Surgical Tool With Proximally Mounted Camera For Use With Cannulas

A surgical system for removal of tissue from a surgical workspace with the body of a patient, said system comprising:

• an aspirator tube;
• a vacuum source;
• a wire extending along the aspirator tube and electrically insulated from at least a portion of the aspirator tube;
• an electrode at a distal end of the wire positioned adjacent a distal tip of the aspirator tube;
• and
• a nerve stimulation source electrically coupled to the wire to deliver stimulation signals to tissue adjacent the distal tip.

A method of removing tissue from a surgical workspace within the body of a patient, said method comprising:

• providing an aspirator system comprising
• an aspirator tube, said aspirator tube having a proximal end and a distal end, with a lumen extending from the proximal end to the distal end, a suction port at the distal end, said distal end configured for insertion into the surgical workspace, and a vacuum source connected to the aspirator tube;
• a camera assembly mounted on the proximal end of the aspirator tube, said camera assembly having a viewing axis oriented substantially parallel to the long axis of the distal end of the aspirator tube;
• wherein at least a portion of the aspirator tube comprises an electrical conductor establishing a conductive pathway between the proximal end and the distal end;
• an insulative covering disposed over at least a portion of the surgical tool between the proximal end and the distal end of the aspirator tube, leaving a conductive region of the proximal end of the aspirator tube and a conductive region of the distal end uncovered;
• and
• a nerve stimulation source electrically coupled to the conductive region of the proximal end of the aspirator tube and operable to deliver an electrical stimulation signal through the conductive pathway to the conductive region of the distal end of the aspirator tube for application to tissue adjacent the distal tip;
• and providing monitoring system comprising:
• a sensor configured for attachment to the patient at a region responsive to stimulation of a nerve passing through tissue proximate the distal tip when the distal tip is inserted into a surgical workspace, said sensor operable to detect a biological response to stimulation of said nerve;
• a control system configured to:
• operate the nerve stimulation source to deliver the electrical stimulation signals;
• receive signals picked up by the sensor;
• output a signal to the surgeon (an audible or visual indication) in response to receiving the signals from the sensor indicative of biological response to the stimulation signal;
• placing the sensor on the patient at a region of the patient responsive to stimulation of a nerve;
• inserting the distal end of the aspirator tube into the body of the patient;
• operating the vacuum source to apply suction to the tissue to aspirate tissue from the body;
• operating the control system to deliver an electrical stimulation signal to the tissue, receive signals indicative of biological response to the stimulation signal detected by the sensor, and output a signal to the surgeon in response to receiving signals from the sensor indicative of physiological response to the stimulation signal.