CN104510507B - 柔性插管和插塞 - Google Patents
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
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- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
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- A61B17/3423—Access ports, e.g. toroid shape introducers for instruments or hands
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
- A61B17/3431—Cannulas being collapsible, e.g. made of thin flexible material
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00743—Type of operation; Specification of treatment sites
- A61B2017/00778—Operations on blood vessels
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
- A61B2017/3445—Cannulas used as instrument channel for multiple instruments
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B2017/3454—Details of tips
- A61B2017/3458—Details of tips threaded
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B2017/348—Means for supporting the trocar against the body or retaining the trocar inside the body
- A61B2017/3482—Means for supporting the trocar against the body or retaining the trocar inside the body inside
- A61B2017/349—Trocar with thread on outside
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Abstract
本发明提供了一种插管系统,其提供了由软质适形材料诸如硅胶形成的并且具有外部螺纹的插管。所述插管缺少刚度,尤其是在轴向上,并因此提供具有外部螺纹以与插管相互作用的插塞,以在插管插入患者体内时保持其形状。
Description
背景技术
本发明涉及医疗插管,并且更具体地涉及软质插管和插塞。
传统上,关节镜检查插管和配对插塞由刚性材料诸如金属或刚性聚合物制成。插管具有平滑的内径,而插塞具有平滑的外径。将插塞置于插管中以将插管插入患者体内,。然后将插管/插塞通过小的刺切口或门静脉推入患者。
传统的刚性插管和插塞存在一些潜在的问题。由于它们是刚性的,所以其可能对患者组织造成一定程度的创伤。另外,由于患者在关节镜检查期间有关节水肿,插管在门静脉处容易变得松弛,有时还会向后滑出。近来,若干硅胶(或其他软质材料)插管已实现商业化,试图解决现存的刚性插管限制。然而,软质材料又引入了新的限制。
当插管和插塞之间的过渡区抵达患者的皮肤时,插入插管/插塞所需的力通常会增大。在以持续增大的力引入刚性插管来克服这种阻力时,刚性插管由于其刚度能保持其形状。然而,软质和柔性插管不能通过将插塞插入其中并将它们推入关节的传统方法来插入关节中。在尝试这样做时,当软质柔性插管的远端碰到外部皮肤时,它会“折叠”在插塞上。当尝试插入具有用以防止插管向后滑出的远侧凸缘的硅胶插管时,该问题尤为明显。
插入具有远侧凸缘的硅胶插管的典型方法是用镊子抓住插管的远端,挤压远侧凸缘,并通过远端将插管“压”入关节。从而,插管便从远端被拉入,而不是从近端被推入。这是种笨拙的插入方法,它会导致门静脉部位的创伤增加并且常常导致门静脉扩大。
发明内容
根据本发明,插管系统包括具有细长管状主体的插管,该管状主体具有穿过其中轴向延伸的套管。主体由柔性材料形成。插塞的尺寸设定成适合放入套管内并且具有外部螺纹,当将插塞设置在套管内时,该外部螺纹接合插管。
优选地,插管主体具有外部螺纹。插管还可具有预成形的内部螺纹,该内部螺纹能够与插塞的外部螺纹配合。在本发明的一个方面,将插塞设置在插管内,并且插塞外部螺纹与插管外部螺纹相互对准。作为另外一种选择,插塞外部螺纹和插管外部螺纹可具有匹配的未相互对准的螺距,使得插塞外部螺纹设置在插管外部螺纹之间的插管的材料中。插管可具有处于松弛构型的平滑的内表面,其中插管的材料是足够柔性的,使得当插塞设置有套管时,由插塞外部螺纹在套管内形成临时螺纹。
根据本发明的方法提供了将柔性插管插入患者体内。所述方法包括以下步骤:a)将其上具有外部螺纹的插塞螺纹旋入由柔性材料形成的插管的套管中;b)将其中设置有插塞的插管插入穿过患者的皮肤中的切口;c)通过插塞上的外部螺纹和插管之间的接合,在步骤b)中保持插管的轴向长度;以及d)从插管移除插塞,并使插管设置在患者体内。
优选地,该方法还包括将患者与在插管上的单独的外部螺纹接合。
在本发明的一个方面,插管在其套管内具有内部螺纹,并且插塞上的外部螺纹和插管之间的接合包括插塞上的外部螺纹与套管内的内部螺纹配合。作为另外一种选择,插管不具有位于其套管内的内部螺纹,并且插塞上的外部螺纹和插管之间的接合包括使插管的材料变形以与插塞上的外部螺纹接合。
附图说明
图1是根据本发明的插管系统的分解侧正视图;
图2是图1的插管系统横截面的侧正视图,其示出了组装在一起的插管及其插塞;
图3是根据本发明的插管系统的替代实施例的分解侧正视图;
图4A是图3的插管系统横截面的侧正视图,其示出了组装在一起的插管及其插塞,其相应的螺纹对准;并且
图4B是图3的插管系统横截面的侧正视图,其示出了组装在一起的插管及其插塞,其相应的螺纹偏置。
具体实施方式
图1和图2示出插管系统10,其包括插管12和插塞14。插管12包括具有远端18和近端20的细长的管状主体16。套管22轴向穿过主体16的长度,从而形成内表面24。外部螺纹26从其外表面28环绕主体16。螺纹26在将插管12穿过患者的皮肤放置后帮助使插管12固定就位(图1和图2中未示出)。内部螺纹30形成于套管22的内表面24内。在近端20处提供了径向延伸的凸缘32。任选地,还可在插管12上提供类似于近侧凸缘32的远侧凸缘(未示出)。
插塞14包括圆柱形主体34,其尺寸设定成适合放入插管12的套管22内。主体34具有远端36和近端38。远端36逐渐变细至钝的顶端39,以有助于插管系统10的插入。如果以具有尖的顶端的套管针替代插塞14并且因此在结合本发明使用时,如本文所述的术语“插塞”通常被理解为广义地涵盖任何刚性插管插入辅助,无论其顶端是钝的还是尖的,则本发明的概念也可应用。外部螺纹40环绕主体的外部42并且与插管12的内部螺纹30配合。当插塞14完全插入插管12中时,在主体近端38处的径向凸缘44邻接插管12上的凸缘32。
插管12由软质柔性材料形成,诸如医用级硅胶,以保护患者的组织并改善正穿过其执行的外科手术的可操纵性。插塞14由刚性材料形成,诸如医用级聚合物或金属。推动此类软质材料穿过患者的皮肤中的切口并且进入关节空间中对一般的平滑插塞是困难的,因为所述材料缺乏轴向刚度,并且趋于聚成一团并且压缩成手风琴样式。通过将螺纹插塞14附连在插管12内,所述二者联接在一起,使得插管12在插入时保持其长度,从而允许其如一般刚性插管那样插入而不会出现无法接受的变形。
在使用中,在皮肤上切出约2至3mm的小切口,将具有被接收在插管12内的插塞14的插管系统推动穿过切口并且经过内部组织,到达患者体内的工作位置,诸如进入关节空间中。插塞螺纹40和软质插管12的相互作用使插管12在插入时保持其形状。在将插管12适当定位后移除插塞14,使插管12保持在适当位置,以根据需要接收关节镜或外科器械。
图3示出了根据本发明的插管系统50的替代实施例,所述插管系统包括插管52和插塞54。与插管系统10的主要差别在于插管52具有套管56,该套管具有没有内部螺纹的平滑内表面58。插塞54具有仍可与插管52配合良好的外部螺纹60,因为形成其的软质材料允许其适形于螺纹60。插管52保持外部螺纹62和近侧凸缘64。
插塞54的螺纹60可具有与插管52的螺纹62类似的螺距,并且可将螺纹60和螺纹62相互螺纹对准或对齐(如图4A所示)或纵向偏置(如图4B所示),使得插塞螺纹60设置在插管螺纹62间的插管52的材料中。在后一种情况中,插管52的螺纹62间的软质材料会形成临时内部螺纹,使插塞54处于适当位置。在任一情况下,一旦插塞54被移除,套管会恢复其平滑的构型,使器械易于插入穿过其中。螺纹60和螺纹62还可具有不同的尺寸,诸如变化的螺距,使得当插塞54螺纹旋入插管52时,二者不相互作用。
尽管已结合其具体实施例对本发明进行了特别说明,但是应当理解,这是说明性而非限制性的,并且应当理解所附权利要求的范围在现有技术所允许的条件下应作宽泛解释。例如,插塞14与螺纹40一起示出,所述螺纹沿其与插管12的相互作用的大部分长度。但是,如果仅在其远端36附近提供螺纹40会极为奏效,因为其在插入时仍可保持插管12的长度。
Claims (4)
1.一种插管系统,包括:
插管,其包括细长管状主体,所述细长管状主体具有轴向穿过其中的套管并且由柔性材料形成;
插塞,其尺寸设定成适合放入所述套管内并具有第一外部螺纹,当所述插塞设置在所述套管内时所述第一外部螺纹接合所述插管;
其中,当所述插塞设置在所述套管内时所述插塞的远端延伸超出所述插管的远端;
其中,所述插管在松弛构型中具有平滑的内表面并且其中所述插管的材料是足够柔性的,使得当所述插塞设置在所述套管内时,由所述第一外部螺纹在所述套管内形成临时螺纹。
2.根据权利要求1所述的插管系统,其中所述细长管状主体具有第二外部螺纹。
3.根据权利要求2所述的插管系统,其中所述插塞设置在所述插管内,并且其中所述第一外部螺纹和所述第二外部螺纹相互对准。
4.根据权利要求2所述的插管系统,其中所述插塞设置在所述插管内,并且其中所述第一外部螺纹和所述第二外部螺纹具有匹配的螺距但未相互对准,使得所述第一外部螺纹被设置在所述第二外部螺纹间的所述插管的材料中。
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US14/039337 | 2013-09-27 | ||
US14/039,337 US9408631B2 (en) | 2013-09-27 | 2013-09-27 | Flexible cannula and obturator |
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- 2014-09-17 CA CA2863794A patent/CA2863794A1/en not_active Abandoned
- 2014-09-19 AU AU2014227528A patent/AU2014227528B2/en not_active Ceased
- 2014-09-25 JP JP2014195292A patent/JP6482805B2/ja not_active Expired - Fee Related
- 2014-09-26 EP EP14186578.2A patent/EP2853209B1/en active Active
- 2014-09-26 CN CN201410503490.7A patent/CN104510507B/zh active Active
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US9408631B2 (en) | 2016-08-09 |
JP2015066440A (ja) | 2015-04-13 |
EP2853209B1 (en) | 2020-08-26 |
IN2014DE02615A (zh) | 2015-06-26 |
US20150094543A1 (en) | 2015-04-02 |
CN104510507A (zh) | 2015-04-15 |
AU2014227528A1 (en) | 2015-04-16 |
AU2014227528B2 (en) | 2019-07-04 |
EP2853209A1 (en) | 2015-04-01 |
JP6482805B2 (ja) | 2019-03-13 |
CA2863794A1 (en) | 2015-03-27 |
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