Title of Invention

"THE HYDRO-DISSECTION SYSTEM FOR SURGERY PARTICULARLY FOR LAPAROSCOPIC SURGERY"

Abstract

The hydro dissection system for surgery, particularly in laparoscopic surgery, comprising of a device for production of high pressure hydro-jet of normal saline/isotonic salt solution and hand instruments, connected with the said device, for controlled delivery of high pressure hydro jet to the operation site in order to facilitate dissection of tissues, the pressure being regulated according to the nature of the tissues to be dissected with or without monopolar diathermy current application facility, wherein the device consisting of medical grade normal saline / isotonic salt solution bottle in which vertical portion of the L shaped inlet pipe is inserted for controlled entry of air to create the air pressure by the rubber bulb connected at the end of the horizontal portion of the inlet pipe, the said air pressure can be measured in the pressure gauge which is connected with the horizontal portion of the L shaped inlet pipe through the T-extension and vertical portion of the L- shaped outlet pipe is inserted to the said bottle wherein horizontal portion is connected to the valve of the hand instrument for controlled delivery of normal saline/isotonic salt solution to the operative site through different types of canulae. Various detachable canula tips have been designed for also getting mechanical advantage during tissue dissection in different surgical situations. Apart from the controlled delivery of normal saline / isotonic salt solution to the operation site, some of the canulae can also be used for dispersing the tissues by scrubbing and sucking out the collected fluid / fumes from inside the body cavity.

Full Text

Background of the invention: Hydro-dissection is a procedure by which tissue planes are easily separated by injecting normal saline / ringer solution / sterile water etc. under pressure (hydro-jet) within the tissues. This is usually done with the help of syringe and needle. It is a time-honoured procedure in open surgery and has been successfully applied in general surgical procedures to facilitate tissue dissection, particularly in difficult situations. It is mostly popular among the Eye-surgeons for cataract operations and Pediatric surgeons for separation of hernia sac, particularly when it is associated with un-descended testis. It has also been tried in laparoscopic tissue dissection by surgeons like Naude GP, Morris E, Bongard FS and a few others where they have used the available suction-irrigation machine with either the laparoscopic aspiration needle or the 5 mm suction-irrigation canula. Hydro-dissection in laparoscopic surgery is not po'pular because of the following reasons: 1. Want of suitable, simple and economic instruments / device. 2. Lack of comprehensive and detailed technique of using high-pressure normal saline or water jet on tissues. 3. Lack of study report on the use of safe range of hydro-thrust on tissues to avoid inadvertent injuries on vital structures. 3 Objective of the present invention: The objective is to invent simple and economic hydro dissection system having device and instruments for production of high pressure hydro-jet as per requirement for tissue dissection and its controlled delivery efficiently to the target tissues along with monopolar Electro-surgical (diathermy) electrode facility for facilitating easier and safe tissue dissection, particularly in laparoscopic procedures. Summary of the invention: A preferred embodiment of the hydro dissection system of the present invention is consisting of mainly two parts whereas one of them is device for production of high pressure hydro jet (normal saline /isotonic salt solution jet) & other one is suitable hand instruments for controlled delivery of the high pressure hydro jet to the operation site with or without monopolar diathermy current application facility. The device essentially is having normal saline/isotonic salt solution bottle in which with L-shaped inlet & outlet pipes are inserted. The inlet pipe is connected to rubber bulb with one-way valve at one end with the provision of the measuring the air pressure by the pressure gauge. There is also a water trap at the bottom of the vertical extended position of L shaped inlet. The L shaped outlet pipe is connected to the valve of the hand instrument preferably provided with a diathermy connector. The hand instrument is 4 provided with various types of hydro dissection canula with different types of canula tips for delivering the normal saline/ isotonic salt solution at high pressure to the operating site. In a preferred embodiment, the device is provided with other elements for efficient functioning. The hand instrument is also provided with other preferred features for effective delivery of high-pressure normal saline jet to the operative site. The hydro dissection system for surgery particularly in laparoscopic surgery comprising of device for production of high pressure hydro-jet of normal saline /isotonic salt solution and hand instruments, connected with the said device,, for controlled delivery of the high pressure hydro jet to the operation site in order to facilitate dissection of tissues, with or without monopolar diathermy current application facility, wherein the device consisting of normal saline/ isotonic salt solution bottle in which vertical portion of the L shaped inlet pipe is inserted for controlled entry of air to create the air pressure by the rubber bulb fitted at the end of the horizontal portion of the inlet pipe, the said air pressure can be measured in the pressure gauge which is connected with the horizontal portion of the L-shaped inlet pipe through the T-extension and vertical portion of the L-shaped outlet pipe to be inserted to the said bottle wherein horizontal portion is connected to the valve of the hand instrument for controlled delivery of high pressure normal saline /isotonic salt solution to the operative site through different types of canulae, the pressure being regulated according to the nature of the tissues to be dissected. 5 1. Brief description of the drawing Numerous other advantages and features of the present invention will become readily apparent from the following detailed description of the invention and embodiments thereof, from the claims and from the accompanying drawings. In the accompanying drawings forming part of the specification, and in which like numerals are employed to designate like parts throughout the same. In the drawing wherein: Figure 1 shows the general arrangement of the system having two parts shown in schematic diagram of the hydro dissection system. Figure 2 shows a device for production and controlled release of high pressure hydro jet of normal saline / isotonic salt solution to the operative site. Figure 3 shows the device as shown in Fig.2 with preferred embodiments including stopcock & valve etc. Figure 4 shows a zero degree blunt and straight tip of the canula through which the normal saline is passed to the operative site. Figure 5 shows canula as shown in Fig. 4 with monopolar diathermy current application facility. 6 Figure 6 shows the different embodiments of the detachable tips to be fitted with the HD canula. Figure 7 shows the composite HD canula with diathermy current application facility and trumpet/rotary valve control. Figure 8 shows the preferred embodiment of HD canula with diathermy current application facility and roller type stopcock to control release of the normal saline/ isotonic salt solution jet. Figure 9 shows sectional view of the modified curved dissector with high pressure hydro jet delivery facility at the working tip of the instrument. Figure 10 shows one of the preferred embodiments of canula tip provided with holes and brush. Figure 11 shows the preferred embodiment of canula tip with brush on both sides. Description of the preferred embodiment with reference to the figures. While this invention is susceptible of embodiment in many different forms, there is shown in the drawing and will herein be described in detail a preferred embodiment of the invention. It should be understood, however that the present disclosure is to be considered as an exemplification of the principles of the invention and is not intended to limit the invention to the embodiment illustrated. The precise shapes and sizes of the components of the device 8s instrument of the system herein described are not essential unless otherwise mentioned. The particular shapes and sizes are shown to the best illustrate the 7 principles of the invention. The preferred components of the system of this invention is illustrated in Fig.2. In Fig 02 the different components have been identified with reference numerals as shown & described below: A Metal sealed normal saline or isotonic salt solution glass bottle. Al Level of normal saline/isotonic salt solution in the glass bottle. Bl Horizontal portion of the L-shaped metal inlet pipe. B2 T-extension of the horizontal portion B1 B3 Vertical portion of the L-shaped metal inlet pipe. B4 Sharp end of the metal inlet pipe. B5 Water trap'. C Rubber bulb. Cl One-way valve. El Rubber tube-connector. E2 Metal tube-connector. F Pressure gauge. Fl Tube connector of the pressure gauge with the B2 extension of the inlet pipe. H Vertical portion of the metal outlet pipe. H1 Sharp end of metal outlet pipe. H2 Horizontal portion of the metal outlet pipe. Ol Synthetic pipe. 8 In Fig 03 the different components have been identified by reference letters as indicated below: Rl Release valve (screw type) S1 Stopcock. S2 Stopcock. T Air filter. V1 One-way valve. Rest all are same as Fig. 02. A commercially available medical grade normal saline/ isotonic salt solution glass bottle (A) with an airtight rubber cap sealed with a metal strip is hung upside down. There are two depressions in the central portion of this metal sealed rubber cap through which an inlet pipe (B3) and a outlet pipe (H) entering are inserted for their respective functions respectively. The inlet metal pipe (B3) is L-shaped. The sharp edge (B4) of the vertical portion pierces the rubber cap through one of the holes and reaches the top of the inverted glass bottle above the level of the Normal saline/isotonic salt solution. The terminal end of the horizontal portion (Bl) is attached to a metal pipe connector (E2) with the help of a rubber tube connector (El). An air inflation rubber bulb (C) with a one-way valve (Cl) is connected to the other end of the metal pipe connector (E2). A pressure gauge (F) is attached to the T-extension of metal inlet pipe (B3) with the help of a pipe line (Fl). The vertical portion of the inlet pipe (B3) is extended downwards to act as a water trap' (B5) which collects the normal saline/isotonic salt solution that enters into the vertical portion of the inlet pipe during its insertion in to the normal saline/isotonic salt solution glass bottle before its tip reaches above the level of fluid. The outlet metal pipe (H) is also L-shaped. The sharp edge of the small vertical portion (H1) pierces the other hole of the metal sealed rubber cap and reaches just above the cap. The horizontal portion (H2) is attached to a synthetic pipe (Ol) of suitable diameter, which is ultimately connected to the hand-instruments of the system, subject of matter of invention, for delivering the hydro-jet to the operation site. In another preferred embodiment of the invention, the following additional attachments are added to the device details of which has been shown in Fig. 3 where as: One release valve (screw type) R1 is connected to the rubber bulb (C) and with the rubber tube-connector (El). One one-way valve (V1) is attached to the terminal end of the Bl portion of the metal inlet pipe. The rubber tube-connector (El) here is to be connected to the other end of the valve (V1). This one-way valve (V1) allows the air to enter the metal inlet pipe and thus into the sealed normal saline glass bottle (A) but prevents its escape. 10 One air filter (T) is attached to the pipeline (Fl) connecting the B2 extension of the metal inlet pipe to the pressure gauge (F). One stopcock (S1) is attached to the B2 extension of the L-shaped metal inlet pipe or the connector (Fl) before being connected to the pressure gauge (F). With this stopcock, the pressure gauge may be disconnected functionally from the air inlet metal pipe when necessary. One stopcock (S2) is attached to the horizontal portion (H2) of the outlet metal pipe before it is ultimately connected to the synthetic pipe (Ol) which finally delivers the high pressure hydro jet to the invented hand instruments. The Hand-instrument of this system has been shown in Fig. 04 where zero degree blunt & straight tip hydro-dissection canula is used: - Different components, which have been shown by the reference numerals, are as follows: 1. Zero degree blunt and straight tip of the canula. 2. Shaft (non-insulated) of the canula. 3. Threaded end of the canula to be attached to the rotary / trumpet type valve (Hub) 4. Threaded connector with canula. 5. Three way valve / stopcock (roller type). 6. Selection lever - the lever in one extreme position opens up one channel 11 and in opposite extreme position opens up the other channel while in the 'mid' position closes both the channels. 7 & 8. Channels to connect with the high-pressure normal saline / isotonic salt solution jet line and sucker machine. 9. Trumpet valve. 10. Spring housing at the bottom of the valve (inside). 11. Lever - when pressed the valve opens up the channel and when the pressure is released the spring pushes up the valve and closes the channel. 12. Connector to high pressure normal saline/isotonic salt solution jet pipe line. V2. Rotary valve (three way). V3. Trumpet type valve attachment with the canula. In this canula, the tip is straight and smooth circumferentially. The opening of the canula tip (1) is made by transecting it vertically so that it looks straight. This has been described as 'zero degree opening'. The various sizes of canula gauges may be used, however 14 G / 16 G is preferred. Tip of the canula (1) is connected to a comparatively wider (5 mm OD) shaft (2) which is non-insulated. Hence, diathermy current is not safe while using this canula. Other end of the shaft (2) is connected to the hub (3) which has got a 12 thread inside. This can be threaded to a conventional three-way rotary valve (V2) or to a conventional trumpet valve (V3) as depicted in fig. 04. While using a rotary valve (three way) V2, inlet 7 & 8 is connected to the high pressure normal saline jet line and suction line, respectively, and the outlet 4 is threaded to the canula. The lever 6 can manipulate this rotary valve so that either the high-pressure saline jet is passed through the H.D. canula or the suction line is opened to suck the fluid inside the abdomen, through the canula. The lever may also be placed in-between these two options to stop both the functions. If a trumpet type valve (V3) is used one valve is enough for the H.D. canula. Here the valve is loaded in a metal jacket where there is a spring beneath the valve (10) and the lever (11) on the other side of the valve. Normally, the spring with in the housing (10) pushes the valve up so that the hole through the valve is not in the same alignment as that of the normal saline jet pipeline (12). Once the valve is pushed down by pressing the lever (11) the hole in the valve comes in the same alignment as that of the normal saline jet pipeline and thus the normal saline passes through the canula. 13 Description of Hydro-dissection (H.D.) canula with Diathermy current application facility has has been provided with reference to figure 5 where as like reference letter/ numerals are same as figure 04 further other components are as follows: 1. Same as fig. 04. 3. Hub of the canula. 13. Insulated shaft (sparing the tip) 14. Diathermy connector. 14a. Alternative site for Diathermy connector. 15. Detachable tip with screw type attachment. V3, V4. Same as fig. 04. Here, the shaft of the canula (except the tip) is insulated. The Diathermy connector (14) is fitted to the hub (3) of the canula. Alternatively, it (14a) may be fitted to the rotary valve (V2) which is threaded with the canula. Connection of this insulated shaft (13) may be detachable (threaded) or fixed by welding etc. Various types of canula tips are necessary according to the different surgical situations, personal preferences of the surgeons and additional mechanical advantages. So, in further modification of this type of canula, different types of detachable tips have been designed. Here, as shown in fig. 06, working tip of 14 the H.D. canula (1) can be threaded to the shaft of the canula (13) with the help of the male and female threading (15). Fig.06 describes the different types of detachable tips for Hydro-dissection (H.D.) canula with Diathermy current application facility. These are as follows: 06/a Zero degree, blunt and straight canula tip. 1. Non-insulated Zero degree, blunt and straight tip. 13a Insulated shaft. 15. Screw type attachment with the rest of the shaft. 06/b Forty-five degree blunt and straight canula tip. 16. Non-insulated Forty-five degree blunt and straight tip. 13a, 15 Same as above. 06/c Zero degree, blunt and curved canula tip. 17a Zero degree, blunt and curved tip. 13a, 15 Same as above. 06/d Forty-five degree blunt and curved canula tip. 17b Forty-five degree blunt and straight tip. 13a, 15 Same as above. 08 /e Hydro-dissection spatula - side view. 18 Oval, small non-insulated plate attached with the tip. 16 Forty-five degree, blunt and straight tip. 15 06/f Hydro-dissection spatula - front view. 18 Oval, small non-insulated plate attached with the tip. 16 Forty-five degree, blunt and straight tip. 06/g Hydro-dissection hook with zero degree, blunt, straight canula tip. 1 Zero degree, blunt, straight tip. 19 Small hook like projection attached with the wall of the canula tip. 06/h Hydro-dissection Hook with forty-five degree, blunt, straight canula tip. 16 Forty-five degree, blunt, straight tip. 19,13,15 Same as above. 06 / i Hydro-dissection brush with smooth and blunt closed canula tip and side holes. 60 Smooth & blunt closed tip 61 Side holes through which the Hydro-jet is delivered at the operating site. 62 Brush attached near the tip of the canula. 13a & 15 Same as above. 06 / j Hydro-dissection brush with Zero degree, blunt and curved canula tip. 62, 17a, 13a & 15 Same as above. 16 Every detachable working tip as shown in fig. 06 has got a non-insulated working tip (1, 16, 17a, 18, 19), a small insulated shaft (13a) and thread (15) at the other end that can be screwed to the main shaft of the canula (13). Various types of working tips which are useful in delivering high pressure normal saline jet to the tissues are shown in fig. 06. Fig. 07 describes composite high pressure saline jet Hydro-dissection (H.D.) canula with Diathermy current application facility and rotary / trumpet valve control: The Caiula shaft comprises: 20 Curved, blunt, non-insulated H.D. canula tip. 21 Straight, blunt, non-insulated H.D. canula tip. 22 Outer insulated suction canula. 23 Knurled tip of canula 22. The Canula hub comprises: 24a Lever for ejection or retrieval of curved H.D. canula 20. 24b Lever for ejection or retrieval of straight H.D. canula 21. 25a Slots to lock lever 24a at desired H.D. canula position. 25b Slots to lock lever 24b at desired canula position. 17 26 Silicon rubber pipe connecting the H.D. canulae to the Rotary valve (28). 27 Suction pipe line connecting suction canula 22 with the stopcock (29). 28 Rotary valve with selection mode. 29 Stopcock attached with suction pipe line. 30 Diathermy connector. 31 High pressure normal saline jet pipe line Connector. 32 Suction pipeline connector. Cross-sectional view of the hub-canula junction comprises: 20, 21 Curved and straight H.D. canula. 27 Suction pipe line, 33 Silicon rubber rings. 34 Outer insulated suction canula. This composite high-pressure saline jet hydro-dissection canula consists of a canula shaft and a canula hub. The outer insulated wider canula (22) contains two narrower H.D. canula (20 & 21) inside it. The outer wider canula (22) is insulated through out and contains a knurled area (23) near its operating tip. One of the inner narrower H.D, canula is zero degree, blunt tipped, curved (20) and the other is zero degree, blunt tipped, straight (21). With the help of the 18 levers on the hub (24a, 24b), the desired canula can be ejected out from within the outer canula (22) to act as the operating tip and can also be retrieved by the reverse movement of the levers. Both the H.D. canula (20, 21) are non-insulated and can be used as a diathermy electrode. The desired H.D. canula (20, 21) with straight or curved operating tip may be ejected out for hydro-dissection along with the use of monopolar diathermy for cutting or coagulation of the vessels and tissues. The wider canula (22) can be used to suck out the collected fluid / fumes from inside the body cavity. The knurled surface near the operating tip of the canula (22) can be used for blunt dissection. The hub-canula junction as shown in fig 07 contains two silicon rubber rings (33) through which the H.D. canula (20, 21) passes. These rubber rings fits snuggly around the canulae to prevent the leakage of gas without compromising the axial movement facility of the canulae. Beside the two rubber rings (33) there is a wide 'D'-shaped area which depicts the suction pipeline (27). On the either side of the hub there are two levers (24a, 24b). These levers are connected with the H.D. canulae inside the hub and projects beyond the surface of the hub through a longitudinal slit. By moving the levers back and forth, the H.D. canulae can be moved forwards or backwards. On either end of these slits, there are two small slots (25a, 25b) where the levers can be locked. 19 The H.D. canulae (20, 21) are connected to a rotary valve (28) with two silicon rubber pipes (26). These rubber pipes are long enough to allow extreme forward movement of the canulae (20, 21) with the help of the levers (24a, 24b). The rotary valve (28) is connected to the high pressure saline jet pipeline with the help of the connector 31. This rotary valve (28) has got three positions that can be selected with the help of the lever (28a) projecting from the surface of the hub. By rotating the lever and selecting, the saline jet may be passed through either of the H.D. canulae 20 / 21 or may be totally stopped from flowing through either of the canulae. The sue'ion pipeline (27) is attached to a stopcock (29) so that the suction can be controlled as per the requirement with the help of a lever (29a) projected on the surface of the hub. The other end of the stopcock (29) is connected to the suction machine with the help of the connector 32. A diathermy connector (30) is attached to the hub so that a monopolar diathermy cable can be connected to this hand-instrument. The whole of the outer surface of the hub except the diathermy connector (30), levers (24a, 24b) and margins of the slots (25a, 25b) is insulated by a non-conductor coating. 20 Fig. 08 describes the modified composite high pressure saline jet Hydro-dissection (H.D.) canula with Diathermy current application facility and roller type stopcock control on saline jet. The different components have been shown whereas: 35 Slots on the inner walls of the slits. 36 Horizontal separators on either side of the interior of the hub. 37a, 37b Rollers. 38 T-type metal connector. Others - same as fig. 07. Description of canula part, carmla-hub junction, levers (24a, 24b) with the H.D. canulae, slits on the hub surface, the slots (25a, 25b) to lock the levers and suction pipeline (27) with Intervening stopcock (29) control are same as that described in fig. 07 (composite high pressure saline jet Hydro-dissection (H.D.) canula with Diathermy current application facility and rotary / trumpet valve control) In this, the hub contains a T-type metal connector (38). The longitudinal limb of this metal connector (38) is connected to the high-pressure hydro jet pipeline with the help of the connector (31). 21 The transverse limb of the metal connector (38) pierces the horizontal separator (36) on either side. On the outer side of the horizontal separators (36), there are two connectors, which are connected to the H.D. canulae (20, 21) with the help of silicon rubber pipelines. Length of these silicon rubber pipe lines are kept redundant so as to allow extreme forward movement of the H.D. canulae (20, 21). Rollers (37a, 37b) are partially projected outside the surface of the hub through the longitudinal slits. These rollers have axles in the center. The inner wall of the slits contains slots (35) where the axles of the rollers are fitted. Thus, the rollers move forwards and backwards along the longitudinal slits on the hub. As depicted in fig. 08 this part of the hub, which contains the slots to accommodate the rollers, are oblique. Hence, the rollers at their extreme forward position compresses the silicon rubber pipe against the horizontal separators (36) of the hub to obliterate the lumen completely so that the saline jet cannot reach the H.D. canulae (20, 21). The rollers in the extreme backward position create no compression over the silicon rubber pipelines and hence, allow the saline jet to pass through them. 22 Fig. 09 is the description of modified curved dissector with high pressure saline jet delivery facility at the working tip. These are as follows: 40 Scissors type handle. 41 Slot to accommodate and lock the globular end of the push-rod. 42 Push-rod - globular end attached with the handle and the other end attached to the working jaw of the instrument (46). 43 Screw to fix the body of the scissors type handle to the canula 52. 44 Rotator attached to the canula. 45 Shaft of the instrument (insulated canula). 45a Insulation over the shaft of the canula. 46 Mobile jaw of the instrument tip. 47 Fixed jaw of the instrument tip. 48 Opening of the hydro-dissection (H.D.) channel. 49a H.D. channel attachment to the canula deep to its insulation. 49b H.D. channel attachment to the rotator and stopcock. 50 Stopcock. 50a Lever attachment to the stopcock. 51 Connector for the high-pressure hydro jet pipe line. 52 Canula. 53 'Apposition lock' with the shaft of the canula 45 which allows rotation of the shaft. 54 Diathermy connector. 23 One of trie types of the conventional curved dissector consists of a scissors type handle (40) having a slot (41) as depicted in fig. 09. This slot accommodates the globular end of the push rod (42) but allows its free rotational movement. The body of the handle is fixed with the help of a screw (43) to a canula (52) through which the push-rod passes. A diathermy connector (54) is also attached to the body of the handle. This canula (52) is connected to the shaft of the instrument (45) with the help of an 'apposition lock' (53)s which allows its free rotation. A convenient size rotator (44) is attached to the shaft of the instrument (45) so that the shaft of the instrument along with its working tip (46, 47) can be rotated freely with the index finger while the thumb and the ring finger operates the scissors type handle. The canula (45) which forms the shaft of the instrument, is insulated throughout (45a) except at the working tip, the hinge joint and the push rod. The other working tip (48) is fixed with the canula shaft (45). The abc ve-mentioned instrument has been modified as herein described: A 14 / 16 gauge metal pipeline (H.D. channel, 49a, 49b) is attached along the shaft of the instrument (45) deep to its insulation (45a). Distaliy, this canula is also attached to the surface of the fixed jaw of the instrument tip (48) where it opens near the tip. The tip of this hydro-dissection canula (49a) is either blunt & curved or blunt & straight. The proximal end of this H.D. canula (49b) 24 passes through the rotator as depicted in fig, 09 and comes out to the surface after a bend. Once it comes out to the surface, it is connected to a stopcock (50), which can be operated by a lever (50a) with the help of the index finger. The stopcock (50) is connected to the high pressure normal saline / isotonic salt solution jet pipeline with the help of a connector (51). Thus, the high pressure normal saline" / isotonic salt solution jet from the above said device (fig, 02) may pass through the stopcock (50) when it is open, then pass through the H.D. normal saline / isotonic salt solution jet channel (49b, 49a) embedded inside the rotator (44), shaft of the instrument (45) deep to its insulation (45a), ultimately to be delivered through the tip at the surface of the fixed jaw (47) of the operating tip. We claim:- The hydro dissection system for surgery particularly in laparoscopic surgery comprising of a device for production of high pressure hydro-jet or normal saline/isotonic salt solution and hand instruments, connected with the said device, for controlled delivery of high pressure hydro jet to the operation site in order to facilitate dissection of tissues, the pressure being regulated according to the nature of the tissues to be dissected with or without monopolar diathermy current application facility, wherein the device consisting of normal saline / isotonic salt solution bottle in which vertical portion of the L shaped inlet pipe is inserted for controlled entry of air to create the air pressure by the rubber bulb connected at the end of the horizontal portion of the inlet pipe, the said air pressure can be measured in the pressure gauge which is connected with the horizontal portion of the L shaped inlet pipe through the T-extension and vertical portion of the L-shaped outlet pipe is inserted to the said bottle wherein horizontal portion is connected to the valve of the hand instrument for controlled delivery of normal saline/ isotonic salt solution to the operative site through the different types of canulae having various detachable canula tips. 2. The hydro dissection system for surgery as claimed in claim 1 wherein said canula is provided with monopolar diathermy current application facility. 26 3. The hydro dissection system for surgery as claimed in claim 1 wherein the horizontal portion (Bl) of the L-shaped inlet pipe is connected to the rubber bulb (C) through the rubber tube (El) one end of which connected to screw type release valve (Rl) wherein other end of the rubber tube connected to the one way valve (VI) for controlling the entry of air inside the inlet pipe and rubber bulb (C) is connected to release valve (Rl) at one end whereas other end connected to one way valve (Cl) - ref. fig 02, 03. 4. The hydro dissection system as claimed in claim 1 wherein T-extension of horizontal portion of inlet pipe connected to the pressure gauge (F) and provided with air filter (T) and stop cock (SI) for filtering and controlling the air in the pressure gauge - ref. fig 03. 5. The hydro dissection system as claimed in claim 1 wherein a stop cock (S2) is provided to the horizontal portion of outlet pipe for controlling the flow of saline to the hand instrument (fig. 03). 6. The hydro dissection system as claimed in claim 1 wherein canula tip (1) of the canula of the hand instrument is connected to comparatively wider non insulator shaft (2) which is connected to the hub (3) having inside thread for connecting with three way rotary valve (V2) with the controlling lever (6) or with a trumpet valve (V3) for controlling the flow of the hydro jet - ref. Fig 04. 7. The hydro dissection system as claimed in claim 1 & 6 wherein shaft (13; fig. 05) of the canula is insulated and diathermy current application facility (14) is fitted to the hub - ref. Fig 05. 27 8. The hydro dissection system as claimed in claim 1 & 7 wherein diathermy application facility (14a) is optionally fitted to the rotary valve / trumpet valve thread ably connected to the canula - ref. Fig. 05. 9. The hydro dissection system as claimed in claim 1 &7 wherein small tip portion of the canula is non-insulated (1) and remaining portion provided with thread to main shaft. Wherein the canula shaft except the small tip portion of the canula is insulated and on small tip portion is detachable with screw type threading (15) or like - ref. Fig 05. 10. The hydro dissection system as claimed in claim 9 wherein the detachable portion of the canula tip (1) is zero degree blunt and straight for delivering the high-pressure saline to the tissue as required - ref. Fig. 06 / a. 11. The hydro dissection system as claimed in claim 9 wherein the detachable portion of the canula tip is Forty-five degree blunt and straight for delivering the high-pressure saline to the tissue as required - ref. Fig. 06 / b. 12. The hydro dissection system as claimed in claim 9 wherein the detachable portion of the canula tip is Zero degree, blunt and curved 28 for delivering the high pressure saline to the tissue as required- ref. Fig. 06 / c. 13. The hydro dissection system as claimed in claim 9 wherein the detachable portion of the canula tip is forty-five degree blunt and curved for delivering the high-pressure saline to the tissue as required - ref. Fig. 06/d. 14. The hydro dissection system as claimed in claim 9 wherein the detachable portion of the canula tip is hydro-dissection spatula for delivering the high-pressure saline to the tissue as required - ref. Fig. 06 / e & f. 15. The hydro dissection system as claimed in claim 9 wherein the detachable portion of the canula tip is hydro-dissection hook with zero degree, blunt, straight for delivering the high pressure saline to the tissue as required - ref. Fig. 06 / g. 16. The hydro dissection system as claimed in claim 9 wherein the detachable portion of the canula tip is hydro-dissection hook with forty- five degree, blunt, straight for delivering the high pressure saline to the tissue as required - ref. Fig. 06 / h. 29 17. The hydro dissection system as claimed in claim 9 wherein the detachable portion of the canula tip is hydro dissection brush (62) with smooth and blunt closed canula tip (60) with side holes (61) - ref. Fig. 06 18. The hydro dissection system as claimed in claim 9 wherein the detachable portion of the canula tip is hydro dissection brush (62) with zero degree, blunt and curved canula tip (17a) - ref. Fig. 06 / j. 19. The hydro dissection system as claimed in claim 1 wherein the hand instrument comprising wider canula shaft (2) and a canula hub(3); inside the wider canula two narrower canulae (20, 21) are situated which are connected to the rotary valve (28) with two silicon rubber pipes (26) through which normal saline jet passes to the narrower canula which is ejectable for hydro dissection along with the use of monopolar diathermy for cutting or coagulation of the vessels and tissue - ref. Fig. 07. 20. The hydro dissection system as claimed in claim 19 wherein the wider canula shaft is insulated throughout the entire length and having a knurled area (23) near its operating tip for blunt dissection - ref. Fig. 07. 21. The hydro dissection system as claimed in claim 19 wherein one of the inner narrower canula is zero degree, blunt tipped, curved (20) whereas 30 other one is zero degree, blunt tipped, straight (21) and both are non insulated and capable of being used as diathermy electrode - ref. Fig. 07. 22. The hydro dissection system as claimed in claim 19 wherein on the either side of the hub two levers, lockable at the small slots (25a, 25b), are provided controlling the longitudinal movement of narrower canula and one of the said canulae is ejected at one time according to the requirement of the operation site - ref. Fig. 07. 23. The hydro dissection system as claimed in claim 19 hub canula junction provided with two silicon rubber rings (33) for passing two narrower canulae (20, 21) to prevent leakage of gas and 'D' shaped area is for passage of section pipeline (27) - ref. Fig. 07. 24. The hydro dissection system as claimed in claim 23 wherein the suction pipeline (27) is connected to a stopcock (29) for controlling the section - ref. Fig. 07. 25. The hydro dissection system as claimed in claim 19 wherein hub contains a T-type metal connector (38) which pierces the horizontal separator (36) on either side, whereas on the outer side of the horizontal separator two connecter are fitted for connecting to the canula (20, 21) with silicon rubber pipelines (26) - ref. Fig. 08. 26. The hydro dissection system as claimed in claim 19 wherein rollers (37a, 37b) are situated outside the surface of the hub, in the longitudinal slit having slots (35) with centrally located axles - ref. Fig. 08. 27. The hydro dissection system as claimed in claim 26 wherein part of the hub, connecting the slot is oblique for controlling the flow of hydro jet into the canula - ref. Fig. 08. 28. The hydro dissection system wherein conventional curved dissector is provided with a 14/16 gauge metal pipeline (49a, 49b fig. 09) along the shaft of the instrument (45) and attached to the surface of the fixed jaw of instrument tip (48) where it opens near the tip which is either blunt & curved or blunt & straight. 29. The hydro dissection system as claimed in claim 28 wherein the proximal end of hydro dissection canula (49b), which passes through the rotator (44), is connected to a stopcock (50) which is attached to the high pressure normal saline jet pipe line by a connector (51) - ref. Fig. 09. 30. The hydro dissection system for surgery, particularly for laparoscopic surgery substantially as herein described with reference to the drawing. The hydro dissection system for surgery, particularly in laparoscopic surgery, comprising of a device for production of high pressure hydro-jet of normal saline/isotonic salt solution and hand instruments, connected with the said device, for controlled delivery of high pressure hydro jet to the operation site in order to facilitate dissection of tissues, the pressure being regulated according to the nature of the tissues to be dissected with or without monopolar diathermy current application facility, wherein the device consisting of medical grade normal saline / isotonic salt solution bottle in which vertical portion of the L shaped inlet pipe is inserted for controlled entry of air to create the air pressure by the rubber bulb connected at the end of the horizontal portion of the inlet pipe, the said air pressure can be measured in the pressure gauge which is connected with the horizontal portion of the L shaped inlet pipe through the T-extension and vertical portion of the L- shaped outlet pipe is inserted to the said bottle wherein horizontal portion is connected to the valve of the hand instrument for controlled delivery of normal saline/isotonic salt solution to the operative site through different types of canulae. Various detachable canula tips have been designed for also getting mechanical advantage during tissue dissection in different surgical situations. Apart from the controlled delivery of normal saline / isotonic salt solution to the operation site, some of the canulae can also be used for dispersing the tissues by scrubbing and sucking out the collected fluid / fumes from inside the body cavity.

Documents:

00196-kol-2004 abstract.pdf

00196-kol-2004 claims.pdf

00196-kol-2004 description(complete).pdf

00196-kol-2004 drawings.pdf

00196-kol-2004 form-1.pdf

00196-kol-2004 form-18.pdf

00196-kol-2004 form-2.pdf

00196-kol-2004 letters patent.pdf