surface of said sheath;
a tissue retractor insertable through said first passage and extendable from said distal end of said trocar sheath, said retractor including an elongated member and a tissue grasper positioned about a distal end of said member, said member and said grasper being sized for insertion through said first passage of said sheath, said grasper including first and second pivotedly interconnected jaws operable between open and closed positions, said elongated member including an outer cannula having a fourth passage extending longitudinally therethrough and an inner rod passing through said fourth passage of said outer cannula, each of said rod and said outer cannula having a distal end connected to said grasper and a proximal end connected to a handle, said first jaw connected to said distal end of said outer cannula, said second jaw connected to said inner rod, said elongated member further including an outer sheath connected to said handle and having a passage extending longitudinally therethrough of which said outer cannula is positioned therein, said handle being positioned about a proximal end of said member, having first and second states for operating said grasper between said open and closed positions, respectively, and including an enclosure having a cavity therein and connected to said proximal end of said outer cannula and a piston slidably positioned in said cavity and connected to said proximal end of said inner rod, said handle further including a spring positioned in said cavity engaging said enclosure and said piston; and a trocar stylet having an outside diameter sized for insertion through said passage of said sheath, said trocar stylet including a pointed distal end that extends from said distal end of said sheath when said stylet is inserted through said passage of said sheath.
a needle-sized trocar sheath having an outside diameter in a range of 10 to 22 gauge, a first distal end, a first proximal end, and a first passage extending longitudinally therethrough, said sheath comprising a retention cap positioned about said first proximal end of said sheath and having a second passage extending longitudinally therethrough and communicating with said first passage of said sheath, said retention cap also having a seal positioned about said second passage for fixedly positioning said stylet relative to said sheath when said stylet is inserted through said second passage of said cap and in said first passage of said sheath;
a retention flange having a third passage therein for insertion of said sheath therethrough, said flange being movably and fixedly positionable about and along an outer surface of said sheath;
a tissue retractor insertable through said first passage and extendable from said distal end of said trocar sheath, said retractor including an elongated member and a tissue grasper positioned about a distal end of said member, said member and said grasper being sized for insertion through said first passage of said sheath, said grasper including first and second pivotedly interconnected jaws operable between open and closed positions, said elongated member including an outer cannula having a fourth passage extending longitudinally therethrough and an inner rod passing through said fourth passage of said outer cannula, each of said rod and said outer cannula having a distal end connected to said grasper and a proximal end connected to a handle, said first jaw connected to said distal end of said outer cannula, said second jaw connected to said inner rod, said elongated member further including an outer sheath connected to said handle and having a passage extending longitudinally therethrough of which said outer cannula is positioned therein, said handle being positioned about a proximal end of said member, having first and second states for operating said grasper between said open and closed positions, respectively, and including an enclosure having a cavity therein and connected to said proximal end of said outer cannula and a piston slidably positioned in said cavity and connected to said proximal end of said inner rod, said handle further including a spring positioned in said cavity engaging said enclosure and said piston; and a trocar stylet having an outside diameter sized for insertion through said passage of said sheath, said trocar stylet including a pointed distal end that extends from said distal end of said sheath when said stylet is inserted through said passage of said sheath.
21. Percutaneously insertable tissue retractor apparatus, comprising a tubular member having an internal passageway extending longitudinally therethrough, and a tissue retractor insertable through the tubular member and having a tissue retractor mechanism extendible from the distal end of the tubular member to retract tissue from adjacent the distal end of the member, characterized in that the tubular member is a needle-like trocar sheath having an outer dimension less than 0.34cms (22 gauge), and in that the retractor and the retractor mechanism thereof are slidably mounted within the interior of the trocar sheath.
22. Apparatus according to claim 21, wherein the retractor mechanism is operable between open and closed positions to retract tissue when inserted past the distal end of the tubular member, and wherein the apparatus comprises an operating arrangement to cause the retractor mechanism to assume the open and closed positions.
23. Apparatus according to claim 22, wherein the retractor mechanism comprises a pivotally mounted jaw mechanism adapted to sever the tissue when operated from the open to the closed position, and to be withdrawn in the closed position via the tubular member.
24. Apparatus according to claim 23, wherein the jaw mechanism comprises a pair of jaws, one being fixed relative to the retractor, and the other being pivotally mounted in order to assume the open and closed positions.
25. Apparatus according to claim 24, wherein the retractor comprises an outer cannula, the distal end of which is connected to the fixed jaw, wherein the retractor mechanism comprises an operating member longitudinally movable within the outer cannula, and wherein the pivotally mounted jaw is opened and closed in response to the relative longitudinal movement of the said operating member.
26. Apparatus according to claim 24 or 25, wherein the retractor comprises a handle with a spring loaded operating device adjacent to the proximal end of the apparatus and arranged to longitudinally move the said operating member.
27. Apparatus according to claim 26, wherein the said operating device is in the form of a button connected to the proximal end of said operating member, and wherein the button acts as a spring loaded piston within a cavity in the said handle, a spring within the cavity serving to spring load the button in a direction to cause the elongated member to close the said jaws when the button is in a relaxed inoperative position.
28. Apparatus according to claim 27, wherein the cavity is connected to the proximal end of the outer cannula.
29. Apparatus according to claim 21, 22, or 23, wherein a stylet with a pointed distal end can be inserted within the passageway of the said tubular member, with the pointed end extending from the distal end of the member to facilitate entry of the member within tissue prior to successive entry into the passageway of the tissue retractor.
30. A percutaneously insertable tissue retractor comprising: an elongated member; a tissue grasper positioned about a distal end of said member and having open and closed positions, both of said elongated member and said grasper in said closed position being sized for insertion through a needle-sized trocar sheath having an outside diameter in a range of 10 to 22 gauge; and a handle positioned about a proximal end of said member and having first and second states for operation of said grasper between said open and closed positions, respectively.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US07/877,644 US5312432A (en) | 1992-05-01 | 1992-05-01 | Percutaneously insertable, needle-sized tissue retractor and system |
| US877,644 | 1992-05-01 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA2091271A1 true CA2091271A1 (en) | 1993-11-02 |
Family
ID=25370405
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA002091271A Abandoned CA2091271A1 (en) | 1992-05-01 | 1993-04-28 | Percutaneously insertable, needle-sized tissue retractor and system |
Country Status (4)
| Country | Link |
|---|---|
| US (1) | US5312432A (en) |
| EP (1) | EP0568296A1 (en) |
| JP (1) | JPH067368A (en) |
| CA (1) | CA2091271A1 (en) |
Families Citing this family (19)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5637112A (en) * | 1992-06-08 | 1997-06-10 | Orthopedic Systems, Inc. | Apparatus for attaching suture to bone |
| US5466243A (en) * | 1994-02-17 | 1995-11-14 | Arthrex, Inc. | Method and apparatus for installing a suture anchor through a hollow cannulated grasper |
| US5499991A (en) | 1994-12-19 | 1996-03-19 | Linvatec Corporation | Endoscopic needle with suture retriever |
| US5961526A (en) * | 1998-02-18 | 1999-10-05 | Boston Scientific Corporation | Coaxial needle and severing snare |
| US5906630A (en) * | 1998-06-30 | 1999-05-25 | Boston Scientific Limited | Eccentric surgical forceps |
| US8066718B2 (en) | 2003-03-18 | 2011-11-29 | Depuy Mitek, Inc. | Expandable needle suture apparatus and associated handle assembly |
| US8585714B2 (en) * | 2003-03-18 | 2013-11-19 | Depuy Mitek, Llc | Expandable needle suture apparatus and associated handle assembly with rotational suture manipulation system |
| WO2006031939A1 (en) * | 2004-09-14 | 2006-03-23 | Uromedica, Inc. | Implantation tool for adjustable implantable genitourinary device |
| WO2007106813A2 (en) * | 2006-03-13 | 2007-09-20 | Minilap Technologies, Inc. | Minimally invasive surgical assembly and methods |
| US8197396B2 (en) | 2006-04-26 | 2012-06-12 | Olympus Medical Systems Corp. | Treatment tool for endoscope and medical procedure |
| US9445801B2 (en) | 2013-03-15 | 2016-09-20 | Cook Medical Technologies Llc | Medical device with selective rigidity |
| US20160256140A1 (en) * | 2015-03-03 | 2016-09-08 | United States Endoscopy Group, Inc. | Microforceps |
| EP3267908B1 (en) | 2015-03-13 | 2020-01-01 | The Regents of The University of Michigan | Tool for neuroma treatment |
| US10933222B2 (en) | 2017-12-05 | 2021-03-02 | Boston Scientific Scimed, Inc. | Tissue retraction system for performing minimally invasive procedures |
| US11583269B2 (en) | 2018-05-04 | 2023-02-21 | Arch Day Design, Llc | Suture passing device |
| US11278274B2 (en) | 2018-05-04 | 2022-03-22 | Arch Day Design, Llc | Suture passing device |
| US10646217B2 (en) | 2018-05-04 | 2020-05-12 | Arch Day Design, Llc | Suture passing device |
| CN109199549B (en) * | 2018-09-26 | 2020-11-13 | 福建中医药大学附属人民医院（福建省人民医院） | Disposable puncture device for laparoscopic surgery |
| US11246586B2 (en) | 2019-08-20 | 2022-02-15 | Arch Day Design, Llc | Instrument to manipulate and pass suture |
Family Cites Families (14)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US86016A (en) * | 1869-01-19 | Silas j | ||
| US3964468A (en) * | 1975-05-30 | 1976-06-22 | The Board Of Trustees Of Leland Stanford Junior University | Bioptome |
| US4122856A (en) * | 1976-10-08 | 1978-10-31 | American Hospital Supply Corporation | Surgical instrument and method of assembly thereof |
| US4517965A (en) * | 1983-06-27 | 1985-05-21 | Ellison Arthur E | Tissue retractor |
| US4655219A (en) * | 1983-07-22 | 1987-04-07 | American Hospital Supply Corporation | Multicomponent flexible grasping device |
| DE3630210A1 (en) * | 1986-09-04 | 1988-03-17 | Wisap Gmbh | INSTRUMENT HANDLE |
| US4863430A (en) * | 1987-08-26 | 1989-09-05 | Surgical Dynamics, Inc. | Introduction set with flexible trocar with curved cannula |
| DE3733194A1 (en) * | 1987-10-01 | 1989-04-13 | Wolf Gmbh Richard | INSTRUMENT FOR HOLDING SURGICAL NEEDLES |
| DE3736150A1 (en) * | 1987-10-26 | 1989-05-03 | Wolf Gmbh Richard | PLIERS, ESPECIALLY HOOK PUNCH |
| CA2003241A1 (en) * | 1988-11-21 | 1990-05-21 | Cecil Harridell Broadnax, Jr. | Bendable trocar |
| US4944741A (en) * | 1988-12-09 | 1990-07-31 | Hasson Harrith M | Laproscopic instrument with pivotable support arm |
| US5002557A (en) * | 1989-04-06 | 1991-03-26 | Hasson Harrith M | Laparoscopic cannula |
| US5133736A (en) * | 1990-05-10 | 1992-07-28 | Symbiosis Corporation | Investment cast end effectors for disposable laparoscopic surgical instrument |
| DE9007115U1 (en) * | 1990-06-27 | 1990-08-30 | Richard Wolf Gmbh, 7134 Knittlingen, De |
-
1992
- 1992-05-01 US US07/877,644 patent/US5312432A/en not_active Expired - Lifetime
-
1993
- 1993-04-21 JP JP5116666A patent/JPH067368A/en active Pending
- 1993-04-26 EP EP19930303237 patent/EP0568296A1/en not_active Withdrawn
- 1993-04-28 CA CA002091271A patent/CA2091271A1/en not_active Abandoned
Also Published As
| Publication number | Publication date |
|---|---|
| EP0568296A1 (en) | 1993-11-03 |
| US5312432A (en) | 1994-05-17 |
| JPH067368A (en) | 1994-01-18 |
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Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| FZDE | Discontinued |