BALLOON TROCAR

Abstract

A balloon trocar includes a cannula assembly including a cannula and an outer sleeve fitting over the cannula. The distal end of the outer sleeve is proximal to the distal end of the cannula. A balloon is coupled to a distal portion of the sleeve and a distal portion of the cannula. The outer surface of the cannula includes a plurality of longitudinal channels for transmitting gas or fluid to the balloon. A bolster having a gel pad at its distal portion is slidably mounted to the cannula assembly and may be locked in a desired position. In use, the trocar is inserted into an incision through a body wall and into a body cavity. The balloon is inflated and the cannula assembly pulled proximally against the incision while the bolster is slid distally to the body wall and locked in place to seal the incision with the compressed balloon.

Description

DESCRIPTION OF THE DRAWINGS

FIG. 1 is a side view of a laparoscopic surgical procedure;

FIG. 2 is a plan view of a laparoscopic surgical procedure showing the placement of trocars;

FIG. 3 is a perspective view of a prior art assembled trocar and obturator;

FIG. 4 is a perspective view of a prior art assembled trocar without an obturator;

FIG. 5 is a perspective view of a prior art cannula;

FIG. 6 is a perspective view of a prior art assembled threaded trocar and obturator;

FIG. 7 is a perspective view of a prior art threaded cannula and housing;

FIG. 8 is a perspective view of a prior art threaded cannula;

FIG. 9 is a perspective view of a prior art cannula having an uninflated balloon at the distal end;

FIG. 10 is a perspective view of a prior art cannula having an inflated balloon at the distal end;

FIG. 11 illustrates a prior art trocar-cannula having a distal retention balloon placed through a body wall in a first position;

FIG. 12 illustrates a prior art trocar-cannula having a distal retention balloon placed through a body wall in a second position;

FIG. 13 is a perspective view of a balloon trocar having a bolster;

FIG. 14 is a perspective view of a cannula portion of the balloon trocar of FIG. 13;

FIG. 15 is a perspective view of a sleeve portion of the balloon trocar of FIG. 13;

FIG. 16 is a partial plan view in cross section depicting the cannula portion, the sleeve portion, a seal, and an obturator of the balloon trocar of FIG. 13;

FIG. 17 illustrates a cannula assembly of the present invention placed through a body wall;

FIG. 18 is a partial plan view in cross section similar to FIG. 16 and including a port portion of the sleeve portion of the balloon trocar;

FIG. 19 is a partial plan view in cross section depicting a distal portion of the cannula portion, sleeve portion, obturator and a balloon coupled between the cannula portion and sleeve portion by windings of thread;

FIG. 20 is a plan view in cross section depicting the balloon trocar;

FIG. 21 is a partial plan view in cross section depicting a distal portion of the cannula portion, sleeve portion, obturator and the balloon coupled between the cannula portion and sleeve portion with a balloon having a second layer;

FIG. 22 is a perspective view of the obturator;

FIG. 23 is a perspective view of a base portion of the bolster of FIG. 13;

FIG. 24 is a perspective view of a collar portion of the bolster of FIG. 13;

FIG. 25 is a perspective view of a lever portion of the bolster of FIG. 13;

FIG. 26 is a side view of the bolster of FIG. 13;

FIG. 27 is a perspective view of the bolster coupled to the sleeve portion of the balloon trocar;

FIG. 28 is an end perspective view of the bolster of FIG. 13;

FIG. 29 is a plan view, in cross section of a sleeve portion of the balloon trocar of FIG. 13 with an inner surface of the sleeve including channels;

FIG. 30 is a partial plan view in cross section depicting a distal portion of the cannula portion, sleeve portion, obturator, a balloon coupled between the cannula portion and sleeve portion by windings of thread, and the inner surface of the balloon coated with grease;

FIG. 31 is a partial plan view of the distal portion of the sleeve portion of the balloon trocar with the distal portion of the sleeve including a plurality of raised rings;

FIG. 32 is a perspective view depicting a bolster having a hollow pad portion with the pad coupled to the base;

FIG. 33 is a perspective view, in cross section, depicting the bolster of FIG. 32 with the hollow pad coupled to the base;

FIG. 34 is a perspective view depicting the bolster of FIG. 32 prior to coupling the hollow pad to the base;

FIG. 35 is a perspective view, in cross section, depicting the bolster of FIG. 32 prior to coupling the hollow pad to the base; and

FIG. 36 is a plan view, in cross section, depicting the bolster of FIG. 32 coupled to the distal portion of the sleeve portion of the balloon trocar.

Claims

1. A cannula assembly, comprising: a cannula including a substantially longitudinal tube having a proximal end, a distal end, a lumen extending between the proximal end and the distal end, a proximal portion having a first, larger periphery, a distal portion having a second, smaller periphery, an annular groove on the outer surface of the distal portion of the cannula toward the distal end of the cannula, and a plurality of channels on the outer surface of the distal portion of the cannula, the channels extending along the length of the cannula from substantially a proximal end of the distal portion of the cannula distally to a point proximal to the annular groove near the distal end of the cannula;a sleeve including a substantially longitudinal tube having a proximal end, a distal end, a lumen extending between the proximal end and the distal end, a proximal portion having a first, larger periphery, a distal portion having a second, smaller periphery, and an annular groove on the outer surface of the distal portion of the sleeve toward the distal end of the sleeve, the lumen of the sleeve being configured to accept the cannula;a balloon including a tubular sleeve, the balloon being sufficiently long to extend between and cover the annular groove on the outer surface of the distal portion of the cannula and the annular groove on the outer surface of the distal portion of the sleeve, the balloon being coupled to the annular groove on the outer surface of the distal portion of the cannula and the annular groove on the outer surface of the distal portion of the sleeve;grease, the grease coating an inner surface of the balloon; anda seal positioned between the cannula and the sleeve and compressed sufficiently to form a seal between the cannula and the sleeve,wherein the sleeve being coupled to the cannula and positioned over the cannula with the proximal portion of the sleeve fitting over at least a distal region of the proximal portion of the cannula and the distal portion of the sleeve fitting over at least a portion of the distal portion of the cannula,the distal end of the sleeve being positioned proximal to a distal end of the plurality of channels on the outer surface of the cannula, andthe space between the outer surface of the cannula with the channels, the inner surface of the sleeve, the seal and the balloon forming a substantially closed chamber.

2. The cannula assembly of claim 1, wherein the plurality of channels on the outer surface of the cannula includes a plurality of substantially longitudinal grooves that are substantially parallel to a longitudinal axis of the cannula

3. The cannula assembly of claim 1, further comprising: an obturator adapted to be removably positioned within the lumen of the cannula, the obturator comprising, an elongate shaft extending along a substantially longitudinal axis between a proximal end and a distal end, anda distal tip having a prolate spheroid shape.

4. The cannula assembly of claim 1, further comprising: a trocar seal positioned at the proximal portion of the cannula, the trocar seal including a valve that provides an instrument seal in the presence of an instrument and provides a zero-seal in the absence of an instrument.

5. The cannula assembly of claim 1, the inner surface of the distal portion of the sleeve including a plurality of channels extending along the length of the sleeve from substantially a proximal end of the distal portion of the sleeve distally to the distal end of the sleeve.

6. The cannula assembly of claim 5, wherein the plurality of channels on the inner surface of the sleeve includes a plurality of substantially longitudinal grooves that is substantially parallel to a longitudinal axis of the sleeve.

7. The cannula assembly of claim 1, the grease including silicone grease.

8. The cannula assembly of claim 1, the tubular sleeve of the balloon including a silicone tubular sleeve and the grease including silicone grease.

9. A cannula assembly, comprising: a cannula including a substantially longitudinal tube having a proximal ends a distal end, a lumen extending between the proximal end and the distal end, a proximal portion having a first, larger periphery, a distal portion having a second, smaller periphery, an annular groove on the outer surface of the distal portion of the cannula toward the distal end of the cannula, and a plurality of channels on the outer surface of the distal portion of the cannula, the channels extending along the length of the cannula from substantially a proximal end of the distal portion of the cannula distally to a point proximal to the annular groove near the distal end of the cannula;a sleeve including a substantially longitudinal tube having a proximal end, a distal end, a lumen extending between the proximal end and the distal end, a proximal portion having a first, larger periphery, a distal portion having a second, smaller periphery, and an annular groove on the outer surface of the distal portion of the sleeve toward the distal end of the sleeve, the lumen of the sleeve being configured to accept the cannula;a balloon including a tubular sleeve, the tubular sleeve including a distensible thermoplastic elastomeric material, the balloon being sufficiently long to extend between and cover the annular groove on the outer surface of the distal portion of the cannula and the annular groove on the outer surface of the distal portion of the sleeve, the balloon being coupled to the annular groove on the outer surface of the distal portion of the cannula and the annular groove on the outer surface of the distal portion of the sleeve; anda seal positioned between the cannula and the sleeve and compressed sufficiently to form a seal between the cannula and the sleeve,wherein the sleeve being coupled to the cannula and positioned over the cannula with the proximal portion of the sleeve fitting over at least a distal region of the proximal portion of the cannula and the distal portion of the sleeve fitting over at least a portion of the distal portion of the cannula,the distal end of the sleeve being positioned proximal to a distal end of the plurality of channels on the outer surface of the cannula, andthe space between the outer surface of the cannula with the channels, the inner surface of the sleeve, the seal and the balloon forming a substantially closed chamber.

10. The cannula assembly of claim 9, wherein the plurality of channels on the outer surface of the cannula includes a plurality of substantially longitudinal grooves that are substantially parallel to a longitudinal axis of the cannula.

11. The cannula assembly of claim 9, further comprising: an obturator adapted to be removably positioned within the lumen of the cannula, the obturator comprising, an elongate shaft extending along a substantially longitudinal axis between a proximal end and a distal end, anda distal tip having a prolate spheroid shape.

12. The cannula assembly of claim 9, further comprising: a trocar seal positioned at the proximal portion of the cannula, the trocar seal including a valve that provides an instrument seal in the presence of an instrument and provides a zero-seal in the absence of an instrument.

13. The cannula assembly of claim 9, the inner surface of the distal portion of the sleeve including a plurality of channels extending along the length of the sleeve from substantially a proximal end of the distal portion of the sleeve distally to the distal end of the sleeve.

14. The cannula assembly of claim 13, wherein the plurality of channels on the inner surface of the sleeve includes a plurality of substantially longitudinal grooves that is substantially parallel to a longitudinal axis of the sleeve.

15. The cannula assembly of claim 9, the distensible thermoplastic elastomeric material of the tubular sleeve of the balloon including styrene-ethylene-butylene-styrene tri-block polymer.

16. The cannula assembly of claim 9, further comprising grease, the grease coating an inner surface of the balloon.

17. The cannula assembly of claim 16, the grease including silicone grease

18. A cannula assembly, comprising: a cannula including a substantially longitudinal tube having a proximal end, a distal end, a lumen extending between the proximal end and the distal end, a proximal portion having a first, larger periphery, a distal portion having a second, smaller periphery, an annular groove on the outer surface of the distal portion of the cannula toward the distal end of the cannula, and a plurality of channels on the outer surface of the distal portion of the cannula, the channels extending along the length of the cannula from substantially a proximal end of the distal portion of the cannula distally to a point proximal to the annular groove near the distal end of the cannula;a sleeve including a substantially longitudinal tube having a proximal end, a distal end, a lumen extending between the proximal end and the distal end, a proximal portion having a first, larger periphery, a distal portion having a second, smaller periphery, an annular groove on the outer surface of the distal portion of the sleeve toward the distal end of the sleeve, and a plurality of raised rings spaced longitudinally along the length of the outer surface of the distal portion of the sleeve, the lumen of the sleeve being configured to accept the cannula, the distal portion of the sleeve including a distal taper, with the proximal end of the distal portion of the sleeve having a larger periphery than the distal end of the distal portion of the sleeve, the plurality of raised rings producing a distal taper, with the raised rings toward the proximal end of the distal portion of the sleeve having a larger periphery than the raised rings toward the distal end of the distal portion of the sleeve, the taper of the raised rings being smaller than the taper of the outer surface of the distal portion of the sleeve;a balloon including a tubular sleeve, the balloon being sufficiently long to extend between and cover the annular groove on the outer surface of the distal portion of the cannula and the annular groove on the outer surface of the distal portion of the sleeve, the balloon being coupled to the annular groove on the outer surface of the distal portion of the cannula and the annular groove on the outer surface of the distal portion of the sleeve; anda seal positioned between the cannula and the sleeve and compressed sufficiently to form a seal between the cannula and the sleeve,wherein the sleeve being coupled to the cannula and positioned over the cannula with the proximal portion of the sleeve fitting over at least a distal region of the proximal portion of the cannula and the distal portion of the sleeve fitting over at least a portion of the distal portion of the cannula,the distal end of the sleeve being positioned proximal to a distal end of the plurality of channels on the outer surface of the cannula, andthe space between the outer surface of the cannula with the channels, the inner surface of the sleeve, the seal and the balloon forming a substantially closed chamber.

19. The cannula assembly of claim 18, wherein the plurality of channels on the outer surface of the cannula includes a plurality of substantially longitudinal grooves that are substantially parallel to a longitudinal axis of the cannula.

20. The cannula assembly of claim 18, further comprising: an obturator adapted to be removably positioned within the lumen of the cannula, the obturator comprising, an elongate shaft extending along a substantially longitudinal axis between a proximal end and a distal end, anda distal tip having a prolate spheroid shape.

21. The cannula assembly of claim 18, further comprising: a trocar seal positioned at the proximal portion of the cannula, the trocar seal including a valve that provides an instrument seal in the presence of an instrument and provides a zero-seal in the absence of an instrument.

22. The cannula assembly of claim 18, the inner surface of the distal portion of the sleeve including a plurality of channels extending along the length of the sleeve from substantially a proximal end of the distal portion of the sleeve distally to the distal end of the sleeve.

23. The cannula assembly of claim 22, wherein the plurality of channels on the inner surface of the sleeve includes a plurality of substantially longitudinal grooves that is substantially parallel to a longitudinal axis of the sleeve

24. The cannula assembly of claim 18, further comprising grease, the grease coating an inner surface of the balloon.

25. The cannula assembly of claim 24, the tubular sleeve of the balloon including a silicone tubular sleeve and the grease including silicone grease.

26. The cannula assembly of claim 18, the tubular sleeve of the balloon including a distensible thermoplastic elastomeric material.

27. The cannula assembly of claim 26, the distensible thermoplastic elastomeric material of the tubular sleeve of the balloon including styrene-ethylene-butylene-styrene tri-block polymer.

28. The cannula assembly of claim 18, each of the raised rings of the sleeve lying on a plane that is substantially perpendicular to a longitudinal axis of the sleeve.

29. The cannula assembly of claim 18, the distance between adjacent raised rings of the sleeve being about twice the longitudinal length of the raised rings.

30. The cannula assembly of claim 18, wherein the ring heights of the rings of the sleeve decrease proximally along the length of the distal portion of the sleeve.

31. The cannula assembly of claim 18, wherein the ring height of the distal-most ring of the sleeve is about 0.13 mm.

32. The cannula assembly of claim 18, further comprising a bolster slidably adjustable along the length of the sleeve proximal to the balloon, the bolster comprising: a base;a clamping mechanism at a proximal portion of the base, the clamping mechanism including an over-center lock design; anda pad at a distal portion of the base, the pad including; an elastomeric, polymeric material,a hollow body having a longitudinal axis, the hollow body having a peripheral wall including a wall thickness, the wall of the hollow body being flexible and having shape memory,a first, proximal, retention flange, the retention flange being positioned at a proximal end of the pad and extending radially inwardly from the hollow body wall of the pad, the retention flange including an aperture positioned substantially along the axis of the hollow body of the pad, anda second, distal, body contact flange, the body contact flange being positioned at a distal end of the pad and extending radially inwardly from the hollow body wall of the pad, the body contact flange including an aperture positioned substantially along the axis of the hollow body of the pad, the aperture in the body contact flange being sized to receive the sleeve.

33. The cannula assembly of claim 32, the elastomeric, polymeric material of the pad of the bolster including silicone.

34. A cannula assembly, comprising: a cannula including a substantially longitudinal tube having a proximal end, a distal end, a lumen extending between the proximal end and the distal end, a proximal portion having a first, larger periphery, a distal portion having a second, smaller periphery, an annular groove on the outer surface of the distal portion of the cannula toward the distal end of the cannula, and a plurality of channels on the outer surface of the distal portion of the cannula, the channels extending along the length of the cannula from substantially a proximal end of the distal portion of the cannula distally to a point proximal to the annular groove near the distal end of the cannula;a sleeve including a substantially longitudinal tube having a proximal end, a distal end, a lumen extending between the proximal end and the distal end, a proximal portion having a first, larger periphery, a distal portion having a second, smaller periphery, and an annular groove on the outer surface of the distal portion of the sleeve toward the distal end of the sleeve, the lumen of the sleeve being configured to accept the cannula;a balloon including a tubular sleeve, the balloon being sufficiently long to extend between and cover the annular groove on the outer surface of the distal portion of the cannula and the annular groove on the outer surface of the distal portion of the sleeve, the balloon being coupled to the annular groove on the outer surface of the distal portion of the cannula and the annular groove on the outer surface of the distal portion of the sleeve;a seal positioned between the cannula and the sleeve and compressed sufficiently to form a seal between the cannula and the sleeve; anda bolster slidably adjustable along the length of the sleeve proximal to the balloon, the bolster comprising a base, a clamping mechanism at a proximal portion of the base, and a pad at a distal portion of the base, the clamping mechanism including an over-center lock design, the pad being made of an elastomeric, polymeric material, the pad including a hollow body, a first, proximal retention flange, and a second, distal, body contact flange, the hollow body having a longitudinal axis, the hollow body having a peripheral wall including a wall thickness, the wall of the hollow body being flexible and having shape memory, the first, proximal, retention flange being positioned at a proximal end of the pad and extending radially inwardly from the hollow body wall of the pad, the retention flange including an aperture positioned substantially along the axis of the hollow body of the pad, the second, distal, body contact flange being positioned at a distal end of the pad and extending radially inwardly from the hollow body wall of the pad, the body contact flange including an aperture positioned substantially along the axis of the hollow body of the pad, the aperture in the body contact flange being sized to receive the sleeve,wherein the sleeve being coupled to the cannula and positioned over the cannula with the proximal portion of the sleeve fitting over at least a distal region of the proximal portion of the cannula and the distal portion of the sleeve fitting over at least a portion of the distal portion of the cannula,the distal end of the sleeve being positioned proximal to a distal end of the plurality of channels on the outer surface of the cannula, andthe space between the outer surface of the cannula with the channels, the inner surface of the sleeve, the seal and the balloon forming a substantially closed chamber.

35. The cannula assembly of claim 34, wherein the plurality of channels on the outer surface of the cannula includes a plurality of substantially longitudinal grooves that are substantially parallel to a longitudinal axis of the cannula.

36. The cannula assembly of claim 34, further comprising; an obturator adapted to be removably positioned within the lumen of the cannula, the obturator comprising, an elongate shaft extending along a substantially longitudinal axis between a proximal end and a distal end, anda distal tip having a prolate spheroid shape.

37. The cannula assembly of claim 34, further comprising: a trocar seal positioned at the proximal portion of the cannula, the trocar seal including a valve that provides an instrument seal in the presence of an instrument and provides a zero-seal in the absence of an instrument.

38. The cannula assembly of claim 34, the inner surface of the distal portion of the sleeve including a plurality of channels extending along the length of the sleeve from substantially a proximal end of the distal portion of the sleeve distally to the distal end of the sleeve.

39. The cannula assembly of claim 38, wherein the plurality of channels on the inner surface of the sleeve includes a plurality of substantially longitudinal grooves that is substantially parallel to a longitudinal axis of the sleeve.

40. The cannula assembly of claim 34, further comprising grease, the grease coating an inner surface of the balloon.

41. The cannula assembly of claim 34, the tubular sleeve of the balloon including a distensible thermoplastic elastomeric material.

42. The cannula assembly of claim 41, the distensible thermoplastic elastomeric material of the tubular sleeve of the balloon including styrene-ethylene-butylene-styrene tri-block polymer.

43. The cannula assembly of claim 34, the elastomeric, polymeric material of the pad of the bolster including silicone.

44. The cannula assembly of claim 34, the first, proximal, retention flange of the pad of the bolster including features that interact with the base of the bolster.

45. The cannula assembly of claim 34, the aperture in the second, distal, body contact flange of the pad of the bolster being smaller than the perimeter of the distal portion of the sleeve.

46. The cannula assembly of claim 34, the pad further including: a proximally-facing lip extending from the perimeter of the aperture in the second, distal, body contact flange; anda plurality of gussets positioned around the lip and extending radially outwardly therefrom, the gussets coupling the lip to the wall of the pad.

47. The cannula assembly of claim 34, the hollow body of the pad being substantially cylindrical.