Energy discharging surgical probe and surgical process having distal energy application without concomitant proximal movement

A process for surgery utilizing a probe, said probe being a multichannel probe of sufficient rigidity to be insertable in a narrow entrance of an operating site, and without side-to-side and up and down manipulation accommodate blunt dissection of anatomical structures without incising them, said probe having an operating portion for insertion to a position within a patient and a proximal controlling portion for insertion and withdrawal of said probe from a position exterior of said patient, said operating portion having a closed blunt non dissecting tip and a cavity axially displaced behind said tip and shielded thereby for location to said operating site, said probe further having a vision device disposed at said cavity, said vision device having a field of view at said cavity when said probe is within said patient and including a conduit to the proximal manipulation portion for transmitting a view from said cavity of said non dissecting tip to said position exterior of said patient, said probe having a non penetrating conduit for energy discharge for transection, incision or treatment from the proximal controlling portion of said probe exterior of said patient to said operating site of said non dissecting tip within said patient, and said probe having means disposed at a distal end of said non dissecting tip for controlling a relative direction of the energy discharging conduit relative to an operating space of said tip within the field of view of said viewing device, said means enabling change of relative direction of said energy discharging conduit with respect to said operating space behind said non dissecting tip, said process including a series of steps comprising:

• inserting said probe to said operating site thus creating a space between tissues in the body of sufficient dimension to facilitate the surgery without interference from collapse of the tissues about said probe, said axial insertion continuing until said cavity behind said non dissecting tip is at said operating site;
• visualizing said operating site with said optical viewing device;
• supplying said non penetrating conduit with energy discharge for transection, incision or treatment to said operating site during said visualization step;
• and
• manipulating said non penetrating conduit through said means for manipulating said energy discharging conduit in treatment at said operating site without concomitant proximal side-to-side manipulation of said probe at said proximal controlling portion of said probe.

A probe apparatus for surgery in an operating site having narrow substantially non manipulable entrance confines inhibiting side-to-side motion of said probe comprising:

• a probe defining at least one interior conduit having an opening at a distal end, said distal end being insertable into said entrance;
• a closed blunt non dissecting tip attached to an end of said probe including means for creating a space between tissues in the body of sufficient dimension to facilitate the surgery without interference from collapse of the tissues about said probe;
• an optical viewing device within said probe, said optical viewing device providing visualization of said space for providing a field of view of said space;
• a non penetrating conduit for energy discharge for transection, incision or treatment at said operating site, said conduit working within said space at said end of said probe behind said closed blunt non-dissecting tip and terminating in said field of view of said optical viewing device for the discharge of said energy;
• means for supplying energy to said non penetrating conduit for energy discharge for transection, incision or treatment at said operating site;
• and
• means for viewing disposed to said end of said probe during the discharge of energy from said conduit;
• said means for defining a space including an expansible and contractible shield mounted to said blunt non dissecting tip of said probe, said shield being movable between a collapsed disposition conformed along a side of said probe to an expanded disposition with respect to said side of said probe whereby said shield may be collapsed with respect to said probe during insertion and expanded when said shield is at said operating site to define said space behind said blunt non-dissecting tip;
• and
• means for expanding and contracting said shield attached to said probe.

A probe apparatus for surgery in an operating site having narrow substantially non manipulable entrance confines inhibiting side-to-side motion of said probe comprising:

• a probe having a closed blunt non dissecting tip at a distal end, said blunt non dissecting tip having means for creating a space between tissues in the body of sufficient dimension to facilitate the surgery without interference from collapse of the tissues about the probe;
• said probe defining at least one interior conduit having an opening at said means for defining a space;
• a suction entrance defined in said space;
• an optical viewing device within said probe, said optical viewing device providing visualization of into said space behind said closed blunt non dissecting tip of said probe for providing a field of view at said end of said probe;
• a non penetrating conduit for energy discharge for transection, incision or treatment at said operating site within said probe, said conduit protruding to the suction entrance at said end of said probe and terminating in said field of view of said optical viewing device for the discharge of said energy;
• means for supplying energy to said non penetrating conduit for energy discharge for transection, incision or treatment at said operating site;
• and
• means for manipulating said non penetrating conduit for energy discharge for transection, incision or treatment with respect to said end of said probe overlying said suction entrance in the view of said optical device at said operating site.