Endoscopic cholangiogram guide instrument and method of use

A guide instrument for presenting a second instrument to a biliary duct as part of a laparoscopic cholangiographic surgical procedure, said instrument comprising:

• (a) a gasping forceps component comprising:
• (i) an elongate shaft extending along a longitudinal axis between a first and a second end;
• (ii) a pair of jaws being positioned at said first end of said shaft and mutually pivotally coupled thereat for movement between an opened and a closed orientation for selectively grasping said duct;
• (iii) an actuator positioned at said second end of said shaft and coupled in a drive relationship with said jaws for moving said jaws between said open orientation and said closed orientation;
• and
• (b) an elongate, generally cylindrical guide tube slidably supported along said longitudinal axis of said elongate shaft having an internal instrument channel therethrough, said instrument channel having a central axis spaced radially from said longitudinal axis and extending between an input end for receiving the second instrument and an output end for expressing the second instrument from said guide tube, said guide tube being rotatable about said longitudinal axis to define with the central axis of said instrument channel a first confrontation radius for presenting the second instrument expressed from the output end of said instrument channel to said biliary duct at a select confrontation angle as said duct is grasped between the jaws of said grasping forceps component.

A method for cannulating a biliary duct with a flexible catheter as part of a laparoscopic cholangiographic surgical procedure, said method comprising the steps of:

• (a) providing a guide instrument comprising:
• (i) a grasping forceps component comprising:
• an elongate shaft extending along a longitudinal axis between a first and a second end;
• a pair of jaws positioned at said first end of said shaft and mutually pivotally coupled thereat for movement between an opened and a closed orientation for selectively grasping said duct;
• and
• an actuator positioned at said second end of said shaft and coupled in a drive relationship with said jaws for moving said jaws between said opened orientation and said closed orientation;
• and
• (ii) an elongate, generally cylindrical guide tube slidably supported on said longitudinal axis of said elongate shaft having an internal catheter channel therethrough, said catheter channel having a central axis spaced radially from said longitudinal axis and extending between an input end for receiving the catheter and an output end for expressing the catheter from said guide tube, said guide tube being rotatable about said longitudinal axis to define with the central axis of said catheter channel a first confrontation radius for presenting the catheter expressed from the output end of said catheter channel to said biliary duct at a confrontation angle effective for cannulating said duct as said duct is grasped between the jaws of said gasping forceps component;
• (b) grasping said biliary duct between the jaws of said grasping forceps component;
• (c) directing the catheter of said guide instrument through the catheter channel of the guide tube to express the catheter from the output end thereof;
• (d) rotating the guide tube about the longitudinal axis of the elongate shaft of the gasping forceps component to present the catheter expressed from the output end of said guide tube to said biliary duct at a confrontation angle effective for cannulating said duct;
• and
• (e) inserting the catheter into said duct for its cannulation.