CA2022964C - Locking trocar sleeve - Google Patents
Locking trocar sleeveInfo
- Publication number
- CA2022964C CA2022964C CA002022964A CA2022964A CA2022964C CA 2022964 C CA2022964 C CA 2022964C CA 002022964 A CA002022964 A CA 002022964A CA 2022964 A CA2022964 A CA 2022964A CA 2022964 C CA2022964 C CA 2022964C
- Authority
- CA
- Canada
- Prior art keywords
- sleeve
- hinges
- seal
- outer sleeve
- invention defined
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Lifetime
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B2017/348—Means for supporting the trocar against the body or retaining the trocar inside the body
- A61B2017/3492—Means for supporting the trocar against the body or retaining the trocar inside the body against the outside of the body
Abstract
An improved trocar sleeve is disclosed for use in laparoscopic surgery. The sleeve is provided with an expanded mushroom hinge at the first end of the sleeve inserted into the abdominal cavity. The mushroom hinge can be expanded within the abdominal cavity to abut against the inner surface of the abdominal wall to hold the sleeve in place. A split seal having a concave shape facing the first end of the trocar sleeve is provided to prevent loss of pressurized gas from within the abdominal cavity through the sleeve as the pressure of the gas itself urges the first and second seal lips on opposite sides of the slit in the seal into sealing engagement.
Description
-28705 2 0 ~ ~9 6 LOCKING TROCAR SLEEVE
TECHNICAL FIELD
The present invention relates in general to medical devices and more particularly relates to an improved trocar sleeve which can be inserted a short distance into the abdominal cavity and expanded to prevent the sleeve from sliding in and out of the incision.
_J _ 2 2022~6~
BACKGROUND OF THE INVENTION
In the past few years, laparoscopic surgery has become increasingly important and widespread. In the past, when doing surgery within the abdominal cavity, a large incision through the abdominal wall was required to permit the surgeon to adequate view the area to be operated on. The development of the laparoscope, a small telescope utilizing fiber optic technology, allows the surgeon to view a cite to be operated on within the abdominal cavity with an incision only large enough to insert the laparoscope. With such a small incision required, laparoscopic surgery reduces the risk of infection to the patient and the extent of -trauma to the body during the surgery. The surgery also reduces the chance of adhesions resulting from exposure of the interior of the body, a relative common occurrence in prior surgery.
In conducting laparoscopic surgery, a small incision is typically cut through the abdominal wall for insertion of a cannula. Pressurized carbon dioxide gas passes through the cannula to inflate the abdomen to create voids for passage of the laparoscope. After inflation, the cannula is removed.
A trocar, or sharp pointed instrument, is then used to form an incision through the abdominal wall which will be used for insertion of the laparoscope. A
trocar sleeve is concentric with the trocar, with only the sharp end of the trocar exposed from the trocar sleeve. Thus, when the trocar is inserted through the abdomen wall, a first end of the trocar sleeve is pushed through the abdomen wall into the abdominal cavity. The trocar is withdrawn from both the abdomen and trocar sleeve, leaving the first end of the trocar sleeve within the abdominal cavity. The laparoscope, or other suitable apparatus, can then be inserted 202296~
through the interior of the trocar sleeve into the abdominal cavity. One example of a trocar assembly is disclosed in U.S. Patent No. 4,601,710 issued July 22, 1986.
While such techniques have proven useful, several disadvantages remain. The trocar sleeve has a tendency to slide in and out of the incision in the abdominal wall, particularly when the surgeon is trying to move the laparoscopic instrumentation through the interior of the trocar sleeve into or out of the abdominal cavity. Further, seals are provided in the passage through the trocar sleeve to prevent the carbon dioxide gas from escaping the abdominal cavity. It is often -difficult and time consuming to force the laparoscopic instrumentation or other device past these seals into the abdominal cavity. Therefore, a need exists for an improved apparatus and method for performing such laparoscopic surgery.
SUMMARY OF THE INVENTION
In accordance with one aspect of the invention there is provided an improved assembly used to transport an endoscopic instrument through an incision in a patient's body, while minimizing loss of gas used to inflate the body cavity during endoscopic procedures, the assembly comprising: a housing; an outer sleeve extending from the housing, with a plurality of hinges to expand radially within the cavity to resist withdrawal; an inner sleeve concentric with, and having a portion secured to, the outer sleeve to transport an endoscopic instrument; an outer sleeve having a proximate portion movable relative to the inner sleeve to expand or retract the hinges; actuator means to move one of the sleeves relative to the other, with user detectable detent means to signal a change in the radial position of the hinges by change in user feel; seal means to prevent gas flow through the interior of the assembly from the body cavity; stop means to engage the exterior of the body to cooperate with the hinges when expanded to resist movement of the assembly and to minimize loss of gas between the outer sleeve and the incision.
In accordance with another aspect of the invention there is provided an improved assembly used to transport instruments through an incision in a patient's body, while preventing loss of gas used to inflate the body cavity during endoscopic procedures, the assembly comprising: a housing; an outer sleeve extending from the housing and having a plurality of radially expandable and retractable hinges adapted for insertion through the incision and expansion within the body cavity to prevent withdrawal; an inner sleeve concentric with the outer sleeve, with a portion secured to the outer sleeve distally of the hinges and with a sealed passage for insertion or removal of an endoscopic instrument without loss of gas from the body cavity; the outer sleeve having a proximate portion above the hinges able to move relative to the inner sleeve to expand or retract the hinges; an actuator coupled to at least one of the sleeves to move one of the sleeves relative to the other to retract or expand the hinges, and having position changes to indicate the status of the hinges, including detent that signal position by a change in user feel; at least one seal element disposed in the housing to prevent liquid or gas flow through the inner sleeve from the body cavity; a movable stop member disposed around the outer sleeve to engage the exterior of the body to cooperate with the expanded hinges to resist movement of the assembly and to prevent the loss of gas between the outer sleeve and the incision.
In accordance with yet another aspect of the present invention, a method for inserting a trocar sleeve through the abdominal wall for laparoscopic surgery is provided.
The method includes the step of forming an incision through the abdominal cavity with a trocar and passing a first end of a trocar sleeve into the abdominal cavity. The first end of the trocar sleeve having a first external dimension for passage through the incision. The method further includes the step of expanding a portion of the first end within the abdominal cavity so that the external diameter of the first end within the cavity is expanded to a larger, second external dimension to abut the inner surface of the abdominal wall about the incision to resist withdrawal of the trocar sleeve from the abdominal cavity.
202~96~
BRIEF DESCRIPTION OF THE DRAWINGS
Further features and advantages of the invention will become more apparent from the following Detailed Description and illustrated in the accompanying drawings, in which:
FIGURE 1 is a side view of a trocar sleeve forming a first embodiment of the present invention prior to expansion;
FIGURE 2 is a side view of the trocar sleeve after expansion of the mushroom hinge;
FIGURE 3 is a side view of a trocar used with the trocar sleeve;
FIGURE 4 is a perspective view of a seal within the -trocar sleeve;
FIGURE 5 is an illustrative view of a first modification of the trocar sleeve where an expanding sponge is used; and FIGURE 6 is an illustrative view of a second modification of the trocar sleeve where an inflatable balloon is used.
7 2U2~96g~
DETAILED DESCRIPTION
with reference now to FIGURES 1-3, a trocar sleeve 10 forming a first embodiment of the present invention is illustrated. With the assistance of a trocar 12, seen in FIGURE 3, a first end 14 of the sleeve 10 is inserted through an incision 16 in the abdominal wall 18 of a patient. The trocar 12 is inserted through passage 26 in the trocar sleeve so that only the sharp pointed end 13 extends from the first end 14 of sleeve 10. The pointed end of trocar 12 then is pushed through the abdominal wall along with first end 14.
The sleeve 10 is secured therein by expansion of a mushroom hinge 20 which abuts the inside surface 22 of the abdominal wall about the incision 16 to prevent premature withdrawal of the trocar sleeve. After removal of trocar 12, laparoscopic instruments and the like can be inserted into the abdominal cavity 24 through passage 26 in the trocar sleeve 10.
With reference to FIGURES 1 and 2, the trocar sleeve 10 can be seen to include an inner cylindrical metal sleeve 28 and a concentric outer cylindrical plastic sleeve 30 preferably of polypropylene. The sleeves 28 and 30 are bonded or fastened together at the first end 14. Near the first end 14, the outer plastic sleeve 30 defines mushroom hinge 20 with a series of living hinges 32 about the circumference of the sleeve 30 separated by elongated slits 34. An outer elastic coating or sleeve 36, preferably of latex, overlies the living hinges 32 and slits 34 to cover the mushroom hinge 20. Coating or sleeve 36 insures that no body tissue is trapped between portions of the mushroom hinge, particularly when contracting the hinge for removal of the sleeve 10 from the patient.
At end 38 of the trocar sleeve opposite the first end, the metal sleeve 28 has a series of openings 40.
A plastic end member 42 is secured to the metal sleeve 28 at end 38 by latches 44 received in the openings 40.
A plastic seal retaining cap 46 is, in turn, secured to the end member 42 by latches 48 on the cap.
An O.D. seal 50, a split seal 52, and a pack ring 54 are confined between the end member 42 and cap 46 to prevent the pressurized gas within the abdominal cavity from escaping through the passage 26 in the metal sleeve 28 as will be described hereinafter. Seals 50 and 52 are preferably of silicon rubber.
A handle 58 is secured to the outer plastic sleeve 30 at end 38. A coil spring 60 acts between the end member 42 and the handle 58 to urge the handle 58 toward the first end of the trocar sleeve.
In the configuration illustrated in FIGURE 1, the coil spring 60 is held in a compressed state between the end member 42 and the handle 58 as resilient latches 62 on the end member 42 are in contact with an end surface 64 of the handle.
A latch release 66 is received about the outer plastic sleeve 30 for movement relative the sleeve 30.
The latch release 66 can be seen to have a conical camming surface 68 which can be moved into engagement with the ends of latches 62 to deflect the latches inward toward the axis 70 of the trocar sleeve 10. The latch release 66 can be activated by the surgeon directly, or, as an alternative, by providing a mechanism whereby withdrawal of the trocar after inserting the sleeve through incision 16 activates the latch release. The latches 62 will be deflected inward enough to release the handle 58 from the end member 42, which permits the spring 60 to expand to the position shown in FIGURE 2. As the spring expands, the spring 202296~
g forces the handle 58, and attached outer plastic sleeve 30, toward the first end relative to the end member 42 and inner metal sleeve 28. This causes the portions of the plastic sleeve 30 at the living hinges to bend and expand the mushroom hinge 20, as seen in FIGURE 2. It can be readily understood that the expanded mushroom hinge abuts the inside surface 22 of the abdominal wall 18 to resist removal of the trocar sleeve.
A dense rubber foam stop 72 can be frictionally engaged with the outer plastic sleeve 30. When the mushroom hinge has been expanded, the stop 72 can be slid downward along the plastic sleeve 30 toward the first end to contact the outer surface 74 of the abdominal wall 18 to resist movement of the trocar sleeve into the abdominal cavity.
It can be readily understood that the trocar sleeve 10 provides a stable platform for insertion of a laparoscopic instrument or the like through the sleeve 10 into the abdominal cavity through passage 56. The expanded mushroom hinge 20 also forms a good seal with the patient's abdominal wall 18 to prevent CO2 loss.
Any tendency for the trocar sleeve 10 to move relative the abdominal wall as the instrument is being inserted or removed will be greatly reduced by the expanded mushroom hinge 20 and stop 72.
When the trocar sleeve 10 is to be removed from the patient, surface 46A is pressed towards the handle 58 at surface 58A in a manner similar to a syringe to collapse the mushroom hinge 20 and compress the spring 60 until the latches 62 again latch against surface 64 of the handle 58 to allow removal of the trocar sleeve.
The mushroom hinge 20 can be collapsed and removed without having to move stop 72.
with reference now to FIGURES 1, 2 and 4, the mechanism for preventing gas from escaping the abdomen 2022g64 through the sleeve 10 will be described. When no laparoscopic instrument is inserted through the trocar sleeve 10, a split seal 52 prevents the escape of gas.
The split seal 52 is formed of a resilient material which has a concave curvature facing the first end 14 of the trocar sleeve. A slit 76 is formed in the split seal which forms a first seal lip 78 and a second seal lip 80 on opposite sides of the slit 76. With the concave shape, the pressurized gas within the abdominal cavity acts to force the lips 78 and 80 together to form a tight seal to prevent the gas escape. When an instrument in inserted in end 38 of the trocar sleeve 10, the resilient lips 78 and 80 simply deflect away from the instrument, permitting the instrument to pass through the passage and into the abdominal cavity.
The O.D. seal 50 forms a seal against the outer cylindrical surface of an instrument as the instrument is inserted into the passage 26 of trocar sleeve 10.
With the combination of the O.D. seal 50 and split seal 52, very little gas is lost as instruments are inserted and removed from the trocar sleeve 10.
With reference to FIGURE 5, a first modification of the trocar sleeve 10 is illustrated. In the first modification, an expanding sponge 90 replaced the mushroom hinge 20 at the first end of the trocar sleeve iO. ~he sponge 90 can be expanded in a manner similar to the mushroom hinge 20 to hold the trocar sleeve within the abdominal cavity.
With reference to FIGURE 6, a second modification of trocar sleeve 10 is illustrated. In the second modification, an inflatable balloon 92 is mounted at the first end of the trocar sleeve which can be inflated to an expanded condition to secure the trocar sleeve within the abdominal cavity.
11 202296~
The sleeve 10 of the present invention reduces the frictional forces encountered by laparoscopic instruments being inserted into or removed from the sleeve as compared to prior designs. One reason for this advantage is that the entire sleeve 10 can be made shorter than past designs which required a longer length to insert through the abdominal wall to resist accidental removal of the sleeve from the patient.
Another reason for the friction reduction is the use of efficient seals 50 and 52.
The trocar 12 can be used to automatically expand mushroom hinge 20 as the trocar is removed from sleeve 10. One possible mechanism for this is illustrated in -FIGURES 2 and 3. A lever 100 can be pivoted to trocar 12 about hinge 106 and urged outwardly by a spring 104, The lever will be retracted into the trocar 12 as the trocar is inserted into the sleeve 10 to place the sleeve 10 through incision 16. When the trocar is removed from sleeve 10, the lever extends outward in the direction of arrow 108 through a slot 102 in the sleeve so that the lever 100 contacts latch release 66.
Further movement of trocar 12 would cause the release 66 to move upward and deploy the mushroom hinge. The lever 100 can be mounted to retract back into trocar 12 in the direction of arrow 110 after sufficient force has been exerted on trocar 12 to move release 66 to allow the trocar to be removed from sleeve 10.
In one possible construction of a sleeve in accordance with the teachings of the present invention, the inner diameter of the sleeve could be about 5 to 6 mm. with the diameter of the expanded hinge about 0.845 inches. The stroke of the sleeve 30 to activate the hinge could be 3/8 inches and sleeve 36 could be 10 mils thick.
12 202~964 While the preferred embodiment of the present invention has been described in detail and shown in the accompanying drawings, it will be evident that various further modifications and uses not illustrated are possible without departing from the scope of the invention.
TECHNICAL FIELD
The present invention relates in general to medical devices and more particularly relates to an improved trocar sleeve which can be inserted a short distance into the abdominal cavity and expanded to prevent the sleeve from sliding in and out of the incision.
_J _ 2 2022~6~
BACKGROUND OF THE INVENTION
In the past few years, laparoscopic surgery has become increasingly important and widespread. In the past, when doing surgery within the abdominal cavity, a large incision through the abdominal wall was required to permit the surgeon to adequate view the area to be operated on. The development of the laparoscope, a small telescope utilizing fiber optic technology, allows the surgeon to view a cite to be operated on within the abdominal cavity with an incision only large enough to insert the laparoscope. With such a small incision required, laparoscopic surgery reduces the risk of infection to the patient and the extent of -trauma to the body during the surgery. The surgery also reduces the chance of adhesions resulting from exposure of the interior of the body, a relative common occurrence in prior surgery.
In conducting laparoscopic surgery, a small incision is typically cut through the abdominal wall for insertion of a cannula. Pressurized carbon dioxide gas passes through the cannula to inflate the abdomen to create voids for passage of the laparoscope. After inflation, the cannula is removed.
A trocar, or sharp pointed instrument, is then used to form an incision through the abdominal wall which will be used for insertion of the laparoscope. A
trocar sleeve is concentric with the trocar, with only the sharp end of the trocar exposed from the trocar sleeve. Thus, when the trocar is inserted through the abdomen wall, a first end of the trocar sleeve is pushed through the abdomen wall into the abdominal cavity. The trocar is withdrawn from both the abdomen and trocar sleeve, leaving the first end of the trocar sleeve within the abdominal cavity. The laparoscope, or other suitable apparatus, can then be inserted 202296~
through the interior of the trocar sleeve into the abdominal cavity. One example of a trocar assembly is disclosed in U.S. Patent No. 4,601,710 issued July 22, 1986.
While such techniques have proven useful, several disadvantages remain. The trocar sleeve has a tendency to slide in and out of the incision in the abdominal wall, particularly when the surgeon is trying to move the laparoscopic instrumentation through the interior of the trocar sleeve into or out of the abdominal cavity. Further, seals are provided in the passage through the trocar sleeve to prevent the carbon dioxide gas from escaping the abdominal cavity. It is often -difficult and time consuming to force the laparoscopic instrumentation or other device past these seals into the abdominal cavity. Therefore, a need exists for an improved apparatus and method for performing such laparoscopic surgery.
SUMMARY OF THE INVENTION
In accordance with one aspect of the invention there is provided an improved assembly used to transport an endoscopic instrument through an incision in a patient's body, while minimizing loss of gas used to inflate the body cavity during endoscopic procedures, the assembly comprising: a housing; an outer sleeve extending from the housing, with a plurality of hinges to expand radially within the cavity to resist withdrawal; an inner sleeve concentric with, and having a portion secured to, the outer sleeve to transport an endoscopic instrument; an outer sleeve having a proximate portion movable relative to the inner sleeve to expand or retract the hinges; actuator means to move one of the sleeves relative to the other, with user detectable detent means to signal a change in the radial position of the hinges by change in user feel; seal means to prevent gas flow through the interior of the assembly from the body cavity; stop means to engage the exterior of the body to cooperate with the hinges when expanded to resist movement of the assembly and to minimize loss of gas between the outer sleeve and the incision.
In accordance with another aspect of the invention there is provided an improved assembly used to transport instruments through an incision in a patient's body, while preventing loss of gas used to inflate the body cavity during endoscopic procedures, the assembly comprising: a housing; an outer sleeve extending from the housing and having a plurality of radially expandable and retractable hinges adapted for insertion through the incision and expansion within the body cavity to prevent withdrawal; an inner sleeve concentric with the outer sleeve, with a portion secured to the outer sleeve distally of the hinges and with a sealed passage for insertion or removal of an endoscopic instrument without loss of gas from the body cavity; the outer sleeve having a proximate portion above the hinges able to move relative to the inner sleeve to expand or retract the hinges; an actuator coupled to at least one of the sleeves to move one of the sleeves relative to the other to retract or expand the hinges, and having position changes to indicate the status of the hinges, including detent that signal position by a change in user feel; at least one seal element disposed in the housing to prevent liquid or gas flow through the inner sleeve from the body cavity; a movable stop member disposed around the outer sleeve to engage the exterior of the body to cooperate with the expanded hinges to resist movement of the assembly and to prevent the loss of gas between the outer sleeve and the incision.
In accordance with yet another aspect of the present invention, a method for inserting a trocar sleeve through the abdominal wall for laparoscopic surgery is provided.
The method includes the step of forming an incision through the abdominal cavity with a trocar and passing a first end of a trocar sleeve into the abdominal cavity. The first end of the trocar sleeve having a first external dimension for passage through the incision. The method further includes the step of expanding a portion of the first end within the abdominal cavity so that the external diameter of the first end within the cavity is expanded to a larger, second external dimension to abut the inner surface of the abdominal wall about the incision to resist withdrawal of the trocar sleeve from the abdominal cavity.
202~96~
BRIEF DESCRIPTION OF THE DRAWINGS
Further features and advantages of the invention will become more apparent from the following Detailed Description and illustrated in the accompanying drawings, in which:
FIGURE 1 is a side view of a trocar sleeve forming a first embodiment of the present invention prior to expansion;
FIGURE 2 is a side view of the trocar sleeve after expansion of the mushroom hinge;
FIGURE 3 is a side view of a trocar used with the trocar sleeve;
FIGURE 4 is a perspective view of a seal within the -trocar sleeve;
FIGURE 5 is an illustrative view of a first modification of the trocar sleeve where an expanding sponge is used; and FIGURE 6 is an illustrative view of a second modification of the trocar sleeve where an inflatable balloon is used.
7 2U2~96g~
DETAILED DESCRIPTION
with reference now to FIGURES 1-3, a trocar sleeve 10 forming a first embodiment of the present invention is illustrated. With the assistance of a trocar 12, seen in FIGURE 3, a first end 14 of the sleeve 10 is inserted through an incision 16 in the abdominal wall 18 of a patient. The trocar 12 is inserted through passage 26 in the trocar sleeve so that only the sharp pointed end 13 extends from the first end 14 of sleeve 10. The pointed end of trocar 12 then is pushed through the abdominal wall along with first end 14.
The sleeve 10 is secured therein by expansion of a mushroom hinge 20 which abuts the inside surface 22 of the abdominal wall about the incision 16 to prevent premature withdrawal of the trocar sleeve. After removal of trocar 12, laparoscopic instruments and the like can be inserted into the abdominal cavity 24 through passage 26 in the trocar sleeve 10.
With reference to FIGURES 1 and 2, the trocar sleeve 10 can be seen to include an inner cylindrical metal sleeve 28 and a concentric outer cylindrical plastic sleeve 30 preferably of polypropylene. The sleeves 28 and 30 are bonded or fastened together at the first end 14. Near the first end 14, the outer plastic sleeve 30 defines mushroom hinge 20 with a series of living hinges 32 about the circumference of the sleeve 30 separated by elongated slits 34. An outer elastic coating or sleeve 36, preferably of latex, overlies the living hinges 32 and slits 34 to cover the mushroom hinge 20. Coating or sleeve 36 insures that no body tissue is trapped between portions of the mushroom hinge, particularly when contracting the hinge for removal of the sleeve 10 from the patient.
At end 38 of the trocar sleeve opposite the first end, the metal sleeve 28 has a series of openings 40.
A plastic end member 42 is secured to the metal sleeve 28 at end 38 by latches 44 received in the openings 40.
A plastic seal retaining cap 46 is, in turn, secured to the end member 42 by latches 48 on the cap.
An O.D. seal 50, a split seal 52, and a pack ring 54 are confined between the end member 42 and cap 46 to prevent the pressurized gas within the abdominal cavity from escaping through the passage 26 in the metal sleeve 28 as will be described hereinafter. Seals 50 and 52 are preferably of silicon rubber.
A handle 58 is secured to the outer plastic sleeve 30 at end 38. A coil spring 60 acts between the end member 42 and the handle 58 to urge the handle 58 toward the first end of the trocar sleeve.
In the configuration illustrated in FIGURE 1, the coil spring 60 is held in a compressed state between the end member 42 and the handle 58 as resilient latches 62 on the end member 42 are in contact with an end surface 64 of the handle.
A latch release 66 is received about the outer plastic sleeve 30 for movement relative the sleeve 30.
The latch release 66 can be seen to have a conical camming surface 68 which can be moved into engagement with the ends of latches 62 to deflect the latches inward toward the axis 70 of the trocar sleeve 10. The latch release 66 can be activated by the surgeon directly, or, as an alternative, by providing a mechanism whereby withdrawal of the trocar after inserting the sleeve through incision 16 activates the latch release. The latches 62 will be deflected inward enough to release the handle 58 from the end member 42, which permits the spring 60 to expand to the position shown in FIGURE 2. As the spring expands, the spring 202296~
g forces the handle 58, and attached outer plastic sleeve 30, toward the first end relative to the end member 42 and inner metal sleeve 28. This causes the portions of the plastic sleeve 30 at the living hinges to bend and expand the mushroom hinge 20, as seen in FIGURE 2. It can be readily understood that the expanded mushroom hinge abuts the inside surface 22 of the abdominal wall 18 to resist removal of the trocar sleeve.
A dense rubber foam stop 72 can be frictionally engaged with the outer plastic sleeve 30. When the mushroom hinge has been expanded, the stop 72 can be slid downward along the plastic sleeve 30 toward the first end to contact the outer surface 74 of the abdominal wall 18 to resist movement of the trocar sleeve into the abdominal cavity.
It can be readily understood that the trocar sleeve 10 provides a stable platform for insertion of a laparoscopic instrument or the like through the sleeve 10 into the abdominal cavity through passage 56. The expanded mushroom hinge 20 also forms a good seal with the patient's abdominal wall 18 to prevent CO2 loss.
Any tendency for the trocar sleeve 10 to move relative the abdominal wall as the instrument is being inserted or removed will be greatly reduced by the expanded mushroom hinge 20 and stop 72.
When the trocar sleeve 10 is to be removed from the patient, surface 46A is pressed towards the handle 58 at surface 58A in a manner similar to a syringe to collapse the mushroom hinge 20 and compress the spring 60 until the latches 62 again latch against surface 64 of the handle 58 to allow removal of the trocar sleeve.
The mushroom hinge 20 can be collapsed and removed without having to move stop 72.
with reference now to FIGURES 1, 2 and 4, the mechanism for preventing gas from escaping the abdomen 2022g64 through the sleeve 10 will be described. When no laparoscopic instrument is inserted through the trocar sleeve 10, a split seal 52 prevents the escape of gas.
The split seal 52 is formed of a resilient material which has a concave curvature facing the first end 14 of the trocar sleeve. A slit 76 is formed in the split seal which forms a first seal lip 78 and a second seal lip 80 on opposite sides of the slit 76. With the concave shape, the pressurized gas within the abdominal cavity acts to force the lips 78 and 80 together to form a tight seal to prevent the gas escape. When an instrument in inserted in end 38 of the trocar sleeve 10, the resilient lips 78 and 80 simply deflect away from the instrument, permitting the instrument to pass through the passage and into the abdominal cavity.
The O.D. seal 50 forms a seal against the outer cylindrical surface of an instrument as the instrument is inserted into the passage 26 of trocar sleeve 10.
With the combination of the O.D. seal 50 and split seal 52, very little gas is lost as instruments are inserted and removed from the trocar sleeve 10.
With reference to FIGURE 5, a first modification of the trocar sleeve 10 is illustrated. In the first modification, an expanding sponge 90 replaced the mushroom hinge 20 at the first end of the trocar sleeve iO. ~he sponge 90 can be expanded in a manner similar to the mushroom hinge 20 to hold the trocar sleeve within the abdominal cavity.
With reference to FIGURE 6, a second modification of trocar sleeve 10 is illustrated. In the second modification, an inflatable balloon 92 is mounted at the first end of the trocar sleeve which can be inflated to an expanded condition to secure the trocar sleeve within the abdominal cavity.
11 202296~
The sleeve 10 of the present invention reduces the frictional forces encountered by laparoscopic instruments being inserted into or removed from the sleeve as compared to prior designs. One reason for this advantage is that the entire sleeve 10 can be made shorter than past designs which required a longer length to insert through the abdominal wall to resist accidental removal of the sleeve from the patient.
Another reason for the friction reduction is the use of efficient seals 50 and 52.
The trocar 12 can be used to automatically expand mushroom hinge 20 as the trocar is removed from sleeve 10. One possible mechanism for this is illustrated in -FIGURES 2 and 3. A lever 100 can be pivoted to trocar 12 about hinge 106 and urged outwardly by a spring 104, The lever will be retracted into the trocar 12 as the trocar is inserted into the sleeve 10 to place the sleeve 10 through incision 16. When the trocar is removed from sleeve 10, the lever extends outward in the direction of arrow 108 through a slot 102 in the sleeve so that the lever 100 contacts latch release 66.
Further movement of trocar 12 would cause the release 66 to move upward and deploy the mushroom hinge. The lever 100 can be mounted to retract back into trocar 12 in the direction of arrow 110 after sufficient force has been exerted on trocar 12 to move release 66 to allow the trocar to be removed from sleeve 10.
In one possible construction of a sleeve in accordance with the teachings of the present invention, the inner diameter of the sleeve could be about 5 to 6 mm. with the diameter of the expanded hinge about 0.845 inches. The stroke of the sleeve 30 to activate the hinge could be 3/8 inches and sleeve 36 could be 10 mils thick.
12 202~964 While the preferred embodiment of the present invention has been described in detail and shown in the accompanying drawings, it will be evident that various further modifications and uses not illustrated are possible without departing from the scope of the invention.
Claims (12)
1. An improved assembly used to transport an endoscopic instrument through an incision in a patient's body, while minimizing loss of gas used to inflate the body cavity during endoscopic procedures, the assembly comprising:
a housing;
an outer sleeve extending from the housing, with a plurality of hinges to expand radially within the cavity to resist withdrawal;
an inner sleeve concentric with, and having a portion secured to, the outer sleeve to transport an endoscopic instrument;
an outer sleeve having a proximate portion movable relative to the inner sleeve to expand or retract the hinges;
actuator means to move one of the sleeves relative to the other, with user detectable detent means to signal a change in the radial position of the hinges by change in user feel;
seal means to prevent gas flow through the interior of the assembly from the body cavity;
stop means to engage the exterior of the body to cooperate with the hinges when expanded to resist movement of the assembly and to minimize loss of gas between the outer sleeve and the incision.
a housing;
an outer sleeve extending from the housing, with a plurality of hinges to expand radially within the cavity to resist withdrawal;
an inner sleeve concentric with, and having a portion secured to, the outer sleeve to transport an endoscopic instrument;
an outer sleeve having a proximate portion movable relative to the inner sleeve to expand or retract the hinges;
actuator means to move one of the sleeves relative to the other, with user detectable detent means to signal a change in the radial position of the hinges by change in user feel;
seal means to prevent gas flow through the interior of the assembly from the body cavity;
stop means to engage the exterior of the body to cooperate with the hinges when expanded to resist movement of the assembly and to minimize loss of gas between the outer sleeve and the incision.
2. The invention defined by claim 1 wherein the actuator means includes biasing means operative between a hinge expansion position, wherein the hinges are in an expanded state, and a hinge retraction position, wherein the hinges are in a retracted state.
3. The invention defined by claim 2 wherein the seal means further comprises an O.D. seal to seal against gas flow between the inner sleeve and the endoscopic instrument.
4. The invention defined by claim 3 wherein the seal means further comprises a closure seal to seal against gas flow through the inner sleeve when the endoscopic instrument is removed from the assembly.
5. The invention defined by claim 4 wherein the stop means comprises a dense, foam rubber annular ring to movably engage the outer sleeve.
6. The invention defined by claim 2 wherein the biasing means includes a spring acting between said inner and outer sleeve.
7. An improved assembly used to transport instruments through an incision in a patient's body, while preventing loss of gas used to inflate the body cavity during endoscopic procedures, the assembly comprising:
a housing;
an outer sleeve extending from the housing and having a plurality of radially expandable and retractable hinges adapted for insertion through the incision and expansion within the body cavity to prevent withdrawal;
an inner sleeve concentric with the outer sleeve, with a portion secured to the outer sleeve distally of the hinges and with a sealed passage for insertion or removal of an endoscopic instrument without loss of gas from the body cavity;
the outer sleeve having a proximate portion above the hinges able to move relative to the inner sleeve to expand or retract the hinges;
an actuator coupled to at least one of the sleeves to move one of the sleeves relative to the other to retract or expand the hinges, and having position changes to indicate the status of the hinges, including detent that signal position by a change in user feel;
at least one seal element disposed in the housing to prevent liquid or gas flow through the inner sleeve from the body cavity;
a movable stop member disposed around the outer sleeve to engage the exterior of the body to cooperate with the expanded hinges to resist movement of the assembly and to prevent the loss of gas between the outer sleeve and the incision.
a housing;
an outer sleeve extending from the housing and having a plurality of radially expandable and retractable hinges adapted for insertion through the incision and expansion within the body cavity to prevent withdrawal;
an inner sleeve concentric with the outer sleeve, with a portion secured to the outer sleeve distally of the hinges and with a sealed passage for insertion or removal of an endoscopic instrument without loss of gas from the body cavity;
the outer sleeve having a proximate portion above the hinges able to move relative to the inner sleeve to expand or retract the hinges;
an actuator coupled to at least one of the sleeves to move one of the sleeves relative to the other to retract or expand the hinges, and having position changes to indicate the status of the hinges, including detent that signal position by a change in user feel;
at least one seal element disposed in the housing to prevent liquid or gas flow through the inner sleeve from the body cavity;
a movable stop member disposed around the outer sleeve to engage the exterior of the body to cooperate with the expanded hinges to resist movement of the assembly and to prevent the loss of gas between the outer sleeve and the incision.
8. The invention defined by claim 7 wherein the actuator means includes biasing means operative between a hinge expansion position, wherein the hinges are in an expanded state, and a hinge retraction position, wherein the hinges are in a retracted state.
9. The invention defined by claim 8 wherein the seal element further comprises an O.D. seal to seal against gas flow between the inner sleeve and the endoscopic instrument.
10. The invention defined by claim 9 which further comprises a closure seal to seal against gas flow through the inner sleeve when the endoscopic instrument is removed from the assembly.
11. The invention defined by claim 10 wherein the stop member comprises a dense, foam rubber annular ring to frictionally and slidably engage the outer sleeve.
12. The invention defined by claim 8 wherein the biasing means includes a spring acting between said inner and outer sleeve.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US07/440,199 US5122122A (en) | 1989-11-22 | 1989-11-22 | Locking trocar sleeve |
| US440,199 | 1989-11-22 |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CA2022964A1 CA2022964A1 (en) | 1991-05-23 |
| CA2022964C true CA2022964C (en) | 1995-02-21 |
Family
ID=23747834
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA002022964A Expired - Lifetime CA2022964C (en) | 1989-11-22 | 1990-08-09 | Locking trocar sleeve |
Country Status (4)
| Country | Link |
|---|---|
| US (1) | US5122122A (en) |
| EP (1) | EP0432363B1 (en) |
| CA (1) | CA2022964C (en) |
| DE (1) | DE69023212T2 (en) |
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-
1989
- 1989-11-22 US US07/440,199 patent/US5122122A/en not_active Expired - Lifetime
-
1990
- 1990-08-09 CA CA002022964A patent/CA2022964C/en not_active Expired - Lifetime
- 1990-08-10 EP EP90115357A patent/EP0432363B1/en not_active Expired - Lifetime
- 1990-08-10 DE DE69023212T patent/DE69023212T2/en not_active Expired - Lifetime
Also Published As
| Publication number | Publication date |
|---|---|
| EP0432363A3 (en) | 1991-09-25 |
| EP0432363B1 (en) | 1995-10-25 |
| EP0432363A2 (en) | 1991-06-19 |
| CA2022964A1 (en) | 1991-05-23 |
| US5122122A (en) | 1992-06-16 |
| DE69023212D1 (en) | 1995-11-30 |
| DE69023212T2 (en) | 1996-04-04 |
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| Date | Code | Title | Description |
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| EEER | Examination request | ||
| MKEX | Expiry |