DE102015103214A1 - trocar - Google Patents

trocar

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Publication number
DE102015103214A1
DE102015103214A1 DE102015103214.7A DE102015103214A DE102015103214A1 DE 102015103214 A1 DE102015103214 A1 DE 102015103214A1 DE 102015103214 A DE102015103214 A DE 102015103214A DE 102015103214 A1 DE102015103214 A1 DE 102015103214A1
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DE
Germany
Prior art keywords
trocar
endoscope
light
shaft
preceding
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
DE102015103214.7A
Other languages
German (de)
Inventor
Peter Eisenkolb
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Karl Storz SE and Co KG
Original Assignee
Karl Storz SE and Co KG
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Karl Storz SE and Co KG filed Critical Karl Storz SE and Co KG
Priority to DE102015103214.7A priority Critical patent/DE102015103214A1/en
Publication of DE102015103214A1 publication Critical patent/DE102015103214A1/en
Application status is Pending legal-status Critical

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3417Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00064Constructional details of the endoscope body
    • A61B1/00071Insertion part of the endoscope body
    • A61B1/0008Insertion part of the endoscope body characterised by distal tip features
    • A61B1/00096Optical elements
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00131Accessories for endoscopes
    • A61B1/00135Oversleeves
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00147Holding or positioning arrangements
    • A61B1/00154Holding or positioning arrangements using guide tubes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00163Optical arrangements
    • A61B1/00165Optical arrangements with light-conductive means, e.g. fibre optics
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/04Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances
    • A61B1/05Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances characterised by the image sensor, e.g. camera, being in the distal end portion
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/06Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements
    • A61B1/07Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements using light-conductive means, e.g. optical fibres
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831Material properties
    • A61B2017/00902Material properties transparent or translucent
    • A61B2017/00907Material properties transparent or translucent for light
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3417Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B2017/3454Details of tips
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/30Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
    • A61B2090/306Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure using optical fibres
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36Image-producing devices or illumination devices not otherwise provided for
    • A61B90/361Image-producing devices, e.g. surgical cameras
    • A61B2090/3614Image-producing devices, e.g. surgical cameras using optical fibre
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36Image-producing devices or illumination devices not otherwise provided for
    • A61B90/361Image-producing devices, e.g. surgical cameras

Abstract

A trocar (20) comprises a shaft (21) having a lumen for receiving the shaft of an endoscope (10) with an endoscope viewing direction (19), a tip (24) at the distal end (22) of the shaft (21) at least a portion of the tip (24) is transparent to light in the wavelength range visible to the healthy human eye, and optical means (30, 40, 50) within the trocar (20) for transmitting light from an object outside the Tip (24) goes out, to a light entry surface (12) of an inserted into the shaft (21) endoscope (10). The optical device (30, 40; 50) is designed to detect light from a trocar viewing direction (38) which is from a predetermined endoscope viewing direction (19) of an endoscope (10) inserted into the shaft (21) of the trocar (20) ) is different, in the endoscope viewing direction (19) to redirect.

Description

  • The present invention is related to a trocar that provides visual control during penetration of the abdominal wall, in particular a trocar for a laparoscopic access system.
  • At the beginning of a laparoscopic procedure, penetrating the abdominal wall with the first trocar carries the risk of injury to abdominal organs. While a second or third trocar can be placed under optical control by means of an endoscope in the first trocar, a visual check during the placement of the first trocar was not possible for a long time. More recently, trocars have been developed that are partially or completely transparent to visible light and provide visual control for penetrating the abdominal wall.
  • In DE 101 10 427 A1 An intubation aid is described in which an optic with illumination and video chip can be reversibly introduced.
  • In EP 0 694 280 A2 is a trocar for penetrating body tissue described. The trocar comprises a transparent cone as an optical window, through which penetrated tissue can be observed.
  • In DE 103 33 956 A1 is a Sichtobturator for penetrating tissue under optical control described. The vision optimizer includes a tube, an optic shaft, and a removable transparent penetrating tip.
  • In US 2008/0033450 A1 is described an endoscopic access with an imaging device on the tube.
  • DE 10 2010 060 877 A1 a trocar system with a translucent tip is described.
  • It is an object of the present invention to provide an improved trocar that provides visual control of the penetration of the abdominal wall.
  • This object is solved by the subject matters of the independent claims.
  • Further developments are specified in the dependent claims.
  • Embodiments of the present invention are based on the idea of designing a trocar with an at least partially transparent tip so as to visually control the penetration of the abdominal wall or other tissue by means of an endoscope inserted into the trocar with a viewing direction that is not parallel to the longitudinal axis of the shaft of the endoscope is possible.
  • A trocar comprises a shaft having a cavity for receiving the shaft of an endoscope with a predetermined endoscope viewing direction, a tip at the distal end of the shaft, wherein at least a portion of the tip for light in the visible to the healthy human eye wavelength range is transparent, and optical means within the trocar for transmitting light emanating from an object outside the tip to a light entrance surface of an endoscope inserted into the shaft, wherein the optical device is adapted to detect light from a trocar viewing direction the predetermined endoscope viewing direction is different, to redirect in the endoscope viewing direction.
  • The term "trocar" is often not consistently distinguished from the tube or cannula, which is used by the trocar, for example, in a patient's abdominal wall to create an artificial access to the abdominal cavity. In particular, for delimitation from the tube or the cannula, a trocar is often referred to as a trocar lancet, trocar stylet, trocar or trocar pin. A trocar acts as a stylet or obturator and allows the insertion of a tube as an artificial access to the abdomen or other natural or artificial cavity in the human or animal body. The trocar may have a blunt tip (for example, for atraumatic expansion of a natural or otherwise existing body opening) or a sharp tip with one or more cutting edges for cutting tissue.
  • The trocar is designed in particular for a laparoscopic access system or as part of a laparoscopic access system. The lumen of the shaft of the trocar is in particular cylindrical with a circular cross-section which is adapted to the cross-section of the shaft of an endoscope. Specifically, the lumen of the shaft of the trocar extends from the proximal end of the trocar to near the distal end thereof so that the shaft of an endoscope can be inserted proximally into the lumen of the shaft of the trocar.
  • The tip at the distal end of the shaft of the trocar has, for example, essentially the shape of a cone or a circular cone or a pyramid with a triangular, quadrangular or other polygonal base. More generally, the tip has a cross section that increases from distal to proximal. Further, the tip may have one or more edges formed as cutting edges extending from distal to proximal.
  • The entire trocar or the entire tip of the trocar may have a material which is transparent to light in the wavelength range visible to the healthy human eye. Alternatively, only a portion of the tip may comprise a transparent material. For example, a window component made of a transparent material seals a window or opening in a component which forms the tip and itself comprises a non-transparent material. A transparent window may be flat or curved and formed and arranged symmetrically or asymmetrically with respect to an axis of symmetry of the outer surface of the tip.
  • In particular, the optical device within the trocar is arranged partially, substantially or completely within the tip of the trocar. The optical device may comprise one or more light-refracting and / or light-reflecting surfaces or interfaces between regions of space with different materials.
  • The endoscope viewing direction is the direction - from the distal end or from the light entry surface of the endoscope - in which an object lies, when looking through the endoscope - with a camera or directly with the eye - in the middle of the captured image appears. The endoscope viewing direction corresponds in particular to the surface normal or the mean surface normal or the axis of symmetry of a light entry surface of the endoscope.
  • By the trocar viewing direction is meant the direction with respect to the tip of the trocar in which a faraway object is located, looking in through a trocar inserted endoscope with the predetermined endoscope viewing direction and through the tip of the trocar in the middle the captured image appears. The trocar viewing direction is in particular parallel to the surface normal or to the mean surface normal of a light entry surface of the optical device. The trocar viewing direction is in particular parallel or substantially parallel to the longitudinal axis of the trocar or to the axis of symmetry of the shaft of the trocar.
  • The trocar makes it possible to use an endoscope, in particular an endoscope, whose viewing direction is not parallel to the longitudinal axis of its shaft, for optical control of the penetration of the trocar into tissue or penetration of a tissue layer by means of the trocar. The optical control by means of the endoscope can significantly reduce the risk of injury or unintentional puncture of an organ to be preserved.
  • By not having to have a relay lens system and any other means for transmitting or capturing an image, the trocar itself may have relatively low manufacturing costs.
  • The use of an endoscope for optical control can save time and speed up the creation of an artificial access by inserting the same endoscope, but now without trocar, into the tube or the artificial access immediately after removing the trocar from the tube and continue to use it can. For this reason, for example, neither a camera has to be converted nor another picture signal source selected.
  • A trocar, as described here, is designed in particular for use with an endoscope whose endoscope viewing direction is not parallel to the longitudinal axis of the shaft of the endoscope.
  • For example, the trocar is intended and configured for use with an endoscope whose endoscope viewing direction is at an angle of 30 degrees with the longitudinal axis of the shaft of the endoscope.
  • The use of the trocar together with an endoscope whose endoscope viewing direction is not parallel to the longitudinal axis of the shaft of the endoscope is made possible by the optical device of the trocar. For laparoscopic procedures, for example, endoscopes are often used with an angle of about 30 degrees between the endoscope viewing direction and the longitudinal axis of the shaft. Without the optical device of the trocar, the simultaneous observation of all or a large part of the cut surface or the surface of the penetrated tissue produced by the trocar would not be possible.
  • [Claim 3] In a trocar as described here, the trocar viewing direction is in particular parallel or substantially parallel to the longitudinal axis of the trocar.
  • The longitudinal axis of the trocar is in particular the longitudinal axis or the axis of symmetry of the shaft or the outer surface of the shaft or the axis of symmetry of the cavity in the shaft of the trocar. The trocar viewing direction is substantially parallel to the longitudinal axis of the trocar, particularly when the angle between the trocar viewing direction and the longitudinal axis of the trocar is not greater than 15 degrees or not greater than 10 degrees or not greater than 5 degrees. In particular, when the light entry surface of the optical device of the trocar is arranged symmetrically to the longitudinal axis of the trocar, the parallelism of the trocar viewing direction and the longitudinal axis of the trocar allow simultaneous observation of the entire sectional area or the entire surface of the opening produced by the trocar.
  • In a trocar as described here, the optical device is designed and arranged in particular such that a region symmetrical to the tip or in the case of a rotationally symmetrical tip to the axis of symmetry of the tip can be observed.
  • The observable region is symmetrical to the tip, in particular, when the most distal point of the tip lies in the center of the captured image of the observable region.
  • In a trocar as described here, the optical device comprises in particular at least one of a reflective surface or a prism arrangement.
  • The reflective surface may be flat or curved. A reflective surface is, for example, a totally reflecting surface of a body or a totally reflecting interface between two spatial regions having different refractive indices. A reflective surface may be further defined by a reflective layer on a surface of a body.
  • A prism assembly may include one or more prisms whose planar or curved surfaces or interfaces break and / or reflect light on the way to the light entry surface at the distal end of an intended endoscope inserted into the trocar. In particular, with a prism arrangement having at least two reflective surfaces, an offset and at the same time an angle between the trocar viewing direction and the endoscope viewing direction can be compensated.
  • An endoscope is inserted in the manner provided in the trocar when the distal end of the endoscope and in particular a light entry surface at the distal end of the endoscope has the intended position and orientation relative to the trocar. In particular, the trocar has a mechanical stop, a step, a shoulder, or one or more other means and features to positively define the intended position and orientation of the distal end of a shaft of an endoscope inserted into the trocar. The optical device has in particular a collecting effect, i. a positive refractive power.
  • In a trocar as described here, the optical device comprises in particular an ordered bundle of optical fibers.
  • An ordered bundle of optical fibers, in particular glass fibers, is often referred to as an image conductor. The bundle of optical fibers is ordered insofar as the relative arrangement of first ends of the optical fibers at a light entry surface of the bundle corresponds to the relative arrangement of second ends of the optical fibers at a light exit surface of the bundle. In particular, the optical device further comprises an objective at the distal end or in front of the light entry surface of the ordered bundle of optical fibers.
  • The optical device may further comprise one or more lenses proximate to the direction of propagation of light emanating from an observed object behind the light exit surface of the ordered bundle. This lens or lenses are provided and designed to create, similar to an eyepiece, a virtual image of the light exit surface of the ordered bundle of optical fibers. The virtual image is then detectable by means of an endoscope inserted in the manner intended in the cavity of the trocar.
  • In a trocar as described here, the optical device further comprises, in particular, a lens or an objective.
  • A lens or lens of the optical device of the trocar may, as described, be provided for producing a real intermediate image at a light entrance surface of an ordered bundle of optical fibers. Alternatively or additionally, a lens or a lens can be provided for producing a virtual intermediate image which can be detected by an endoscope inserted into the cavity of the trocar in the intended manner.
  • Alternatively or additionally, a lens or a lens may be provided for the distortion or equalization of an image. Distortion or equalization may allow for an enlarged view of relevant areas or provide better visibility of structures stretched through the tip of the trocar.
  • Alternatively or additionally, a lens or a lens may be provided for adapting the surface in which objects are located that can be sharply imaged or sharply viewed through the endoscope to the shape of the tip of the trocar. An adaptation of the area in which objects can be sharply imaged can enable simultaneous detection of a large part or the entire outer surface of the tip of the trocar or of adjacent structures.
  • In a trocar as described here, the optical device has, in particular, a refractive surface or boundary surface which is non-rotationally symmetrical.
  • In a trocar as described herein, the optical device includes, in particular, a refractive surface or interface that is non-rotationally symmetric about the optical axis of the optical device at the location of the refractive surface.
  • A non-rotationally symmetric refractive surface or interface of the optical device, in particular a free-form surface, with relatively compact design, a desired distortion or equalization or adaptation of the surface in which objects can be sharply imaged or sharply detected, to the outer surface of the tip of the Allow trocars. This is especially true in the case of a non-symmetrical to the tip of the trocar arranged light entrance surface of the optical device.
  • In a trocar as described here, the optical device in particular causes a shortening of the distance in which an object can be seen sharply by an endoscope inserted in the intended manner into the trocar.
  • In particular, when the mean distance between the outer surface of the tip of the trocar and the light entry surface at the distal end of an endoscope as provided in the trocar is less than the subject distance for which the endoscope is intended, the optical device comprises one or more lenses or one or more curved refractive or reflective surfaces that enable sharp imaging of the abutting structures of the endoscope through the endoscope.
  • [Claim 10] A trocar, as described here, furthermore comprises, in particular, a lighting device for transmitting illumination light, which emanates from a light exit surface of an endoscope inserted into the shaft.
  • In a trocar as described here, the illumination device comprises in particular a light guide.
  • In particular, the illumination device comprises a bundle of light guides or optical waveguides.
  • In a trocar as described here, the illumination device comprises, in particular, a reflective or refractive surface.
  • The reflective or refractive surface may be planar or curved and part of a prism array of one or more transparent material prisms.
  • A lighting device for transmitting illumination light may enable complete and / or uniform or substantially uniform illumination of the area to be viewed through the tip of the trocar, even if the trocar is intended for an endoscope, on the illumination light in one direction or in one spatial area leakage, which is unsuitable for complete or even illumination of the area to be viewed by the trocar.
  • [Claim 13] A trocar system comprises a trocar as described herein and a tube having a lumen whose cross-section corresponds to the cross section of the trocar.
  • The tube, sometimes also referred to as a cannula (cannula, sleeve, tubular sheath) is particularly provided and adapted to remain during a micro-invasive procedure, for example in an opening formed by the trocar in the abdominal wall of a patient, and so the opening keep open and create an artificial access. The cross section of the tube corresponds to the cross section of the trocar such that the two cross sections are similar and the cross section of the lumen of the tube is only so much larger than the cross section of the trocar that the trocar is guided play and friction in the tube.
  • Brief description of the figures
  • Embodiments will be explained in more detail with reference to the accompanying figures. Show it:
  • 1 a schematic representation of a section through a distal end of a shaft of an endoscope;
  • 2 a schematic representation of a section through a distal end of a trocar;
  • 3 a schematic representation of a section through a distal end of another trocar;
  • 4 a schematic representation of a section through a distal end of another trocar;
  • 5 a schematic representation of a section through a distal end of another trocar;
  • Description of the embodiments
  • 1 shows a schematic representation of a section through a distal end 11 the shaft of an endoscope 10 , The cutting plane contains the longitudinal axis 18 of the shaft of the endoscope 10 , The endoscope 10 points at the distal end 11 a light entry surface 12 on, which is formed by the outer surface of a transparent window member. Furthermore, the endoscope points 10 at the distal end 11 or near the distal end 11 a lens 13 , a prism arrangement 14 and a negative lens 17 on. Deviating from the underlying understanding of the term this text is often used here as a lens 13 designated device, the prism arrangement 14 and the negative lens 17 together referred to as the lens. From one in 1 not shown object outgoing light passing through the light entry surface 12 in the endoscope 10 enters and through the negative lens 17 passes through reflections at reflective interfaces within the prism array 14 in the direction of the lens 13 directed. The objective 13 creates a real image of the object, for example, from an in 1 not shown image sensor converted into an image signal or from an in 1 not shown relay lens system or a in 1 not shown ordered bundles of optical fibers to the proximal end of the endoscope 10 is transmitted.
  • Furthermore, the endoscope points 10 one or more light guides 15 for transmitting illumination light to a light exit surface 16 at the distal end 11 of the endoscope 10 on. The light entry surface 12 and the light exit surface 16 lie in the illustrated example in a plane orthogonal to the viewing direction 19 of the endoscope 10 , The direction of view 19 is the straight line on which objects are lying, in the intended use of the endoscope 10 appear in the middle of the captured image. The direction of view 19 of the endoscope 10 is not parallel to the longitudinal axis 18 of the shaft of the endoscope 10 , In the illustrated example, close the line of sight 19 of the endoscope 10 and the longitudinal axis 18 of the shaft of the endoscope 10 an angle of about 30 degrees.
  • 2 shows a schematic representation of a section through a trocar 20 and an endoscope 10 as it is based on the 1 is shown. Because the endoscope 10 not part of the trocar 20 is, it is represented only by the contours of its constituents. The cutting plane of the 2 corresponds to the cutting plane of 1 ,
  • The trocar 20 includes a shaft 21 with a cavity in which the shaft or at least the distal end of the shaft of an endoscope 10 can be arranged. At the in 2 shown situation, the distal end of the shaft is based on the 1 illustrated endoscopes 10 in the shaft 21 of the trocar 20 arranged. The inner surface of the cavity in the shaft 21 of the trocar 20 corresponds to the outer surface of the distal end of the shaft of the endoscope, except for a small mechanical clearance, which allows a low-friction insertion 10 , This is a planned and in 2 illustrated position and orientation of the shaft of the endoscope 10 relative to the trocar 20 positively defined.
  • At the distal end 22 of the shaft 21 of the trocar 20 is a bit 24 made of glass, plastic, sapphire or other transparent material. The summit 24 For example, it is essentially conical or circular-cone-shaped or has the shape of a pyramid with a triangular, quadrangular or other polygonal base. The summit 24 has in the illustrated example a substantially constant wall thickness, ie the distance between the inner surface 25 and the outer surface 26 is the same or substantially the same in all places or in almost all places. On the inner surface 25 and on the outer surface 26 in each case a reflection-reducing coating can be provided.
  • At the outer surface 26 the top 24 Can cut one, two, three, four or more of the transparent material of the tip 24 or be provided from a different material. In the example shown, the peak is 24 at least in the sectional plane of the 2 symmetrical to the longitudinal axis 28 of the trocar 20 , The longitudinal axis 28 of the trocar 20 is in particular at the same time the axis of symmetry of the shaft 21 of the trocar 20 , In the illustrated example, the longitudinal axis corresponds 28 of the trocar 20 the longitudinal axis 18 of the shaft of the endoscope 10 , Deviating from the illustration in 2 can the longitudinal axis 28 of the trocar 20 for example, parallel to the longitudinal axis 18 of the shaft of the endoscope 10 be.
  • The trocar 20 comprises an optical device of a first lens 30 , a prism arrangement 40 and a second lens 43 , The first lens 30 is distal or in the direction of propagation of an object outside the trocar 20 outgoing light in front of the prism array 40 arranged. The second lens 43 is proximal or in the direction of propagation of an object outside the trocar 20 outgoing light behind the prism array 40 arranged. The light exit surface of the second lens 43 is opposite the light entry surface 12 (see. 1 ) of the endoscope 10 and symmetrical to the viewing direction 19 of the endoscope 10 arranged.
  • The optical axis 38 the lens 30 is parallel to the longitudinal axis 28 of the trocar 20 , Deviating from the illustration in 2 can the optical axis 38 the first lens 30 with the longitudinal axis 28 of the trocar 20 coincide. Deviating from the illustration in 2 can the optical axis 38 the first lens 30 with the longitudinal axis 28 of the trocar 20 include an angle that is not zero.
  • The prism arrangement 40 has reflective surfaces 41 . 42 in the form of - at the intended angle of incidence - total reflecting interfaces. By reflection on the reflective surfaces 41 . 42 the prism arrangement 40 becomes one to the optical axis 38 the first lens 30 Symmetrical beam in a direction of view 19 of the endoscope 10 broken symmetrical beam that enters the endoscope 10 entry.
  • The trocar 20 further comprises light guides 60 with a light entry surface 61 opposite the light exit surface 16 of the endoscope 10 (see. 1 ) and a light exit surface 62 , The light guides 60 are provided and adapted to from the light exit surface 16 of the endoscope 10 to absorb emerging illumination light and its light exit surface 62 to lead. The light exit surface 62 is arranged and oriented so that from the light exit surface 62 the light guide 60 Exiting illumination light on the outer surface 26 the top 24 of the trocar 20 adjacent objects illuminated as completely and evenly.
  • For an immediate coupling of illumination light from the light guides 60 in the optical device 30 . 40 . 43 of the trocar 20 and thus into the observation beam path of the endoscope 10 To avoid, the trocar points 20 between the light guides 60 and the optical device 30 . 40 . 43 a light absorbing area 80 on. If essentially the entire trocar 20 is formed of a transparent material, is the area 80 between the optical fibers and the optical device 30 . 40 . 43 provided with light-absorbing pigments. Alternatively, the light absorbing area 80 made of a light-absorbing material or of a material whose surfaces reflect light. Deviating from the illustration in 2 For example, the entire shaft 21 and its distal end 22 in which the light guide 60 and the optical device 30 . 40 . 43 may be formed or made of metal or other non-transparent material. In this case, either the entire top is 24 made of an optically transparent material or the tip 24 is formed, for example, from the same non-transparent material and has one or more sub-areas, which are formed from an optically transparent material.
  • When penetrating tissue, such as the abdominal wall of a patient, can be on the optical device 30 . 40 . 43 of the trocar 20 and the endoscope 10 the displaced tissue or the inner surface of the freshly generated channel, which on the outer surface 26 the top 24 of the trocar 20 is considered. Protective structures can be detected and their injury avoided. Through the optical device 30 . 40 . 43 can with the endoscope popular with medical staff 10 with a line of sight 19 that are not parallel to the longitudinal axis 18 of the shaft of the endoscope 10 is, all or substantially all of the outer surface 26 the top 24 of the trocar 20 adjacent surface of the displaced tissue are considered.
  • At the in 2 example shown points the top 24 a cavity on the inside surface 25 the top 24 is enclosed. Deviating from the illustration in 2 may the tip 24 be formed by a solid component of a transparent material. This eliminates the inner surface 25 the top 24 , the elaborate reflection-reducing coating of the inner surface 25 and disturbing reflections of illumination light on the inner surface 25 the top 24 ,
  • 3 shows a schematic representation of a section through another trocar 20 , in the basis of the 1 illustrated endoscope 10 is used. The type of representation corresponds to that of the 1 and 2 , In particular, the sectional plane corresponds to 3 the cutting planes of the 2 and 1 , The in 3 Trocar shown 20 is similar in some features, properties and functions based on the 2 Trocar shown. Following are features, features and functions of the in 3 shown trocars 20 described in which this from the basis of 2 Trocar differentiates.
  • The in 3 Trocar shown 20 differs from that based on the 2 represented trocar in particular in that the optical device of the trocar 20 a lens 30 with a light entry surface 32 that are not rotationally symmetric to the optical axis 38 the optical device is at this point. Instead, the light entry surface 32 the lens 30 a freeform surface. This can be done by means of the optical device 30 . 43 Capturable image of the outer surface 26 the top 24 of the trocar 20 distorted or equalized. Alternatively or additionally, the non-rotationally symmetrical light entry surface 32 the lens 30 to adapt the simultaneously sharply imaged area the outer surface 26 the top 24 of the trocar 20 contribute.
  • Instead of the light entry surface 32 the lens 30 or in addition to this, the light exit surface of the lens 30 and / or other interfaces or surfaces of the lenses 30 . 43 non-rotationally symmetrical to the optical axis of the observation beam path at the respective location. Deviating from the illustration in 3 may further include a prism assembly 40 as they are based on the 2 is shown between the lenses 30 . 43 or instead of the lens 43 be provided.
  • 4 shows a schematic representation of a section through another trocar 20 , in the basis of the 1 illustrated endoscope 10 is used. The type of representation corresponds to that of the 1 to 3 , In particular, the sectional plane corresponds to 4 the cutting planes of the 1 to 3 , The in 4 Trocar shown 20 is similar in some features, properties and functions based on the 2 and 3 trocars shown. Following are features, features and functions of the in 4 shown trocars 20 described in which this of the basis of the 2 and 3 distinguishes trocars.
  • The in 4 Trocar shown 20 is different from the ones based on the 2 and 3 trocars represented in particular in that an ordered bundle 50 is provided by glass fibers or other optical fibers for transmitting an image. Distal or in front of the light entry surface 51 of the ordered bundle 50 of light guides is a lens or a first lens 30 provided a real picture of the outer surface 26 the top 24 at the light entry surface 51 of the ordered bundle 50 generated by optical fibers.
  • To adapt the surface in which objects can be viewed simultaneously sharply, to the shape of the outer surface 26 the top 24 of the trocar 20 can the light entry surface 51 of the ordered bundle 50 of light guides deviating from the illustration in 4 have a non-planar shape. For example, the light entry surface 51 of the ordered bundle 50 of light guides deviating from the illustration in 4 cone-shaped.
  • Proximal or with respect to the direction of propagation of light emanating from a subject under consideration, behind the light exit surface 52 of the orderly bundle 50 is a second lens 53 arranged by means of the endoscope 10 detectable virtual image of the light exit surface 52 of the ordered bundle 50 generated by optical fibers.
  • The use of an ordered bundle 50 of optical fibers allows almost any arrangement and orientation of the first lens 30 relative to the light entry surface 12 of the endoscope 10 (see. 1 ). For example, the lens 30 also deviating from the illustration in 4 be readily arranged so that the optical axis 38 the lens 30 with the longitudinal axis 28 of the trocar 20 coincides.
  • 5 shows a schematic representation of a section through another trocar 20 , in the basis of the 1 illustrated endoscope 10 is used. The type of representation corresponds to that of the 1 to 4 , In particular, the sectional plane corresponds to 5 the cutting planes of the 1 to 4 , The in 5 Trocar shown 20 is similar in some features, properties and functions based on the 2 to 4 Trocar shown. Following are features, features and functions of the in 5 shown trocars 20 described in which this from the basis of 2 to 4 Trocar differentiates.
  • The in 5 Trocar shown 20 differs from that based on the 2 Trokar shown in particular by the fact that for the transmission of illumination light, the light from the exit surface 16 of the endoscope 10 (see. 1 ), instead of optical fibers a prism arrangement 70 with several reflective surfaces 71 . 72 is provided. In the example shown, the prism arrangement 70 formed from a single transparent body whose surface is partially or completely mirrored or provided with a reflective layer.
  • Deviating from the illustration in 5 can the prism arrangement 70 be formed of several bodies with different transparent materials, which in particular have different refractive indices. Instead of a partial Verspiegelung or coating with a reflective layer, the prism arrangement 70 be formed so that the reflective surfaces 71 . 72 reflect due to total reflection.
  • At the in 5 The example shown is the first reflecting surface 71 curved. One or more curved reflective surfaces may cause beam shaping and uniform illumination of the outer surface 26 the top 24 of the trocar 20 contribute to adjacent tissue.
  • In 5 is also a tube 90 shown in the trocar 20 is introduced. The tube 90 has the shape of a lateral surface of a cylinder, in particular a circular cylinder. The tube 90 encloses the trocar 20 like a jacket. In the in 5 shown configuration, body tissue, such as an abdominal wall, by means of the trocar 20 penetrated or an existing body opening widened and at the same time the tube 90 be inserted into the created opening. After complete penetration, for example, the abdominal wall, the tube remains 90 during a micro-invasive procedure in the abdominal wall and provides access for a medical instrument or multiple medical instruments. In particular, after pulling out the trocar 20 from the tube 90 and removing the endoscope 10 from the trocar 20 the endoscope 10 be used immediately for the micro-invasive procedure.
  • Characteristics and properties of the basis of the 2 to 5 shown trocars and the variants described are partially combinable. For example, even with the basis of 3 and 4 trocars shown 20 the light guides 60 for transmitting illumination light through one or more prism arrays 70 as they are based on the 5 is replaced. Furthermore, even with the basis of 3 . 4 and 5 shown trocars, as related to 2 described the tips 24 be designed as a massive transparent body to disturbing reflections on the inner surface 25 the top 24 to avoid.
  • Deviating from the representations on the basis of 2 to 5 especially when using fiber optics 60 for transmitting illumination light whose light exit surfaces 62 be arranged differently or be provided a plurality of separate light exit surfaces. With several, optional to the lens 30 distributed around light exit surfaces 62 or one the lens 30 arcuately partially surrounding or circular completely surrounding light exit surface 62 the light guide 60 can be a uniform illumination of on the outer surface 26 the top 24 of the trocar 20 adjacent tissue.
  • LIST OF REFERENCE NUMBERS
  • 10
    endoscope
    11
    distal end of the endoscope 10
    12
    Light entry surface of the endoscope 10
    13
    Lens of the endoscope 10
    14
    Prism arrangement of the endoscope 10 ; optional as part of the lens 13 to watch
    15
    Light guide of the endoscope 10 for transmitting illumination light to the light exit surface 16
    16
    Light exit surface of the endoscope 10 for illumination light
    17
    Negative lens; optional as part of the lens 13 to watch
    18
    Longitudinal axis of the shaft of the endoscope 10
    19
    Viewing direction of the endoscope 10
    20
    trocar
    21
    Shank of the trocar 20
    22
    distal end of the shaft 21
    24
    Tip of the trocar 20 , transparent to light in the visible wavelength range
    25
    inner surface of the top 24 of the trocar 20
    26
    outer surface of the top 24 of the trocar 20
    28
    Longitudinal and symmetrical axis of the trocar 20
    30
    Lens or lens in the trocar 20
    32
    Light entrance surface of the lens 30
    38
    optical axis of the lens 30 and viewing direction of the lens 30
    40
    Prism arrangement in the trocar 20
    41
    first reflective surface of the prism array 40
    42
    second reflective surface of the prism assembly 40
    43
    Lens, in particular proximally or behind the prism arrangement 40
    50
    ordered bundle of optical fibers for transmitting an image
    51
    Light entry surface of the ordered bundle 50 of light guides
    52
    Light exit surface of the ordered bundle 50 of light guides
    53
    Lens proximal or behind the light exit surface 52 of the ordered bundle 50
    60
    Light guide for transmitting illumination light from the light exit surface
    16
    of the endoscope 10 goes out
    61
    Light entry surface of the light guide 60
    62
    Light exit surface of the light guide 60
    70
    Prism arrangement for transmitting illumination light from the light exit surface 16 of the endoscope 10 goes out
    71
    first reflective surface of the prism array 70
    72
    second reflective surface of the prism assembly 70
    80
    light-absorbing area of the trocar 20
    90
    Tubus, which together with the trocar 20 forms a trocar system
  • QUOTES INCLUDE IN THE DESCRIPTION
  • This list of the documents listed by the applicant has been generated automatically and is included solely for the better information of the reader. The list is not part of the German patent or utility model application. The DPMA assumes no liability for any errors or omissions.
  • Cited patent literature
    • DE 10110427 A1 [0003]
    • EP 0694280 A2 [0004]
    • DE 10333956 A1 [0005]
    • US 2008/0033450 A1 [0006]
    • DE 102010060877 A1 [0007]

Claims (13)

  1. Trocar ( 20 ), with: a shaft ( 21 ) with a cavity for receiving the shaft of an endoscope ( 10 ) with a predetermined endoscope viewing direction ( 19 ), a tip ( 24 ) at the distal end ( 22 ) of the shaft ( 21 ), wherein at least a portion of the tip ( 24 ) is transparent to light in the wavelength range visible to the healthy human eye; an optical device ( 30 . 40 ; 50 ) within the trocar ( 20 ) for transmitting light from an object outside the tip ( 24 ), to a light entry surface ( 12 ) one in the shaft ( 21 ) introduced endoscope ( 10 ), the optical device ( 30 . 40 ; 50 ) is adapted to detect light from a trocar viewing direction ( 38 ), which depend on the predetermined endoscope viewing direction ( 19 ) is different, in the endoscope viewing direction ( 19 ) to divert.
  2. Trocar ( 20 ) according to the preceding claim, wherein the trocar ( 20 ) for use with an endoscope ( 10 ), whose endoscope viewing direction ( 19 ) not parallel to the longitudinal axis ( 18 ) of the stem of the endoscope ( 10 ) is formed.
  3. Trocar ( 20 ) according to one of the preceding claims, in which the trocar viewing direction ( 38 ) parallel or substantially parallel to the longitudinal axis of the trocar ( 20 ).
  4. Trocar ( 20 ) according to one of the preceding claims, in which the optical device ( 30 . 40 ; 50 ) is formed and arranged so that one to the top ( 24 ) or in the case of a rotationally symmetrical tip ( 24 ) to the symmetry axis ( 24 ) the top ( 24 ) symmetrical region can be observed.
  5. Trocar ( 20 ) according to one of the preceding claims, in which the optical device has at least one reflective surface ( 41 . 42 ) or a prism arrangement ( 40 ).
  6. Trocar ( 20 ) according to one of the preceding claims, in which the optical device comprises an ordered bundle of optical fibers ( 50 ).
  7. Trocar ( 20 ) according to one of the preceding claims, wherein the optical device further comprises a lens or a lens ( 30 ).
  8. Trocar ( 20 ) according to one of the preceding claims, in which the optical device ( 30 . 40 ; 50 ) a light-refracting surface ( 32 ) or interface which is not rotationally symmetric.
  9. Trocar ( 20 ) according to one of the preceding claims, in which the optical device ( 30 . 40 ; 50 ) a shortening of the distance, in which an object by a the way intended in the trocar ( 20 ) used endoscope ( 10 ) can be seen sharply causes.
  10. Trocar ( 20 ) according to one of the preceding claims, further comprising: a lighting device ( 60 ; 70 ) for transmitting illumination light emitted from a light exit surface ( 16 ) one in the shaft ( 21 ) introduced endoscope ( 10 ).
  11. Trocar ( 20 ) according to the preceding claim, in which the illumination device comprises a light guide ( 60 ).
  12. Trocar ( 20 ) according to the preceding claim, in which the illumination device has a reflective or refractive surface ( 70 ).
  13. Trocar system with a trocar ( 20 ) according to one of the preceding claims and a tube with a lumen whose cross-section to the cross section of the trocar ( 20 ) corresponds.
DE102015103214.7A 2015-03-05 2015-03-05 trocar Pending DE102015103214A1 (en)

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102018110523A1 (en) * 2018-05-02 2019-11-07 Karl Storz Se & Co. Kg Endoscope and imaging device for an endoscope

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0694280A2 (en) 1990-11-06 1996-01-31 PARTOMED Medizintechnik GmbH Instrument for penetrating body tissue
DE10110427A1 (en) 2001-03-06 2002-09-12 Pierre Foss Optical aid for use in medical intubations has an endoscope type illumination device and video chip that can be inserted in the intubation tube assisting in its correct positioning and thus saving patient lives
DE10333956A1 (en) 2003-07-25 2005-02-17 Richard Wolf Gmbh Viewing obturator, comprising removable inner shaft with transparent penetration tip
US20050261717A1 (en) * 1993-09-13 2005-11-24 Sauer Jude S Optical trocar
US20080033450A1 (en) 2006-08-04 2008-02-07 Lex Bayer Surgical Port With Embedded Imaging Device
US20100016664A1 (en) * 2006-12-20 2010-01-21 Tyco Healthcare Group Lp Surgical visual obturator
DE102010060877A1 (en) 2010-11-29 2012-05-31 Reiner Kunz trocar

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0694280A2 (en) 1990-11-06 1996-01-31 PARTOMED Medizintechnik GmbH Instrument for penetrating body tissue
US20050261717A1 (en) * 1993-09-13 2005-11-24 Sauer Jude S Optical trocar
DE10110427A1 (en) 2001-03-06 2002-09-12 Pierre Foss Optical aid for use in medical intubations has an endoscope type illumination device and video chip that can be inserted in the intubation tube assisting in its correct positioning and thus saving patient lives
DE10333956A1 (en) 2003-07-25 2005-02-17 Richard Wolf Gmbh Viewing obturator, comprising removable inner shaft with transparent penetration tip
US20080033450A1 (en) 2006-08-04 2008-02-07 Lex Bayer Surgical Port With Embedded Imaging Device
US20100016664A1 (en) * 2006-12-20 2010-01-21 Tyco Healthcare Group Lp Surgical visual obturator
DE102010060877A1 (en) 2010-11-29 2012-05-31 Reiner Kunz trocar

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102018110523A1 (en) * 2018-05-02 2019-11-07 Karl Storz Se & Co. Kg Endoscope and imaging device for an endoscope
EP3571975A2 (en) 2018-05-02 2019-11-27 Universität Stuttgart Medical endoscope and imaging device for a medical endoscope

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