Proximal-end securement of a minimally invasive working channel

Abstract

The present invention is directed at minimally invasive systems in which the proximal end portion of the working channel has either zero or a limited range of movement in the lateral direction. A first embodiment has a slidable collar attached to a pair of flanges, wherein movement of the collar is bounded by an annular frame. A second embodiment has a substantially spherical element attached to the tube. A third embodiment has a plurality of caps. A fourth embodiment is adapted for a larger working channel.

1 . A minimally-invasive surgical access system, comprising;
 a) a tube having an outer wall, a longitudinal bore, a proximal end portion and a distal end portion;   b) a sliding tab comprising a collar having a pair of opposed flanges extending therefrom, wherein the collar is slidable along the outer wall of the tube; and   c) an annular frame having a pair of substantially opposed slots,   wherein the flanges of the collar respectively extend through the slots of the annular frame, and   wherein the tube extends through the annular frame.   
     
     
         2 . The system of  claim 1  further comprising :
 d) an arm extending from a stationary unit, wherein the arm is attached to the annular frame. 
 
     
     
         3 . The system of  claim 1  wherein the collar comprises a threaded hole, and further comprising:
 d) a set screw received in the threaded hole of the collar. 
 
     
     
         4 . The system of  claim 3  wherein the set screw can extend through the collar and contact the outer wall of the tube in the proximal end portion of the tube to lock the collar to the tube. 
     
     
         5 . The system of  claim 1  wherein each flange comprises a portion of a spherical surface and each slot describes an arc, wherein the flange mates with the slot. 
     
     
         6 . The system of  claim 1  wherein the distal end portion of the tube has a docking feature adapted to dock to bone or cartilage. 
     
     
         7 . The system of  claim 1  wherein the collar does not contact the annular frame. 
     
     
         8 . The system of  claim 3  wherein the annular frame has a cutout. 
     
     
         9 . The system of  claim 8  wherein the cutout aligns radially with the set screw. 
     
     
         10 . The system of  claim 1  wherein the proximal portion of the tube is able to move in a substantially frustoconical volume when the distal end portion of the tube is fixed. 
     
     
         11 . A minimally-invasive surgical access system, comprising;
 a) a tube having an outer wall, a longitudinal bore, a proximal end portion, a distal end portion, and a substantially spherical element radially surrounding a segment of the outer wall;   b) a sliding tab having a base and a pair of opposed flanges extending therefrom; the base having a hole therethrough defining a rim having a static portion and a slidable portion,   c) an annular frame having a pair of substantially opposed slots,   wherein each flange of the sliding tab extends through a respective slot of the annular frame,   wherein the tube extends through the annular frame, and   wherein the static portion of the rim releasably contacts a first portion of the substantially spherical element and the slidable portion of the rim releasably contacts a second portion of the substantially spherical element.   
     
     
         12 . The system of  claim 11  further comprising:
 d) an arm extending from a stationary unit, wherein the arm is attached to the annular frame. 
 
     
     
         13 . The system of  claim 11  wherein the base comprises a first cutout, and further comprising:
 d) a sliding door slidably received in the cutout. 
 
     
     
         14 . The system of  claim 13  wherein the sliding door comprises the slidable portion of the rim. 
     
     
         15 . The system of  claim 14  wherein the slidable portion of the rim comprises a substantially hemispherical portion, wherein the substantially hemispherical portion releasably mates with the second portion of the substantially spherical element. 
     
     
         16 . The system of  claim 13  wherein the sliding door is slidably actuated by a screw. 
     
     
         17 . The system of  claim 13  wherein the annular frame has a second cutout. 
     
     
         18 . The system of  claim 11  wherein the distal end portion of the tube has a docking feature adapted to dock to bone or cartilage. 
     
     
         19 . The system of  claim 11  wherein each flange is flat and each slot is substantially rectangular, wherein the flange mates with the slot. 
     
     
         20 . The system of  claim 19  wherein the second cutout aligns radially with the set screw. 
     
     
         21 . The system of  claim 11  wherein the static portion of the rim comprises a substantially hemispherical portion that releasably mates with the first portion of the substantially spherical element. 
     
     
         22 . The system of  claim 11  wherein the flanges of the sliding tab are not orthogonal to the tube. 
     
     
         23 . A minimally invasive surgical access system, comprising;
 a) an upper cap describing a first portion of a substantially spherical surface,   b) an middle cap describing a second portion of the substantially spherical surface and having a central hole,   c) a lower cap describing a third portion of the substantially spherical surface,   d) a tube having an outer wall having an attachment portion, a longitudinal bore, a proximal end portion, a distal end portion,   wherein the upper cap and the lower cap are attached to and radially extend from the outer wall of the tube,   wherein at least one of the upper cap and the lower cap is removably attached to the outer wall of the tube,   wherein the tube is received in the central hole of the middle cap, and wherein the middle cap is received between the upper cap and the lower cap.   
     
     
         24 . The system of  claim 23  wherein the upper cap is located proximal to the lower cap. 
     
     
         25 . The system of  claim 23  wherein the middle cap has a fixation element for fixation to a stationary unit. 
     
     
         26 . The system of  claim 25  further comprising:
 e) an arm extending from the stationary unit, wherein the arm is attached to the fixation element. 
 
     
     
         27 . The system of  claim 23  wherein the proximal portion of the tube is able to move in a substantially frustoconical volume when the distal end portion of the tube is fixed. 
     
     
         28 . The system of  claim 23  wherein the distal end portion of the tube has a docking feature adapted to dock to bone. 
     
     
         29 . The system of  claim 23  wherein the upper cap, middle cap, and lower cap are located in a proximal-most quarter of the tube. 
     
     
         30 . The system of  claim 23  wherein one of the upper or lower cap has a threaded hole, the outer wall has a threaded portion, and the cap having the threaded hole is threadably received on the threaded portion of the outer wall of the tube. 
     
     
         31 . The system of  claim 23  wherein one of the upper cap and the lower cap is removably attached to the outer wall of the tube, and the other of the caps is integrally attached to the outer wall of the tube. 
     
     
         32 . The system of  claim 23  wherein both of the upper cap and the lower cap are removably attached to the outer wall of the tube. 
     
     
         33 . The system of  claim 23  wherein both of the upper cap and the lower cap are threadably attached to the outer wall of the tube. 
     
     
         34 . An apparatus comprising:
 a) an arm having a proximal end portion connected to a stationary object and a distal end portion,   b) a medial-lateral bar connected to the distal end portion of the arm and having a first rail;   c) a cranial-caudal bar having:
 i) a first rail in slidable engagement with the first rail of the medial-lateral bar in a first direction and 
 ii) a second rail extending substantially perpendicularly from the first rail of the cranial-caudal bar; 
   d) a working channel construct comprising:
 i) a tube having an outer surface and a proximal end portion, and 
 ii) a slider attached to the outer surface of the tube and having a first rail in slidable engagement with the second rail of the cranial-caudal bar. 
   
     
     
         35 . The apparatus of  claim 34  wherein the cranial-caudal bar has a release button for releasable attachment to the medial-lateral bar. 
     
     
         36 . The apparatus of  claim 34  wherein the slider has a release mechanism for releasable attachment to the cranial-caudal bar. 
     
     
         37 . The apparatus of  claim 34  wherein the medial-lateral bar has a first window therein for slidable reception of the cranial-caudal bar. 
     
     
         38 . The apparatus of  claim 34  wherein the cranial-caudal bar has a third rail extending from the first rail of the cranial-caudal bar in a direction substantially parallel to the second rail of the cranial-caudal bar. 
     
     
         39 . The apparatus of  claim 38  wherein the slider further comprises iii) a second rail substantially parallel to the first rail of the slider, wherein the second rail of the slider is in slidable engagement with the third rail of the cranial-caudal bar. 
     
     
         40 . The apparatus of  claim 39  wherein the tube is disposed between the second and third rails of the cranial caudal bar. 
     
     
         41 . The apparatus of  claim 40  wherein a fourth rail connects the second and third rails of the cranial-caudal bar to form a second window, and the tube extends through the second window. 
     
     
         42 . The apparatus of  claim 34  wherein the first rail of the medial-lateral bar and the first rail of the cranial-caudal bar have mating teeth thereon. 
     
     
         43 . The apparatus of  claim 34  wherein the second rail of the cranial-caudal bar and the first rail of the slider have mating teeth thereon. 
     
     
         44 . The apparatus of  claim 34  further comprising: e) a medical device located within the tube. 
     
     
         45 . The apparatus of  claim 44  wherein the medical device is an instrument. 
     
     
         46 . The apparatus of  claim 44  wherein the medical device is an implant. 
     
     
         47 . The apparatus of  claim 34  wherein the first rail of the medial-lateral bar and the first rail of the cranial-caudal bar have matching arcuate shapes. 
     
     
         48 . The apparatus of  claim 34  wherein the second rail of the cranial-caudal bar and the first rail of the slider have matching arcuate shapes. 
     
     
         49 . The apparatus of  claim 34  wherein the slider is attached to the outer surface of the tube at the proximal end portion of the tube. 
     
     
         50 . The apparatus of  claim 34  wherein the outer surface of the tube at the proximal end portion of the tube has a thread thereon, the slider has a window having a matching thread thereon, and the slider is threadably engaged with the proximal end portion of the tube. 
     
     
         51 . The apparatus of  claim 34  wherein the first rail of the cranial-caudal is in slidable engagement with the first rail of the medial-lateral bar by virtue of a bolt-slot connection. 
     
     
         52 . The apparatus of  claim 34  wherein the tube has a distal end centerpoint, and the distal end centerpoint remains at the same location in space when a position of the slider along the second rail of the cranial-caudal bar is changed. 
     
     
         53 . An apparatus comprising:
 a) an arm having a proximal end portion connected to a stationary object and a distal end portion,   b) a medial-lateral bar connected to the distal end portion of the arm and having a first rail;   c) a cranial-caudal bar having:
 i) a first rail in slidable engagement with the first rail of the medial-lateral bar in a first direction and 
 ii) a second rail extending substantially perpendicularly from the first rail of the cranial-caudal bar; 
   d) a surgical instrument construct comprising:
 i) an endoscope having an outer surface and a proximal end portion, and 
 ii) a slider attached to the outer surface of the endoscope and having a first rail in slidable engagement with the second rail of the cranial-caudal bar. 
   
     
     
         54 . The apparatus of  claim 53  wherein the cranial-caudal bar has a release button for releasable attachment to the medial-lateral bar. 
     
     
         55 . The apparatus of  claim 53  wherein the slider has a release mechanism for releasable attachment to the cranial-caudal bar. 
     
     
         56 . The apparatus of  claim 53  wherein the medial-lateral bar has a first window therein for slidable reception of the cranial-caudal bar. 
     
     
         57 . The apparatus of  claim 53  wherein the cranial-caudal bar has a third rail extending from the first rail of the cranial-caudal bar in a direction substantially parallel to the second rail of the cranial-caudal bar. 
     
     
         58 . The apparatus of  claim 57  wherein the slider further comprises iii) a second rail substantially parallel to the first rail of the slider, wherein the second rail of the slider is in slidable engagement with the third rail of the cranial-caudal bar. 
     
     
         59 . The apparatus of  claim 58  wherein the endoscope is disposed between the second and third rails of the cranial caudal bar. 
     
     
         60 . The apparatus of  claim 59  wherein a fourth rail connects the second and third rails of the cranial-caudal bar to form a second window, and the endoscope extends through the second window. 
     
     
         61 . The apparatus of  claim 53  wherein the first rail of the medial-lateral bar and the first rail of the cranial-caudal bar have mating teeth thereon. 
     
     
         62 . The apparatus of  claim 53  wherein the second rail of the cranial-caudal bar and the first rail of the slider have mating teeth thereon. 
     
     
         63 . The apparatus of  claim 53  wherein the first rail of the medial-lateral bar and the first rail of the cranial-caudal bar have matching arcuate shapes. 
     
     
         64 . The apparatus of  claim 53  wherein the second rail of the cranial-caudal bar and the first rail of the slider have matching arcuate shapes. 
     
     
         65 . The apparatus of  claim 53  wherein the slider is attached to the outer surface of the endoscope at the proximal end portion of the endoscope. 
     
     
         66 . The apparatus of  claim 53  wherein the outer surface of the endoscope at the proximal end portion of the endoscope has a thread thereon, the slider has a window having a matching thread thereon, and the slider is threadably engaged with the proximal end portion of the endoscope. 
     
     
         67 . The apparatus of  claim 53  wherein the first rail of the cranial-caudal is in slidable engagement with the first rail of the medial-lateral bar by virtue of a bolt-slot connection. 
     
     
         68 . The apparatus of  claim 53  wherein the endoscope has a distal end centerpoint, and the distal end centerpoint remains at the same location in space when a position of the slider along the second rail of the cranial-caudal bar is changed.