The present invention relates to a laparoscopy trocar for minimally invasive surgical procedures. In particular the invention relates to an improved disposable laparoscopy trocar for use in accessing the abdominal cavity of a patient.
BACKGROUND TO THE INVENTION
Laparoscopy is a well-known surgical procedure in which one or more small incisions is made in the abdominal cavity, and a pressurised gas, usually carbon dioxide, is used to inflate the abdominal cavity. This act can be commonly referred to as insufflation. Insufflation creates a cavity in which the surgeon can more freely access and view the internal organs. A cannula is inserted through an incision to provide a path into the abdominal cavity. A laparoscope is inserted through the cannula to view the internal cavity and organs during the surgical procedure, which allows the surgeon to view inside the cavity. The cannula generally comprises an elongate tube which traverses the abdominal wall and comprises at least one valve seal, through which instruments can be introduced into the cavity, and which seals around the shaft of the instruments to maintain the pressurised gas within the cavity during the procedure. Second valve seals can be included to improve the sealing function in both the presence of, and in the absence of, surgical tools or instruments within the cannula.
An obturator is used inside the cannula, during insertion of the cannula, in order to drive the cannula through the incision made by the surgeon. The obturator generally has a pointed end in order to drive the sides of the incision apart, to accommodate the cannula. In most cases, the obturator is inserted into the cannula in the same manner as a surgical tool would be inserted, and so is accommodated in the bore of the cannula. The obturator generally has some form of tapered point, which acts to separate the wall as the cannula is introduced. The obturator can be hollow in order to accommodate a laparoscope. Further, at least the tip can be transparent, so that when introducing the trocar through the incision, it is possible for the surgeon to view the layers of the abdominal wall during insertion of the obturator into the abdominal cavity.
The cannula is provided with a source of pressurised fluid, generally a substantially inert gas such as CO2. The source of gas is controlled via a valve situated on the cannula, which can be opened to allow gas into the abdomen and closed to stop the flow of gas into the abdomen. The fluid valve on the cannula is generally operated manually by the user to release fluid into the abdominal cavity, or prohibit the fluid from entering the abdominal cavity under pressure. Conversely, the valve can be opened to release fluid from the cavity and closed to retain fluid within the cavity when no pressurised fluid source is connected.
There is disclosed a laparoscopy trocar, having a cannula and an obturator for use in inserting the cannula into the abdominal cavity of a patient. The cannula comprises a fluid control valve for opening and closing a fluid flow path from outside the bore of the cannula into the bore of the cannula, and the obturator comprises a control means configured to cause the fluid control valve to move between its open and closed positions upon insertion of the obturator into the cannula. A novel tip for the obturator is disclosed comprising a concave bladed front edge formed between a pair of concave tip faces.
The present invention provides a laparoscopy trocar, comprising:
The control means may be configured to cause the fluid control valve to close when the obturator is inserted into the cannula.
The control means may comprise mechanical means configured to mechanically actuate the fluid control valve.
The control means may be configured to actuate a manipulable handle of the fluid control valve.
The control means may be configured to prevent actuation of the fluid control valve when the obturator is placed in full engagement with the cannula.
The control means may be disposed in a handle portion of the obturator.
The fluid control valve may be disposed in a handle portion of the cannula.
The respective handle portions of the cannula and the obturator may be configured to align with one another when the obturator is fully inserted in the cannula, the handle of the cannula being at least partially received, optionally fully received, in the handle of the obturator.
The respective handle portions of the cannula and the obturator may be configured to enclose an input portion of the fluid control valve to prevent external actuation of the input portion.
The control means may comprise at least one sloped portion provided in the handle portion of the obturator, the sloped portion being configured to drive the input portion of the fluid control valve laterally relative to the axis of the bore of the cannula, to actuate the fluid control valve.
The sloped portion may be configured to rotate the input portion of the fluid control valve to actuate the fluid control valve.
The control means may comprise a pair of sloped portions configured to engage opposite sides of the input portion to actuate the fluid control valve.
In a further aspect, the invention provides a laparoscopy trocar, comprising:
The tip of the obturator may further comprise a convex rear face substantially opposite the front edge.
The rear face may be oriented so as to be convex in a direction away from the longitudinal axis of the shaft
The plane of the front edge of tip may be oriented in a first direction away from a longitudinal axis of the shaft, the first direction being substantially parallel to a longitudinal axis of the handle portion of the obturator.
A cannula of a laparoscopy trocar of the invention is also provided. An obturator of a laparoscopy trocar of the invention is also provided.
The invention further provides a method of manufacturing a product, the product being a laparoscopy trocar according to the invention, a cannula of the invention or an obturator according of the invention, comprising the steps of:
The invention further provides a computer-readable medium having data thereon representing a three-dimensional model suitable for use in manufacturing a laparoscopy trocar, cannula or obturator of the invention.
Embodiments of the invention will now be described with reference to the accompanying drawings, in which:
These two distal and proximal portions 240 and 260 may be separated by a step, ridge or other, optionally graduated, change in outer dimension of the handle portions 200, 210, 220.
As will be appreciated in relation to later figures, this can allow distal portion 260 of the handle portion 200 to be received in a handle portion of an obturator when the two items are combine, as will be described in relation to later figures.
The body 320 in the illustrated example forms a handle portion of the obturator. As will be described in further detail in relation to later figures, when the obturator 300 is combined with the cannula 100, the handle portion 200 of the cannula 100 and the body 320 of the obturator 300 combine to form an integrated handle portion of the laparoscopy trocar.
The handle portion 320 generally comprises a receiving area 321 for receiving a handle portion 200 of the cannula. An extension portion 322 of the handle portion 320 extends away from the receiving area 321, such that when the handle portion 200 of the cannula and the handle portion 320 of the obturator 300 are combined, an extended handle portion is provided to the overall trocar assembly comprising the obturator 300 and the cannula 100. The extension portion 322 may comprise convex portions 323 and 324 configured to accommodate the fingers of a user when grasping the overall handle of the trocar.
However, it can be advantageous for the laparoscopy trocar to be manufactured as a disposable single use item. In such cases, it can be preferable to manufacture all components from materials which can be manufactured at low costs, for example by 3D printing, or by injection moulding at high volume, to create a low cost disposable assembly. In these instances, it may be preferable to omit complex electronic components and so a mechanical means for controlling the fluid control valve when the obturator is introduced into the cannula can be preferred, as is illustrated in the embodiments shown in the figures.
In
The internal workings of the fluid control valve are conventional and so are not illustrated in detail herein in the interests of efficiency of the disclosure. A skilled reader will be familiar with the types of fluid control valve required to switch on and off a CO2 feed to the internal bore 103 of the cannula 100.
In
The second sloped surface 402 is provided to a rearward side of the axis of rotation 20 of the handle 230. As can be seen in
Sloped surface 401 may be provided additionally, or alternatively, to sloped surface 402. Sloped surface 401 can be positioned on an opposite side of the axis of rotation 20 of the fluid control valve to the shaft 330. In such an arrangement, the axis 20 of the fluid control valve falls between the axis 331 of the shaft 330 and the sloped surface 401 when the trocar is assembled.
As will be appreciated, therefore, when the handle 230 of the fluid control valve of the cannula 100 is brought into engagement with one and/or the other of the first 401 and second 402 sloped surfaces, the handle 230 will be caused to rotate around its axis 20. In the preferred arrangement illustrated, the control means 400 will engage simultaneously both ends 231 and 232 of the handle 230, on the sloped surfaces 401 and 402 respectively.
This can cause the fluid control valve to be switched between its open and closed configurations. This switching can occur when the cannula is introduced in a direction of arrow C.
Details of the tip 310 of the obturator 300 shown in
The handle portion 320 can also be configured to include an opening 350 to allow the connector portion 251 of the fluid port 250 to pass at least partially within the handle portion 320 of the obturator. As shown in the preferred embodiment illustrated, the fluid port 250 may be completely housed in the cavity 325 of the handle portion 320, as can be seen in
As can be seen, when the handle 230 of the fluid control valve is introduced towards the mechanical control means 400, the first 401 and/or second 402 sloped surfaces engage one or the other (preferably both) of the first 231 and/or second 232 ends of the handle 230 of the fluid control valve to actuate the fluid control valve as described above.
Partial internal detail of the fluid control valve 233 can be seen. However, the full internal workings of the valve are not explained in detail, since these are conventional for a rotational fluid control valve as used in known cannulas. As can be seen in the figure, the handle 230 of the fluid control valve 233 is received in a cavity 327, which encloses the handle portion 230, such that it cannot rotate to its open position. Although the embodiment shown in
As is conventional, the cannula 100 further comprises one or more valve seals located in the bore 103. The illustrated example comprises two valve seals. A first valve seal 121 is conventionally configured to seal the bore 103 in the absence of any obturator or surgical instrument being present in the bore 103. The second seal 122 is also conventional and is configured to seal around the obturator 300, or any other instrument inserted into the bore 103, while bellows 123, located around the central part of the seal 122, permit some lateral movement of the instrument within the bore 103 whilst allowing a sealing edge of the valve seal 122 to maintain a fluid-tight seal around the outer surface of the inserted instrument. Such first 121 and second 122 seals are conventional in the art and so detail of them is not described herein and any such suitable seal or seals can be used in the cannula 100 of embodiments of the present invention.
A further novel aspect of the laparoscopy trocar described herein, is the form of the tip 310 of the obturator 300. The form of the tip can be seen throughout
The rear edge or face 312 of the tip 310 of the obturator is configured so as not to have any sharp edge which would cut the abdominal wall. The rear face is preferably convex, as shown in
A tip configured in such a manner can reduce the amount of friction, and therefore the amount of force, required to insert the obturator into the abdominal cavity. The bladed front face 311 is configured in such a manner that it will can at least partially cut through the layers of the abdominal wall upon insertion. Therefore, a little more trauma may be caused by the tip 310 than if no bladed edge 311 were provided. However, in certain situations blunt edges can cause greater friction and tearing of the abdominal wall depending upon the hardness, or lack thereof, of the abdominal wall. Therefore providing one sharp edge to the obturator can reduce the overall level of trauma caused in certain situations. However, the form of the tip allows a lesser degree of force to be used, which reduces the risk of the trocar penetrating the cavity wall in a less controlled manner and thus decreasing the possibility of injury of internal organs, vessels or other internal abdominal structures by the trocar tip on insertion of the obturator 300 and cannula 100.
As can be appreciated from the figures, a plane of the tip which is substantially aligned with the front edge 311 and the rear edge 312 is substantially parallel with both a longitudinal axis of the handle portion 320, and also with a longitudinal axis 331 of the obturator itself. This fore-aft alignment of the tip 310 with the longitudinal dimension of the handle portion 320 means that the tip 310 and its front and rear edges 311 and 312 are better aligned with the hand of a user when gripping the body or handle portion 320 of the obturator, specifically when combined with the cannula 100. This can improve the overall ergonomics of the laparoscopy trocar, facilitating insertion of the trocar into the abdominal cavity. It can be preferable to have the sharp or front edge 311 oriented in the direction described for the following reasons:
Regarding the rear face 312, the convex rear face is significantly elongated in comparison to the front edge, as this will reduce its angle of insertion and thus concur to minimize the insertion force.
Any part of the obturator, cannula or the laparoscopy trocar assembly described herein may be manufactured by automated manufacturing means and methods. Such means and methods can include material removal techniques, and/or additive manufacturing systems and techniques, which are commonly known as 3D-printing systems and techniques. Such manufacturing methods generally require the creation of a computer readable model of the product to be manufactured. From that virtual three-dimensional model, a computer can derive a set of instructions to instruct a 3D printer to manufacture the product, or indeed for a material removal device to “machine” the product from a block of material, by methods generally known as material removal techniques. Different materials having different properties can be better suited to either additive manufacture, or material removal techniques, but both generally start from a 3D model and generate instructions from the model to control a 3D printer or material removal device (often called a CNC-computer numerically controlled-machining device). Such devices are widely available and are not described herein in the interests of efficiency of the disclosure, but such devices will be well known to the person skilled in the art of such automated manufacturing techniques and apparatus'. Suitable 3D models for generating manufacturing instructions can be general 3D CAD (computer aided design) files and those themselves can be considered a computer programme product suitable for generating instructions for the manufacture of the product by automated manufacturing means. Such models can be interpreted by 3D printing software, or a 3D printer device, in order to manufacture the products. Further, metal removal, or CNC machining software can also interpret the CAD models to create instructions for a material removal device to create the product from a block of solid material. Further, such 3D CAD files can be used to create a form for a mould for manufacturing the device by moulding processes, such as injection moulding. Injection moulding can be the most efficient way of manufacturing the components described herein and so use of the described CAD files representing the product to create moulds for injection moulding of the product is included within the scope of this disclosure.
Although the invention has been described above with reference to one or more preferred embodiments, it will be appreciated that various changes or modifications may be made without departing from the scope of the invention as defined in the appended claims.
Number | Date | Country | Kind |
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1614658.1 | Aug 2016 | GB | national |
Filing Document | Filing Date | Country | Kind |
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PCT/EP2017/071767 | 8/30/2017 | WO | 00 |