# US 2019/0167299 A1 · Cannula with proximally mounted camera

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- Number: US 2019/0167299 A1
- Document ID: US20190167299A1
- Status: Published application
- Kind: A1
- Application number: 15/576,536
- Filed: 2017-08-17
- Published: 2019-06-06
- Earliest claimed: 2016-08-17
- Assignees: Rebound Therapeutics Corporation
- Applicants: Rebound Therapeutics Corporation
- Inventors: Peter G. DAVIS; Ross TSUKASHIMA; Jeffrey J. VALKO; Michael R. HENSON; Todd MCINTYRE
- Web page: https://patentgrep.com/patent/US20190167299A1

## CPC

- A61B 17/3421: {Cannulas}
- A61B 1/000094: {extracting biological structures}
- A61B 1/04: combined with photographic or television appliances
- A61B 1/06: with illuminating arrangements
- A61B 1/313: for introducing through surgical openings, e.g. laparoscopes
- A61B 1/3132: {for laparoscopy}
- A61B 90/10: for stereotaxic surgery, e.g. frame-based stereotaxis
- A61B 90/35: Supports therefor
- A61B 90/361: {Image-producing devices, e.g. surgical cameras}
- A61B 17/3494: {with safety means for protection against accidental cutting or pricking, e.g. limiting insertion depth, pressure sensors (for the peridural space A61B17/3401)}
- A61B 2017/00026: {Conductivity or impedance, e.g. of tissue}
- A61B 2017/00035: {pH}
- A61B 2017/00221: {with wireless transmission of data, e.g. by infrared radiation or radiowaves}
- A61B 2017/00455: {Orientation indicators, e.g. recess on the handle}
- A61B 2017/00907: {for light}
- A61B 2017/3454: {Details of tips}
- A61B 2034/2055: {Optical tracking systems}
- A61B 2090/064: {for measuring force, pressure or mechanical tension}
- A61B 2090/0811: {for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument}
- A61B 2090/103: {Cranial plugs for access to brain}
- A61B 2090/306: {using optical fibres}
- A61B 2090/309: {using white LEDs}
- A61B 2090/3618: {with a mirror}
- A61B 2090/363: {Use of fiducial points}
- A61B 2090/373: {using light, e.g. by using optical scanners}
- A61B 2090/3937: {Visible markers}
- A61B 2090/3966: {Radiopaque markers visible in an X-ray image}
- A61B 2090/3983: {Reference marker arrangements for use with image guided surgery}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

A cannula system and method for accessing a blood mass in the brain. The system comprises a cannula with a camera mounted on the proximal end of the cannula with a view into the cannula lumen and the surgical field below the lumen. A prism, reflector or other suitable optical element is oriented between the camera and the lumen of the cannula to afford the camera a view into the cannula while minimizing obstruction of the lumen. The system may also include an obturator with a small diameter shaft and a large diameter tip which is optically transmissive, so that a surgeon inserting or manipulating the assembly can easily see that the obturator tip is near brain tissue (which is white) or blood (which is red).

## Claims

### Claim at position 1

1-87. (canceled)

### Claim 88

A method of accessing a blood mass in the brain of a patient, said method comprising:
providing a cannula system comprising:
a cannula comprising a cannula tube with a proximal end and a distal end and a lumen extending from the proximal end to the distal end; and
a camera secured to the proximal end of the cannula, with a portion of the camera overhanging and partially obstructing the lumen;
an obturator comprising a shaft having a proximal end and a distal end, and an obturator tip disposed on the distal end of said shaft, said tip being optically transmissive, and having a proximal surface and a tapered distal surface, said obturator being slidable within the cannula tube, and positionable within the cannula tube such that the proximal end of the shaft extends proximally out of the cannula proximal end while the tapered distal surface extends out of the cannula distal end; with the obturator in the cannula such that the tip is disposed in the distal end of the cannula, with the tapered distal surface extending from the distal end of the cannula;
inserting the cannula obturator into the brain, to advance the cannula distal end and obturator tip toward the blood mass; and
viewing, on a display, an image of the proximal surface of the tip, while advancing the cannula distal end and obturator tip into the brain.

### Claim 89 (depends on 88)

The method of claim 88 further comprising:
advancing the cannula distal end and obturator tip into the brain until the blood mass is visible through the obturator tip, and thereafter removing the obturator from the cannula while leaving the cannula disposed within the brain, with the distal end of the cannula proximate the blood mass.

### Claim 90 (depends on 88)

The method of claim 88 further comprising:
advancing the cannula distal end and obturator tip into the brain along a first axis until the blood mass is visible through the obturator tip, and thereafter tilting the cannula and obturator to move the cannula distal end and obturator tip transversely relative to said first access until brain tissue is visible through the obturator tip, to determine a lateral margin of the blood mass.

### Claim 91 (depends on 88)

The method of claim 88 further comprising:
advancing the cannula distal end and obturator tip into the brain along a first axis until the blood mass is visible through the obturator tip, and thereafter further advancing the cannula distal end and obturator tip into the brain along the first axis until the brain tissue is visible through the obturator tip, to determine an axial margin of the blood mass.

### Claim 92

A method for imaging a surgical field in a patient's brain comprising the steps:
providing a cannula system for accessing a surgical field, said cannula comprising:
a cannula comprising a cannula tube with a proximal end and a distal end and a lumen extending from the proximal end to the distal end; and
a camera secured to the proximal end of the cannula, wherein said camera is translatable from a first position in which the camera extends into the lumen or a cylindrical space defined by the lumen of the cannula tube and extending therefrom, to a second position in which the camera resides outside of the lumen or the cylindrical space defined by the lumen of the cannula tube;
moving the camera to the second position;
inserting an obturator with a proximal end and a distal end through the cannula lumen;
inserting the distal end the cannula and the distal end of the obturator into the patient's brain;
removing the obturator;
moving the camera to the first position;
operating the camera to obtain an image of the surgical field.

### Claim 93

A method for imaging a surgical field in a patient's brain comprising the steps:
providing a cannula having a cannula tube with a distal end and a proximal end and a central lumen to permit access to the surgical field;
providing a camera movably secured to the proximal end of the cannula wherein the imaging system comprises:
an imaging sensor;
a prism to direct light from the surgical field to the image detector;
providing a light source secured to the distal end of the cannula for illuminating the surgical field;
inserting an obturator through the cannula lumen;
inserting the distal end the cannula and obturator into the patient's brain;
removing the obturator;
turning on the light source; and
orienting the camera to obtain a view of the surgical field; and
operating the camera to obtain an image of the surgical field.

### Claim 94 (depends on 92)

The method of claim 92, further comprising the step of:
inserting a surgical instrument through the cannula tube, into the surgical field, while the camera is in the first position.

### Claim 95 (depends on 92)

The method of claim 92, further comprising the step of:
inserting a surgical instrument through the cannula tube, into the surgical field, while the camera is oriented to obtain a view of the surgical field.

### Claim at position 10

96-97. (canceled)