Surgery – Instruments – Means for inserting or removing conduit within body
Reexamination Certificate
1993-06-03
2001-05-01
Stright, Jr., Ronald K. (Department: 3762)
Surgery
Instruments
Means for inserting or removing conduit within body
C606S170000, C606S185000, C604S115000, C604S117000, C604S165010, C604S274000
Reexamination Certificate
active
06224608
ABSTRACT:
TECHNICAL FIELD
The present invention relates to a device for retaining a medical instrument in engagement with body tissue and, more specifically, to an improved device for maintaining the desired positional relationship between a trocar tube and body tissue.
BACKGROUND AND OBJECTS OF THE INVENTION
Devices for holding medical instruments in penetrating relationship with body tissue are known. See, for example, U.S. Pat. No. 2,256,942 which discloses an instrument having a fluted or undulated surface for retaining the device in the walls of the bladder or viscus; U.S. Pat. No. 3,750,667 which discloses a device having a thread which serves to measure the depth of introduction of the device into osseous tissue; and U.S. Pat. No. 4,670,008 which discloses a high flux threaded needle for injecting or removing fluids from the body, the needle having a threaded portion to permit easy insertion of the needle and secure the device in the patient.
Threaded structures have also been applied to larger diameter trocars which are used for introducing viewing and surgical instruments into the body. Such trocars are shown and described in U.S. Pat. Nos. 4,601,710; 4,654,030, and 4,902,280. One commercially available trocar includes an integrally molded threaded portion for holding the trocar in the patient's skin. Another device provides a depth penetration indicator adjustable to a desired position along a trocar and including a threaded portion for holding the trocar in the patient's skin.
The present invention provides an improved thread configuration for holding a medical instrument associated therewith in a desired position relative to a patient's body, specifically the patient's skin. The thread configuration of the present invention facilitates insertion and removal of the anchoring device into the patient's skin with decreased tissue trauma, and also provides sufficient holding power to maintain the medical instrument in the desired position.
SUMMARY OF THE INVENTION
In accordance with the invention a tissue gripping thread configuration is provided having a base surface, a distal foot section connected to the base surface, a sloping distal thread surface extending from the distal foot section to a thread apex, a proximal foot section connected to the base surface, and a proximal thread end wall substantially perpendicular to the base surface extending from the proximal foot section to the thread apex. In order to provide optimum insertion and tissue holding characteristics, the flank angle of the distal sloping surface is substantially greater than the flank angle of the proximal thread wall surface. Preferably, the distal thread surface, thread apex and the distal and proximal foot sections are curved to further optimize insertion and removal force and minimize tissue trauma. Preferred radii of curvature are disclosed. In the preferred embodiment the proximal thread wall has a flank angle of about 10°. That is, the proximal wall is inclined from a configuration perpendicular to the base surface by an angle of about 10°.
The tissue gripping thread may be associated in any suitable manner with a medical instrument having an elongated portion to engage and secure the instrument relative to body tissue. The thread configuration preferably is disposed in a helical arrangement surrounding at least part of the instrument elongated portion. In a preferred application, the threads are disposed on a cylindrical trocar guide tube. In one embodiment a trocar penetration depth indicator and positioning device is provided with an elongated cylindrical section configured to surround a trocar guide tube with the helical threads disposed outwardly of the guide tube outer surface. In this embodiment, the penetration depth indicator and positioning device is secured to the guide tube in the desired position and the trocar is inserted into body tissue. The threads are brought into contact with the body tissue and rotated so that the threads engage the body tissue and hold the trocar in position. In an alternative embodiment the elongated guide tube surrounding structure is integral with and extends from the guide tube housing. In this embodiment the entire guide tube housing is rotated to engage the body tissue.
The preferred thread configuration reduces tissue trauma during insertion into and removal from tissue while ensuring sufficient tissue gripping capability to prevent inadvertent removal of the instrument from the tissue.
It will be understood by those skilled in the art that the foregoing general description and the following detailed description as well are exemplary and explanatory of the invention but are not restrictive thereof.
REFERENCES:
patent: 137414 (1873-04-01), Burdick
patent: 2256942 (1941-09-01), Duffy
patent: 3241554 (1966-03-01), Coanda
patent: 3726522 (1973-04-01), Silberman
patent: 3750667 (1973-08-01), Pshenichny
patent: 4601710 (1986-07-01), Moll
patent: 4654030 (1987-03-01), Moll
patent: 4670008 (1987-06-01), Von Albertini
patent: 4902280 (1990-02-01), Lander
patent: 4926860 (1990-05-01), Stice et al.
patent: 5009643 (1991-04-01), Reich et al.
patent: 0232600 (1987-08-01), None
Instruction for Use, ENDOPATH Disposable Surgical Trocar and Sleeve, copyright Ethicon, Inc. 1989.
Auto Suture SURGIGRIP 5mm Disposable Sleeves, box with instructions for use, copyright 1990, United States Surgical Corporation.
Bone Screw Technical Information, Copyright Richards Manufacturing Co., Inc., 1980.
Ciccolella Michael
Matula Paul A.
Stright Jr. Ronald K.
United States Surgical Corporation
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