JP2023532125A - Lighting device for hand-held surgical instruments with smoke evacuation system - Google Patents

Abstract

An illumination device for attachment to a hand-held electrosurgical instrument is disclosed having opposed proximal and distal ends and an elongated housing defining an internal chamber containing a battery-powered illumination assembly for illuminating a surgical site. the housing having a smoke evacuation tube associated therewith for removing smoke generated at the surgical site, the smoke evacuation tube extending and retracting relative to the distal end of the housing for handheld electrosurgery; Adapted and configured to accommodate different length end effectors associated with the instrument.

Description

[Cross reference to related applications]
This application claims priority benefit to U.S. Nonprovisional Application No. 16/918,449, filed July 1, 2020, and continues in part to U.S. Provisional Application No. 16/519,744, filed July 23, 2019, the disclosure of which is incorporated herein by reference in its entirety.

TECHNICAL FIELD The subject invention is directed to surgical instruments and, more particularly, to battery powered lighting devices for use with handheld electrosurgical instruments including smoke evacuation systems.

In the realm of medicine, illuminators are used to direct light onto a particular area being manipulated or examined. For example, the illuminator can be used with a handheld electrosurgical device, such as the BOVIE® pencil, which is typically used to cut tissue during surgical procedures.

Some devices known in the art include integrated light sources, but these devices are generally expensive and relatively bulky. Cordless and corded illuminators for surgical instruments are also known in the art, but can also add bulk and prevent the user from manipulating the instrument accurately or in confined spaces. Other devices known in the art include integrated smoke evacuation conduits, but these devices are generally expensive and present usability challenges due to the additional bulk that impacts ergonomics.

Additionally, many lighting devices, particularly corded devices and overhead lights, require constant repositioning, rely on an assistant to hold or reposition, and can disturb the surgical field. Additionally, coded luminaires, as well as light sources incorporated in fixtures, can become hot and can burn the user and/or patient and possibly even cause a fire.

Headlights can be used as an alternative to lighting devices during surgical procedures. However, like lighting devices, headlights are bulky, typically require cables to connect to a power source, require constant readjustment, and can pose a potential safety hazard. Moreover, when worn on the surgeon's head, they are remote from the surgical field, reducing their effectiveness, and they can cause fatigue and strain when worn for extended periods of time.

As is known, when handheld lighting devices, overhead lighting and/or headlamps are used during surgical procedures, the surgeon's hands/instruments can block the light and cast shadows on the surgical site, which is undesirable. These shadows require the user to periodically reposition the light source and may even require the surgeon to move the head to try different angles of the headlamp toward the surgical site.

A particularly useful battery-powered illuminator designed for attachment to a handheld electrosurgical device, particularly for use with the BOVIE® pencil, is disclosed in commonly-owned U.S. Pat. No. 9,851,060, the disclosure of which is incorporated herein by reference in its entirety. This device overcomes the drawbacks of the prior art lighting devices mentioned above.

The use of handheld electrosurgical devices, such as the BOVIE® pen, to dissect tissue typically produces surgical smoke as tissue cells are energized during surgery. Heat from the energy causes the intracellular fluid to vaporize, which increases the intracellular pressure and ultimately ruptures the cell membrane. When this happens, a plume of smoke containing mostly water vapor is released into the operating room. At the same time, the heat chars proteins and other organics within cells, releasing contaminants such as charred cell debris and gaseous hydrocarbons.

These small particles and gases are potentially dangerous if inhaled. If surgical fumes are not expelled from the surgical site closest to where they are generated, they become airborne and can be inhaled. This has led to the development and use of smoke evacuation systems during surgical procedures. A smoke evacuator is basically a vacuum pump with one or more filters designed to remove surgical smoke and aerosols and remove contaminants from the surgical site. Additionally, they can return filtered air to the operating room.

In view of the growing need and desire for surgical evacuation systems in the operating room, the inventors have determined that it would be advantageous to incorporate such systems directly into battery-operated lighting devices used with hand-held electrosurgical instruments. This disclosure presents several new and useful embodiments of battery-powered lighting devices for use with electrosurgical instruments, such as the BOVIE® pencil, which incorporates a smoke evacuation system.

The present invention relates to a new and useful illumination device for attachment to a handheld surgical instrument, preferably removably attached to a handheld electrosurgical instrument. More particularly, the present invention is directed to a lighting apparatus for attachment to a handheld electrosurgical instrument having opposed proximal and distal ends and including an elongated housing defining an internal chamber containing a battery-powered lighting assembly for illuminating a surgical site, the housing positioned adjacent, near, or proximal to the proximal end of the housing from an inlet positioned adjacent, near, or proximal to the distal end of the housing for removing smoke generated at the surgical site. It has at least one smoke evacuation passage associated therewith that extends to the outlet.

In one embodiment of the lighting device, the smoke exhaust passageway is located within a housing of the lighting device separated from the interior chamber by an inner wall of the housing. In another embodiment of the lighting device, the smoke exhaust passageway is located outside the housing of the lighting device separated from the inner chamber by an outer wall of the housing.

A connection fitting is associated with the outlet of the smoke evacuation passageway for connecting the smoke evacuation passageway with the smoke evacuation pipe communicating with the suction source. Preferably, the filter element is arranged in at least one of the smoke evacuation passages or arranged in the smoke evacuation pipe. It is envisioned that the smoke exhaust passageway may have any cross-sectional configuration including, for example, a rectangular cross-sectional configuration, a square cross-sectional configuration, an elliptical cross-sectional configuration, or a circular cross-sectional configuration.

In yet another embodiment of the lighting device, the associated smoke exhaust passageway extends through a nozzle assembly removably connected to an exterior sidewall of the housing of the lighting device. In such embodiments, the nozzle assembly may be removably connected to the outer wall of the housing by a snap-fit connection mechanism that includes an engaging flange on the outer wall of the housing and a pair of deflectable engaging protrusions on the nozzle assembly, or vice versa. Alternatively, the associated nozzle assembly may be removably connected to the outer wall of the housing by a sliding tongue and groove connection mechanism comprising a groove portion of the outer wall of the housing and a tongue portion of the nozzle assembly, or vice versa. In yet another embodiment, the nozzle assembly may be removably connected to the outer wall of the housing by an adhesive strip.

Preferably, the associated nozzle assembly includes an inlet nozzle, a smoke exhaust tube extending proximally from the inlet nozzle, and a barbed connection fitting at the proximal end of the smoke exhaust tube. The inlet nozzle includes at least one inlet orifice adapted and configured to maximize smoke emission range and performance so that it can be positioned near the ablation site where smoke is generated. In this regard, it is also envisioned that the inlet nozzle may be configured to telescope or otherwise extend distally so that it may be positioned in close proximity to the smoke generating source.

A filter element may be disclosed in at least one of an inlet nozzle, a barbed fitting, or a smoke exhaust pipe. A fitting is operatively associated with the smoke evacuation tube for securing the tube to the surgical instrument.

Preferably, the battery powered lighting assembly includes a printed circuit board containing at least one LED lighting component, at least one battery cell, and a switching mechanism. An actuating button is associated with the housing for actuating the switching mechanism. In an embodiment of the invention, at least one rotatable fan is positioned within the smoke exhaust passageway and operably connected to the printed circuit board of the battery powered lighting assembly. The fan may be configured to direct airflow from the smoke exhaust passageway or to draw airflow into the smoke exhaust passageway.

In an embodiment of the invention, the illuminator housing includes a clamping mechanism for selectively attaching the illuminator to a surgical instrument. The clamp mechanism includes a generally U-shaped clamp body having a pair of opposed parallel clamp arms, with an adjustable retaining screw associated with one clamp arm and an inner surface of the other clamp arm having a compliant material plate thereon. The clamping mechanism is pivotally connected to the housing about a pivot axis extending perpendicular to the longitudinal axis of the elongated housing.

In another embodiment of the invention, the internal chamber of the housing has a conical bore for receiving the distal end of a surgical instrument. In this embodiment, the battery powered lighting assembly is adapted and configured to activate or otherwise turn on when the distal end of the surgical instrument is received within the conical bore. Conversely, the battery-operated lighting assembly is adapted and configured to deactivate or otherwise turn off when the distal end of the surgical instrument is removed from the conical bore.

The present invention is also directed to a kit for performing a surgical procedure that includes a packaging enclosure, a battery-powered lighting device housed within the packaging enclosure configured to attach to a handheld surgical instrument, and a smoke evacuation nozzle assembly housed within the packaging enclosure configured to attach to the lighting device. The kit may further include a handheld surgical instrument within the packaging enclosure for performing the surgical procedure.

Preferably, the smoke exhaust nozzle assembly includes an inlet nozzle, a smoke exhaust tube extending proximally from the inlet nozzle, a barbed connection fitting at the proximal end of the smoke exhaust tube, and a clamping mechanism associated with the tube for selectively attaching the tube to a surgical instrument.

The present invention is also directed to a method for performing a surgical procedure comprising attaching an illuminating device to a surgical instrument, the illuminating device having an integrally or contiguously associated smoke evacuation passageway, and connecting an outlet of the smoke evacuation passageway to a suction source, such as a smoke evacuator or suction device. The method may further include performing electrocautery using the surgical instrument and activating the suction source to perform smoke evacuation through the inlet of the smoke evacuation passageway.

Preferably, attaching the lighting device to the surgical instrument includes automatically activating a light source of the lighting device, and the method further includes detaching the lighting device from the surgical instrument, thereby automatically deactivating the light source. Preferably, connecting the outlet of the smoke evacuation passageway to the suction source includes attaching a smoke evacuation tube to the first side of the lighting device, and the method further comprises removing the smoke evacuation tube from the first side of the lighting device and reinstalling the smoke evacuation tube to the second side of the lighting device.

The present invention is also directed to a lighting apparatus for attachment to a handheld electrosurgical instrument having opposed proximal and distal ends and including an elongated housing defining an internal chamber containing a battery-operated lighting assembly for illuminating a surgical site, the housing having a smoke exhaust tube associated therewith for removing smoke generated at the surgical site, the smoke exhaust tube extending and retracting relative to the distal end of the housing to provide different length end-effectors associated with the handheld electrosurgical instrument, such as cautery blades, loops or needles. Adapted and configured to accommodate the effector.

The smoke evacuation tube includes a proximal body portion for communicating with a suction source, a distal suction inlet for receiving smoke generated at the surgical site, and a distal body portion having a proximal connecting barb for providing a sealed connection with the distal end of the proximal body portion, more particularly for connecting to a tube associated with the suction source and providing a good seal.

In one embodiment of the invention, the distal body portion of the smoke exhaust tube includes an elongated track adapted and configured to slidably cooperate with rails on the outer wall of the housing. Preferably, the housing has rails on opposite side walls thereof for cooperating with elongated tracks on the distal body portion of the smoke exhaust tube. Alternatively, the housing has elongated tracks on opposite sidewalls thereof for cooperating with rails on the distal body portion of the smoke exhaust tube.

Alternatively, the distal body portion of the smoke exhaust tube is adapted and configured to be selectively attached to the housing at locations along its length by adhesive patches, bands, or straps. Alternatively, hook and loop, cable ties, strings, or other attachment mechanisms can be used. In another embodiment of the invention, the distal body portion of the smoke exhaust tube includes an elongate ratchet rack adapted and configured to cooperate with a deflectable pawl associated with the outer wall of the housing. Preferably, the housing has deflectable pawls on opposite sidewalls thereof for cooperating with an elongated ratchet rack on the distal body portion of the smoke exhaust tube.

In yet another embodiment of the invention, the distal body portion of the smoke exhaust tube includes an elongated gear rack adapted and configured to cooperate with at least one pinion gear associated with the outer wall of the housing. Preferably, the housing has pinion gears on opposite sidewalls thereof for cooperating with an elongated gear rack on the distal body portion of the smoke exhaust tube. Alternatively, the at least one pinion gear is associated with a distal body portion of the smoke exhaust tube adapted and configured to cooperate with an elongated gear rack of the housing.

In another embodiment of the invention, the distal body portion of the smoke evacuation tube includes a mounting flange for engaging rails in the outer wall of the housing, and the distal body portion includes a telescoping inner tube that is telescoping relative to the distal body portion by axial rotation via a helical thread to provide a distal suction inlet. Preferably, the housing has pinion gears on opposite sidewalls thereof for cooperating with an elongated gear rack on the distal body portion of the smoke exhaust tube.

In yet another embodiment of the present invention, the distal body portion of the smoke evacuation tube includes a mounting flange for engaging rails in the outer wall of the housing, and the distal body portion includes a plurality of graduated telescoping inner tube members telescoping relative to the distal body portion. Preferably, the housing has pinion gears on opposite sidewalls thereof for cooperating with an elongated gear rack on the distal body portion of the smoke exhaust tube.

The present invention is also directed to an illumination apparatus for attachment to a handheld electrosurgical instrument, which includes an elongated housing having opposed proximal and distal ends and defining an interior chamber containing a battery-powered illumination assembly for illuminating a surgical site, the interior chamber defining a conical bore extending from the proximal end of the housing for receiving the distal end of the electrosurgical instrument, and having an associated smoke exhaust tube for removing smoke generated at the surgical site. Preferably, the smoke exhaust tube is configured to telescope relative to the distal end of the housing, and the lighting assembly is activated when the distal end of the electrosurgical instrument is received in the conical bore and deactivated when the distal end of the electrosurgical instrument is removed from the conical bore. It is envisioned and well within the scope of the present disclosure that the smoke exhaust tube assembly may include at least one filter element for filtering particles and debris entrained in the smoke exhaust tube from the surgical site.

The present invention is also directed to a method that includes attaching a smoke exhaust tube to a handheld electrosurgical instrument to remove smoke generated at a surgical site, and then adjusting the smoke exhaust tube relative to the distal end of the electrosurgical instrument to accommodate different length end effectors installed on the electrosurgical instrument. The method further includes attaching a lighting device to the distal end of the electrosurgical instrument to illuminate the surgical site, and attaching a smoke evacuation tube includes attaching the smoke evacuation tube to the lighting device. Adjusting the smoke evacuation tube includes extending the smoke evacuation tube distally relative to the distal end of the lighting device and retracting the smoke evacuation tube proximally relative to the distal end of the lighting device.

These and other features of the lighting apparatus of the present invention will become readily apparent to those skilled in the art to which the present invention pertains from the following brief description of the drawings and the associated detailed description of the preferred embodiments.

1 is a perspective view of an attachable lighting device having an internal smoke evacuation passageway separated from a surgical instrument; FIG. 2 is a perspective view of a lighting device having an internal smoke evacuation passage mounted on the surgical instrument shown in FIG. 1; FIG. 1 is a perspective view of a lighting device having an internal smoke evacuation passage attached to a surgical instrument with a smoke evacuation tube connected; FIG. FIG. 10 is a front view of a lighting device with an internal smoke evacuation passage attached to a surgical instrument; FIG. 10 is a rear view of a lighting device with internal smoke evacuation passages attached to a surgical instrument; 2 is a front perspective view of the lighting device shown in FIG. 1; FIG. FIG. 7 is a front view of the lighting device shown in FIG. 6; FIG. 7 is a side view of the illumination device shown in FIG. 6; FIG. 7 is a rear view of the illumination device shown in FIG. 6; FIG. 7 is a rear perspective view of the lighting device shown in FIG. 6; FIG. 7 is an exploded perspective view of the lighting device shown in FIG. 6 , with parts separated for convenience of explanation; FIG. 8 is a cross-sectional view of the lighting device with internal smoke evacuation passage taken along line AA of FIG. 7; FIG. 10 is a perspective view of a luminaire having an internal smoke exhaust passageway including an internal fan separate from the surgical instrument that can be attached. Figure 14 is a perspective view of the illumination device of Figure 13 attached to a surgical instrument; 15 is a perspective view of the illumination device and surgical instrument of FIG. 14 with a smoke exhaust tube connected; FIG. 16 is a front view of the illumination device and surgical instrument of FIG. 15; FIG. 16 is a rear view of the illumination device and surgical instrument of FIG. 15; FIG. 14 is a front perspective view of the lighting device shown in FIG. 13; FIG. FIG. 19 is a front view of the lighting device shown in FIG. 18; FIG. 19 is a side view of the lighting device shown in FIG. 18; FIG. 19 is a rear view of the lighting device shown in FIG. 18; FIG. 19 is a rear perspective view of the lighting device shown in FIG. 18; 19 is a perspective view of the printed circuit board, LEDs, switch and fan subassembly housed in the lighting device of FIG. 18; FIG. Figure 19 is an exploded perspective view of the lighting device of Figure 18, with parts separated for ease of illustration; FIG. 20 is a cross-sectional view of the lighting device along line BB of FIG. 19; 1 is a perspective view of a surgical lighting system with an attachable smoke evacuation subassembly separated from a surgical instrument; FIG. 27 is a perspective view of the surgical lighting apparatus shown in FIG. 26 with a smoke evacuation subassembly attached and engaged to the distal end of a surgical instrument; FIG. Figure 28 is a front view of the assembly shown in Figure 27 showing the left side attachment; Figure 28 is a front view of the assembly shown in Figure 27 showing the right side attachment; Figure 28 is a right side view of the assembly shown in Figure 27; Figure 28 is a top view of the assembly shown in Figure 27; 32 is a partial cross-sectional view taken along line CC of FIG. 31; FIG. FIG. 27 is an exploded perspective view of the lighting device shown in FIG. 26; 27 is a top view of the illumination device shown in FIG. 26; FIG. Figure 35 is a cross-sectional view taken along line DD of Figure 34; Figure 27 is a perspective view of a subassembly comprising a printed circuit board, battery, switch and LEDs housed in the lighting device shown in Figure 26; 37 is a front end view of the subassembly shown in FIG. 36; FIG. FIG. 27 is a side view of the lighting device shown in FIG. 26; 39 is a partial cross-sectional view taken along line EE of FIG. 38 showing a slide mechanism for releasably connecting the smoke evacuation subassembly to the lighting device; FIG. Figure 37 is a front end view of the lighting device shown in Figure 36; 27 is a perspective view of the smoke exhaust nozzle assembly shown in FIG. 26; FIG. 42 is a front end view of the smoke exhaust nozzle assembly shown in FIG. 41; FIG. 42 is a side view of the smoke exhaust nozzle assembly shown in FIG. 41; FIG. 43 is an enlarged local view of the connecting tongue shown in FIG. 42; FIG. 42 is a bottom view of the smoke exhaust nozzle assembly shown in FIG. 41; FIG. FIG. 12 is a perspective view of another surgical lighting apparatus having a removable attachable smoke evacuation subassembly separated from a surgical instrument; 47 is a perspective view of the surgical lighting apparatus shown in FIG. 46 with a smoke evacuation subassembly attached and engaged to the distal end of a surgical instrument; FIG. Figure 48 is a front view of the assembly shown in Figure 47 showing the left side attachment; 48 is a front view of the assembly shown in FIG. 47 showing the right side attachment; FIG. Figure 48 is a top view of the assembly shown in Figure 47; Figure 48 is a right side view of the assembly shown in Figure 47; FIG. 52 is a partial cross-sectional view taken along line GG of FIG. 51; 47 is a right side view of the lighting device shown in FIG. 46; FIG. 47 is a top view of the illumination device shown in FIG. 46; FIG. 47 is a front end view of the subassembly shown in FIG. 46; FIG. FIG. 54 is a partial cross-sectional view taken along line HH of FIG. 53; 47 is a perspective view of the smoke exhaust nozzle assembly shown in FIG. 46; FIG. 58 is a front end view of the smoke exhaust nozzle assembly shown in FIG. 57; FIG. 58 is a rear end view of the smoke exhaust nozzle assembly shown in FIG. 57; FIG. FIG. 60 is an enlarged localized view of the connecting arm shown in FIG. 59; FIG. 47 is a perspective view similar to FIG. 46, wherein the smoke exhaust tube extending from the nozzle assembly includes a clip for engaging the proximal end of the surgical instrument; FIG. 62 is a perspective view as in FIG. 61 with the clip of the smoke evacuation tube engaging the proximal end of the surgical instrument; 63 is a top view of the assembly shown in FIG. 62; FIG. 63 is a right side view of the assembly shown in FIG. 62; FIG. 63 is a rear end view of the assembly shown in FIG. 62; FIG. 63 is an exploded side view of the smoke evacuation passage shown in FIG. 62, including the nozzle assembly, smoke evacuation tube, engagement clip, and barbed connector; FIG. Figure 63 is an assembled side view of the smoke exhaust passage shown in Figure 62; 68 is a cross-sectional view of the barbed connector taken along line KK of FIG. 67 showing possible positions of the filter element; FIG. Figure 63 is a rear end view of the smoke exhaust passage shown in Figure 62; Figure 63 is a front end view of the smoke exhaust passage shown in Figure 62; Figure 47 is a perspective view similar to Figure 46, wherein the nozzle assembly includes an adhesive strip for securing the smoke exhaust passageway to the lighting device, shown separated from the surgical instrument; 72 is a perspective view similar to FIG. 71 with the lighting device positioned at the distal end of the surgical instrument and the nozzle assembly of the smoke exhaust passage attached to the lighting device by an adhesive strip; FIG. 73 is a front end view of the assembly shown in FIG. 72 with the adhesive strips in an unlocked state; FIG. 73 is a front end view of the assembly shown in FIG. 72 with adhesive strips in place; FIG. 73 is a top view of the assembly shown in FIG. 72 with adhesive strips in place; FIG. 73 is a right side view of the assembly shown in FIG. 72 with the adhesive strips secured; FIG. 73 is a bottom view of the assembly shown in FIG. 72 with the adhesive strips secured; FIG. 1 is a perspective view of a luminaire having an external smoke exhaust passage, separated from a surgical instrument, to which it can be attached; FIG. FIG. 79 is a perspective view of a lighting device in which an external smoke discharge passage is attached to the distal end portion of the surgical instrument shown in FIG. 78; FIG. 80 is a top view of the assembly shown in FIG. 79; Figure 80 is a right side view of the assembly shown in Figure 79; Figure 80 is a front end view of the assembly shown in Figure 79; Figure 80 is a perspective view of the lighting device shown in Figure 79 with the smoke exhaust pipe disconnected from the external smoke exhaust path; Fig. 80 is a perspective view of the lighting device shown in Fig. 79 with a smoke exhaust pipe connected to the external smoke exhaust path; Figure 85 is a front end view of the lighting device shown in Figure 84; FIG. 86 is a cross-sectional view taken along line LL in FIG. 85; Fig. 3 is a front end view of a tubular smoke discharge inlet nozzle; 88 is a side view of the inlet nozzle shown in FIG. 87; FIG. FIG. 88 is a cross-sectional view taken along line MM of FIG. 87; FIG. 10 is a perspective view of a multi-orifice smoke exhaust inlet nozzle configured to distribute suction over a distance to better draw in surgical smoke to cover a larger area of the surgical field. Figure 91 is an exploded perspective view of the inlet nozzle shown in Figure 90; Figure 91 is a front end view of the inlet nozzle shown in Figure 90; Figure 91 is a side end view of the inlet nozzle shown in Figure 90; 62 is an exploded perspective view of a kit having a packaging enclosure configured to hold the lighting device and smoke evacuation assembly shown in FIG. 61; FIG. 95 is a perspective view of the kit shown in FIG. 94 with the lighting device and smoke evacuation assembly packaged within the enclosure; FIG. 95 is a top perspective view of the packaging enclosure shown in FIG. 94; FIG. 95 is a bottom perspective view of the packaging enclosure shown in FIG. 94; FIG. 62 is an exploded perspective view of a kit having a lighting device, a smoke evacuation assembly and a packaging enclosure configured to hold a surgical instrument shown in FIG. 61, the surgical instrument having connecting wires (one skilled in the art will readily appreciate that the wires have been omitted in previous figures for ease of illustration); FIG. 99 is a perspective view of the kit shown in FIG. 98 with the lighting device, smoke evacuation assembly, and surgical instruments packaged within an enclosure; FIG. FIG. 12 is a perspective view of another lighting device separated from an attachable surgical instrument including multiple external smoke exhaust passages; 100 is a perspective view similar to FIG. 100, with an illumination device attached to the distal end of a surgical instrument; FIG. Figure 102 is a perspective view of the assembly shown in Figure 101 with a smoke exhaust pipe connected to the smoke exhaust passage on the right side of the lighting device; Figure 102 is a perspective view of the assembly shown in Figure 101 with a smoke exhaust pipe connected to the smoke exhaust passage on the left side of the lighting device; 103 is a top view of the assembly shown in FIG. 102; FIG. Figure 101 is a front end view of the lighting device shown in Figure 100; 101 is a side view of the illumination device shown in FIG. 100; FIG. FIG. 107 is a cross-sectional view taken along line NN of FIG. 106; FIG. 10 is a perspective view of a lighting device attached to the distal end of a surgical instrument, the lighting device having a plurality of separate mounting locations for mounting smoke evacuation passageways, the entrance nozzle of the smoke evacuation passageway being attached to the bottom of those mounting locations. 109 is a side view of the assembly shown in FIG. 108; FIG. 109 is a front end view of the assembly shown in FIG. 108; FIG. Figure 109 is a perspective view of the assembly shown in Figure 108 with two separate two smoke exhaust passageway inlet nozzles attached to the lighting device in two different positions; 112 is a side view of the assembly shown in FIG. 111; FIG. 112 is a front end view of the assembly shown in FIG. 111; FIG. FIG. 4 is a perspective view of a surgical lighting device attached to a surgical instrument and shown with a smoke evacuation tube separated from the lighting device, the smoke evacuation tube configured to slide back and forth relative to the lighting device along rails; 115 is a perspective view showing the sliding smoke exhaust tube of FIG. 114 attached to the lighting device on each side of the housing; FIG. 115 is a perspective view showing the sliding smoke exhaust tube of FIG. 114 attached to the lighting device on each side of the housing; FIG. FIG. 10 is a perspective view showing a surgical instrument having electrodes of different types and lengths, and a sliding smoke exhaust tube placed at different positions relative to the housing of the lighting device to complement the different electrodes. FIG. 10 is a perspective view showing a surgical instrument having electrodes of different types and lengths, and a sliding smoke exhaust tube placed at different positions relative to the housing of the lighting device to complement the different electrodes. FIG. 10 is a perspective view showing a surgical instrument having electrodes of different types and lengths, and a sliding smoke exhaust tube placed at different positions relative to the housing of the lighting device to complement the different electrodes. 1 is a front view of a surgical instrument, a lighting device, and a sliding smoke evacuation tube; FIG. FIG. 10 is a partial top view of surgical instruments, lighting and a sliding smoke exhaust tube; FIG. 122 is a cross-sectional view taken along line NN of FIG. 121; 115 is a perspective view of the lighting device shown in FIG. 114; FIG. 124 to 127 are a top view, a left side view, a front view and a right side view of the illumination device shown in FIG. 123. FIG. 124 to 127 are a top view, a left side view, a front view and a right side view of the illumination device shown in FIG. 123. FIG. 124 to 127 are a top view, a left side view, a front view and a right side view of the illumination device shown in FIG. 123. FIG. 124 to 127 are a top view, a left side view, a front view and a right side view of the illumination device shown in FIG. 123. FIG. Figure 127 is an enlarged local view of region P, taken from Figure 126; 115 is a perspective view of the distal portion of the sliding smoke evacuation tube shown in FIG. 114, including the suction inlet; FIG. Fig. 3 is a front view of the suction inlet of the smoke exhaust pipe; FIG. 131 is a cross-sectional view taken along line RR of FIG. 130; Fig. 3 is a perspective view of another smoke exhaust pipe of the present invention separated from the lighting device; FIG. 3 is a perspective view showing a smoke exhaust pipe attached to the housing of the lighting device by an adhesive strap; FIG. 3 is a perspective view showing a smoke exhaust pipe attached to the housing of the lighting device by an adhesive strap; FIG. 3 is a perspective view showing a smoke exhaust pipe attached to the housing of the lighting device by an adhesive strap; FIG. 10 is a perspective view showing a surgical instrument having electrodes of different types and lengths, and a smoke exhaust tube attached to the lighting device and placed at different positions relative to the housing of the lighting device to complement the different electrodes. FIG. 10 is a perspective view showing a surgical instrument having electrodes of different types and lengths, and a smoke exhaust tube attached to the lighting device and placed at different positions relative to the housing of the lighting device to complement the different electrodes. FIG. 10 is a perspective view showing a surgical instrument having electrodes of different types and lengths, and a smoke exhaust tube attached to the lighting device and placed at different positions relative to the housing of the lighting device to complement the different electrodes. FIG. 12 is a partial top view showing the smoke exhaust tube strapped to the lighting device; FIG. 12 is a partial bottom view showing the smoke exhaust tube strapped to the lighting device; 1 is a front view of a surgical instrument, a lighting device and a strapped smoke exhaust tube; FIG. 133 is a perspective view of a distal portion of the strapped smoke exhaust tube shown in FIG. 132, including a suction inlet; FIG. 143 is a front view of the suction inlet of the smoke exhaust tube shown in FIG. 142; FIG. FIG. 144 is a cross-sectional view taken along line SS in FIG. 143; 1 is a perspective view of a surgical illuminator attached to a surgical instrument and shown with a smoke exhaust tube separated from the illuminator, the smoke exhaust tube configured to slide gradually back and forth relative to the illuminator along a ratchet rack that interacts with a pawl associated with the illuminator housing; FIG. Figure 146 is a perspective view showing the smoke exhaust tube of Figure 145 attached to the lighting device on both sides of the housing; Figure 146 is a perspective view showing the smoke exhaust tube of Figure 145 attached to the lighting device on both sides of the housing; FIG. 10 is a perspective view showing a surgical instrument having electrodes of different types and lengths, and smoke exhaust tubes incrementally placed at different positions relative to the housing of the lighting device to complement the different electrodes. FIG. 10 is a perspective view showing a surgical instrument having electrodes of different types and lengths, and smoke exhaust tubes incrementally placed at different positions relative to the housing of the lighting device to complement the different electrodes. FIG. 10 is a perspective view showing a surgical instrument having electrodes of different types and lengths, and smoke exhaust tubes incrementally placed at different positions relative to the housing of the lighting device to complement the different electrodes. FIG. 10 is a partial top view showing the smoke exhaust pipe mounted to the lighting device with the locking pawl engaged in the toothed rack; FIG. 12 is a partial bottom view showing the smoke exhaust pipe attached to the lighting device; 152 is a front view of the surgical instrument, lighting device and smoke exhaust tube shown in FIG. 151; FIG. Figure 153 is an enlarged local view of region U, taken from Figure 152; FIG. 152 is a cross-sectional view taken along line TT of FIG. 151; 156-158 are front, bottom and side views of the illumination assembly shown in FIG. 145. FIG. 156-158 are front, bottom and side views of the illumination assembly shown in FIG. 145. FIG. 156-158 are front, bottom and side views of the illumination assembly shown in FIG. 145. FIG. Figure 157 is an enlarged local view of region V from Figure 156; Figure 158 is an enlarged local view of region W taken from Figure 157; 146 is a perspective view of the distal portion of the smoke exhaust tube shown in FIG. 145; FIG. 162 and 163 are front and side views of the suction inlet of the smoke exhaust tube shown in FIG. 161; 162 and 163 are front and side views of the suction inlet of the smoke exhaust tube shown in FIG. 161; Figure 163 is an enlarged local view of region Y taken from Figure 162; FIG. 163 is a cross-sectional view taken along line XX of FIG. 162; FIG. 10 is a perspective view of a surgical illuminator attached to a surgical instrument and shown with a smoke exhaust tube separated from the illuminator, the smoke exhaust tube configured to gradually translate back and forth relative to the illuminator along a gear rack that interacts with a pinion gear associated with a housing of the illuminator; Figure 167 is a perspective view showing the smoke exhaust tube of Figure 166 attached to the lighting device on both sides of the housing; Figure 167 is a perspective view showing the smoke exhaust tube of Figure 166 attached to the lighting device on both sides of the housing; FIG. 10 is a perspective view showing a surgical instrument having electrodes of different types and lengths, and smoke exhaust tubes incrementally placed at different positions relative to the housing of the lighting device to complement the different electrodes. FIG. 10 is a perspective view showing a surgical instrument having electrodes of different types and lengths, and smoke exhaust tubes incrementally placed at different positions relative to the housing of the lighting device to complement the different electrodes. FIG. 10 is a perspective view showing a surgical instrument having electrodes of different types and lengths, and smoke exhaust tubes incrementally placed at different positions relative to the housing of the lighting device to complement the different electrodes. 167 is a front view of a view of the surgical instruments, illumination device, and smoke exhaust tube shown in FIG. 166; FIG. Figure 173 is an enlarged local view of region Z from Figure 172; FIG. 4 is a partial side view showing the smoke exhaust pipe attached to the lighting device with the gear rack and pinion cooperatively engaged; FIG. 4 is a partial top view showing the smoke exhaust pipe attached to the lighting device with the gear rack and pinion cooperatively engaged; FIG. 176 is a cross-sectional view taken along line AA-AA of FIG. 175; 167 is a perspective view of the distal portion of the smoke exhaust tube shown in FIG. 166; FIG. 162 and 163 are front and side views of the suction inlet of the smoke exhaust tube shown in FIG. 177; 162 and 163 are front and side views of the suction inlet of the smoke exhaust tube shown in FIG. 177; Figure 178 is a bottom view of the smoke exhaust tube of Figure 177; FIG. 179 is a cross-sectional view taken along line AB-AB in FIG. 178; 1 is a perspective view of a surgical illuminator attached to a surgical instrument and shown with a smoke exhaust tube separated from the illuminator, the smoke exhaust tube including a telescoping distal portion that moves relative to the tube by screw threads; FIG. Figure 183 is a perspective view showing the smoke exhaust tube of Figure 182 attached to the lighting device on both sides of the housing; Figure 183 is a perspective view showing the smoke exhaust tube of Figure 182 attached to the lighting device on both sides of the housing; FIG. 10 is a perspective view showing a surgical instrument having electrodes of different types and lengths and an extensible smoke exhaust tube placed at different positions relative to the housing of the lighting device to complement the different electrodes. FIG. 10 is a perspective view showing a surgical instrument having electrodes of different types and lengths and an extensible smoke exhaust tube placed at different positions relative to the housing of the lighting device to complement the different electrodes. FIG. 10 is a perspective view showing a surgical instrument having electrodes of different types and lengths and an extensible smoke exhaust tube placed at different positions relative to the housing of the lighting device to complement the different electrodes. FIG. 183 is a front view of the surgical instrument, lighting device, and extensible smoke exhaust tube shown in FIG. 182; FIG. 12 is a partial side view showing the extensible smoke evacuation tube attached to the lighting device; FIG. 10 is a partial top view showing the extensible smoke evacuation tube attached to the lighting device; 191 and 192 are front views of the illumination device shown in FIG. 182. FIG. 191 and 192 are front views of the illumination device shown in FIG. 182. FIG. 183 is an exploded perspective view of the view of the extensible smoke evacuation tube shown in FIG. 182; FIG. 183 is an assembled perspective view of the extensible smoke evacuation tube shown in FIG. 182; FIG. 195 and 196 are front and side views of the extensible smoke evacuation tube shown in FIG. 182; 195 and 196 are front and side views of the extensible smoke evacuation tube shown in FIG. 182; FIG. 197 is a cross-sectional view taken along line AC-AC of FIG. 196; Figure 198 is an enlarged local view of area AD taken from Figure 197; FIG. 194 is a perspective view of the telescoping portion of the smoke exhaust tube shown in FIG. 193; Figure 200 is a front view of the suction inlet of the tube shown in Figure 199; 194 is a perspective view of the distal body portion of the extensible smoke evacuation tube shown in FIG. 193; FIG. 202 is a front view of the distal body portion of the extensible smoke evacuation tube shown in FIG. 201; FIG. Figure 203 is a cross-sectional view taken along line AE-AE of Figure 202; 1 is a perspective view of a surgical illuminator attached to a surgical instrument and shown with a smoke exhaust tube separated from the illuminator, the smoke exhaust tube including a plurality of extendable extensions; FIG. 205 is a perspective view showing the extensible smoke exhaust tube of FIG. 204 attached to the lighting device on both sides of the housing; FIG. 205 is a perspective view showing the extensible smoke exhaust tube of FIG. 204 attached to the lighting device on both sides of the housing; FIG. FIG. 10 is a perspective view showing a surgical instrument having electrodes of different types and lengths and an extensible smoke exhaust tube extending to different locations relative to the housing of the lighting device to complement the different electrodes. FIG. 10 is a perspective view showing a surgical instrument having electrodes of different types and lengths and an extensible smoke exhaust tube extending to different locations relative to the housing of the lighting device to complement the different electrodes. FIG. 10 is a perspective view showing a surgical instrument having electrodes of different types and lengths and an extensible smoke exhaust tube extending to different locations relative to the housing of the lighting device to complement the different electrodes. FIG. 205 is a front view of the surgical instrument, lighting device, and extensible smoke exhaust tube shown in FIG. 204; FIG. 10 is a partial top view showing the extensible smoke evacuation tube attached to the lighting device; FIG. 212 is an AF-AF sectional view of FIG. 211; 213 and 214 are front views of the illumination device shown in FIG. 204. FIG. 213 and 214 are front views of the illumination device shown in FIG. 204. FIG. 205 is an exploded perspective view of the extensible smoke evacuation tube shown in FIG. 204; FIG. 205 shows a perspective view of the extensible smoke evacuation tube shown in FIG. 204; FIG. 217 is a front plan view of the extensible smoke evacuation tube shown in FIG. 216; FIG. FIG. 218 is a cross-sectional view taken along line AG-AG in FIG. 217; 219 is an enlarged local view of area AE obtained from FIG. 218; FIG. Figure 217 is a side view of the extensible smoke evacuation tube shown in Figure 216 in a fully extended state; FIG. 221 is a cross-sectional view taken along line AJ-AJ in FIG. 220; Figure 222 is an enlarged local view of area AK of Figure 221; Figure 222 is an enlarged local view of area AL of Figure 221; Figure 222 is an enlarged local view of area AM of Figure 221;

In order that those skilled in the art can easily understand how to make and use the lighting apparatus of the present invention without undue experimentation, preferred embodiments thereof are described in detail below with reference to the drawings.

Referring now to the drawings, like reference numerals identify like structural elements of various embodiments of the present invention, FIG. Illumination device 20 is adapted and configured to be attached to surgical instrument 10, preferably at its distal end, as shown in FIG. As shown in FIG. 3, an elongated smoke evacuation tube 30 connects the proximal end of the internal smoke evacuation passageway 8 of the lighting device 20 to a suction source such as a smoke evacuator or pump (not shown).

4-12, lighting device 20 has a generally rectangular housing with opposed proximal and distal ends defined by left and right housing components 2 and 2'. As best shown in FIG. 12, the housing of illuminator 20 defines an internal chamber that houses a battery powered illumination assembly for illuminating the surgical site. The light assembly includes a printed circuit board 28 with at least one or two integrated or embedded LED light light components 32, a mechanical switching mechanism 26, and a battery cell 24. A concave lens 6 is located at the distal end of the housing for directing the light source 32 .

A push button actuator 4 is associated with the housing portion 2 for manually actuating a switching mechanism 26 that controls the battery operated light assembly. The housing defined by left and right housing components 2 and 2' includes an internal smoke evacuation passageway 8 defined by left and right passageway portions 8 and 8', as best seen in FIG. The smoke exhaust passage 8 is separated from the inner chamber of the housing by an inner wall 5 . A smoke evacuation passageway 8 extends from an inlet located adjacent the distal end of the housing to an outlet or connection fitting 18, 18' located adjacent the proximal end of the housing. A connection fitting 18 allows an elongated smoke evacuation tube 30 to connect the smoke evacuation passageway 8 with a suction source, such as a smoke evacuator (not shown).

6-10, illuminator 20 includes a clamping mechanism 12 for selectively attaching the illuminator as seen in FIG. 2 to a surgical instrument. Clamping mechanism 12 includes a generally U-shaped clamping body having a pair of opposed parallel clamping arms 12' and 12''. An adjustable retaining screw 16 is associated with clamp arm 12 ′, the inner surface of clamp arm 12 ″ having a compliant material plate 14 thereon for closely engaging the geometry of surgical instrument 10 . A clamping mechanism 12 is pivotally connected to the housings 2, 2' about a pivot axis defined by a pin 22 extending perpendicular to the longitudinal axis of the elongated housing 2 for adjusting the angle of light of the illuminator 20 relative to the distal end of the surgical instrument 10 to intersect the distal tip of the instrument. Those skilled in the art will readily appreciate that other mechanical clamping mechanisms, such as spring-loaded clamps, can be used to attach the illuminator to the surgical instrument. Alternatively, other types of attachment means can be used, such as hook-and-loop fasteners, adhesive tape, and the like.

It is envisioned that a filter element may be placed in the smoke exhaust passage 8 or in the smoke exhaust tube 30 to filter debris and/or contaminants from the air passing from the surgical site. It is also envisioned that the internal smoke evacuation passage 8 may have a rectangular cross-sectional configuration as shown in FIG. 4, or alternatively the internal smoke evacuation passage may have a square cross-sectional configuration, an elliptical cross-sectional configuration, a circular cross-sectional configuration, or any other shaped cross-sectional configuration that is known and/or can be readily manufactured.

13 and 14, there is shown another embodiment of a lighting device, indicated generally by the reference numeral 40, which has an external smoke exhaust passageway 15. As shown in FIG. The external smoke exhaust passage 15 is located outside the main housing 52, 52' of the lighting device 40 and is separated from the internal chamber by the outer wall of the housing. As shown in FIG. 15, an elongated smoke evacuation tube 50 connects a fitting 56 at the proximal end of the external smoke evacuation passageway 15 of the lighting device 40 to a suction source such as a pump or smoke evacuator (not shown).

18-25, illuminator 40 includes an adjustable clamping mechanism 12 substantially identical to clamp mechanism 12 of illuminator 20 to facilitate selective attachment of illuminator 40 to the distal end of surgical instrument 10. The lighting device 40 also includes a battery powered lighting assembly having a printed circuit board 58 with an LED light source 32 embedded therein, a battery cell 24 and a switch 26 controlled by the activation button 4 . Lens 6 is positioned in a retaining slot at the distal end of housing 52 , 52 ′ adjacent LED light source 32 .

Lighting device 40 also includes an internal rotary fan 54 positioned near the distal entrance of external smoke exhaust passage 15 . The fan 54 may be configured to direct airflow from the smoke exhaust passage 15 or draw airflow into the smoke exhaust passage 15 . The fan 54 is electrically connected to a printed circuit board 58 and powered by the battery 24 of the lighting assembly housed within the two-part rectangular housing 52, 52' of the lighting device 40.

Those skilled in the art will readily appreciate that multiple fans or micro-fans can be positioned within the exterior smoke exhaust passage 15 of the lighting device 40 . It should also be appreciated that one or more fans may be similarly positioned in the interior smoke exhaust passage 8 of the lighting device 20 described above.

As best shown in FIG. 25, the filter element 62 is positioned near the proximal end of the exterior smoke exhaust passage 15 of the lighting device 40 . Filter element 62 may comprise carbon or activated carbon, may be a single layer or multi-layer composite, and may include mesh, paper, or other filter layers that may be hydrophobic.

Referring now to FIGS. 26-45, there is shown another surgical lighting system, generally designated 510, for use with handheld electrosurgical instrument 10 cooperating with removable smoke evacuation assembly 520. As shown in FIG. 27 and 28, and the left wall of the lighting device 510, as shown in FIG.

Smoke evacuation assembly 520 includes an inlet nozzle 506 that defines a smoke evacuation passage located adjacent the distal end of lighting device 510 . An elongated smoke exhaust tube 508 extends from the proximal outlet 516 of the inlet nozzle 506 for communication with a smoke evacuator or pump. As best seen in FIG. 32, a sliding connector 514 extends from the bottom surface of the inlet nozzle 506 for engaging either one of the interface connectors 512 and 512' located on the left and right sidewalls of the lighting device 510 (see also FIG. 40). For example, as shown in FIGS. 38-45, the sliding connector 514 includes slotted tongues 522 for interacting with grooves 518 formed in the sliding connectors 512, 512'.

33-37, illuminator 510 includes a generally conical housing 504 having a substantially flat upper surface 505 to allow an unobstructed line of sight for a surgeon utilizing surgical instrument 10. The housing 504 has an internal cavity that supports the lighting assembly, which includes a printed circuit board 546 having a plurality of circumferentially-spaced embedded LED light sources 548 , battery cells 544 , and a switching mechanism 562 . Lens 540 is positioned at the distal end of housing 504 adjacent or near LED light source 548 . An engagement collar 552 having a cooperating spring 554 is operably associated with the housing 504 of the illuminator 510 to engage the distal end of the surgical instrument 10 when the surgical instrument 10 is received within the interior cavity 556 of the illuminator 510.

In use, when the distal end of the electrosurgical instrument 10 is inserted into the conical alignment sleeve 556 within the interior cavity of the illuminator 510, the distal end of the instrument 10 bends downward to contact the flexible cantilever foot that contacts the switching mechanism 562, illuminating the LED light source. At such point, the distal end of the instrument is mechanically retained by the spring-loaded engagement collar 552 . As a result, a surgeon using instrument 10 can incise tissue while illuminating the surgical site and removing smoke therefrom with illuminator 510 and its smoke evacuation assemblies 520 mounted on either side thereof.

46-60, there is shown yet another surgical lighting system, designated 530, for use with handheld electrosurgical instrument 10 in cooperation with removable smoke evacuation assembly 550. As shown in FIG. As will be described in more detail below, the housing 532 of the lighting device 530 includes snap-fit engagement structures 528, 528' to facilitate attachment of the smoke evacuation assembly 550 to the right side wall of the housing 532, as shown in FIG. 48, or the left side wall of the housing 532, as shown in FIG.

Smoke evacuation assembly 550 includes an inlet nozzle 524 that defines a smoke evacuation passage located adjacent the distal end of housing 532 . An elongated smoke exhaust tube 508 extends from the proximal outlet 526 of the inlet nozzle 524 for communication with a smoke evacuator or pump. 52, snap-fit connectors 536 extend from the bottom surface of inlet nozzle 524 for engaging snap-fit connectors 528 and 528' on the left and right side walls of housing 532 of lighting device 530. As best seen in FIG. 53-60, snap-fit connector 536 includes a pair of deflectable legs 536' and 536'' for interlocking or otherwise engaging complementary grooves 534, 534' of sliding connectors 528, 528'.

61-70, another embodiment of a removable smoke evacuation assembly, generally designated 560, for use with lighting device 510 is shown. Smoke exhaust assembly 560 includes inlet nozzle 506 and elongated smoke exhaust tube 566 . Inlet nozzle 506 is adapted and configured for attachment to housing 504 of lighting device 510, as described in detail above.

Retaining clip 568 is operably positioned along the length of tube 566, as shown in FIGS. 69 and 70, to selectively engage the proximal end of surgical instrument 10 for use with surgical instrument 10 (see FIG. 65). Retaining clip 568 includes a pair of barbed retaining legs 568' and 568'' that serve to hold tube 566 in a fixed position so as not to interfere with performance of the surgical procedure.

A barbed connector fitting 564 is operably disposed at the proximal end of smoke evacuation tube 566 to communicate with a smoke evacuator or pump. Other types of connectors or fittings can also be used. As best seen in FIG. 68, filter element 572 is positioned with the central passageway of connector fitting 564 to filter smoke-filled air passing under suction by a smoke evacuator or pump. Filter element 572 may be formed from carbon, activated carbon, or similar filter media.

71-77, another embodiment of a removable smoke evacuation assembly 580 for use with lighting device 570 used with handheld surgical instrument 10 is shown. Smoke exhaust assembly 580 includes inlet nozzle 576 , elongated smoke exhaust tube 582 and adhesive strip 578 . Adhesive strip 578 extends at least partially around the perimeter of housing 574 of lighting device 570 and is sized and configured to securely secure nozzle 576 thereto.

78-86, another embodiment of a lighting device 590 having an external smoke exhaust passage 588 integrally formed with a housing 584 of the lighting device 590 for use with the handheld electrosurgical instrument 10 is shown. Smoke exhaust passage 588 can have any type of cross-sectional configuration, but as shown has a generally elliptical cross-sectional configuration and extends from an inlet adjacent the distal end of housing 584 to an outlet 592 adjacent or near the proximal end of housing 584. Smoke evacuation tube 586 connects with outlet 592 to allow communication with a smoke evacuator or pump, as best shown in FIG.

As best seen in FIG. 86, the lighting device 590 has an internal cavity with a conical alignment sleeve 556 and a lighting assembly that includes a printed circuit board 546 with multiple embedded LED light sources 548, battery cells (not shown), and a switching mechanism 562. Lens 540 is positioned at the distal end of housing 584 and spacer 542 is positioned between lens 540 and light source 548 on printed circuit board 546 . An engagement collar 552 having a cooperating spring 554 is operably associated with the interior cavity 556 of the illumination device 584 to engage the distal end of the surgical instrument 10 when received within the interior cavity 556 of the illumination device 590.

In use, when the distal end of electrosurgical instrument 10 is inserted into sleeve 556 within the interior cavity of illuminator 590, the distal end of instrument 10 contacts the flexible member and pushes it downward to engage switching mechanism 562 and illuminate LED light source 548. At such point, the distal end of instrument 10 is mechanically retained by spring-loaded engagement collar 552 . As a result, a surgeon using electrosurgical instrument 10 can use illuminator 590 and its external smoke exhaust passage 588 integrally formed with housing 584 to illuminate the surgical site and dissect tissue while removing smoke therefrom.

87-89, a cylindrical or tubular smoke exhaust inlet nozzle 602 having a distal inlet portion 602 and a proximal outlet portion 606 sized and configured to communicate with the smoke exhaust tube 586 is shown. Those skilled in the art will readily appreciate that the inlet nozzle 602 can be used as an alternative nozzle mechanism for any of the smoke evacuation assemblies described and illustrated herein.

90-93, another smoke exhaust inlet nozzle 605 is shown that includes a rear body portion 608 configured to communicate with the smoke exhaust tube 586 and a multi-orifice front body portion 612 configured to spread suction over a distance to better draw in surgical smoke covering a larger area of the surgical field. Those skilled in the art will readily appreciate that the multi-orifice nozzle-like nozzle 605 shown in FIG. 90 can be used as an alternative nozzle mechanism for any of the smoke evacuation assemblies described and illustrated herein.

Referring now to FIGS. 94-97, there is shown a kit for performing surgical procedures with handheld surgical instruments that includes a packaging enclosure 610 configured to hold the battery operated lighting device 510 and removable smoke evacuation assembly 560 shown in FIGS. Smoke evacuation assembly 560 includes a nozzle inlet 506, an elongated tube 566 having a proximal connector 564, and a clip 568 for attachment to the proximal end of a handheld surgical instrument.

98-99, another kit for performing a surgical procedure is shown that includes a packaging enclosure 620 configured to hold a battery-powered illuminator 510, a smoke evacuation assembly 560 for attaching to the illuminator 510, and a hand-held electrocautery 100 (such as the BOVIE® Pencil) to which the illuminator 510 is attached so as to illuminate the surgical site without unduly obstructing the surgeon's line of sight. Including. The kit allows the surgeon to perform an electrocautery procedure and illuminate the surgical site while evacuating smoke.

100-107, there is shown yet another embodiment of a lighting device having an integral smoke evacuation assembly, generally indicated at 710, also designed for use with handheld electrosurgical instrument 10. Lighting device 710 includes a generally conical housing 702 that includes integral left and right smoke exhaust passages 706' and 706''. Each smoke evacuation passageway has an inlet 708' and 708'' adjacent or near the distal end of the housing 702 for drawing in smoke and an exit barb 704' and 704'' adjacent or near the proximal end of the housing 702 for communicating with the smoke evacuation tube 720.

As best seen in FIG. 107, the lighting device 710 has an internal cavity with a conical alignment sleeve 556 and a lighting assembly including a printed circuit board 546 with one or more embedded LED light sources and one or more battery cells 544. A lens 540 is disposed at the distal end of housing 702 . In use, performing a surgical procedure using illuminating device 710 includes attaching illuminating device 710 to the distal end of surgical instrument 10 to activate an LED light source, and then connecting outlet 704 of one of smoke evacuation passages 706′ or 706″ by smoke evacuation tube 720 to a suction source. If desired, to prevent obstruction of the surgical site by the smoke evacuation tube 720 during the procedure, the method further includes removing the smoke evacuation tube 720 from one of the smoke evacuation passages 706' or 706'' and reattaching the smoke evacuation tube 720 to the other smoke evacuation passage 706' or 706'', as shown in FIGS.

108-113, there is shown an illuminator 730 for use with a handheld surgical instrument 10 having three separate mounting positions (it is envisioned that there may be more than three mounting positions) for engaging an inlet nozzle 506 of a removable smoke evacuation assembly having an elongated smoke evacuation tube 508 for communicating with a smoke evacuator or pump (not shown). More specifically, as best seen in FIG. 110, the generally conical housing 732 of the lighting device 730 includes a first mounting flange 512 on the right side of the housing 732, a second mounting flange 512' on the left side of the housing 732, and a third mounting flange 512'' on the bottom of the housing 732.

It is envisioned that the smoke evacuation assembly inlet nozzle 506 can be mounted in any of three or more positions. Alternatively, as shown in FIGS. 111-113, multiple smoke evacuation assembly inlet nozzles 506 can be attached to the housing 732 of the lighting device 730 to enhance the smoke evacuation effectiveness of the system.

114-131, there is shown an assembly 1100 including a lighting device 1120 for attachment to the handheld electrosurgical instrument 10 to illuminate the surgical site and an associated smoke exhaust tube 1110 for removing smoke generated at the surgical site. Illumination device 1120 includes an elongated housing 1102 having opposed proximal and distal ends and defining an internal chamber containing a battery-powered illumination assembly for illuminating a surgical site. Smoke exhaust tube 1110 is adapted and configured to extend and retract with respect to the distal end of housing 1102, as shown in FIGS.

Smoke exhaust tube 1110 includes a proximal body portion 1108 for communicating with a suction source, a distal body portion 1106 having a distal suction inlet for receiving smoke generated at the surgical site, and a proximal connecting barb 1116 for cooperating with the distal end of proximal body portion 1108. Distal body portion 1106 of smoke exhaust tube 1110 includes an elongated track 1118 adapted and configured to slidably cooperate with rails 1114 on the outer wall of housing 1102 .

The smoke exhaust tube 1110 can be slidably advanced, moved, or adjusted manually by the user and stays in the desired position using friction. Preferably, the housing 1102 has rails 1114 on opposite sidewalls thereof for cooperating with the elongated tracks 1118 of the distal body portion 1106 of the smoke evacuation tube 1110 so that the smoke evacuation tube 1110 can be associated with the right or left side of the housing 1102, as shown in FIGS.

132-144, an assembly 1200 including a distal body portion 1206 of a smoke exhaust tube 1220 is shown adapted and configured to be selectively attached to a housing 1204 of a lighting device 1210 at locations along its length by adhesive bands or straps 1202. The distal body portion 1206 has a distal suction inlet 1214 for receiving smoke generated at the surgical site and a proximal connecting barb 1212 for cooperating with the distal end of the proximal body portion 1208 of the smoke exhaust tube 1220, more particularly for connecting to tubing associated with a suction source and providing a good seal.

Straps 1202 may be configured as hook-and-loop fasteners, cable ties, or the like. As shown in FIGS. 136-139, the user can place the smoke exhaust tube 1220 at the appropriate distance, secure the strap 1202, or attach adhesive to accommodate different length cautery blades or other types of end effectors associated with the handheld electrosurgical instrument 10 (i.e., cautery blades 10A, 10B, 10C). The user can then remove the strap 1202 or break the adhesive, adjust the position of the tube assembly 1220 and reattach it to the housing 1204 of the lighting device 1210 .

145-165, there is shown an assembly 1300 in which the distal body portion 1304 of the smoke exhaust tube 1320 includes an elongated ratchet rack 1312 adapted and configured to cooperate with a deflectable pawl 1308 or tooth associated with the outer wall of the housing 1302 of the lighting device 1310. More specifically, ratchet rack 1314 includes a plurality of teeth and deflectable pawl 1308 has rigid locking teeth 1316 for interacting with the teeth of rack 1314 as distal body portion 1304 moves relative to housing 1302 of lighting device 1310.

The pawl 1308 acts like a spring to pinch the distal body portion 1304 of the smoke exhaust tube 1320 against the housing 1302 of the lighting device 1310 . The user can bend pawl 1308 outward to position, move or adjust the position of smoke exhaust tube 1320, then release pawl 1308 so it moves back down and teeth 1316 can pinch certain grooves between the teeth of ratchet rack 1314 of distal body portion 1304 to hold it in place. Housing 1302 of lighting device 1310 also adds side rails 1312 to contribute to stability.

Preferably, the housing 1302 of the lighting device 1310 has deflectable pawls 1308 on opposite sidewalls thereof for cooperating with an elongated ratchet rack 1314 on the distal body portion 1304 of the smoke evacuation tube 1320 so that the smoke evacuation tube 1320 can be associated with the right or left side of the housing 1302, as shown in FIGS. In use, the smoke exhaust tube 1320 is telescopic with respect to the distal end of the housing 1302 of the illuminator 1310, as shown in FIGS. 148-150, to accommodate different length ablation blades or other types of end effectors associated with the handheld electrosurgical instrument 10 (i.e., ablation blades 10A, 10B, 10C).

The distal body portion 1304, as best seen in FIGS. 161-165, has a distal suction inlet 1322 for receiving smoke generated at the surgical site and a proximal connecting barb 1318 for cooperating with the distal end of the proximal body portion 1306 of the smoke exhaust tube 1320, more particularly for connecting to tubing associated with a suction source and providing a good seal.

166-181, there is shown an assembly 1400 in which the distal body portion 1406 of the smoke exhaust tube 1420 includes an elongated gear rack 1414 adapted and configured to cooperate with rotatable pinion gears 1404 or teeth associated with the outer wall of the housing 1402 of the lighting device 1410. More specifically, gear rack 1414 extends along a support track 1412 projecting from the outer wall of housing 1402 and pinion gear 1404 is supported for rotation on axle 1416 extending from the outer wall of housing 1404 . Preferably, the housing 1402 has pinion gears 1404 on opposite sidewalls thereof for cooperating with an elongated gear rack 1414 on the distal body portion 1406 of the smoke exhaust tube 1420 so that the smoke exhaust tube 1420 can be associated with the right or left side of the housing 1402, as shown in FIGS.

The distal body portion 1406 as best seen in FIGS. 177-181 has a distal suction inlet for receiving smoke generated at the surgical site and a proximal connecting barb 1418 for cooperating with the distal end of the proximal body portion 1408 of the smoke exhaust tube 1420, more particularly for connecting to tubing associated with a suction source and providing a good seal. As best seen in FIG. 178, gear rack 1414 is formed as an I-beam structure 1422 for engaging support rails 1412 .

In use, the user can rotate the pinion gear 1404 to advance the smoke exhaust tube 1420 distally or vice versa to retract it proximally. The smoke exhaust tube 1420 is telescopic with respect to the distal end of the housing 1402 of the illuminator 1410, as shown in FIGS. 169-171, to accommodate different length ablation blades or other types of end effectors associated with the handheld electrosurgical instrument 10 (i.e., ablation blades 10A, 10B, 10C).

It is envisioned that the smoke exhaust tube assembly could utilize two pinion gears instead of a single gear and support rail. It is also envisioned that the smoke exhaust tube assembly could utilize friction wheels and linear friction surfaces instead of pinion gears and linear gear racks.

182-203, an assembly 1500 is shown that includes a retractable inner tube 1506 in which the distal body portion 1504 of the smoke exhaust tube 1520 is extendable relative to the distal body portion 1504 by axial rotation via a helical thread to provide a suction inlet. More specifically, as best seen in FIGS. 197 and 198, the internal bore of distal body portion 1504 includes an inwardly projecting boss 1516 for cooperating with helical groove 1522 formed in inner tube 1506 .

The outer surface of the distal body portion 1504 is provided with a mounting flange 1514 for engaging rails 1512 on the outer wall of the housing 1502 of the lighting device 1510 . Preferably, the housing 1502 has rails 1512 on opposite sidewalls thereof for engaging mounting flanges 1514 of the distal body portion 1504 of the smoke evacuation tube 1520 so that the smoke evacuation tube 1520 can be associated with the right or left side of the housing 1502, as shown in FIGS.

In use, the user can rotate inner tube 1506 relative to distal body portion 1505 to advance inner tube 1506 distally or vice versa to retract proximally. Inner tube 1506 is telescopic with respect to the distal end of housing 1502 of illuminator 1510 to accommodate different length ablation blades associated with handheld electrosurgical instrument 10 (i.e., ablation blades 10A, 10B, 10C), as shown in FIGS.

As best seen in FIGS. 201-203, the distal body portion 1504 has a proximal connecting barb 1418 for cooperating with the distal end of the proximal body portion 1508 of the smoke evacuation tube 1520, and more specifically for connecting to tubing associated with a suction source to provide a good seal.

204-224, an assembly 1600 is shown in which the distal body portion 1606 of the smoke exhaust tube 1620 is telescopic relative to the distal body portion 1606 and includes a plurality of graduated telescopic inner tube members (1608 and 1612) providing distal suction inlets.

The outer surface of distal body portion 1606 is provided with a mounting flange 1618 for engaging rails 1616 on the outer wall of housing 1602 of lighting device 1610 . Preferably, the housing 1602 has rails 1616 on opposite sidewalls thereof for engaging mounting flanges 1618 on the distal body portion 1606 of the smoke evacuation tube 1620 so that the smoke evacuation tube 1620 can be associated with the right or left side of the housing 1602, as shown in FIGS.

In use, the user can distally advance or proximally retract the graduated telescoping inner tubular members 1608 and 1612 relative to the distal end of the housing 1602 of the illuminator 1610 to accommodate different length ablation blades associated with the handheld electrosurgical instrument 10 (i.e., ablation blades 10A, 10B, 10C), as shown in FIGS.

As best seen in FIGS. 212 and 215-224, the distal body portion 1606 has a proximal connecting barb 1632 for cooperating with the distal end of the proximal body portion 1614 of the smoke exhaust tube 1620, and more specifically for connecting to tubing associated with a suction source to provide a good seal. The proximal end of the inner tubular member 1612 also has an inner stop flange 1624 for cooperating with the outer stop flange 1626 at the distal end of the inner tubular member 1608 (see FIG. 223), and the proximal end of the inner tubular member 1608 has an inner stop flange 1622 for cooperating with the outer stop flange 1628 at the distal end of the distal body portion 1606 (see FIG. 224). The distal end of inner tubular member 1612 includes a distal suction inlet 1604 best seen in FIG.

Those skilled in the art will readily appreciate that the present disclosure provides smoke evacuation solutions for multiple cautery blades or end effector tip lengths. Therefore, if the surgeon changes from a 2 inch to a 4 inch or 6 inch cautery blade, loop or needle, the length of the smoke exhaust tube assembly can be easily adjusted to accommodate the length of the end effector. As a result, the smoke may be expelled closest to the ablation site prior to more extensive smoke dispersion. Furthermore, when significant smoke spread occurs, lighting that would otherwise be useful during surgery can interfere with visualization by illuminating the smoke cloud, a related challenge in visualization.

The smoke exhaust tube assembly disclosed herein also provides a clear line of sight for the surgeon. At certain angles, the surgeon may need to retract the smoke evacuation tip proximally if it obscures his or her view of the tip of the blade, including, for example, while performing surgical incisions in tight spaces or tight access. Smoke evacuation elements offset from active ablation blades as disclosed herein not only improve visualization of the incision site due to reduced physical obstruction, but also draw smoke from the active site into the evacuation mechanism. Furthermore, improved illumination under these conditions improves visualization of ablation activity. It is also envisioned that the smoke exhaust tube assembly may be made from a clear plastic material to improve visualization.

The smoke exhaust tube assembly disclosed herein also provides improved surgical access. When operating in narrow cavities, the surgeon may only have enough space to access at the tip and may need to retract the smoke evacuator to allow the device to be small enough to fit in the cavity. Having the flexibility to move the position of the smoke evacuation tip allows flexibility for the surgeon in different spaces.

The smoke exhaust tube assemblies disclosed herein can have a cylindrical or rounded cross-sectional configuration, as shown. However, those skilled in the art will readily appreciate that the cross-sectional shape of the smoke exhaust tube assembly and/or its components may be any other non-cylindrical shape dictated by design, including elliptical, square, polygonal, etc.

Although the present disclosure has been shown and described with reference to preferred embodiments, those skilled in the art will readily appreciate that changes and modifications can be made without departing from the spirit or scope of the disclosure.

Claims (37)

A lighting device for attachment to a handheld electrosurgical instrument, comprising:
An illumination apparatus comprising an elongated housing having opposed proximal and distal ends and defining an interior chamber containing an illumination assembly for illuminating a surgical site, the elongated housing having an associated smoke exhaust tube for removing smoke generated at the surgical site, the smoke exhaust tube configured to telescope relative to the distal end of the housing. 2. The lighting device of claim 1, wherein the smoke exhaust tube includes a proximal body portion for communicating with a suction source and a distal body portion having a distal suction inlet and a proximal connecting barb for receiving smoke generated at the surgical site. 3. The lighting device of claim 2, wherein the distal body portion of the smoke exhaust tube includes an elongated track adapted and configured to slidably cooperate with a complementary structure on an outer wall of the housing. 4. The lighting device of claim 3, wherein said housing has structure on opposite side walls thereof for cooperating with said elongated track of said distal body portion of said smoke exhaust tube. 3. The lighting device of claim 2, wherein the distal body portion of the smoke exhaust tube is adapted and configured to be selectively attached to the housing at locations along its length by adhesive or fasteners. 3. The lighting device of Claim 2, wherein the distal body portion of the smoke exhaust tube includes an elongated ratchet rack configured to cooperate with a deflectable pawl associated with an outer wall of the housing. 7. The lighting device of claim 6, wherein said housing has deflectable pawls on opposite sidewalls thereof for cooperating with said elongated ratchet rack on said distal body portion of said smoke exhaust tube. 3. The lighting device of Claim 2, wherein the distal body portion of the smoke exhaust tube includes an elongated gear rack configured to cooperate with at least one pinion gear associated with an outer wall of the housing. 9. The lighting device of claim 8, wherein the housing has at least one pinion gear on opposing sidewalls thereof for cooperating with the elongated gear rack on the distal body portion of the smoke exhaust tube. 3. The lighting device of claim 2, wherein the distal body portion of the smoke exhaust tube includes a mounting flange for engaging structure in the outer wall of the housing, and wherein the distal body portion includes a retractable inner tube telescoping relative to the distal body portion by axial rotation via a helical thread. 11. The lighting device of claim 10, wherein the housing has structure on opposite sidewalls thereof for engaging the mounting flange of the distal body portion of the smoke exhaust tube. 3. The lighting device of claim 2, wherein the distal body portion of the smoke exhaust tube includes a mounting flange for engaging structure in an outer wall of the housing, and wherein the distal body portion includes a plurality of graduated telescoping inner tube members telescoping relative to the distal body portion. 13. The lighting device of claim 12, wherein the housing has structure on opposite sidewalls thereof for engaging the mounting flange of the distal body portion of the smoke exhaust tube. 2. The lighting device of claim 1, wherein the lighting assembly comprises a printed circuit board having at least one LED lighting component, at least one battery cell, and a switch for operating the lighting assembly. 15. The lighting apparatus of claim 14, wherein the internal chamber of the housing has a conical bore extending from the proximal end of the housing for receiving a distal end of the electrosurgical instrument. 16. The illumination apparatus of claim 15, wherein the switch is configured to activate the illumination assembly when the distal end of the electrosurgical instrument is received in the conical bore and deactivate the illumination assembly when the distal end of the electrosurgical instrument is removed from the conical bore. 2. The lighting device of claim 1, further comprising at least one filter element operably associated with said smoke exhaust pipe. A lighting device for attachment to a handheld electrosurgical instrument, comprising:
An elongated housing having opposed proximal and distal ends and defining an interior chamber containing a battery-operated lighting assembly for illuminating a surgical site, the interior chamber defining a conical bore extending from the proximal end of the housing for receiving a distal end of the electrosurgical instrument, and having an associated smoke exhaust tube for removing smoke generated at the surgical site, the smoke exhaust tube configured to telescope relative to the distal end of the housing. lighting device. 19. The lighting apparatus of claim 18, wherein the lighting assembly is activated when the distal end of the electrosurgical instrument is received in the conical bore and is deactivated when the distal end of the electrosurgical instrument is removed from the conical bore. 19. The lighting device of Claim 18, wherein said lighting assembly comprises a printed circuit board containing at least one LED lighting component, at least one battery cell, and a switch for operating said lighting assembly. 19. The lighting device of claim 18, wherein the smoke exhaust tube includes a proximal body portion for communicating with a suction source and a distal body portion having a distal suction inlet and a proximal connecting barb for receiving smoke generated at the surgical site. 22. The lighting device of Claim 21, wherein the distal body portion of the smoke exhaust tube includes an elongated track configured to slidably cooperate with rails on the outer wall of the housing. 23. The lighting device of claim 22, wherein said housing has structure on opposite side walls thereof for cooperating with said elongated track of said distal body portion of said smoke exhaust tube. 22. A lighting device according to claim 21, wherein the distal body portion of the smoke exhaust tube is adapted and configured to be selectively attached to the housing at locations along its length by adhesives or fasteners. 22. The lighting device of Claim 21, wherein the distal body portion of the smoke exhaust tube includes an elongated ratchet rack configured to cooperate with a deflectable pawl associated with an outer wall of the housing. 26. The lighting device of claim 25, wherein said housing has deflectable pawls on opposite sidewalls thereof for cooperating with said elongated ratchet rack on said distal body portion of said smoke exhaust tube. 22. The lighting device of Claim 21, wherein the distal body portion of the smoke exhaust tube includes an elongated gear rack configured to cooperate with at least one pinion gear associated with an outer wall of the housing. 28. The lighting device of claim 27, wherein said housing has at least one pinion gear on opposing sidewalls thereof for cooperating with said elongated gear rack on said distal body portion of said smoke exhaust tube. 22. The lighting device of claim 21, wherein the distal body portion of the smoke exhaust tube includes a mounting flange for engaging structure in the outer wall of the housing, and wherein the distal body portion includes a retractable inner tube telescoping relative to the distal body portion by axial rotation via a helical thread to provide the suction inlet. 30. The lighting device of claim 29, wherein said housing has structure on opposite sidewalls thereof for engaging said mounting flange of said distal body portion of said smoke exhaust tube. 22. The lighting device of claim 21, wherein the distal body portion of the smoke exhaust tube includes a mounting flange for engaging structure in an outer wall of the housing, the distal body portion including a plurality of graduated telescoping inner tube members telescoping relative to the distal body portion to provide the suction inlet. 32. The lighting device of claim 31, wherein said housing has structure on opposite sidewalls thereof for engaging said mounting flange of said distal body portion of said smoke exhaust tube. 19. The lighting device of Claim 18, further comprising at least one filter element operably associated with said smoke exhaust tube. a method,
a) attaching a smoke exhaust tube to a handheld electrosurgical instrument to remove smoke generated at a surgical site; and b) adjusting the smoke exhaust tube relative to a distal end of the electrosurgical instrument to accommodate end effectors of different lengths located on the electrosurgical instrument. 35. The method of claim 34, further comprising attaching a lighting device to a distal end of the electrosurgical instrument to illuminate the surgical site, wherein the step of attaching the smoke evacuation tube comprises attaching the smoke evacuation tube to the lighting device. 36. The method of Claim 35, wherein the step of adjusting the smoke evacuation tube comprises distally extending the smoke evacuation tube relative to a distal end of the lighting device. 36. The method of Claim 35, wherein the step of adjusting the smoke evacuation tube comprises proximally retracting the smoke evacuation tube relative to a distal end of the lighting device.

Images