WO2010041900A2

WO2010041900A2 - Port and port assembly for use with tool for minimally invasive surgery, and method of using same port and port assembly

Info

Publication number: WO2010041900A2
Application number: PCT/KR2009/005795
Authority: WO
Inventors: Chang Wook Jeong
Original assignee: Chang Wook Jeong
Priority date: 2008-10-10
Filing date: 2009-10-09
Publication date: 2010-04-15
Also published as: WO2010041900A3; KR20100040633A

Abstract

The present invention relates to port and port assembly for use with an easy-to-control tool for minimally invasive surgery or a surgical robotic system that adopts the principles of the tool for minimally invasive surgery, and a method of using the same.

Description

PORT AND PORT ASSEMBLY FOR USE WITH TOOL FOR MINIMALLY INVASIVE SURGERY, AND METHOD OF USING SAME PORT AND PORT ASSEMBLY

Minimally invasive surgery is a surgical approach that involves use of instruments inserted through several tiny incision openings to perform a surgery causing minimal tissue trauma.

This minimally invasive surgery relatively reduces changes in metabolism of the patient in the period of post-surgical care, so it is beneficial to rapid recovery of the patient. Therefore, using such minimally invasive surgery shortens length of a hospital stay of the patient after the surgery and allows patients to return to normal physical activities more quickly. In addition, minimally invasive surgery causes less pain and reduces scar to patients after surgery.

The most general form of the minimally invasive surgery is endoscopy. Among them, a laparoscopy that involves minimally-invasive inspection and operation inside abdominal cavity is known as the most general form of endoscopy. To operate the standard laparoscopic surgery, an abdomen of the patient is insufflated with gas, and small incisions (about 1/2 inch or less) are formed for use as an entrance of a tool for the laparoscopic surgery, through which a trocar is inserted. In general, laparoscopic surgical tools include a laparoscope (for observation of a surgical site) and other working tools. Here, the working tools are similar in structure to the conventional tools used for small incision surgery, except that the end effector or working end of each tool is separated from its handle by an elongated shaft. For instance, working tools may include a clamp, a grasper, scissors, a stapler, needle holder, and so forth. To perform the surgery, a user, such as a surgeon, puts the working tool into a surgical site through the trocar, and manipulates it from the outside of abdominal cavity. Then, the surgeon monitors the procedure of the surgery through a monitor that displays the image of the surgical site that is taken by the laparoscope. The endoscopic approach similar to this is broadly used in retroperitoneoscopy, pelviscopy, arthroscopy, cisternoscopy, sinuscopy, hysteroscopy, nephroscopy, cystoscopy, urethroscopy, pyeloscopy, and so on.

Although this minimally invasive surgery has a number of advantages, it has shortcomings in the difficulty of approaching the conventional minimally invasive surgical tools to a surgical site and the inconvenient or complicate manipulation of such tools because of an end effector connected to a rigid and long shaft. As attempts to solve the above problems, the present inventor has devised a novel tool for minimally invasive surgery as described in Korean Patent Application Nos. 2008-51248, 2008-61894, 2008-79126 and 2008-90560 filed prior to this application, the contents of which are herein incorporated by reference in their entirety.

In particular, among these applications, the minimally invasive surgical tools disclosed in Korean Patent Application Nos. 2008-79126 and 2008-90560 are very useful in a case where only a single incision is formed in a patient's body to perform surgery. Accordingly, the inventor devised a port for use with the minimally invasive surgical tool described in at least one of the prior applications or with a surgical robotic system which adopts the principles of the tool.

The present invention is directed to solve all of the problems mentioned above.

It is, therefore, an object of the present invention to provide a port suitable for use with a tool for carrying out a minimally invasive surgery in a dexterous and convenient manner with the least number of incisions in a patient's body, most preferably, with only one incision.

As described above, the present invention provides the port suitable for use with a tool for carrying out a minimally invasive surgery in a dexterous and convenient manner with the least number of incisions in a patient's body, most preferably, with only one incision. By the combination use of the two, minimally invasive surgery causes less pain, reduces scar to patients during or after surgery, and shortens length of a hospital stay of the patient after the surgery.

The above and other objects and features of the present invention will become apparent from the following description of preferred embodiments, given in conjunction with the accompanying drawings, in which:

Fig. 1 is a perspective view showing the outer appearance of a port 100 in accordance with a first embodiment of the present invention;

Fig. 2 is a perspective view showing the configuration of a main body 200 in accordance with the first embodiment of the present invention, and Figs. 3 and 4 are a front through view and a top through view of the main body 200 in accordance with the first embodiment of the present invention;

Fig. 5 is a perspective view showing the configuration of a cannula insert part 300 in accordance with the first embodiment of the present invention, and Fig. 6 is a perspective view showing a state where plugs 350 cover cannulas 330 that constitute the cannula insert part 300 in accordance with the first embodiment of the present invention;

Figs. 7, 8 and 9 respectively show a perspective view and a front through view showing the configuration of a plug 350 in accordance with the first embodiment of the present invention;

Figs. 10 and 11 show a perspective view showing an example of configurations to maintain a coupled state between the main body 200 and the cannula insert part 300 in accordance with the first embodiment of the present invention;

Fig. 12 is a perspective view showing another example of configurations to maintain a coupled state between the main body 200 and the cannula insert part 300 in accordance with the first embodiment of the present invention;

Figs. 13 and 14 show a perspective view showing still another example of configurations to maintain a coupled state between the main body 200 and the cannula insert part 300 in accordance with the first embodiment of the present invention;

Figs. 15 and 16 show a perspective view showing an example of configurations of main body 200 and obturator 400 in accordance with the first embodiment of the present invention;

Figs. 17, 18 and 19 are a perspective view showing a state where a plurality of obturators used for the present invention is inserted into the main bodies 200, respectively;

Figs. 20 and 21 show a state where an insert port 100 in accordance with the first embodiment of the present invention is inserted into a patient s abdominal wall and secured with suture;

Fig. 22 shows an example of how a minimally invasive surgical tool 1 and an endoscope 2 are inserted through cannulas 330 in accordance with the first embodiment of the present invention;

Fig. 23 shows another example of how a minimally invasive surgical tool 1 and an endoscope 2 are inserted through cannulas 330 in accordance with the first embodiment of the present invention;

Fig. 24 is a perspective view showing the configuration of an insert port 100A in accordance with a second embodiment of the present invention;

Fig. 25 is a perspective view showing the configuration of a cannula insert part 300A used for the insert port 100A in accordance with the second embodiment of the present invention;

Figs. 26 and 27 show a perspective view and a front through view showing the configuration of the cannula insert part 300A in accordance with the second embodiment of the present invention, respectively;

Fig. 28 is a perspective view showing the configuration of an insert port 100B in accordance with a third embodiment of the present invention;

Fig. 29 is a perspective view showing the configuration of a cannula insert part 300B in accordance with the third embodiment of the present invention; and

Figs. 30 and 31 show a perspective view and a side view showing a state where minimally invasive surgical tools 1 and an endoscope 2 are inserted and operated through an insert port 100A in accordance with the second embodiment of the present invention, respectively.

In accordance with one aspect of the present invention, there is provided a port for minimally invasive surgery comprising, a main body, and a cannula insert part positioned in the main body, having an insert main body and a plurality of cannulas, wherein at least two cannulas of the plurality of cannulas are substantially parallel to each other.

In accordance with another aspect of the present invention, there is provided a method for using the above port for minimally invasive surgery comprising, inserting at least one tool for minimally invasive surgery through at least one of the plurality of cannulas, and inserting at least another tool for minimally invasive surgery through at least another cannula.

In accordance with yet another aspect of the present invention, there is provided a method for using the above port for minimally invasive surgery comprising, inserting an endoscope through the at least one cannula inclined at a predetermined angle, and inserting a tool for minimally invasive surgery through one of the two cannulas substantially parallel to each other.

In the following detailed description, reference is made to the accompanying drawings that show, by way of illustration, specific embodiments in which the invention may be practiced. These embodiments are described in sufficient detail to enable those skilled in the art to practice the invention. It is to be understood that the various embodiments of the invention, although different, are not necessarily mutually exclusive. The following detailed description is, therefore, not to be taken in a limiting sense, and the scope of the present invention is defined only by the appended claims that should be appropriately interpreted along with the full range of equivalents to which the claims are entitled. In the drawings, like reference numerals identify similar or like elements through the several views.

Hereinafter, preferred embodiments of the present invention will be explained in detail with reference to the accompanying drawing so that the invention can easily be carried out by those skilled in the art.

Embodiment I

Fig. 1 is a perspective view showing the outer appearance of a port 100 (hereinafter, referred to as an "insert port" or simply "port") in accordance with a first embodiment of the present invention.

As shown in Fig. 1, the insert port 100 in accordance with the first embodiment of the present invention has a barrel shape of predetermined diameter and length (it should be noted, however, that the shape of the insert port 100 is not always limited to the barrel shape). The insert port 100 includes a main body 200 at least a portion of which is inserted into a patient's body, and a cannula insert part 300 positioned in the main body 200, to which an endoscope, minimally invasive surgical tools, etc., are inserted. In some cases, the insert port 100 may further include an obturator positioned inside the main body 200, for forming an incision, securing a path for inserting a surgical tool, protecting internal organs, and so on. More details on this will be provided below.

Fig. 2 is a perspective view showing the configuration of a main body 200 in accordance with the first embodiment of the present invention, and Figs. 3 and 4 are a front through view and a top through view of the main body 200 in accordance with the first embodiment of the present invention.

A plurality of insert corrugations 210 is protrusively formed at regular intervals, along the outer contour of the main body 200. As shown in Fig. 3, one cross section of the insert corrugation 210 looks close to a right-angled triangle. This allows easy insertion of the main body 200 into a patient's body and for ensuring the inserted main body 200 stay secure inside the patient's body.

A first insert groove 220 of a predetermined depth is formed inside the main body 200. The first insert groove 220 is matched with an insert ring of the cannula insert part 300 to be described later, thereby coupling the main body 200 to the cannula insert part 300. Preferably, the first insert groove 220 and the insert ring are configured in a manner that once they are matched and coupled, they are not easily separated from each other.

In order to help the main body 200 stay inserted into an incision, a plurality of (preferably three) fixing rods 230 are protrusively attached to an upper end of the main body 200. The fixing rods 230 each have a fixing hole 232 at the tip, through which a suture thread is inserted to stitch each of the fixing roads 230 together with the epidermis of the body. In this way, the main body 200 and further, the insert port 100 can be fixed.

Fig. 5 is a perspective view showing the configuration of the cannula insert part 300 in accordance with the first embodiment of the present invention, and Fig. 6 is a perspective view showing a state where plugs 350 cover cannulas that constitute the cannula insert part 300 in accordance with the first embodiment of the present invention. The following is a detailed explanation about the configuration of the cannula insert part 300 with reference with the drawings.

An insert ring 320 which is to be inserted into the first insert groove 220 mentioned above is formed on the outside of an insert main body 310. This allows the main body 200 to couple to the insert main body 310.

Also, a plurality of cannulas 330 is positioned inside the insert main body 310. Preferably, at least part of the plurality of cannulas 330 that are arranged adjacent to or in contact with each other have their central axes substantially parallel to each other. Preferably, the cannulas 330 are sufficiently long for a surgical tool to insert into them and be in position stably.

Since all kinds of surgical tools, such as an endoscope or minimally invasive surgical tools, can be inserted into the cannulas 330, the cannulas 330 come in diverse sizes (diameters) to meet user's needs. Here, the cannulas 330 are preferably made of hard, non-bendable materials to continuously keep their straight barrel shape.

In addition, two or more cannulas 330 are included in the cannula insert part 300. Preferably, the number of cannulas 330 ranges 3 to 5. Figs. 5 and 6 illustrate three cannulas 330 in a bundle.

Meanwhile, after the cannula insert part 300 is placed inside the main body 200, it is desirable to secure the cannula insert part 300 to the body 200 to keep the state. Also, in order to prevent inflow or outflow of gas into or from a patient's body for minimally invasive surgery, the cannulas 330 are coupled to the insert main body 310 in an airtight manner. For example, the plurality of cannulas 330 covered with plugs 350 to be described later is positioned inside the insert main body 310 for the insert port 100 to stay in airtight state. To be more specific, the plurality of cannulas 330 is positioned inside the insert main body 310 in a manner that there is no gap between them and the bottom of the insert main body 310.

At least one cannula 330 out of the plurality of cannulas 330 is provided with a gas supply pipe 340. The gas supply pipe 340 has a cock valve 342 to control an inflow/outflow of gas. More details on this will follow.

As depicted in Fig. 6, each of the plural cannulas 330 is covered by a plug 350 such that gas cannot flow in or flow out through the cannulas having no surgical tool being inserted thereto and foreign matters cannot get into a patient's body either. More details on the configuration of the plug will be given below.

Referring now to Figs. 7, 8 and 9, the plug 350 covers cannula 330, closing one end of the cannula 330. Preferably, the plug 350 is made of flexible materials in double layer to let an endoscope or minimally invasive surgical tools go through it. A slit 352 is formed on each layer of the plug 350 in non-parallel directions (preferably, perpendicular to each other). Preferably, the plug 350 is made of silicon materials excellent in resilience and restoring force. The silicon plugs 350 prevent the inflow/outflow of gas and the intrusion of foreign matters through the cannulas 330 and facilitate the insertion of any kind of surgical tools through the cannulas 330. If necessary, a person skilled in the art may adopt a different gas inflow/outflow prevention mechanism besides the plug 350.

The cannula insert part 300 in accordance with this embodiment may further adopt the following configuration.

While a user conducts surgery, the cannula insert part 300 may rotate inside the main body 200. That is to say, although the cannula insert part 300 is closely coupled to the inside of the main body 200, if an external force that is not quite small is continuously applied, it may rotate. Depending on the type of surgery, it may not be always desirable to make the cannula insert part 300 rotate about the main body 200. To prevent this occurrence if necessary, as shown in Figs. 10 and 11, a linear protrusion 360 may be formed in the outer face of the insert main body 310. Preferably, the linear protrusion 360 is formed over the insert ring 320. Correspondingly, a linear groove 240 may be formed on the inside of the main body 200 to receive the linear protrusion 360. As the linear protrusion 360 is fitted into the linear groove 240, the cannula insert part 300 will not rotate unnecessarily.

A configuration to maintain the coupled state between the cannula insert part 300 and the main body 200 may be an example as shown in Fig. 12. That is, a second insert groove 322 may be formed on the outer face of an insert main body 310 and a fixing ring 324 made of resilient materials is fitted into the second insert groove 322. Thus, when the insert main body 310 is inserted into the main body 200, the fixing ring 324 is inserted into the first insert groove 220 and the second insert groove 322 at the same time, thereby more easily achieving a strong fixation of the cannula insert part 300. Here, the cannula insert part 300 may further include a switch 370 for controlling the restoring force of the fixing ring 324. The first insert groove 220 into which the fixing ring 324 is inserted has a sectional configuration to ensure that the fixing ring 324 is not slipped out accidently after insertion. For example, the first insert groove 220 may have an edged or rounded cross section.

In order to help the cannula insert part 300 stay coupled to the main body 200, as depicted in Figs. 13 and 14, a plurality of support rods 380 are protrusively formed on the outer face of the cannula insert part 300, and "L" shaped fixing grooves 250 are formed in the main body 200 to receive the support rods 380. In this case, the fixing grooves 250 may take any shape as long as the support rods 380 are safely seated therein.

Meanwhile, an obturator 400 may be inserted into the main body 200. As illustrated in Figs. 15 and 16, the obturator 400 is insertedly fixed into the main body 200. The fixation principle or mechanism is substantially the same as above.

Figs. 17. 18 and 19 show a state where a plurality of obturators 400 in accordance with the present invention is inserted into the main bodies 200, respectively. As shown, the end portion of the obturator 400 may be rounded (Fig. 17) or edged (Fig. 18), or may include a blade 430 (Fig. 19).

The insert port 100 having the above-described configuration in accordance with the first embodiment of the present invention is basically used as follows.

First, a user inserts the obturator 400, as shown in Fig. 15, into the main body 200, and fits the fixing ring 420 of the obturator 400 into the first insert groove 220 on the inside of the main body 200. In this manner, as depicted in Fig. 16, the obturator 400 is fixed on the main body 200.

Next, the user inserts the obturator 400 being fixed on the main body 200 into an incision the user has formed by using a scalpel or the like. And then, the user separates the obturator 400 from the main body 200. After that, the user inserts the cannula insert part 300 into the main body 200. In result, the insert ring 320 of the insert main body 310 is fitted into the first insert groove 220 on the inside of the main body 200, thus allowing the cannula insert part 300 to fix or couple to the main body 200.

In the course of the above, the user may anchor the main body 200 to a patient's body, using suture. Fig. 20 and Fig. 21 well illustrate a state where the insert part 100 in accordance with the first embodiment of the present invention is inserted into a patient's abdominal wall and secured with suture.

Next, the user inserts minimally invasive surgical tools 1 or an endoscope 2 as shown in Fig. 22 through the cannulas 330 of the cannula insert part 300 to conduct surgery (as shown in the drawing, the minimally invasive surgical tools 1 are preferably positioned in symmetric with each other). As shown in Fig. 22, when two or more minimally invasive surgical tools 1 are used, they are preferably inserted through the cannulas 330 which are positioned substantially in parallel with each other. By nature of the minimally invasive surgery, in the state shown in Fig. 21, it may need to open the cock valve 342 provided to the gas supply pipe 340 to insufflate gas into a patient's body and to close the cock valve 342 if the insufflation of a required amount of gas is complete. This operation may also be need during surgery.

The plurality of cannulas 330 (especially the cannulas 330 into which the minimally invasive surgical tools 1 are inserted) are positioned with their central axes substantially parallel to each other, so the user may conduct surgery using an endoscope in 0 to 5 degree direction of view.

Depending on the type of surgery, it can be more useful to obtain images that are taken at an angle by the endoscope 2. In this case, as shown in Fig. 23, a light-receiving lens of the endoscope 2 may crook at a predetermined angle to help the user conduct surgery more conveniently. As the endoscope 2 suitable for the present invention, any of endoscopes that are bent at diverse angles such as a joint which are described in the previously-filed Korean Patent Application Nos. 2008-51248, 2008-61894, 2008-79126 and 2008-90560, or any of freely bending flexible endoscopes can be used.

Embodiment II

Fig. 24 is a perspective view showing the configuration of an insert port 100A in accordance with a second embodiment of the present invention, and Fig. 25 is a perspective view showing the configuration of a cannula insert part 300A used for the insert port 100A in accordance with the second embodiment of the present invention.

The insert port 100A and the cannula insert part 300A in accordance with the second embodiment of the present invention have many similarities with the configuration in accordance with the first embodiment of the present invention, so configuration, positions, etc. of individual elements thereof will be omitted here.

However, in accordance with this embodiment, as shown in Figs. 24 and 25, one of plural cannulas 330A included in the cannula insert part 300A is inclined at a predetermined angle to the other cannulas 330A. Here, the predetermined angle is about 15 degrees. It should be noted that although any of the plural cannulas 330A arranged in a bundle may be tilted as mentioned above, the other cannulas 330A should be positioned on both sides of the inclined cannula 330A.

As noted above, the inclined cannula 330A may be used in many applications, but it is particularly useful for receiving an endoscope that needs to be positioned for the user's eye direction. Figs. 26 and 27 are a perspective view and a front through view showing the configuration of the cannula insert part 300A in accordance with the second embodiment of the present invention, respectively.

According to the views shown in Figs. 24 to 27, it can be seen that a gas supply pipe 340A may be connected directly to the bottom of an insert main body 310A, instead of being attached to the cannula 330A as in the first embodiment. The position and the configuration of the gas supply pipe 340A may not be limited thereto, but can be modified as desired.

Figs. 30 and 31 are provided for further description in relation to this embodiment. Fig. 30 is a perspective view showing a state where minimally invasive surgical tools 1 and an endoscope 2 are inserted and operated through the insert port 100A in accordance with the second embodiment of the present invention, and Fig. 31 is a side view of Fig. 30.

As shown, the endoscope 2 can be inserted through the cannula 330A this is inclined at a predetermined angle. Since the endoscope 2 itself has approximately 30 degree direction of view, the user uses the insert port 100A of the second embodiment of the present invention to thus observe an operation field of a patient almost equally to a case where he or she watches it directly with his or her eyes.

Preferably, the endoscope 2 used for this embodiment may be a rigid endoscope, and the inclination angle of the cannula 330A to the other cannulas 330A or the angle of the endoscope 2 itself may vary depending on user's needs.

Embodiment III

A third embodiment of the present invention will now be explained with reference to Figs. 28 and 29.

Figs. 28 and 29 respectively show perspective views illustrating the configuration of an insert port 100B and the configuration of a cannula insert part 300B, in accordance with the third embodiment of the present invention.

The insert port 100B and the cannula insert part 300B in accordance with the third embodiment of the present invention have many similarities with the configuration in accordance with the first embodiment of the present invention, so configuration, positions, etc. of individual elements thereof will be omitted here.

In accordance with this embodiment, as shown in Figs. 28 and 29, the cannula insert part 300B may further include auxiliary cannulas 332B. The auxiliary cannulas 332B may be used for an assistant of the user to insert other surgical tools that are different from ones the main user operates and push aside retracting organ(s) or tissue(s) during surgery, or to do other things to help the surgery go smoothly.

Although two auxiliary cannulas 332B are illustrated, this is for illustrative purposes only. The auxiliary cannulas 332B are preferably closed by plugs 350 to prevent the undesired inflow or outflow of gas. In addition, Figs. 28 and 29 illustrate that the auxiliary cannulas 332B are smaller in diameter than the cannulas 330B, but the diameter of the auxiliary cannulas 332B may vary depending on needs. Moreover, during actual surgery, the cannulas 330B and the auxiliary cannulas 332B may be undistinguishably used by the main user and the assistant of the user.

While the present invention has been described with respect to certain preferred embodiments, it will be apparent to those skilled in the art that various changes and modifications may be made without departing from the scope of the invention as defined in the following claims.

Claims

Port for minimally invasive surgery comprising,

a main body, and

a cannula insert part positioned in the main body, having an insert main body and a plurality of cannulas,

wherein at least two cannulas of the plurality of cannulas are substantially parallel to each other.
The port as claimed in claim 1, wherein at least one of the plurality of cannulas is inclined at a predetermined angle to the at least two cannulas substantially parallel to each other.
The port as claimed in claim 2, wherein the at least one cannula inclined at a predetermined angle is positioned between the at least two cannulas substantially parallel to each other.
The port as claimed in claim 1, wherein the plurality of cannulas are coupled to the insert main body in an airtight manner.
The port as claimed in claim 1, further comprising at least one gas supply pipe.
The port as claimed in claim 5, wherein the at least one gas supply pipe is connected to at least one of the plurality of cannulas.
The port as claimed in claim 5, wherein the at least one gas supply pipe is independent of the plurality of cannulas.
The port as claimed in claim 1, further comprising a plurality of plugs for closing each one end of the plurality of cannulas,

wherein each of the plurality of plugs comprises at least one slit,

wherein at least a portion of the plurality of plugs comprise at least two slits that are not parallel to each other.
The port as claimed in claim 1, wherein the main body is coupled to the insert main body, and at least part of the coupling is achieved by a rotation prevention element comprised in the main body and/or the insert main body.
The port as claimed in claim 9, wherein the rotation prevention element comprises at least one groove and at least one protrusion.
The port as claimed in claim 9, wherein the rotation prevention element comprises at least one fixing groove and at least one supporting rod.
Port assembly for minimally invasive surgery comprising,

the port for minimally invasive surgery as claimed in any of claims 1 to 11, and

at least one obturator,

wherein the at least one obturator is configured to be coupled to the main body.
Method for using the port for minimally invasive surgery as claimed in claim 1, comprising,

inserting at least one tool for minimally invasive surgery through at least one of the plurality of cannulas, and

inserting at least another tool for minimally invasive surgery through at least another cannula.
Method for using the port for minimally invasive surgery as claimed in claim 2, comprising,

inserting an endoscope through the at least one cannula inclined at a predetermined angle, and inserting a tool for minimally invasive surgery through one of the two cannulas substantially parallel to each other.