Object inserter including a penetration-resisting bearing surface and method

Abstract

A surgical tool for inserting a spile or plug into the punctal opening of a meatus such as a lacrimo-nasal canaliculus. The tool includes a distal end having a plug-carrying structure which includes distally extending rod for engaging an axial bore in the plug, and an abutment having a radial prominence supporting a penetration-resisting bearing surface which prevents over-insertion of the plug by contacting tissue surrounding the punctal opening. The abutment can be shaped and dimensioned to provide effective and comfortable penetration resistance while affording ample visibility to the surgeon user. The rod can be axially withdrawn through a rod tracking tube having a precisely dimensioned central lumen restricting off-axis movement of the rod. The abutment can be fixed to the rod or detached from it.

What is claimed is: 
     
         1 . The combination of an object and a tool for inserting said object through an opening in the body of a patient;
 wherein said tool comprises:
 a member having a distal portion, and a rod projecting from said distal portion; 
 said rod having a distal segment elongated along an axis, said distal segment having a free distal rod end carrying said object; 
 an abutment located an axial distance from said distal rod end; 
 wherein said abutment comprises:
 a penetration-resisting bearing surface located at an axial position to resist penetration of said fee distal rod end beyond a given distance, thereby preventing over-penetration of said object into the body of said patient; and, 
 a visibility enhancer though said penetration-resisting bearing surface. 
 
   
     
     
         2 . The combination of  claim 1 , wherein said visibility enhancer comprises at least one radial notch forming an angular discontinuity in said penetration-resisting bearing surface. 
     
     
         3 . The combination of  claim 1 , wherein said visibility enhancer comprises a pane of translucent material. 
     
     
         4 . The combination of  claim 1 , wherein said penetration-resisting bearing surface extends beyond a maximum radial extent of said object. 
     
     
         5 . The combination of  claim 1 , wherein said penetration-resisting bearing surface is dimensioned to bear against at least part of the tissue surrounding said opening during insertion of said object into the body of said patient. 
     
     
         6 . The combination of  claim 1 , wherein said abutment is substantially cylindrical and wherein said penetration-resisting bearing surface is substantially circular having a diameter of between about 0.91 mm and about 6.0 mm. 
     
     
         7 . The combination of  claim 1 , wherein said abutment comprises a plurality of angularly spaced apart surface portions having a cumulative area forming said penetration-resisting bearing surface. 
     
     
         8 . The combination of  claim 1 , which further comprises said distal portion of said tool having a lumen. 
     
     
         9 . A tool for inserting an object into an opening in the body of a patient, said tool comprises:
 a hand-graspable member;   a rod extending distally from said member;   said rod having a distal segment elongated along an axis, said distal segment having a free distal rod end; and,   an abutment located an axial distance proximal from said distal rod end;   wherein said abutment comprises:
 a radial prominence supporting an penetration-resisting bearing surface a radial distance from said distal segment; 
 wherein said penetration-resisting bearing surface is shaped, dimensioned, and located to directly or indirectly bear against at least part of the tissue surrounding said opening during insertion of said object into the body of a patient; and, 
 a visibility enhancer though said penetration-resisting bearing surface. 
   
     
     
         10 . The tool of  claim 9 , wherein said visibility enhancer comprises at least one radial notch forming an angular discontinuity in said penetration-resisting bearing surface. 
     
     
         11 . The combination of  claim 9 , wherein said visibility enhancer comprises a pane of translucent material. 
     
     
         12 . The tool of  claim 9 , wherein said penetration-resisting bearing surface is shaped and dimensioned to prevent over-penetration of said distal segment into said body. 
     
     
         13 . The tool of  claim 9 , wherein said penetration-resisting bearing surface extends at least 0.1 mm beyond a maximum radial extent of the object being inserted. 
     
     
         14 . A method for inserting an object into an opening in the body of a patient, said method comprises:
 selecting an oblong inserter tool including a rod having a distal segment having a free distal rod end, and an abutment located an axial distance proximal from said distal rod end, said abutment supporting a penetration-resisting bearing surface having a radial dimension greater than a maximum radial dimension of said object, said penetration-resisting bearing surface being oriented to bear against tissue surrounding said opening;   releasably carrying an object with said distal rod end;   pushing said tool axially into said body until said penetration-resisting bearing surface prevents further axial movement of said tool;   visualizing a portion of said tissue surrounding said opening through a visibility enhancer on said abutment;   releasing said object from said tool; and,   axially pulling said tool away from said object.   
     
     
         15 . The method of  claim 14 , wherein said visualizing comprises:
 viewing a portion of said tissue surrounding said opening through a gap in said penetration-resisting bearing surface.   
     
     
         16 . The method of  claim 14 , wherein said visualizing comprises:
 viewing a portion of said tissue surrounding said opening through a pane of translucent material in said abutment.   
     
     
         17 . The method of  claim 14 , wherein the penetration-resisting bearing surface directly contacts a portion of the tissue surrounding said opening thereby preventing over-insertion of the object into said body. 
     
     
         18 . The method of  claim 14 , wherein said selecting further comprises:
 choosing an inserter tool so that said penetration-resisting bearing surface has a radial dimension which is at least 0.1 mm larger than the maximum radial dimension of the object.   
     
     
         19 . The method of  claim 14 , which further comprises:
 preventing bending of said rod to a bend radius of less than 0.35 meter during said pushing.   
     
     
         20 . The method of  claim 14 , which further comprises:
 preventing the object from inadvertently falling off the rod during insertion.