Surgery – Endoscope – With guide means for body insertion
Patent
1995-05-10
1997-03-11
Apley, Richard J.
Surgery
Endoscope
With guide means for body insertion
600104, 604104, 604264, 606185, A61B 104
Patent
active
056095627
DESCRIPTION:
BRIEF SUMMARY
TECHNICAL FIELD
This invention relates to the field of operative and diagnostic laparoscopic surgical procedures and in particular to a new and improved visually directed trocar laparoscopic instrument and method of use for conducting such procedures.
BACKGROUND OF INVENTION
Operative and diagnostic laparoscopy is the most commonly performed surgical procedure in the United States today. Therefore, any complication associated with this procedure poses a major public health concern.
Conventional known laparoscopic procedures usually are carried out as follows: navel into the abdominal cavity of a patient. abdomen. blindly inserted through the navel into and through the abdominal wall of the abdominal cavity. with light source placed in the sleeve thus making visualization of the interior of the cavity possible. can be carried out safely through the central opening in the trocar sleeve with remotely operable surgical instruments in a conventional known manner.
There are several reports in the medical literature that the first two steps of a laparoscopic procedure as outlined above can be omitted, and the laparoscopic trocar assembly be directly inserted blindly into the abdominal cavity. Results of these papers indicate that complications can still be expected since the entry through the abdominal cavity wall into the abdominal cavity remains blind.
SUMMARY OF INVENTION
It is therefore a primary purpose of this invention to make available a new and improved, visually directed, laparoscopic instrument which allows the laparoscopic surgeon to enter the abdominal or other cavity of a patient under direct vision. This visually directed laparoscopic procedure will eliminate most if not all major and minor complications associated with the blind invasive surgical technique presently employed in laparoscopic procedures as described above.
In practicing the invention a new and improved laparoscopic instrument is provided with an elongated, hollow trocar having a tipped end of pyramidal or the like or conical configuration suitable for insertion through layers of human skin and flesh forming the walls of a cavity with the tipped end being fabricated from light transparent material. The inclined edges of the pyramidal configuration each form a piercing edge. The tipped end of light transparent material preferably is shaped to form a light transmission and imaging element for projecting light outwardly into an abdominal or other cavity of a patient, and for receiving back and directing light images onto a suitable light image receptor of a conventional miniaturized light telescope designed for surgical purposes. Each piercing edge of the pyramidal configuration cooperates with the light transmission and imaging element to pierce human flesh. The hollow trocar is open at one end and has a central passageway formed therein of sufficient diameter to permit detachable slidable insertion of the elements of a miniaturized light telescope together with essential power supply conductors for energizing the light source and light receptors such as a bundle of fiber optic light coupling elements for deriving and providing back light images usable for laparoscopic diagnostic procedures even while the trocar is being surgically inserted through the navel and is penetrating through the layers of skin and abdominal wall of a patient and on into the abdominal cavity. The open end permits removal of the components inserted into the hollow trocar.
In preferred embodiments of the invention, the laparoscopic instrument includes a hollow tubular trocar sleeve that surrounds and encloses the trocar for a substantial portion of its length to form a combined trocar and sleeve assembly. The trocar is slidable lengthwise relative to the trocar sleeve whereby the trocar can be removed after visually controlled physical placement of the trocar and sleeve assembly into the abdominal wall of a patient's abdominal cavity at a desired location and to a desired depth. The trocar then can be replaced with a somewhat large fiber optic light teles
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Apley Richard J.
Flanagan Beverly M.
Worldwide Optical Trocar Licensing Corporation
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