Surgery – Instruments – Cutting – puncturing or piercing
Utility Patent
1999-03-08
2001-01-02
Buiz, Michael (Department: 3731)
Surgery
Instruments
Cutting, puncturing or piercing
Utility Patent
active
06168607
ABSTRACT:
FIELD OF THE INVENTION
The present invention relates to a trocar assembly which includes a laparoscopic trocar and trocar sleeve (also called a cannula).
BACKGROUND
Laparoscopy is a method for the exploration of the peritoneal cavity wherein a sterile gas is blown or insufflated into the peritoneal cavity through the tubular portion or cannula section. The tubular portion or cannula section of the trocar assembly is connected to a gas source so that the pressure of the gaseous pocket within the peritoneal cavity may be maintained. This gaseous pocket within the peritoneal cavity is known as a pneumoperitoneum.
The visual exploration of the organs within the peritoneal cavity or other areas of the body is carried out by means of an endoscope or a similar device which passes through the tubular portion or cannula section of a trocar assembly after the tubular portion of a trocar assembly has been put in place in an abdominal wall. Similarly, one or more additional cannulas may be introduced into the pneumoperitoneum for the introduction of various tools to allow additional procedures such as biopsies.
The tubular portion or cannula section of the trocar assembly is a particularly important element, because it must pass through the flesh or tissue surrounding the peritoneal cavity without causing any postoperative trauma, yet still provide for anchorage to the abdominal wall. Above all, the tubular portion of the trocar assembly must assure that a seal is formed between the pneumoperitoneum and the atmosphere external to the peritoneal cavity.
Currently, most trocar assemblies are made of metal to facilitate their sterilization and re-use. Specifically, stainless steel is most commonly used. As far as the sealing means within the trocar assembly are concerned, other synthetic materials are used.
In general, the body portion of prior art trocar assemblies consists of a collection of detachable elements which allow access to the sealing means. After the insertion of the trocar assembly into the patient, the sealing means within the trocar assembly becomes contaminated by blood and other secretions. Thus, these prior art trocar assemblies must be disassembled and cleaned before they can be sterilized for reuse. Consequently, in prior art trocar assemblies that may be taken apart for cleaning, some type of connection means, threadable or otherwise, must be provided between the different parts of the trocar assembly. In some newer prior art trocar assemblies, synthetic materials are used in place of stainless steel. In these newer trocar assemblies, the synthetic materials which are used to seal the pneumoperitoneum from the atmosphere are generally not sterilizable. Such materials are described in European Patent Nos. A-564,373 and A-541,970.
The reusable character of the prior art trocar assemblies requires that they be made of expensive materials, or have a complex and expensive design. Complex and expensive designs provide significant drawbacks for the user. These drawbacks are in addition to those drawbacks which result from the cost of cleaning and re-sterilizing the trocar assemblies.
To overcome these drawbacks, it has been found that less expensive disposable trocar assemblies may be used. French Patent Nos. A-2,691,625 and A-2,694,181 disclose such disposable trocar assemblies. Despite the fact that the trocar assemblies are disposable, it has been found that some medical care personnel attempt to sterilize these disposable trocar assemblies for re-use.
French Patent No. A-2,691,625 defines the of a fibrous, synthetic material for making trocar assemblies. This fibrous, synthetic material is used for the manufacture of both the tubular body portion or cannula section of the trocar assembly, and, also the removable perforation device. Thus, the fibrous synthetic material allows for a reduction in the manufacturing cost of the trocar assembly, but it does not prevent reuse of the trocar assembly.
French Patent No. A-2,694,181 describes, more particularly, the structure of a sealing means in the tubular portion of cannula section of a trocar assembly. This patent does not address the problem of preventing reuse of the sealing means in a trocar assembly.
The object of the present invention is to provide a laparoscopic trocar assembly which is inexpensive to make, provides a seal to prevent the escape of gas back through the trocar assembly, and yet cannot be re-sterilized and used again Thus, once the trocar assembly is used it should be rendered unusable.
SUMMARY OF THE INVENTION
The trocar assembly of the present invention includes a tubular body portion or cannula section made of a synthetic material. The tubular body portion includes means which retain it in abdominal wall and also provides for the guidance of a removable device, typically a laparoscopic trocar, used to perforate the tissue surrounding the abdominal cavity. The removable device for perforation of the tissue surrounding the abdominal cavity is mounted so that it can slide axially within the tubular body portion. Also mounted within the tubular body portion are sealing means which are capable of cooperating with the perforation device, or with other types of surgical tools, to seal the perforated body cavity from the escape of gas. The sealing means includes a unidirectional closing means mounted within a sleeve at the end of the tubular body portion of the trocar assembly. The sleeve is further extendable by a guidance funnel, which is mounted on the external portion of the sleeve to be coaxial with the bore of the tubular body.
The unidirectional closing means is a shouldered disk which is mounted within the sleeve at the end of the tubular body portion of the trocar assembly. The shouldered disk unidirectional closing means is mounted under a socket within in the sleeve. The sleeve has a circular lip forming a sealing joint where it contacts the guidance funnel. The socket and the shouldered disk form a subassembly which is immobilized and permanently retained in the sleeve of the tubular body by a cover. The synthetic material from which this subassembly is formed is selected from those materials which cannot be sterilized by immersion in the type of sterilizing bath found in most hospitals. Similarly, the synthetic material from which the tubular body and the cover are made is selected from those materials which cannot be sterilized by insertion into the type of sterlizing autoclave found in most hospitals.
Because of the structure of the present invention, notably the locking of the cover to the sleeve portion to the tubular body, the subassembly which includes the unidirectional closing means and the sealing means cannot be extracted from the trocar assembly. This permanent mounting prevents, prior to any re-sterilization, the removal of any blood or secretions that may soil the subassembly. Moreover, the sterilization means conventionally used in hospitals, that is sterilization by autoclaving or sterilization by immersion in a sterilizing bath, will actually cause the partial destruction of one or more of the components of the trocar assembly. Specifically, sterilization by autoclaving or sterilization by immersion will destroy one or more of the tubular body portion, the cover, and the closing and sealing subassembly. The destruction of one or more parts of the trocar assembly renders it unusable.
As a result, the trocar assembly of the present invention, in addition to having a structure and a composition of a synthetic material, which leads to very low costs, cannot be resterilized by means readily available in a hospital environment. Consequently, any attempt to render a contaiminated trocar assembly, made according to the present invention, reusable by either immersion bath sterilization or autoclave sterilization will render it unusable.
In one embodiment of the invention, the removable tissue perforation device is also made of a synthetic material. This removable tissue perforation device includes, at its end, a conical part having an angle at the center of between 35° and 50°, and two flat ar
d'Arpiany Francis
Wattiez Arnaud
Arismendi, Jr. A. M. (Andy)
Bui Vy Q
Buiz Michael
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