1. Technical Field
The present disclosure relates to an apparatus for penetration of body tissue. More particularly, the present disclosure relates to an obturator including an instrument holding mechanism for selectively securing an endoscope, laparoscope, or other surgical instruments within the obturator to provide visualization during penetration of the peritoneum or other body tissue.
2. Background of Related Art
In endoscopic surgical procedures, surgery is performed in any hollow viscus of the body through a small incision or through narrow endoscopic tubes (cannulas) inserted through a small entrance wound in the skin or through a naturally occurring orifice. In laparoscopic procedures, surgery is performed in the interior of the abdomen. Laparoscopic and endoscopic procedures often require the clinician to act on organs, tissues and vessels far removed from the incision, thereby requiring that any instruments used in such procedures be of sufficient size and length to permit remote operation. Generally, a trocar includes a stylet or obturator having a sharp tip for penetrating the body cavity. Typically, a trocar is used to puncture the body cavity and may include a cannula that remains in place for use during the laparoscopic procedure. Subsequently, the surgical region is insufflated thereby creating a working space.
It may be advantageous to provide an obturator that can be placed within an incision or body opening of a patient with a structure to retain a viewing instrument in a desired position during a surgical procedure.
Accordingly, the present disclosure relates to devices for accessing/penetrating body tissue during a surgical procedure. The present disclosure is directed to a surgical device for directly observing the penetration of the peritoneum or other body portions. The surgical device includes an obturator and an instrument retention element. The obturator includes a transparent window for passing optical images to a clinician, directly through an eyepiece or to an imaging system of an endoscope or laparoscope positioned within the obturator.
The device includes an elongate tubular member including a proximal end, a distal end, a sidewall defining a bore between the proximal and distal ends, and an instrument retention element that partially obstructs the bore. The device may include a housing near the proximal end. The instrument retention element is configured to receive an instrument. The instrument retention element may also be configured to hold instruments with a plurality of diameters. The instrument retention element may also be configured to restrict the movement of the instrument. The instrument may be a scope.
In an embodiment of the device, the instrument retention element is located between the housing and the distal end. In this embodiment, the instrument retention element is made from an elastomeric material. The elastomeric material may form an o-ring. The elastomeric material may expand around the instrument when receiving the instrument such that the interference between the instrument retention element and the instrument restricts the movement of the instrument. An inner surface of the sidewall may include a retainer to retain the instrument retention element in a longitudinal position within the elongate tubular body. The retainer may be a depression in the inner surface. The depression may form an annular groove. The retainer may also be parallel ribs protruding from the inner surface. The parallel ribs may form rings.
In another embodiment of the device, the instrument retention element may be located at the proximal end of the device. In this embodiment, the instrument retention element includes a flange at least partially obstructing the bore and at least one longitudinal slot through the instrument retention element. The slot may be configured to expand when the instrument retention element receives an instrument. The instrument retention element may be constructed of a rigid material.
In an embodiment, the device includes an elongate tubular member including a proximal end, a distal end, a sidewall defining a bore between the proximal and distal ends, and an instrument retention element which partially obstructs the bore. The elongate tubular member includes first and second flanges near the proximal end. The first and second flanges may be cylindrical. The first and second flanges define a housing which may include a slot configured to retain the instrument retention element. The instrument retention element is configured engage an instrument. The instrument retention element may be configured to engage instruments with a plurality of diameters. The instrument retention element may also be configured to restrict the movement of the instrument. The instrument may be a scope.
In a particular embodiment of the device, the instrument retention element is made from a compliant material located in the housing. In this embodiment, the instrument retention element may partially deform when the instrument retention element receives an instrument.
In another embodiment of the device, the instrument retention element is made from a rigid material. In this embodiment, the instrument retention element may include a backspan connecting two legs. The instrument retention element may act like a leaf spring when the instrument retention element engages an instrument. Each of the two legs may also include a locking mechanism. The locking mechanism may be a tab configured to be received by the housing. The tab may be configured to act like a clip to engage a wall of the housing.
The present disclosure relates to devices for accessing/penetrating body tissue during a surgical procedure. The present disclosure is directed to a surgical device for directly observing the penetration of the peritoneum or other body portions. The obturator may include a transparent window for passing optical images to a clinician, directly through an eyepiece or to an imaging system of an endoscope or laparoscope positioned within the obturator.
The device may include an elongate tubular member including a proximal end, a distal end, a sidewall defining a bore between the proximal and distal ends, and an instrument retention element which partially obstructs the bore. The instrument retention element may be configured to receive an instrument. The instrument retention element may also be configured to hold instruments with a plurality of diameters. The instrument retention element may also be configured to restrict the movement of the instrument. The instrument may be a scope.
In an embodiment of the device, the instrument retention element may be near the distal end of the elongate tubular member. The instrument retention element may be made of a compliant material which is configured to partially deform when receiving an instrument. In this embodiment, the instrument retention element may be positioned within a tip positioned at the distal end of the obturator. The instrument retention element may be secured to an interior surface of the sidewall or located in a recess of the interior surface.
In another embodiment of the device, the instrument retention element may be located between the housing and the distal end. In this embodiment, the instrument retention element may be made from an elastomeric material. The elastomeric material may form an o-ring. The elastomeric material may expand around the instrument when receiving the instrument such that the interference between the instrument retention element and the instrument restricts the movement of the instrument. An inner surface of the sidewall may include a retainer to retain the instrument retention element in a longitudinal position within the elongate tubular body. The retainer may be a depression in the inner surface. The depression may form an annular groove. The retainer may also be parallel ribs protruding from the inner surface. The parallel ribs may form rings.
In accordance with various embodiments, the present disclosure may also relate to a surgical device including an obturator and an instrument retention element. The obturator includes a sidewall having an arcuate inner surface that defines a central longitudinal channel into which an instrument may be inserted. The instrument retention element engages the sidewall of the obturator such that at least a portion of the o-ring extends radially inward of the arcuate inner surface so as to engage an instrument inserted into the central longitudinal channel of the obturator.
The instrument retention element may be configured to engage an endoscope. The instrument retention element may be configured to engage instruments of varying diameters. The instrument retention element may be configured to restrict the longitudinal movement of the instrument relative to the obturator. The instrument retention element may be made from an elastomeric material. The instrument retention element may be an o-ring.
In an embodiment, the arcuate inner surface has a retainer configured to retain the instrument retention element. The retainer may include at least one of a depression, an annular groove, a rib, or a ring. The obturator may include an elongate tubular member which forms a portion of the sidewall, the instrument retention element being located on the elongate tubular member. The obturator may include a handle which forms a portion of the sidewall, the instrument retention element being located on the handle.
In another embodiment, the present disclosure may relate to a surgical device, including an obturator and an instrument retention element. The obturator includes a sidewall having an arcuate outer surface. The sidewall has an arcuate inner surface that defines a central longitudinal channel into which an instrument may be inserted. The sidewall further defines at least one bore extending between the arcuate inner and outer surfaces of the sidewall. The instrument retention element engages the arcuate outer surface of the obturator such that the instrument retention element extends radially into the bore. At least a portion of the instrument retention element extends radially inward of the arcuate inner surface so as to engage an instrument inserted into the central longitudinal channel of the obturator.
The instrument retention element may be configured to engage an endoscope. The instrument retention element maybe configured to engage instruments having varying diameters. The instrument retention element may be further configured to restrict the longitudinal movement of the instrument relative to the obturator. The instrument retention element may be made from an elastomeric material. The instrument retention element may be an o-ring. The obturator may include an elongate tubular member which forms a portion of the sidewall, the instrument retention element being located on the elongate tubular member. The obturator may include a handle which forms a portion of the sidewall, the instrument retention element being located on the handle.
A method for using an obturator with any one of the presently disclosed instrument retention elements is also disclosed. The method includes making a first incision or accessing a naturally occurring orifice. A cannula is placed within the incision or orifice and secured in a desired position. The cannula is secured in the desired position and an obturator including one of the presently disclosed instrument retention elements is inserted into the cannula. A housing on the obturator may be configured to secure the obturator to the cannula. An instrument is inserted into a bore of the obturator and is received by the instrument retention element. The instrument retention element may be configured to allow the clinician to insert the instrument into a desired position within the bore and maintain the instrument in the desired position after the instrument is released by the clinician. The instrument may allow the clinician to directly or indirectly view a body cavity through the obturator.
In still another embodiment, the present disclosure may relate to a method of using a surgical device including providing an obturator, inserting an instrument into a central longitudinal channel of the obturator such that an instrument retention element engages the instrument and restricts longitudinal movement of the instrument relative to the obturator, and using the obturator to engage tissue during a surgical procedure. The obturator includes a sidewall having an arcuate outer surface. The sidewall has an arcuate inner surface that defines the central longitudinal channel. The sidewall further defines at least one bore extending between the arcuate inner and outer surfaces of the sidewall. The obturator also includes the instrument retention element engaging the arcuate outer surface of the obturator such that the instrument retention element extends radially into the bore. At least a portion of the instrument retention element extends radially inward of the arcuate inner surface. The obturator may be formed of a clear material. The instrument may be an endoscope. In such an arrangement, the obturator may be used to penetrate tissue while the endoscope provides a visual image of the tissue being penetrated.
The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments of the disclosure and, together with a general description of the disclosure given above, and the detailed description of the embodiment(s) given below, serve to explain the principles of the disclosure, wherein:
As used herein, the term “distal” refers to the portion that is being described which is farther from a user, while the term “proximal” refers to the portion that is being described which is closer to a user. In the following description, well-known functions or constructions are not described in detail to avoid obscuring the present disclosure in unnecessary detail. Further, to the extent consistent, any of the embodiments described herein may be used in conjunction with any or all of the other embodiments described herein.
Referring now to the drawings, in which like reference numerals identify identical or substantially similar parts throughout the several views,
Device 10 includes elongate tubular member 20 having proximal end 21, distal end 22, and sidewall 23. Sidewall 23 defines bore 24 extending between proximal end 21 and distal end 22 as shown in
Now referring to
First and second flanges 25, 26 define housing 30 therebetween. Housing 30 may include instrument retention element 40 as shown in
Now referring to the embodiment shown in
In a particular embodiment of device 10, instrument retention element 40 is made from a compliant material. In this embodiment, instrument retention element 40 partially deforms when engaging instrument 280 as shown in
In another embodiment of device 10 shown in
Referring now to
In yet another embodiment of device 10 illustrated in
In still another embodiment of device 10 illustrated in
This embodiment may include retainer 82 in interior surface 23a of sidewall 23 configured to retain instrument retention element 80 in a fixed longitudinal position within bore 24. Retainer 82 may be a depression as shown in
In still yet another embodiment of device 10 illustrated in
In another embodiment, the present disclosure may relate to a surgical device in which the instrument retention element resides and is supported on the outer surface of the obturator, but extends into the longitudinal channel of the obturator through bores defined by a sidewall of the obturator. An example embodiment of such an arrangement is shown in, e.g.,
Advantageously, and as set forth above in connection with other embodiments described herein, the instrument retention element 80 may be made from an elastomeric material. The instrument retention element 80 may be an o-ring. It should also be noted that the instrument retention element 80 may be located on either the elongate tubular member or the handle located at the proximal end of the obturator.
The embodiment shown in
In order to use the surgical device shown in
Referring now to
Once cannula 210 is secured in a desired position, surgical device 10 is then inserted and secured to cannula 210. Alternatively, if surgical device 10 was used to create incision 255 or surgical device 10 is inserted in a natural orifice, surgical device 10 may be is inserted in cannula 210 before incision 255 is created. Once inserted cannula 210 is in the desired position, surgical device 10 is inserted into body cavity 254 until housing 30 mates with the proximal end 211 of cannula 210. Housing 30 may be configured to secure surgical device 10 to cannula 210.
When surgical device 10 is in the desired position, the clinician inserts instrument 280 into bore 24. When instrument 280 is inserted into bore 24, instrument 280 is engaged by an instrument retention element (any of the disclosed instrument retention elements 40, 60, 70, 80, or 90 may be used). The instrument retention element may be configured to allow the clinician to insert instrument 280 to a desired position within bore 24 while maintaining instrument 280 in the desired position once the clinician releases instrument 280.
Once in the desired position, the clinician is able to directly view body cavity 254 through instrument 280 or indirectly view body cavity 254 on a monitor (not shown) receiving a signal from instrument 280.
While several embodiments of the disclosure have been shown in the drawings, it is not intended that the disclosure be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. Any combination of the above embodiments is also envisioned and is within the scope of the appended claims. Therefore, the above description should not be construed as limiting, but merely as exemplifications of particular embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.
This application is a National Stage Application of PCT/US2014/011592 under 35 USC §371 (a), filed Jan. 15, 2014, which claims the benefit of and priority to U.S. Provisional Application Ser. No. 61/754,014, filed Jan. 18, 2013, and U.S. Provisional Application Ser. No. 61/754,022, filed Jan. 18, 2013, and U.S. Provisional Application Ser. No. 61/754,026, filed Jan. 18, 2013, the disclosure of each is hereby incorporated by reference in its entirety.
Filing Document | Filing Date | Country | Kind |
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PCT/US2014/011592 | 1/15/2014 | WO | 00 |
Number | Date | Country | |
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61754014 | Jan 2013 | US | |
61754022 | Jan 2013 | US | |
61754026 | Jan 2013 | US |