Laparoscopic specimen removal apparatus

Abstract

An improved retractable cleat device having a housing and a telescopic cleat member absent a handle. The telescopic cleat member is lockable in the housing in a retracted position via a cam channel having at least one interval engaging a cam follower. The cam channel includes at least one interval which unlocks the telescopic cleat and allows the telescopic cleat to move to an upraised position via a bias force of a compression spring.

1. A laparoscopic specimen extractor comprising:
 (a) an outer tube assembly insertable in an incision or trocar;  
 (b) an inner tube assembly slidably mounted coaxially in said outer tube to slide between a retracted position to a deployed position and having an operator end and a patient end;  
 (c) a cage having one end securely coupled to said patient end and a free end wherein, when said inner tube assembly is in said retracted position, said cage is collapsed and contained in said outer tube assembly and, when said inner tube assembly is in said deployed position, said cage is at least partially ejected from said outer tube assembly and said free end automatically opened and expanded into a tulip shape, said cage comprising a plurality of spaced spring loaded strips secured to the inner circumferential wall of said patient end of said inner tube assembly and which project from said patient end wherein said free end of said cage comprises tips of said plurality of spaced spring loaded strips, each strip having a free end twisted approximately 90° (ninety degrees) with respect to the rest of itself to form a twisted section and a hole is bored in such twisted section wherein said twisted section is substantially perpendicular to a center axis of said inner tube assembly and said cage and wherein as the twisted sections are cinched closed, said cage forms a substantially elliptical or football shape;  
 (d) means journalled through said inner tube assembly and secured to said free end of said cage for cinching closed said free end; and,  
 (e) a pathway coaxially through said inner tube assembly and said cage and adapted to have journalled therethrough said cinching close means, adapted to have inserted coaxially therethrough a grasping laparoscopic instrument for retrieving a specimen, adapted to have retracted therethrough said grasping laparoscopic instrument to deposit said specimen in said cage and adapted to aspirate or morcelate said specimen in said cage therethrough.  
 
     
     
       2. The extractor of  claim 1 , wherein said cage is lined with a liner or bag. 
     
     
       3. The extractor of  claim 1 , wherein said outer tube assembly includes a patient end and an operator end, and first and second finger rings oriented across from each other at said operator end of said outer tube assembly. 
     
     
       4. The extractor of  claim 1 , wherein said inner tube assembly comprises:
 an end cap coupled to said operator end of said inner tube assembly;  
 a thumb cradle integrated with said end cap;  
 a center hole formed in said end cap to permit coaxial insertion of said laparoscopic instrument; and,  
 an auxiliary hole formed in said end cap for passage of said cinching closed means journalled through said inner tube assembly.  
 
     
     
       5. The extractor of  claim 4 , wherein said cinching closed means comprises:
 a first drawstring coupled to said tips of a first set of spring loaded strips of said plurality of spring loaded strips and journalled through said inner tube assembly;  
 a second drawstring coupled to said tips of a second set of spring loaded strips of said plurality of spring loaded strips and journalled through said inner tube assembly; and,  
 means coupled to said first and second drawstrings for pulling said first and second drawstrings to cinch close, simultaneously, said tips of said first set of spring loaded strips and said tips of said second set of spring loaded strips.  
 
     
     
       6. The extractor of  claim 5 , wherein said pulling means comprises a ring. 
     
     
       7. The extractor of  claim 5 , wherein said inner tube assembly comprises:
 an end cap coupled to said operator end of said inner tube assembly;  
 a center hole formed in said end cap to permit coaxial insertion of said laparoscopic instrument;  
 an auxiliary hole formed in said end cap for passage of said first and second drawstrings journalled through said inner tube assembly; and,  
 wherein said pulling means comprises a drawstring handle assembly including:  
 a rod having one end secured to an outer wall of said end cap and projecting therefrom;  
 a palm rest integrated with a distal end of said rod; and,  
 a finger squeeze slide slidably mounted on said rod and having secured thereto said first and second drawstrings wherein squeezing said palm rest and said finger squeeze slide slides said finger squeeze slide upward to said palm rest thus pulling said first and second drawstrings, simultaneously.  
 
     
     
       8. A laparoscopic specimen removal apparatus comprising:
 (a) a grasping laparoscopic instrument for retrieving a specimen; and,  
 (b) a laparoscopic specimen extractor comprising: 
 (i) an outer tube assembly insertable in an incision or trocar,  
 (ii) an inner tube assembly slidably mounted coaxially in said outer tube to slide between a retracted position to a deployed position and having an operator end and a patient end,  
 (iii) a cage having one end securely coupled to said patient end and a free end wherein, when said inner tube assembly is in said retracted position, said cage is collapsed and contained in said outer tube assembly and, when said inner tube assembly is in said deployed position, said cage is at least partially ejected from said outer tube assembly and said free end automatically opened and expanded into a tulip shape, said cage comprising a plurality of spaced spring loaded strips secured to the inner circumferential wall of said patient end of said inner tube assembly and which project from said patient end wherein said free end of said cage comprises tips of said plurality of spaced spring loaded strips, each strip having a free end twisted approximately 90° (ninety degrees) with respect to the rest of itself to form a twisted section and a hole is bored in such twisted section wherein said twisted section is substantially perpendicular to a center axis of said inner tube assembly and said cage;  
 (iv) means journalled through said inner tube assembly and secured to said free end of said cage for cinching closed said free end, and,  
 (v) a pathway coaxially through said inner tube assembly and said cage and adapted to have inserted coaxially therethrough said grasping laparoscopic instrument for retrieving said specimen, adapted to have retracted therethrough said grasping laparoscopic instrument to deposit said specimen in said cage and adapted to aspirate or morcelate said specimen in said cage therethrough.  
 
 
     
     
       9. The apparatus of  claim 8 , wherein said cage is lined with a liner or bag. 
     
     
       10. The apparatus of  claim 8 , wherein said outer tube assembly includes a patient end and an operator end, and first and second finger rings oriented across from each other at said operator end of said outer tube assembly. 
     
     
       11. The apparatus of  claim 8 , wherein said inner tube assembly comprises:
 an end cap coupled to said operator end of said inner tube assembly;  
 a thumb cradle integrated with said end cap;  
 a center hole formed in said end cap to permit coaxial insertion of said laparoscopic instrument; and,  
 an auxiliary hole formed in said end cap for passage of said cinching closed means journalled through said inner tube assembly.  
 
     
     
       12. The apparatus of  claim 11 , wherein said cinching closed means comprises:
 a first drawstring coupled to said tips of a first set of spring loaded strips of said plurality of spring loaded strips and journalled through said inner tube assembly;  
 a second drawstring coupled to said tips of a second set of spring loaded strips of said plurality of spring loaded strips and journalled through said inner tube assembly; and,  
 means coupled to said first and second drawstrings for pulling said first and second drawstrings to cinch close, simultaneously, said tips of said first set of spring loaded strips and said tips of said second set of spring loaded strips.  
 
     
     
       13. The apparatus of  claim 12 , wherein said pulling means comprises a ring. 
     
     
       14. The apparatus of  claim 12 , wherein said inner tube assembly comprises:
 an end cap coupled to said operator end of said inner tube assembly;  
 a center hole formed in said end cap to permit coaxial insertion of said laparoscopic instrument;  
 an auxiliary hole formed in said end cap for passage of said first and second drawstrings journalled through said inner tube assembly; and,  
 wherein said pulling means comprises a drawstring handle assembly including: 
 a rod having one end secured to an outer wall of said end cap and projecting therefrom;  
 a palm rest integrated with a distal end of said rod; and,  
 a finger squeeze slide slidably mounted on said rod and having secured thereto said first and second drawstrings wherein squeezing said palm rest and said finger squeeze slide slides said finger squeeze slide upward to said palm rest thus pulling said first and second drawstrings, simultaneously.  
 
 
     
     
       15. A laparoscopic specimen extractor comprising:
 (a) a bag having open ends,  
 (b) a means for supporting said bag comprising a plurality of spaced spring loaded strips secured to the inner circumferential wall said bag and which project from one end of said bag, said strips having a plurality of tips wherein said support means is spring biased and arranged to automatically open into a tulip shape when ejected to a deployed position, each of said strips having a free end twisted approximately 90° (ninety degrees) with respect to the rest of itself to form a twisted section and a hole is bored in such twisted section wherein said twisted section is substantially perpendicular to a center axis of said deployed bag;  
 (c) means coupled to said plurality of tips for cinching closed said support means, and  
 (d) a pathway, formed coaxially through said laparoscopic specimen extractor and said support means and having said cinching closed means journalled axially therethrough wherein said pathway is adapted to have inserted coaxially therethrough a grasping laparoscopic instrument for retrieving said specimen, adapted to have retracted therethrough said grasping laparoscopic instrument to deposit said specimen in said bag and adapted to aspirate or morcelate said specimen in said bag therethrough.  
 
     
     
       16. The extractor apparatus of  claim 15 , wherein said support means cinches closed to a generally elliptical or football shape. 
     
     
       17. A specimen extractor comprising:
 ( a )  an outer assembly having an operator end and a patient end;      ( b )  an inner assembly having an operator end and a patient end, the inner assembly being slidably mounted with respect to the outer assembly and slidable between a retracted position and a deployed position;      ( c )  a cage coupled to the patient end of the inner assembly and having open and closed states, the cage comprising a base and a plurality of biased strips with tips which project from the patient end of the outer assembly when the inner assembly is placed in a deployed position;      ( d )  an actuator operatively connected to the cage, the actuator being able to change the state of the cage from open to closed by cinching closed the tips of the strips, wherein the actuator includes a first string connected to one or more of the tips and a second string attached to other of the tips; and      ( e )  wherein the cage is moved from open to closed when both the first and second strings are pulled, forming an elliptical shape.     
     
     
       18. The specimen extractor of  claim 17 , wherein the number of strips operatively connected to the plurality of strings is an even number and each string is connected to less than the total number of strips. 
     
     
       19. The specimen extractor of  claim 17 , wherein each string is operatively connected to at least two of the same tips of the strips. 
     
     
       20. A specimen extractor comprising:
 ( a )  an outer assembly having an operator end and a patient end;      ( b )  an inner assembly having an operator end and a patient end, the inner assembly being slidably mounted with respect to the outer assembly and slidable between a retracted position and a deployed position;      ( c )  a cage coupled to the patient end of the inner assembly and having open and closed states, the cage comprising a base and a plurality of biased strips with tips which project from the patient end of the outer assembly when the inner assembly is placed in a deployed position; and      ( d )  an actuator operatively connected to the cage, the actuator being able to change the state of the cage from open to closed by cinching closed the tips of the strips, wherein when the cage is in an open state the cage has a tulip shape.     
     
     
       21. A specimen extractor comprising:
 ( a )  an outer assembly having an operator end and a patient end;      ( b )  an inner assembly having an operator end and a patient end, the inner assembly being slidably mounted with respect to the outer assembly and slidable between a retracted position and a deployed position;      ( c )  a cage coupled to the patient end of the inner assembly and having open and closed states, the cage comprising a base and a plurality of biased strips with tips which project from the patient end of the outer assembly when the inner assembly is placed in a deployed position;      ( d )  an actuator operatively connected to the cage, the actuator being able to change the state of the cage from open to closed by cinching closed the tips of the strips, wherein when the cage is in a closed state and contains a specimen to be extracted the cage forms a substantially elliptical or football shape; and      ( e )  the actuator comprising a plurality of drawstrings, wherein a first drawstring cinches closed a first plurality of said tips and a second drawstring cinches closed a second plurality of said tips.     
     
     
       22. A specimen extractor comprising:
 ( a )  an outer assembly having an operator end and a patient end;      ( b )  an inner assembly having an operator end and a patient end, the inner assembly being slidably mounted with respect to the outer assembly and slidable between a retracted position and a deployed position;      ( c )  a cage coupled to the patient end of the inner assembly and having open and closed states, the cage comprising a base and a plurality of biased strips with tips which project from the patient end of the outer assembly when the inner assembly is placed in a deployed position;      ( d )  an actuator operatively connected to the cage, the actuator being able to change the state of the cage from open to closed, generally elliptical shape by cinching closed the tips of the strips, wherein the cage has a liner; and      ( e )  the actuator comprising a plurality of drawstrings, wherein a first drawstring cinches closed a first plurality of said tips and a second drawstring cinches closed a second plurality of said tips.     
     
     
       23. A specimen extractor comprising:
 ( a )  an outer assembly having a first end and a second end;      ( b )  an inner assembly having a first end and a second end, the inner assembly being slidably mounted with respect to the outer assembly and slidable between a retracted position and a deployed position;      ( c )  a cage coupled to the second end of the inner assembly, the cage comprising a base, a front end, and a plurality of biased strips, the front end including an opening, and the cage having three states including a closed state when the inner assembly is in a retracted position, an open state when inner assembly is in a deployed position, and a cinched closed state when the inner assembly is in a deployed position and the cage is cinched closed, wherein the opening of the front end increases in size from cinched close, to closed, and then to open states;      ( d )  an actuator operatively connected to the cage, the actuator being able to change the state of the cage from the open state to the cinched closed state; and      ( e )  the actuator including multiple drawstrings that engage the plurality of biased strips, one drawstring engaging at least a first of said strips and a second drawstring that engages at least a second of said strips.     
     
     
       24. The specimen extractor of  claim 23 , wherein the plurality of strips have a plurality of tips, and wherein the actuator includes a plurality of strings operatively connected to the plurality of tips of the strips. 
     
     
       25. The specimen extractor of  claim 24 , wherein the number of strips operatively connected to the plurality of strings is an even number and each string is connected to less than the total number of strips. 
     
     
       26. The specimen extractor of  claim 24 , wherein each string is operatively connected to at least two of the same tips of the strips. 
     
     
       27. The specimen extractor of  claim 23 , wherein when the cage is in an open state the cage has a tulip shape. 
     
     
       28. The specimen extractor of  claim 23 , wherein when the cage is in a cinched closed state and contains a specimen to be extracted the cage forms a substantially elliptical or football shape. 
     
     
       29. The specimen extractor of  claim 23 , wherein the cage has a liner. 
     
     
       30. A specimen extractor comprising:
 ( a )  an outer assembly having a proximal operator end, a distal patient end and an open ended bore;      ( b )  an inner assembly having a proximal operator end and a distal patient end, the inner assembly being slidably mounted in the bore of the outer assembly and being slidable relative to the outer assembly;      ( c )  a cage coupled to the patient end of the inner assembly, the cage comprising a base and a plurality of biased strips with tips that project distally from the patient end of the inner assembly;      ( d )  an actuator that moves the cage, wherein the actuator includes a plurality of strings that are connected to the plurality of tips of the strips, wherein one string attaches to at least a first one of the tips and a second string attaches to at least a second one of the strips;      ( e )  wherein the cage can be moved into a collapsed position by pulling the cage into the bore of the outer assembly, moving the inner assembly and cage relative to the outer assembly proximally;      ( f )  wherein the cage can be moved to a deployed position that enables intake of a specimen to be extracted by moving the inner assembly and cage distally until the cage is positioned distally of the patient end of the outer assembly; and      ( g )  wherein in the deployed position, the cage is biased to open distally and can be closed to an elliptical shape after intake of a specimen by pulling the multiple strings proximally.     
     
     
       31. The specimen extractor of  claim 30 , wherein the number of strips operatively connected to the plurality of strings is an even number and each string is connected to less than the total number of strips. 
     
     
       32. The specimen extractor of  claim 30 , wherein each string is operatively connected to at least two of the same tips of the strips. 
     
     
       33. A specimen extractor comprising:
 ( a )  an outer assembly having a proximal operator end, a distal patient end, and an outer assembly bore;      ( b )  an inner assembly having a proximal operator end and a distal patient end, the inner assembly being slidably mounted in the outer assembly bore and with respect to the outer assembly;      ( c )  a cage coupled to the patient end of the inner assembly, the cage having collapsed, open and closed states, the cage comprising a base and a plurality of biased strips with tips which project distally from the patient end of the inner assembly;      ( d )  the cage being movable between collapsed and open positions by moving the inner assembly and cage from a position within the outer assembly bore to a position that spaces the cage distally of the outer assembly bore;      ( e )  an actuator operatively connected to the cage and including multiple circumferentially spaced drawstrings, each drawstring being connected to a different plurality of the tips, the actuator enabling a change of the state of the cage from open to closed by cinching closed the tips of the strips when the cage is positioned distally of the outer assembly bore;      ( f )  wherein when the cage is in an open position, the cage has a tapered shape that gradually increases in diameter distally, enabling intake in a distal to proximal direction of a specimen to be extracted; and      ( g )  a grasping instrument that has operator and patient ends, that grasping instrument being extendable through the inner assembly and cage, the patient end of the grasping instrument having a tool for enabling extraction of a specimen.