CH712350A2 - Trocarset, in particular for eye-contour surgery, and protective cap therefor. - Google Patents

Abstract

The invention relates to a trocar assembly, in particular for ophthalmic posterior surgery, comprising an instrument for setting a cut, the instrument comprising at least one stem (11) with one at a first end (15) of the stem (11) in extension of the stem (11) formed needle (19) with a tip (25), a tube (21) which on the needle (19) plugged or plugged, a protective cap (13) attachable to the first end (15) of the stem ( 11) for covering the needle (19) and tube (21), as far as it is placed on the needle (19), and a marking element (31) for marking a puncture site. Furthermore, the invention relates to a protective cap (13) for a trocar. According to the invention, provision is made for the marking element (31) to be arranged on the protective cap (13) and / or for the protective cap to have two spaced-apart arms (35, 37) spaced apart from one another in the longitudinal direction of the protective cap (13).

Description

description

TECHNICAL FIELD OF THE INVENTION

The invention comprises a trocar assembly (es), in particular for the eye-back surgery, according to the preamble of claim 1 or 2. Furthermore, the invention comprises a protective cap for a trocar.

BACKGROUND OF THE INVENTION

A trocar is a surgical instrument that provides access to a body cavity and keeps it open. In particular, a trocar includes a tube (i.e., a tube, cannula, cannula tube, cannula) in which a needle with handle and tip removably inserted, which is needed to seat the tube. The front part of the needle is expediently designed as a point, in particular as a blade (for example a triangular point). The needle is attached to a handle member via its rear part (i.e., the rear part facing away from the tip). The needle and the tube are inserted together through a tissue cover into a body cavity, so that the tube extends through the tissue cover into the body cavity and thereby forms an access to the body opening. After withdrawing the needle from the tube, surgical instruments may be passed through the tube into the body cavity, e.g. an optic (endoscope), grasping and / or cutting instrument, or fluids (e.g., irrigation fluid) and gases are vented or introduced across the tube.

In particular, in ophthalmic surgery, the site is marked at the insertion of a trocar, at which the tube is to be set, in particular, a certain distance is advantageously marked by the corneal edge. A marker used for this purpose is formed in common Trokarausführungen at the rear end of the handle member of the needle in the form of a survey structure. When using such an embodiment, the handle part must be turned over with its pointed needle after marking by 180 degrees to set in particular after marking with the needle at the front end of the handle portion of the tube. If necessary, the turning over can be done with one hand. However, the surgeon runs the risk of injuring himself at the tip of the needle due to carelessness, or at least injuring the surgical glove, thereby rendering both the tip and the surgical field non-sterile. At least a change of gloves would be necessary, which would lead to additional costs and a prolonged duration of surgery. In addition, the operator runs the risk of carelessness with the needle tip to push objects or clothing, whereby the tip can be contaminated and damaged.

After insertion of the tube at the desired location, the needle is pulled out without the tube with pull out. To do this, the tube is usually held back with tweezers at the setting site while the needle is pulled out of the tube. Furthermore, the tube is removed from the eye after surgery. Again, tweezers are usually used for this purpose. The need to use tweezers or other aids often also carries the risk of cross-contamination with risks for the patient.

TASK

It is therefore an object of the present invention to provide an alternative surgical instrument set for setting access into a body cavity, which is usable in the simplest possible, safer and efficient manner. In particular, an alternative surgical trocar system or a trocar set is to be provided. Specifically, a trocar kit or trocar set is to be provided for ophthalmic posterior segment surgery, or a trocar system or trocar set is to be proposed for use in ocular posterior segment surgery. In addition, means are to be provided which improve the handling of a trocar or a trocar system or trocar set, in particular for use in eye-back surgery. A risk of injury to the treating surgeon when handling the instrument should be as low as possible or preferably not pass. Furthermore, the danger of contamination when setting trocar accesses and, in particular during operations on the back part of the eye, should be as low as possible. The number of work steps, which are necessary for setting an access into a body cavity, should expediently be reduced as possible or be low.

DESCRIPTION OF THE INVENTION

This invention fulfills the foregoing requirements by providing a trocar assembly, particularly for ophthalmic posterior segment surgery, including an instrument for placement of an incision, the instrument comprising at least one pedicle with an extension at a first end of the pedicle a needle which is attached to the needle, a protective cap which can be placed on the first end of the handle for covering the needle and tube (cannula) insofar as it is placed on the needle, - A marking element for marking a puncture site, characterized in that the marking element is provided on the protective cap.

This trocar kit has the advantage that it allows a quick and safe operation in a few steps.

The tube, when attached to the needle, is in particular strippable from the needle. He is e.g. designed as a hollow access sleeve open at both ends and optionally provided with a valve. Conveniently, the marking element is suitable for marking a puncture site in a tissue, in particular a body tissue, e.g. on the eye.

Preferably, the marking element is formed on the tip of the protective cap. In this case, the tip of the protective cap can be designed in the form of an edge. The edge is expediently designed such that it runs perpendicular to the longitudinal extent of the needle in the protective cap placed on the style. Preferably, the edge of the protective cap crosses the needle axis in extension of the needle at a position in front of the needle when the protective cap is placed on the style.

Conveniently, the marking element has at least two spaced-apart elevations, e.g. trained as thorns, up. These elevations are expediently formed on the aforementioned edge (in particular projecting beyond this) in a spaced arrangement.

In a preferred arrangement, the marking element is formed or aligned on the cap so that when attached to the stem cap one or more surveys of the marking element (especially in extension of the base (or the reason) to the saddle point of the respective Survey) with attached protective cap have a parallel to the needle and rectified alignment. This is for the purpose of similar handling of the stem regardless of whether to mark a site for the puncture or for setting the tube.

The protective cap includes in particular a cap edge and a cap tip. Advantageously, the cap on the cap side preferably at least two spaced-apart, substantially parallel to each other in the longitudinal direction of the cap aligned arms. In a preferred example, the cap on two cap edge side two spaced apart substantially in the longitudinal direction of the cap parallel aligned arms on.

The stem has (esp. For receiving the arms) along the longitudinal side preferably at least two spaced-apart, substantially in the longitudinal direction of the stem parallel to each other aligned grooves or channels, in which the arms of the protective cap can engage. In a preferred example, the handle has on the longitudinal side two spaced-apart, substantially in the longitudinal direction of the stem parallel aligned grooves or channels, in which the arms of the protective cap can engage.

The arms, especially in combination with the grooves or channels, act as a guide of the protective cap when removing or optionally when placing the cap. The protective cap can be placed on the first (front) end of the handle and thus over the needle. The guide is used to protect the needle, in particular its cutting tip or the blade when removing the cap by the user, since the needle or blade is very sensitive and slightly bent when in contact with other objects. The guide further provides some sort of protection against twisting the protective cap over the style, which is advantageous in making a mark.

The arms of the protective cap are preferably designed such that they, esp. When the protective cap is removed from the stem, are used as tweezers.

Preferably, the length of the arms of the protective cap calculated from cap edge is greater than the length of the cap from top to cap edge. The length of the arms is preferably in the range of 1 cm to 7 cm, preferably in the range of 1.5 cm to 6 cm and more preferably in the range of 2 cm to 5 cm.

The stem is optionally formed such that the protective cap is also placed on the second end of the stem further. Respectively. The second (rear) end of the stem is optionally formed such that the protective cap can be plugged thereon. This results in an extension of the stem or handpiece, which can have ergonomic advantages.

Optionally, the grooves or channels extend substantially along the entire longitudinal extension of the stem. As a result, the protective cap can be placed on each of the two ends of the stem.

Conveniently, the tip of the needle is designed as a cutting tip, in particular for setting a cut for insertion of the needle and tube into a body cavity, When attached to the needle tube, the needle closes the opening of the tube substantially and / or it protrudes the needle tip out of the tube.

Preferably, the tube is equipped with a valve.

The trocar set may be designed as a disposable item.

The handle is expediently designed or shaped as a handle body or handle.

In an alternative embodiment, there is provided a trocar set, in particular for ophthalmic posterior segment surgery, comprising - an incision setting instrument comprising at least one pedicle with a stylet tip formed at a first end of the pedicle in extension of the pedicle, - A tube which is plugged or plugged onto the needle, - A protective cap placed on the first end of the stem for covering the needle and tube, insofar as it is placed on the needle, - A marking element for marking a puncture site, thereby distinguished that the cap on the cap side two spaced apart, substantially parallel to each other in the longitudinal direction of the cap parallel aligned arms.

This invention meets the foregoing requirements by further providing a protective cap for a trocar or its needle point, in particular for a trocar for the eye-behind section surgery, wherein a marking element is provided for marking a puncture site on the protective cap. Preferably, the marking element is formed on the tip of the protective cap. The trocar includes in particular a tube in which a needle is inserted. The needle is equipped at its rear end with a handle, in particular a handle, and at its front end with a tip. Tube and needle are conveniently detachable from each other.

The cap optionally has the cap edge side two spaced apart, substantially in the longitudinal direction of the cap parallel aligned arms. The arms are preferably designed such that they can be used as tweezers. The length of the arms of the protective cap calculated from the cap edge is preferably greater than the length of the protective cap from tip to cap edge.

In addition, a protective cap for a trocar is disclosed, which is characterized in that it has two spaced-apart cap edge side, substantially parallel to each other in the longitudinal direction of the cap aligned arms.

Named optional features can be realized in any combination, as far as they are not mutually exclusive.

Additional advantages of the present invention will become apparent from the following description. BRIEF DESCRIPTION OF THE FIGURES

Further advantages and features of the invention will become apparent from the following detailed description of an embodiment of the invention with reference to schematic representations. In a not to scale, schematic representation:

1 shows a view of a trocar set according to the invention with the protective cap placed on the front end, in particular covering the needle and optionally the tube;

2 shows an exploded view of a trocar set according to the invention;

3 shows a view of a trocar set according to the invention with the protective cap placed on the rear end;

4 shows a view of a trocar set without the protective cap;

5 shows a protective cap according to the invention in three side views: (a) first side view, (b) second side view, rotated 90 degrees relative to the first side view, and (c) third side view, rotated 180 degrees from the first side view.

DETAILED DESCRIPTION OF THE FIGURES

In FIGS. 1-3, a trocar set according to the invention is shown in different ways of representation. FIG. 4 shows a trocar set according to the invention without its protective cap, and FIG. 5 shows a protective cap of a trocar set according to the invention in three views. In the following, the same reference numerals for the same or functionally identical elements in different figures.

A trocar set according to the invention includes a stem 11 (i.e., an elongated handle member, for example) and a protective cap 13 as shown in FIG. The stem serves as a handle. The stem 11 has a front end 15 and a rear end 17. In Fig. 1, the protective cap 13 is attached to the front end of the stem 11. The plugged-on at the front end 15 of the handle 11 protective cap 13 covers and protects a needle 19 and optionally a tube 21, which can be strippably attached to the needle 19. Needle 19 and tube 21 are visible in FIG.

As shown in Fig. 2, a receptacle 23 for a needle 19 is formed at the front end 15 of the stem 11. The needle 19 may be secured in the receptacle 23 or secured therein, e.g. by pressing in or another type of fastening. Needle 19 and stem 11 are thus firmly connected or firmly connected. The needle 19 is thus attached via its rear part on the stem 11. The handle 11 serves as a handle by means of which a surgeon can push the needle 19 with the plugged onto the needle 19 tube 21 into a tissue cover over a body cavity and pull out with retention of the tube 21 again to tube 21 access to the body cavity to lay.

An inventive trocar set thus further includes the needle 19, which is attached to the stem 11, and the tube 21, which can be pushed onto the needle 19 and is pushed. The tube 21 is in particular releasably pushed onto the needle 19 or attached. Needle 19 and tube 21 are conveniently such that the tube 21 is e.g. can be withdrawn from the needle 19 by grasping with tweezers.

Tubus 21 and needle 19 are preferably designed such that the front end 27 of the pushed onto the needle 19 tube 21 is closed by the needle 19. Conveniently, at least the tip 25 of the needle 19 protrudes from the front end 27 of the tube 21 and beyond the front edge 27 of the tube 25 also. As a result, the needle 19 can puncture or cut the tissue during insertion into a tissue layer. At the same time, upon further penetration of the needle 19 into the tissue layer, the tube 21 is pushed together with the needle 19 into the tissue layer. When the needle 19 is retracted (ie, pulled away from the tissue layer), the tube 21 may slide off the needle 19 (ie, with the aid of tweezers, the tube 21 may be stripped from the needle 19) and remain in the tissue layer, providing access to the body cavity is laid.

The needle 19 has expediently a tapered tip 25. Preferably, the tip 25 is designed as a cutting blade, so that it can pierce or cut through a fabric ceiling.

Tubus 21 and needle 19 together form a trocar.

The tube 21 has expediently at its rear end 29 an enlarged opening (preferably with a valve), which serves to accommodate surgical tool and leads easier. A valve may help to keep access through the tube as close as possible to, or seal against, a penetrating surgical tool or lead, e.g. Liquid in the body cavity can not escape through the tube 21.

A valve 30 may be mounted on the tube 21. Conveniently, the valve 30 is mounted on the rear part of the tube 21. The valve 30 can sit together with the tube 21 on the needle 19. Valve 30 and tube 21 are preferably inserted into one another. Valve 30 and tube 21 can be stripped together from the needle 19. The valve 30 may optionally be removed from the tube 21 or the use of a valve 30 is optional. The trocar, i. Tubus 21 and needle 19, and the tube 21 is optionally also without a valve used.

On the cap 13, preferably on the cap tip 34, a marking element 31 is provided, which is suitable for marking a puncture site in a body tissue. The marking element 31 expediently comprises at least two elevations, preferably e.g. three rectified peaks, e.g. formed as thorns on a straight line with precisely defined distances from each other; for example 3 mm between first and second elevation and 1 mm between second and third elevation, and thus 4 mm between first and third elevation. When the protective cap 13 is placed on the stem 11, said straight line crosses the needle axis (i.e., axis in extension of the needle) at a position in front of the needle point 25. The straight line and needle axis are expediently oriented perpendicular to one another. The said straight line is designed here in particular as an edge.

The protective cap 13 preferably has at least two arms 35, 37 projecting parallel from the protective cap edge 33 substantially in the longitudinal direction of the protective cap. These arms 35, 37 serve for clamping the cap 13 on the stem 11 and for placing and depositing the cap 13 for guiding the protective cap 13 and on the other hand, when the cap 13 is removed from the stem 11, as tweezers. In both cases, it is advantageous if the arms 35, 37 have elastic properties.

Conveniently, the handle 11 laterally at least two grooves 41, 42 in a longitudinal direction, which are designed such that therein when attaching the cap 13 to the front end 15 or optionally the rear end 17 of the handle 11, the arms 35th , 37 of the protective cap 13 are received. Preferably, the at least two grooves 41, 42 are formed along the entire extension of the stem. These grooves 41, 42 serve to guide during placement and removal of the protective cap. In particular, this function protects the cutting tip 25 from damage when placing and removing the protective cap 13 over the front end 15 of the handle 11. The arms 35, 37 of the protective cap 13 and the grooves 41 41 of the handle 11 are in particular for the purpose mentioned in terms of their shape coordinated.

In Fig. 1, a trocar set with over the front end 15 of the handle 11 patch cap 13 is shown. This arrangement is particularly useful for protecting the needle tip during delivery and storage and during preparation for surgery. In particular, with the marking elements 31 on the protective cap tip 34, the location in the tissue can be marked, where access to a body cavity is to be set.

In Fig. 3, a trocar set with over the rear end 17 of the handle 11 patch cap 13 is shown. This arrangement is e.g. useful in setting access into a body cavity by e.g. the cap extends the handle 11 to improve the grip. Alternatively, the cap 13 may also be discarded after marking. In that case, the trocar set as shown in Fig. 4 may be used for setting access into a body cavity without a cap 13.

In Fig. 5, the protective cap 13 is shown in three views, respectively rotated in sequence of Fig. 5a, Fig. 5b and Fig. 5c by 90 degrees about the longitudinal axis.

For better clamping action on the stem 11, the arms 35, 37 on the inside elevations 43, 44 and the grooves 41, 42 as a counterpart to the elevations 43, 45 at a suitable location notches 43, 44. Alternatively, the arms could have notches and the grooves could have mating elevations.

The arms 35, 37 of the protective cap 13 are further advantageously designed as tweezers, i. the arms 35, 37 are such that the arm ends 45, 47 can be manually compressed against each other with the fingers of one hand to grasp an object, i. the arms 35, 37 have a certain elasticity. So that the grasping of objects, in particular of the tube 21, can be carried out particularly advantageously, the arms 35, 37 are tapered towards the respective end 45, 47 and / or expediently have a notch 46, 48 which corresponds to the object to be grasped can be adjusted.

The trocar set according to the invention is particularly suitable for use in posterior segment surgery in which the working access to the posterior segment of the eye is set by means of the trocar system.

On the end 34 of the tapered, inventive cap 13 (or at the cap tip 34) are the marking elements 31 for marking the eye tissue. A surgeon can, without the handpiece, which he holds in a first hand to rotate 180 degrees, in the following order, first put a mark on the eye tissue, secondly deduct the protective cap 13 with the second hand from the handle 11, third by pushing the Needle 19 in the eye, place the tube 21 in the tissue cover and fourthly with the arms 35, 37 of the still in the second hand of the surgeon protective cap 13 strip the tube 21 of the needle 19 by the arms 35, 37 as Tweezers used. Marking and puncture can thus be carried out successively with the same hand and without the handle 11 from the hand.

Marked and pierced is usually in the sclera (dermis) of the eye in about 3-4 mm distance to the corneal edge as possible in the area of Pars Plana.

Characterized in that the marking element 31 is formed or aligned in such a way on the protective cap 13 that the individual elevations of the marking element 31 (in particular in extension from the base to the saddle point of each survey) with attached protective cap 13 a to the needle 19 parallel and rectified alignment, it can be ensured that the handling of the stem 11 when marking a puncture site and when inserting the needle 11 after removing the cap 13 is as similar as possible. This is advantageous to the surgeon since, regardless of whether the surgeon makes a mark or makes a puncture of the needle, the positions and trajectory of the surgeon, i. e.g. his standing position and posture or his arm positions and hand positions of the arm of the performing hand during the execution movements are essentially the same.

The arms 35, 37 of the cap 13 serve, on the one hand, to avoid tilting the cap 13 against the longitudinal axis of the handle 11 and thus potentially damaging the cutting blade 25 of the needle 19. The pointed ends 45, 47 of the arms 35, 37 of the protective cap 13 are also suitable as tweezers for removing the tube 21 from the needle 19.

The protective cap 13 may optionally, as in the case of a fountain pen, be attached to the rear side 17 of the handpiece 11. Thus, the handpiece or the handle 11 is extended and improves the ergonomics.

The trocar set 9 according to the invention combines the functions of a protective cap, a marking element and tweezers in a single element, namely the protective cap 13 according to the invention.

While specific embodiments have been described above, it will be apparent that various combinations of the illustrated embodiments may be practiced insofar as the embodiments are not mutually exclusive.

While the invention has been described above with reference to specific embodiments, it is obvious that changes, modifications, variations and combinations may be made without departing from the spirit of the invention.

REFERENCE LIST

9 trocar set 11 stem, also called handle or handpiece 13 protective cap 15 front end of the stem 17 rear end of the stem 19 needle, also called blade

Claims (17)

23 Tube for the needle 25 Tip of the needle, also called cutting tip 27 Front end of the tube, front edge of the tube with tube opening 29 Rear end of the tube, rear edge of the tube Tube with extended tube opening 30 Valve 31 Marking elements 33 Protective cap rim 34 Cap tip 35 First arm 37 Second arm 41 First groove 42 Second groove 43 First elevation 44 Second elevation 45 First rejuvenation 46 First notch 47 Second rejuvenation 48 Second notch Claims A trocar assembly, particularly for ophthalmic posterior surgery, comprising - an incision setting instrument including at least one stem (11) with an extension of the stem at a first end (15) of the stem (11) (11) formed needle (19) with a tip (25), - a tube (21) which on the needle (19) plugged or attachable, - a protective cap (13) placed on the first end (15) of the Handle (11) for covering the needle (19) and tube (21), as far as it is placed on the needle (19), - a marking element (31) for marking a puncture site, characterized in that the marking element (31) on the Protective cap (13) is provided. 2. A trocar assembly, in particular for ophthalmic posterior surgery, comprising - an instrument for setting a cut containing the instrument at least one stem (11) with one at a first end (15) of the stem (11) in extension of the stem (11) formed needle (19) with a tip (25), - a tube (21), softer on the needle (19) plugged or plugged, - a protective cap (13) placed on the first end (15) of the Stem (11) for covering the needle (19) and tube (21), as far as it is placed on the needle (19), - a marking element (31) for marking a puncture site, characterized in that the cap cap side two spaced apart, Has arms (35, 37) aligned parallel to one another in the longitudinal direction of the protective cap (13). 3. A trocar kit according to one of the preceding claims 1 or 2, characterized in that the marking element (31) is formed on the tip (34) of the protective cap (13). 4. A trocar set according to one of the preceding claims 1 or 3, characterized in that the cap on the cap side has two spaced apart, substantially in the longitudinal direction of the cap (13) mutually parallel arms (35, 37). 5. A trocar set according to one of the preceding claims 2 or 4, characterized in that the stem (11) has longitudinally two spaced apart, substantially in the longitudinal direction of the stem parallel aligned grooves (41,42) or channels, in which the arms (35, 37) of the protective cap (13) can engage. 6. A trocar set according to one of the preceding claims 2, 4 or 5, characterized in that the arms (35, 37) of the protective cap (13) are designed in such a way that they, in particular when the protective cap (13) from the stem (11 ), are usable as tweezers. 7. A trocar set according to one of the preceding claims 2, 4-6, characterized in that the length of the arms (35, 37) of the protective cap (13) calculated from the cap edge (33) is greater than the length of the protective cap (13) of Tip (34) to cap edge (33). 8. A trocar set according to any one of the preceding claims 2, 4-7, characterized in that the grooves (41, 42) or channels extend substantially along the entire longitudinal extent of the stem (11). 9. A trocar set according to one of the preceding claims 1-8, characterized in that the protective cap (13) can be placed further on the second end (17) of the handle (19). 10. A trocar set according to one of the preceding claims 1-9, characterized in that on the style (11) attached to the protective cap (13), the marking element (31) and the needle (19) have rectified alignment. 11. A protective cap for a trocar, characterized in that a marking element (31) for marking a puncture site on the protective cap (13) is provided. 12. A protective cap for a trocar, characterized in that the protective cap (13) cap edge side two spaced apart, substantially in the longitudinal direction of the protective cap (13) mutually parallel arms (35, 37). 13. A protective cap according to claim 11, characterized in that the marking element (31) is formed on the tip (34) of the protective cap (13). 14. A protective cap according to claim 11, characterized in that the tip of the protective cap is designed in the form of an edge, wherein the marking element, which consists of at least two mutually objected elevations, is formed on the aforementioned edge. 15. A protective cap according to any one of claims 11,13 or 14, characterized in that the protective cap (13) cap edge side two spaced, substantially in the longitudinal direction of the cap (13) mutually parallel arms (35, 37). 16. A protective cap according to any one of claims 12, 14 or 15, characterized in that the arms (35, 37) of the protective cap (13) are formed such that they can be used as tweezers. 17. A protective cap according to any one of claims 12, 14, 15 or 16, characterized in that the length of the arms (35, 37) of the protective cap (13) calculated from the cap edge (33) is greater than the length of the protective cap (13) from top (34) to cap edge (33).