Devices and methods for percutaneous surgery

An apparatus for use in percutaneous surgery, comprising:

• an elongated cannula having a length and defining a first area within said cannula transverse to said length and an outer dimension sized for percutaneous introduction into a patient, said cannula further including a distal working end and an opposite proximal end, said cannula defining a working channel between said ends having a second area substantially equal to said first area and sized for receiving a surgical tool therethrough;
• a viewing element including a lens at a distal end thereof,
• a fixture supporting said viewing element relative to said cannula with said lens disposed adjacent said working end of said cannula, said fixture including:
• a body having means for engaging said viewing element;
• a ring attached to said body, said ring sized to substantially encircle said cannula;
• and
• means for compressing said ring about said cannula whereby said ring grips said cannula to support said fixture thereon.

An apparatus for use in percutaneous surgery, comprising:

• an elongated cannula having a length and defining a first area within said cannula transverse to said length and an outer dimension sized for percutaneous introduction into a patient, said cannula further including a distal working end and an opposite proximal end, said cannula defining a working channel between said ends having a second area substantially equal to said first area and sized for receiving a surgical tool therethrough;
• a viewing element including a lens at a distal end thereof, said viewing element including:
• a proximal end adjacent said proximal end of said cannula;
• an image transmission channel extending from said lens at least to said proximal end;
• an optics cannula carrying said image transmission channel and having an irrigation/aspiration channel extending therethrough;
• and
• a fixture supporting said viewing element relative to said cannula with said lens disposed adjacent said working end of said cannula, said fixture having a body defining an irrigation/aspiration port in communication with said irrigation/aspiration channel when said viewing element is supported by said fixture, said port being connectable to a source of irrigation fluid or aspiration vacuum.

An apparatus for use in percutaneous surgery, comprising:

• an elongated cannula having a length and defining a first area within said cannula transverse to said length and an outer dimension sized for percutaneous introduction into a patient, said cannula further including a distal working end and an opposite proximal end, said cannula defining a working channel between said ends having a second area substantially equal to said first area and sized for receiving a surgical tool therethrough;
• a viewing element including:
• a lens at a distal end thereof;
• an optics cannula having a proximal end fixed to said fixture and a distal end supporting said lens;
• and
• a fixture supporting said viewing element relative to said cannula with said lens disposed adjacent said working end of said cannula, said fixture including a ring slidably mounted for translation along and rotation about said cannula, whereby the position of said lens relative to said distal end of said cannula can be varied by movement of said ring relative to said cannula.

An apparatus for use in percutaneous surgery, comprising:

• an elongated device for defining a working channel at a surgical site, said elongated device having an outer surface defining an outer dimension;
• a viewing element connectable to a viewing apparatus and including a lens at a distal end thereof;
• and
• a fixture supporting said viewing element relative to said elongated device with said lens disposed adjacent said working channel defined by said elongated device, said fixture including means for removably gripping said fixture to said outer surface of said elongated device.

A method for manufacturing an elongated cannula for supporting a viewing device during percutaneous surgery on the spine of a patient, comprising the steps of:

• (a) measuring a distance from the lamina of a spinal vertebra to the skin of the patient;
• (b) determining a first portion of a length of the cannula to be less than the distance measured in step (b), said first portion for introduction into the patient;
• (c) determining a second portion of said length to be about one-fourth (1/4) of the length of said first portion, the second portion external to the patient;
• (d) providing the elongated cannula having the length determined according to steps (b) and (c);
• and
• (e) providing a fixture for supporting the viewing element and means for mounting said fixture on said cannula at the second portion of the cannula.

An apparatus for use in percutaneous surgery, comprising:

• a cannula defining a working channel;
• a viewing element;
• a fixture for supporting said viewing element on said cannula, comprising:
• a body defining an optics bore for supporting a portion of said viewing element;
• a ring attached to said body, said ring sized to substantially encircle said cannula,
• said ring including:
• a pair of adjacent free ends;
• a pair of opposing arms extending from a corresponding one of said free ends and defining a slot therebetween;
• and
• a mechanism connected to said arms and operable to compress said arms toward each other.

An apparatus for use in percutaneous surgery, comprising:

• a cannula defining a working channel therethrough;
• a ring sized to substantially encircle said cannula, said ring including a pair of adjacent free ends and a pair of opposing arms extending from a corresponding one of said free ends, said arms defining a slot extending between said free ends;
• and
• a mechanism connected to said arms operable to compress said arms toward each other.