ENDOLUMINAL INTRODUCER
An introducer for use during endoscopic procedures provides insufflation, washing, and aspiration functions, and provides for the protection of the endoluminal surface during laparoscopic examination of an anastomosis or suture line following low anterior resection of the bowel. The introducer may be designed for the insertion of an endoscope capable of white light and/or near infra-red fluorescence imaging into the rectum for analysis of an anastomosis following low anterior resection of the bowel.
1 . An introducer for use during endoscopic procedures, comprising:
a tube with a proximal end and a distal end and with at least one channel of sufficient diameter to accommodate the passage of an endoscope from the proximal end to the distal end;
an insufflation arrangement configured to pass insufflation gas through a channel in the tube to its distal end; and
an insufflation chamber arrangement configured to maintain insufflation and substantially prevent the insufflation gas from exiting the proximal end of the tube.
2 . The introducer of claim 1 , wherein the tube is dimensioned to be at least as long as the endoscope so that the endoscope does not extend beyond the distal end of the tube.
3 . The introducer of claim 1 , wherein the insufflation chamber arrangement comprises a transparent window at the end of the endoscope channel of the introducer.
4 . The introducer of claim 1 , wherein the insufflation chamber arrangement is a seal between the endoscope and the channel into which the endoscope is inserted.
5 . The introducer of claim 1 , wherein the insufflation arrangement is an insufflation bulb.
6 . The introducer of claim 5 , wherein the insufflation bulb is operatively connected to the tube by way of a luer or barbed connection.
7 . The introducer of claim 1 , wherein the tube comprises a plurality of channels for separate passage of two or more of the endoscope, the insufflation gas, irrigation fluid and aspirated fluid.
8 . The introducer of claim 7 , further comprising at least one pumping arrangement configured to pass irrigation fluid or aspirating fluid, the pumping arrangement being selected from the group consisting of an air pump, a water pump, a vacuum pump, or a combination thereof.
9 . The introducer of claim 1 , further comprising a transparent window on the distal end of the tube that is transparent to UV, visible, or infra-red light, but does not allow the endoscope to pass beyond the distal end of the tube.
10 . A system for assessing a surgical margin or anastomosis in a patient, comprising:
a tube with a proximal end and a distal end and with at least one channel of sufficient diameter to accommodate the passage of an endoscope from the proximal end to the distal end;
an insufflation arrangement configured to pass insufflation gas through a channel in the tube to its distal end;
an insufflation chamber arrangement configured to maintain insufflation and substantially prevent the insufflation gas from exiting the proximal end of the tube; and
an endoscope deployable into the tube.
11 . The system of claim 10 , wherein the tube is dimensioned to be at least as long as the endoscope so that the endoscope does not extend beyond the distal end of the tube.
12 . The system of claim 10 , wherein the insufflation chamber arrangement comprises a transparent window at the end of the endoscope channel of the introducer.
13 . The system of claim 10 , wherein the insufflation chamber arrangement is a seal between the endoscope and the channel into which it is inserted.
14 . The system of claim 10 , wherein the insufflation arrangement is an insufflation bulb.
15 . The system of claim 14 , wherein the insufflation bulb is operatively connected to the tube by way of a luer or barbed connection.
16 . The system of claim 10 , wherein the tube comprises a plurality of channels for separate passage of two or more of the endoscope, the insufflation gas, irrigation fluid, and aspirated fluid.
17 . The system of claim 16 , wherein at least one pumping arrangement configured to pass irrigation fluid or aspirating fluid, the pumping arrangement being selected from the group consisting of an air pump, a water pump, a vacuum pump, or a combination thereof.
18 . The system of claim 10 , further comprising a transparent window on the distal end of the tube that is transparent to UV, visible, or infra-red light, but does not allow the endoscope to pass beyond the distal end of the tube.
19 . The system of claim 10 , wherein the endoscope is configured to illuminate and image with white light.
20 . The system of claim 10 , wherein the endoscope is configured to illuminate and image with near infra-red light.
21 . The system of claim 10 , wherein the endoscope is configured to illuminate and image with white light or near infra-red light or both.