Apparatus and methods for performing minimally-invasive surgical procedures

Abstract

Devices, tools and methods for performing minimally invasive surgical procedures. Methods of performing minimally invasive ablation procedures. Methods of performing rapid exchange of tools in a device while the device remains in a reduced-access surgical space.

1 - 82 . (canceled) 
     
     
         83 . The system of claim  22 , wherein said distal tip comprises a ball-ended tip. 
     
     
         84 - 225 . (canceled) 
     
     
         226 . A surgical system for performing minimally invasive surgical procedures, said surgical system comprising:
 an elongated body having a distal end portion, an external body surface, an interior region encompassed by said external body surface, and at least two lumens extending generally along a direction of a longitudinal axis of said elongated body, wherein one of the two lumens is configured for receiving an endoscope therein; and   a lens forming an elongated distal tip having a convex configuration with respect to the distal end portion of the elongated body and an outer circumferential surface that is entirely smooth and continuous to allow for endoscopic visability of a surgical field, wherein the distal tip comprises a proximal end, a curved and blunt distal end for blunt dissection of tissue, and an exterior side surface extending therebetween, when attached to the distal portion of the elongated body, the distal tip is configured to allow for endoscopic visibility of a surgical field along a length of the distal tip through the exterior side surface so as to minimize visual distortion.   
     
     
         227 . The system of  claim 226 , wherein the distal tip is configured to provide an endoscopic field of view allowing for visibility of tissue from the distal tip proximal end to a location distal thereto. 
     
     
         228 . The system of  claim 227 , wherein the distal tip is configured to breakup reflected waves of light from the curved and blunt distal end, minimizing formation of rings of reflected light. 
     
     
         229 . The system of  claim 226 , wherein the elongated distal tip is transparent. 
     
     
         230 . The system of  claim 226 , wherein the elongated distal tip forms a fluid tight enclosure attached to the one of the two lumens configured for receiving an endoscope. 
     
     
         231 . The system of  claim 226 , wherein the distal tip is configured to breakup reflected waves of light from the curved and blunt distal end, minimizing formation of rings of reflected light, and when the elongated distal tip is attached to the elongated body, the elongated distal tip is longitudinally offset with respect to a distal opening of the second lumen such that the curved and blunt distal end extends distally beyond the opening. 
     
     
         232 . The system of  claim 226 , wherein the other one of the two lumens is configured for receiving a tool extendible beyond the blunt distal end of the elongated distal tip. 
     
     
         233 . A method for performing minimally invasive surgical procedures, said method comprising the steps of:
 dissecting tissue by pushing a dissection tip of a surgical system for performing minimally invasive surgical procedures through the tissue, wherein the system comprises a shaft through which an endoscope and an adjoining lumen configured for receiving a surgical tool are positioned along a length of the shaft; and   visualizing through the dissection tip a surgical field and a distal portion of the surgical tool positioned through the lumen, wherein the dissection tip extends from the shaft and encloses an end of the endoscope and has a curved and blunt distal end for blunt dissection of tissue, and an exterior side surface extending between the shaft and the curved and blunt distal end, wherein visualization of the surgical field is along a length of the dissection tip through the exterior side surface so as to minimize visual distortion.   
     
     
         234 . The method of  claim 233 , further comprising the step of:
 employing the curved and blunt distal end of the dissection tip to bluntly dissect tissue.   
     
     
         235 . The method of  claim 234 , further comprising the step of:
 inserting the surgical tool into the lumen of the shaft so as to deliver a working end of the tool to the surgical field, wherein the tool is selected from the group consisting of a suction assembly, a snare catheter, a snare capture tool, a hook tool, a bolo tool, a retrieval tool, a perforation tool, a mapping probe tool, a linear ablating probe tool, a point/disk ablation probe tool, a cautery tool, a graspers tool, and a scissors tool.   
     
     
         236 . The method of  claim 235 , wherein the tool is inserted into the lumen of the shaft so that a portion of the tool extends through the lumen and beyond a distal most end of the dissection tip. 
     
     
         237 . The method of  claim 236 , wherein the tool is a cautery tool, and the method further comprises the step of:
 cauterizing tissue using the cautery tool that is visualized through the dissection tip.   
     
     
         238 . The method of  claim 233 , wherein the surgical tool is retractable with respect to a field of view of the dissection tip. 
     
     
         239 . The method of  claim 236 , wherein the method further comprises the step of:
 employing the tool to manipulate tissue while visualizing the manipulated tissue through the dissection tip.   
     
     
         240 . A surgical system for performing minimally invasive surgical procedures, said surgical system comprising:
 an elongated body having a distal end portion, an external body surface, and an interior region encompassed by said external body surface; and   an elongated distal tip having a convex configuration with respect to the distal end portion of the elongated body, wherein the distal tip comprises a proximal end, a blunt distal end for blunt dissection of tissue, and an exterior side surface extending between the proximal end and the blunt distal end, wherein the distal tip is attached to the distal portion of the elongated body, and the distal tip allows endoscopic visibility of a surgical field by an endoscope disposed in the elongated body so that the endoscopic visibility extends along a length of the distal tip through the exterior side surface and includes a portion of the tool disposed within the elongated body.   
     
     
         241 . The system of  claim 240 , wherein the portion of the tool endoscopically visible through the exterior side surface of the distal tip is a working end of the tool. 
     
     
         242 . The system of  claim 241 , wherein the tool is selected from the group consisting of a suction assembly, a snare catheter, a snare capture tool, a hook tool, a bolo tool, a retrieval tool, a perforation tool, a mapping probe tool, a linear ablating probe tool, a point/disk ablation probe tool, a cautery tool, a graspers tool, and a scissors tool. 
     
     
         243 . The system of  claim 240 , wherein the endoscope is housed by one of the two lumens extending generally along a direction of a longitudinal axis of the elongated body. 
     
     
         244 . The system of claim  2450 , wherein at least two lumens extend generally along a direction of a longitudinal axis of the elongated body, wherein one of the two lumens is configured to receive an endoscope therein and the other one of the two lumens is configured to receive a tool therein. 
     
     
         245 . A surgical system for performing minimally invasive surgical procedures, said system comprising:
 an elongated body having a distal end portion, a proximal end portion, an external body surface, an interior region encompassed by the external body surface, and at least a first lumen and a second lumen extending at least partially through the interior region and generally along a direction of a longitudinal axis of said elongated body, wherein the first lumen is configured to receive an endoscope therein; and   a lens having a bullet shaped portion forming an elongated distal tip that extends distally with respect to said distal end portion of said elongated body, wherein the elongated distal tip comprises a curved and blunt distal end allowing for blunt dissection of tissue and a sidewall extending from a proximal end of the elongated distal tip to the curved and blunt distal end that allows for viewing of the surgical field therethrough.   
     
     
         246 . The system of  claim 245 , wherein the elongated body further comprises a semi-flexible sleeve having distal and proximal sleeve end portions, and wherein the elongated distal tip is rigid and attachable to a distal end of the elongated body. 
     
     
         247 . The system of  claim 246 , wherein the sleeve is sufficiently flexible to navigate internal structures to at least partially encircle the internal structures. 
     
     
         248 . The system of  claim 246 , further comprising an endoscope inserted in the elongated body, wherein the endoscope is positioned for viewing through the distal tip. 
     
     
         249 . The system of  claim 246 , wherein the distal tip comprises at least one port in fluid communication with at least one lumen in the elongated body. 
     
     
         250 . The system of  claim 245 , wherein the bullet shaped portion of the lens has a symmetrical configuration about a longitudinal axis of the lens. 
     
     
         251 . The system of  claim 245 , wherein a portion of the first lumen is substantially parallel to a portion of the second lumen. 
     
     
         252 . The system of  claim 245 , wherein the endoscope is housed by the first lumen. 
     
     
         253 . The system of  claim 252 , wherein the second lumen is configured to receive a cautery tool. 
     
     
         254 . The system of  claim 253 , wherein at least a portion of the cautery tool is housed by the second lumen so as to move within the second lumen.