Finger-mounted surgical instruments

Abstract

A device is described that has an instrument portion secured to a sleeve/cuff portion, where the sleeve/cuff portion is configured to receive a portion of user's finger therein and to radially compress onto the user's finger to hold the instrument portion thereon. The present invention is particularly well suited for use in minimally invasive surgical procedures. The present invention also teaches a method of forming a knot in suture material as well as other techniques for treating patients.

What is claimed is: 
     
         1 . A surgical device for attaching to a digit of a user, comprising:
 a finger attachment sleeve formed in a tube with a closed distal end and an open proximal end, the sleeve sized to slidingly receive a user's digit through the open end and comprising a biaxial helically wound braided tubular structure configured to radially expand when longitudinally compressed and configured to contract when longitudinally stretched, wherein the sleeve in a relaxed state has an inner diameter somewhat smaller than an outer diameter of the user's digit, such that the sleeve must be longitudinally compressed to radially expand and fit the sleeve onto the user's digit and the sleeve has an inherent inward bias that causes the braided tubular structure to contract to a fastened diameter and grip onto the user's digit; and   an instrument portion secured to the finger attachment sleeve.   
     
     
         2 . The device of  claim 1 , wherein the sleeve comprises an inner lumen of between 1 and 6 cm in inner length and between 1 and 3 cm in inner diameter. 
     
     
         3 . The device of  claim 2 , wherein the instrument portion has a length of from 1 cm to 20 cm. 
     
     
         4 . The device of  claim 1 , wherein the instrument portion has a length of from 1 cm to 20 cm. 
     
     
         5 . The device of  claim 1 , the instrument portion comprises a knot pushing element secured to the closed distal end of the sleeve and configured to engage a suture during a medical procedure. 
     
     
         6 . The device of  claim 5 , wherein the knot pusher includes an elongated member that extends a length from the distal tip and terminates in a distal face with a groove thereacross configured to receive a suture therein. 
     
     
         7 . The device of  claim 6 , wherein the elongated member forms a helical twist just proximal to the grooved distal face, the helical twist being formed by a helical bend in the elongated member. 
     
     
         8 . The device of  claim 6 , wherein the groove has a radius of between 0.1 to 1 mm. 
     
     
         9 . The device of  claim 6 , wherein the groove divides the distal face into a first face portion and a second face portion. 
     
     
         10 . The device of  claim 9 , wherein the first face portion extends distally farther than the second face portion, with a first face portion inner side surface extending past the second face portion and presenting a surface to engage against a suture. 
     
     
         11 . The device of  claim 1 , wherein the instrument portion is a scissors, wherein a first shaft comprises a first blade portion at a first shaft distal end and a second shaft comprises a second blade portion at a second shaft distal end wherein the two shafts are rotatably connected around a pivot joint and wherein the proximal end of the first shaft is secured to the sleeve. 
     
     
         12 . The device of  claim 1 , wherein the instrument portion is a clamp, wherein a first shaft comprises a first a first clamp portion at a first shaft distal end and a second shaft comprises a second clamp portion at a second shaft distal end wherein the two shafts are rotatably connected around a pivot joint and wherein the proximal end of the first shaft is secured to the sleeve. 
     
     
         13 . The device of  claim 12 , further including a lock to hold the clamp closed. 
     
     
         14 . A surgical device, comprising:
 a first finger attachment sleeve formed in a tube with a closed distal end and an open proximal end, the sleeve sized to slidingly receive a user's first digit through the open end and comprising a biaxial helically wound braided tubular structure configured to radially expand when longitudinally compressed and configured to contract when longitudinally stretched, wherein the sleeve in a relaxed state has an inner diameter somewhat smaller than an outer diameter of the user's first digit, such that the sleeve must be longitudinally compressed to radially expand and fit the sleeve onto the user's digit and the sleeve has an inherent inward bias that causes the braided tubular structure to contract to a fastened diameter and grip onto the user's first digit;   a second finger attachment sleeve formed in a tube with a closed distal end and an open proximal end, the sleeve sized to slidingly receive a user's second digit through the open end and comprising a biaxial helically wound braided tubular structure configured to radially expand when longitudinally compressed and configured to contract when longitudinally stretched, wherein the sleeve in a relaxed state has an inner diameter somewhat smaller than an outer diameter of the user's second digit, such that the sleeve must be longitudinally compressed to radially expand and fit the sleeve onto the user's digit and the sleeve has an inherent inward bias that causes the braided tubular structure to contract to a fastened diameter and grip onto the user's second digit; and   an instrument portion secured to the first finger attachment sleeve and to the second finger attachment sleeve.   
     
     
         15 . The surgical device of  claim 14 , wherein the instrument portion comprises scissors comprising a first shaft and a second shaft and a pivot joint rotatably connecting the first shaft and the second shaft, wherein the first shaft comprises a first scissor blade at a distal end thereof and the second shaft comprises a second scissor blade at a distal end thereof, wherein a proximal end of the first shaft is secured to the first finger attachment sleeve and wherein a proximal end of the second shaft is secured to the second finger attachment sleeve. 
     
     
         16 . The surgical device of  claim 14 , wherein the instrument portion comprises a surgical clamp comprising a first shaft and a second shaft and a pivot joint rotatably connecting the first shaft and the second shaft, wherein the first shaft comprises a first clamp portion at a distal end thereof and the second shaft comprises a second clamp portion at a distal end thereof, wherein a proximal end of the first shaft is secured to the first finger attachment sleeve and wherein a proximal end of the second shaft is secured to the second finger attachment sleeve. 
     
     
         17 . The device of  claim 16 , further including a lock to hold the surgical clamp closed.