DE102016110598A1 - Endoscopic trocar sleeve - Google Patents

Abstract

The invention relates to an endoscopic trocar sleeve (12), characterized in that the trocar sleeve comprises a tube (16) for passage of an endoscopic instrument through body tissue and the tube (16) is designed such that after insertion of the tube into the body tissue of the body tissue is attributable. Moreover, the invention relates to a system (10) for introducing a trocar sleeve (12) into body tissue and / or holding an endoscopic instrument, characterized in that it comprises an endoscopic trocar sleeve (12) according to the invention and an insertion instrument (14) for inserting the trocar sleeve (12 ) in a body tissue or in an opening in a body tissue.

Description

background

The invention relates to an endoscopic trocar of the type mentioned in the preamble of claim 1.

With endoscopes, surgical work, eg in the abdomen, can be performed in a minimally invasive manner that reduces both the number and size of surgical incisions and resulting scars, as well as facilitates patient recovery. To introduce the endoscopic instruments into a body cavity, such as the abdomen, accesses must be made through bodily tissue, such as the abdominal wall. This is usually done with trocar sleeves which are pushed through the abdominal wall with an internal sharp or pointed trocar, and serve as an access after withdrawal of the mandrel. Exemplary trocars are eg in DE 10 2008 004 131 A1 and DE 10 2009 012 205 A1 shown.

Trocar sleeves are usually made of a rigid material that ensures the integrity of the inner channel of the sleeves and thus allows easy insertion of the instruments. Currently, trocar sleeves are therefore usually made of a hard plastic or metal.

Typically, such trocar sleeves are provided in their out-of-body region with a valve which permits escape of gases or liquids from the abdomen, e.g. at times when no endoscopic instrument occludes the inner canal of the trocar sleeve. In particular, the escape of gases from the abdomen must be prevented as a rule, since the gas usually introduced before the operation serves to give the surgeon a good overview of the organs of the abdominal cavity. In addition, the trocar sleeves may include other working channels, clamping devices and the like which further increase the complexity of the construction of the sleeve.

This complexity means that the currently available trocar sleeves are expensive and expensive to manufacture. At the same time, this complexity is redundant for a number of applications. For example, For some applications, several trocar sleeves are laid simultaneously to allow the surgeon to see or treat the surgical site from multiple perspectives. In such cases, there are usually trocar sleeves, through which there is no regular replacement of the endoscopic instruments, or which need not be equipped with a wide range of additional equipment, since e.g. only hand instruments are introduced which remain in the trocar sleeve during the operation.

Object of the present invention is therefore to provide a generic trocar sleeve, which is produced with significantly reduced production costs and costs while fulfilling the minimum requirement that escape of gas from the body cavity is prevented.

Description of the invention

The problem is solved by endoscopic trocar sleeves with the features of claim 1.

The invention thus relates to an endoscopic trocar sleeve characterized in that the trocar sleeve comprises a tube for passage of an endoscopic instrument through body tissue.

In other words, the endoscopic trocar sleeve is an endoscopic trocar tube. The term "sleeve" is used herein only as it is the common technical term in the art for devices for the passage of endoscopic instruments through body tissue. The term "sleeve" here is not to be understood that the intended for the passage of endoscopic instruments channel is rigid or fixed. According to the invention provided for the passage of endoscopic instruments channel of the trocar is a flexible and easily closable by external pressure hose.

It is particularly preferred that the tube is designed so that it can be pressed by the body tissue (transverse to the passage direction through the tissue) after insertion of the tube into the body tissue. By pushing the hose closed the hose so that no gases or liquids can enter or exit, or that the incoming or outgoing volume of gases and / or liquids substantially, i. at least 80%, is reduced. In other words, the tube is thus designed such that, after insertion of the tube into the body tissue, it is closable by the body tissue transversely to the passage direction through the tissue.

When inserting the endoscopic trocar sleeve into body tissue, body tissue is displaced from the puncture area by being pushed to the sides. The body tissue which presses the tube is thus in particular the tissue displaced during passage or insertion of the tube into the body tissue. The body tissue surrounding the tube exerts transverse to the Passage direction through the body tissue pressure on the hose out. This pressure is sufficient to reduce the cross-section of the tube and squeeze the tube when no instruments are passed through the tube. The pressure of the surrounding body tissue is also sufficient to displace any gases or liquids that might leak or enter through the tube and to force the tube against the back pressure exerted by such gases or fluids.

The closing or closing of the tube is reversible. While the pressure of the surrounding, displaced tissue is sufficient to keep the tube closed, the tube may e.g. be reopened by inserting an endoscopic instrument.

The tube is designed such that it is suitable for the passage of an endoscopic instrument through body tissue. It is understood that the tube for this purpose comprises an inner channel through which instruments can be passed. The channel is formed by the interior of the hose. The channel can be used after insertion of the trocar sleeve in body tissue for the passage of various endoscopic instruments.

The interior of the hose can be a channel without seals. The escape of gases from the surgical area is inventively prevented or reduced to an acceptable minimum, that the pressure of the surrounding body tissue is able to quickly close the channel by squeezing after removal of an instrument. The escape of gases when inserted endoscopic instrument is prevented, since the body tissue can press the inside of the tube substantially final to the instrument.

According to the invention, the trocar sleeve may additionally comprise a seal for sealing the tube. Suitable seals are known in the art and may e.g. be selected from the group consisting of duckbill-shaped seals (duck beak valve) and annular seals. The seal is preferably made of a flexible material that is also capable of conforming to and enclosing the shape of an instrument pushed through the seal.

The hose is a flexible elongated hollow body with a mostly round cross-section. Alternatively, however, the hose may also be e.g. an oval, e.g. have elliptical, spherical or polygonal cross-section.

The hose is preferably made of a material selected from the group of plastics, metals and other suitable compounds, as well as blends, composites and composites containing plastics and / or metals. Hoses made of these materials have the necessary flexibility for the present invention in a suitable wall thickness. Suitable composite materials may be e.g. be formed as a metal frame with a plastic layer or as plastic with injected or otherwise inserted metal strip.

The wall thickness of the tube is chosen such that sufficient stability is ensured with simultaneous flexibility. This can be ensured according to the invention in particular by making the tube from a foil, i. e.g. from a very thin metal or plastic sheet. The hose is therefore preferably a hose made of a metal or plastic film.

The hose can e.g. have a wall thickness of 0.5 mm or less, preferably 0.1 mm or less. This means that the hose is e.g. has a wall thickness of 0.001 mm to 0.1 mm. Experience has shown that metal foils may be thinner than plastic foils. The person skilled in the art is able to determine suitable wall thickness ranges which ensure that the hose can be pushed by surrounding body tissue and at the same time has sufficient stability for the instruments carried out. Sufficient stability is ensured if the tube is not damaged in the course of its passage through body tissue during routine surgery. In addition, the tube has sufficient resistance to cracking to ensure that it does not crack when the instruments are removed from the trocar sleeve or trocar sheath from the body tissue (e.g., after surgery is completed).

Since the material of the tube is flexible and therefore also able to adapt to movements of the body tissue, the risk of tissue trauma is reduced by the trocar sleeves according to the invention in comparison to known trocar sleeves.

The body tissue through which the tubing of the trocar sleeve is made usually consists of one or more layers of tissue, such as skin, subcutaneous and muscle layers. Preferably, the body tissue encloses a cavity in which the endoscopic operation is to be performed.

The trocar sleeve according to the invention is in particular for the passage of an endoscopic Instruments suitable through a stomach wall or abdominal wall. In this case, the trocar sleeve would be passed through the abdominal wall such that the distal end portion of the trocar sleeve terminates in the abdomen, the tube passes through the various layers of the abdominal wall (eg, in a substantially orthogonal manner), and the proximal end portion of the trocar sleeve is outside the abdominal wall Belly ends.

Endoscopic instruments that can be passed through the trocar sleeve, or tube of the trocar sleeve, are e.g. selected from the group of rigid endoscopes, flexible endoscopes and video endoscopes. Due to their flexible structure, the trocar sleeves according to the invention are particularly suitable for endoscopic instruments that need to be moved frequently during the operation. These include e.g. thin hand instruments with outer diameters of less than 5 mm, in particular less than 3 mm.

The tube may have a usual for trocar sleeves inner diameter. Thus, the hose may e.g. have an inner diameter of 1 mm to 7 mm, preferably from 2 mm to 6 mm. The trocar sleeves according to the invention are particularly suitable for the field of mini-laparoscopy, are used in the trocar sleeves with a diameter of less than 5 mm. Therefore, in a particularly preferred embodiment, the tube has an inner diameter of 5 mm or less, more preferably 3.5 mm or less. This information relates to the inner diameter of the hose in the unfolded (i.e., uncompressed) state.

The trocar sleeve may have a length commonly used with trocar sleeves, e.g. a length of 50 mm to 150 mm, preferably a length of 60 mm to 80 mm. It is also conceivable to produce longer or shorter trocar sleeves.

The trocar sleeve may have a support member at its proximal end portion (i.e., in the area remaining outside the abdominal wall of the patient). The proximal end region is the region of the trocar sleeve which is intended to remain outside the body tissue to be punctured or pierced. The proximal end region is thus the region of the trocar sleeve that is furthest removed from the surgical site during surgery. The support element can support the tube on the outer wall of the body tissue and at the same time serve as an insertion aid and support for the instruments to be introduced into the tube. The support element serves, e.g. to support the introduction of an endoscopic instrument.

The support element may e.g. a funnel or ring or consist of one or more flat, wing-like elements which extend from the proximal end of the tube web-like radially away from the proximal tube opening. In a particularly preferred embodiment, the support element is a funnel. The funnel or ring preferably extends in a circle around the proximal tube opening. The or the flat, wing-like element may e.g. be rectangular or have the shape of a petal. The trocar sleeve may have in its proximal end, e.g. have one, two, three, four, five or more of such flat, wing-like elements. If the trocar sleeve has four such wing-like elements, the elements can be seen in plan view onto the proximal end of the trocar sleeve, e.g. give a cross shape.

The support element may e.g. a radius of e.g. 0.2 mm to 50 mm. More preferably, the support member is a funnel or ring having a radius of e.g. 0.2 mm to 50 mm.

The support member may be secured to the hose, for example by welding or gluing. The support element may e.g. pass directly into the tubing of the trocar and be made of the same material. In such a case, hose and support element could be integrally formed. Alternatively, however, the support member may be made of a more rigid material, such as a stronger (e.g., thicker) plastic or metal. The wall thickness of the support element can thus be greater than the wall thickness of the hose. For support on the skin, the support element may be provided with support elements on its distal side.

The support element may e.g. in a preferred embodiment, be a funnel. The funnel favors or simplifies the introduction of endoscopic instruments into the trocar sleeve. For example, the funnel may be slightly sloping in the direction of the proximal tube opening, so that the instruments slide into the tube. The hose represents the neck of the funnel.

The trocar sleeve according to the invention may be provided at its proximal end region, e.g. in the region of the support element (for example of the funnel or ring) or on the support element, one or more receptacles for releasably fixable mounting of an insertion instrument. The recordings are used in particular to prevent slippage of the insertion instrument relative to the endoscopic trocar sleeve.

For introducing the trocar sleeve into the body tissue is preferably a Insertion instrument that resembles common incision picks. The insertion instrument is characterized by comprising a grip portion and a tube stabilizing portion.

The handle part is designed so that it allows the surgeon to introduce the introduction element together with the trocar sleeve in the body tissue. For this purpose, the grip part can preferably be gripped and held by the surgeon directly or via a gripping device. The grip part may e.g. be at least partially cylindrical. The gripping member preferably has a larger cross-section than the hose stabilizing member to provide a comfortable grip.

The hose stabilizing part is designed so that it can be passed through the hose, i. can be brought into engagement with the hose. Preferably, the hose stabilizing part is at least as long as the hose.

The hose stabilizing part may e.g. have the same cross-sectional shape as the hose. The tube stabilizing part can thus be e.g. be round, oval, elliptical, spherical or polygonal in cross-section.

More preferably, the tube stabilizing part has an outer diameter which corresponds to the inner diameter of the tube or is only slightly smaller, e.g. smaller by 0.001 mm to 0.01 mm. In this way, the tube will surround the tubing stabilizing member substantially adjacent when the introducer is inserted into the trocar sleeve. A displacement of the tube during insertion of the trocar sleeve into body tissue is thereby prevented or reduced to an acceptable minimum.

The insertion instrument preferably also has one or more connecting elements. The one or more connecting elements of the insertion instrument is / are engageable with the receptacle for releasably fixable holder of an insertion instrument and / or releasably fixable on this / these. The connecting elements may e.g. be simple extrusions from the surface of the introducer. In such a case, the pictures would be e.g. each complementary shape recesses in the support element (e.g., the funnel or ring).

The introducer may further be provided at its distal end, e.g. subsequently to or as part of the tube stabilizing member, comprise a spike or tip adapted to open the body tissue. Suitable shapes and shapes for such tips are known in the field of trocar spines.

Moreover, the insertion instrument may have at its distal end in the proximal direction in front of the mandrel or tip a stabilizing element which prevents slippage of the tube on the tube stabilizing part during insertion of the system into body tissue. The stabilizing element can be, for example, a thickening or structuring of the surface which revolves around the tube stabilizing part in the distal end region or is interrupted. In this case, the tube would end on introduction preferably immediately proximal to the circumferential thickening or structuring. A displacement of the tube by frictional forces during insertion would be prevented or significantly reduced. The structuring of the surface may e.g. be designed as a circumferential or single barb or scale-like structure. In this case, the thickening or structuring on a size and shape, which ensures that the tube does not slip when introduced and that the hose stabilization part can be removed after the introduction of the hose.

The trocar sleeve may include (e.g., at its proximal end portion or end) a plug for occluding the tube. Closure of the tube is preferably accomplished by occluding the proximal tube opening, i. The plug can be inserted proximally into the tube.

The plug may e.g. attached to the trocar sleeve to prevent loss of the stopper. The attachment may e.g. be connected via an elastically bendable band or the like with the proximal end portion of the trocar sleeve. However, the plug does not necessarily have to be attached to the trocar sleeve.

The plug preferably comprises a cover part and a plug neck. The cross-sectional diameter of the lid part is preferably larger than that of the stopper neck. The plug neck may have the same cross-sectional shape as the hose. The plug neck can thus be e.g. be round, oval, elliptical or spherical in cross-section. The diameter and shape of the plug neck will generally correspond to the diameter or shape of the hose stabilizing part. More preferably, the plug neck has an outer diameter corresponding to the inner diameter of the hose. In this way, the tube will surround the plug neck substantially adjacent. Thus, the stopper is able to close the hose securely.

Such a plug is not a prerequisite for the present invention, since the pressure of the body tissue is already sufficient to close the trocar sleeve. However, it is still possible to supplement the trocar sleeve with a stopper. This can be used, for example, if the trocar sleeve is not used during the operation for a long period of time.

Plug and insertion element are preferably made of a material which has a significantly higher strength than the hose. Thus, the insertion element and / or the plug may e.g. be made of a plastic, metal or glass.

Preferably, introducer and / or plugs are reusable while the trocar sleeve is usable only once.

In a further aspect, the invention relates to a system for introducing a trocar sleeve into body tissue and / or holding an endoscopic instrument, characterized in that it comprises an endoscopic trocar sleeve according to the invention and an insertion instrument described herein for inserting the trocar sleeve into a body tissue or into an opening in a body tissue includes.

The body tissue is preferably an abdominal wall. The insertion of the trocar sleeve preferably comprises passing the trocar sleeve through the body tissue, e.g. through the abdominal wall.

Moreover, in one aspect, the invention also relates to a method for passing an endoscopic instrument through body tissue and holding an endoscopic instrument, in particular by means of a system according to the invention, characterized in that it comprises steps in which: a) a system according to the invention in an opening used in a body tissue, wherein the system is used such that the hose traverses the body tissue, b) the insertion instrument from the endoscopic trocar sleeve, c) introduces an endoscopic instrument into the tube channel of the endoscopic trocar sleeve. The body tissue is preferably an abdominal wall.

The insertion of the system according to the invention into the opening of a body tissue, e.g. an abdominal wall, in step a) can take place in an existing opening in the abdominal wall. Alternatively, the opening may be created upon insertion. As described elsewhere herein, the opening may be created, for example, by a spike or a point at the distal end of the insertion instrument. Alternatively, the opening may also be previously, e.g. by means of a scalpel.

After insertion in step a), the tube will preferably substantially span the abdominal wall in its entire thickness. Thus, then the distal end portions of the trocar sleeve and the insertion instrument in the abdominal cavity, while the proximal end portion of the trocar sleeve and the handle portion of the insertion instrument remain outside the tree space.

It is understood that the method according to the invention is not restricted to use in the abdominal wall. The method can also be used for other body tissues.

Brief description of the figures

In the drawings, embodiments of the invention are shown schematically. Show it:

1 a trocar sleeve according to the invention with insertion instrument;

2 the trocar sleeve off 1 after removal of the introduction element from the hose;

3 a further trocar sleeve according to the invention with insertion element and plug;

4 the trocar sleeve off 3 after removal of the introducer from the tube and insertion of the stopper into the tube to occlude the trocar sleeve; and

5 schematically the proximal end of the tube in plan view with various embodiments of a support element (A to E).

embodiments

Further advantages, characteristics and features of the present invention will become apparent in the following detailed description of embodiments with reference to the accompanying drawings. However, the invention is not limited to these embodiments.

1 to 4 show a inflated for an endoscopic operation with gas human abdominal cavity (left side of the figures) with overlying abdominal wall which extends between the axes II-II and III-III. A puncture channel passing through the abdominal wall is a trocar sleeve 12 misplaced, which projects with its distal end into the abdomen.

1 shows a system according to the invention 10 for introducing a trocar sleeve into body tissue and / or holding an endoscopic instrument. The introductory instrument 14 is in the trocar sleeve 12 pushed in, leaving the hose 16 the trocar sleeve 12 the hose stabilization part 22 encloses. While on the picture shown a distance between the inner wall of the hose 16 and the outer wall of the hose stabilizing part 22 Recognizable, the pressure of the surrounding body tissue in practice will cause the hose 16 the hose stabilization part 22 surrounds adjacent. Only because of the better representability is a distance shown in the figures.

The hose 16 has a seal 30 on, which should be pronounced in the present embodiment as duckbill gasket. The seal 30 encloses the hose stabilization part 22 and even after removal of the same and insertion of an endoscopic instrument into the tube 16 enclose the instrument. In this way, leakage of gases from the abdominal cavity is excluded or at least even more reduced.

The endoscopic trocar sleeve 12 further comprises a support member, which in the embodiment shown as a funnel 18 is trained. The funnel 18 falls slightly towards its center, in which the proximal opening of the tube 16 lies, off. This way, through the funnel 18 the introduction of endoscopic instruments into the tube 16 much easier. At the same time, the tissue is the proximal opening of the tube 16 surrounds, through the funnel 18 protected.

The funnel 18 has recordings 30 on, the complementary shape to fasteners 26 of the introductory instrument 14 are. In the illustration shown are the connecting elements 26 not in the shots 30 introduced. The illustration thus shows a state in which the introduction element 14 already removed easily from the trocar sleeve.

The introductory element 14 has a handle part 20 Allowing the surgeon or other medical staff to access the system 10 to grab and guide. The handle part 20 and preferably also the remainder of the introducer 14 are made of a stable, little bendable material, such as a hard plastic. This will ensure that the introductory instrument 14 provides sufficient stability for the introduction of an opening, introduction into an opening and the stabilization of the hose. The introductory element 14 is preferably designed to be reusable.

The introductory element 14 also distal to the handle 20 a handle thickening 28 on. This leads to a better grip of the instrument and ensures, for example, that the surgeon does not distally from the handle part 20 slip.

The axis II shows the stitch direction of the system 10 at. It can be seen that the system 10 essentially orthogonal to the surface of the body tissue was inserted into the body tissue.

2 shows the trocar sleeve 12 out 1 after the introductory instrument 14 completely out of the hose 16 the trocar sleeve 12 was removed. The body tissue surrounding the tube has the tube 16 compressed so that the interior of the hose 16 was closed. Possibly in the figure recognizable distances between the hose inner walls are due to the better representability. In practice, the tube is substantially completely occluded by the pressure of the surrounding body tissue. It can be seen that it is in the funnel 18 to a slight drape comes when the hose 16 is compressed.

3 shows a further embodiment of the system according to the invention 10 , the system being similar to the one in 1 shown in most features. This in 3 shown system 10 is different from the one in 1 shown in particular in that the endoscopic trocar sleeve 12 a stopper 32 having, by an elastically bendable band 34 at the funnel 18 the trocar sleeve 12 is attached. The plug 32 has a lid part 38 and a plunger neck 40 on, wherein the outer diameter of the latter about the inner diameter of the hose 16 equivalent. The plug neck 40 is intended in the hose 16 to be introduced. The lid part 38 would then be on the proximal opening of the tube 16 as well as the funnel 18 rest.

The elastically bendable band 34 is made of a material that is sufficiently elastically deformable to the plug 32 both in the proximal mouth region of the tube 16 as well as to be able to lead him away from this, so as not to hinder the introduction of endoscopic instruments and their handling. The length of the elastic band 34 is also adapted to these requirements.

4 shows the trocar sleeve 12 out 3 after the introductory instrument 14 completely out of the hose 16 the trocar sleeve 12 was removed and the stopper 32 into the proximal mouth of the tube 16 was introduced. The body tissue surrounding the tube has the tube 16 compressed, so that the Interior of the hose 16 closed around the plug neck. In practice, the distal portion of the tube, into which the plug neck does not protrude, can be further compressed by the body tissue than in 4 will be shown. This does not negatively affect the handling of the trocar sleeve. The plug neck in 4 goes through the hose 16 therefore not on its entire length. However, it is also possible to have a stopper 32 to use, the plug neck the hose 16 through its entire length or at least through the thickness of the body tissue.

5 schematically shows various embodiments of the proximal end of the tube 17 , ie the end of the tube remaining outside the body, with different support elements. The figure parts A to E show in plan view of the proximal end portion of the hose supporting elements (A) in the form of a funnel 18 , (B) with four flat, wing-like, rectangular elements 19 in the shape of a cross, (C) with two flat, wing-like, rectangular elements 19 , (D) with three flat, wing-like, rectangular elements 19 and € with a flat, wing-like element in the form of a petal 19 ,

Although the present invention has been described in detail with reference to the embodiments, it will be understood by those skilled in the art that the invention is not limited to these embodiments, but rather modifications are possible in such a way that individual features omitted or other combinations of individual features presented realized unless the scope of the appended claims is exceeded. The present disclosure includes all combinations of the featured individual features.

LIST OF REFERENCE NUMBERS

10

 system

12

 Endoscopic trocar sleeve

14

 introducer

16

 tube

17

 proximal end of the tube

18

 funnel

19

 flat, wing-like element

20

 handle part

22

 Hose stabilizing part

24

 mandrel

26

 connecting element

28

 Handle portion thickening

30

 admission

32

 plug

34

 elastically bendable band

36

 poetry

38

cover part

40

 plugs neck

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 102008004131 A1 [0002]
• DE 102009012205 A1 [0002]

Claims (9)

Endoscopic trocar sleeve ( 12 ) characterized in that the trocar sleeve is a hose ( 16 ) for passing an endoscopic instrument through body tissue and the tube ( 16 ) is configured such that it can be urged by the body tissue after insertion of the tube into the body tissue. Endoscopic trocar sleeve ( 12 ) according to claim 1, characterized in that the hose ( 16 ) has a wall thickness of 0.1 mm or less. Endoscopic trocar sleeve ( 12 ) according to one of claims 1 to 2, characterized in that the hose ( 16 ) is made of a material selected from the group of plastics, metals, mixtures containing plastics and / or metals, composites containing plastics and / or metals, and composites containing plastics and / or metals. Endoscopic trocar sleeve ( 12 ) according to one of claims 1 to 3, characterized in that the trocar sleeve ( 12 ) further comprises at its proximal end a support element, wherein the support element as a funnel ( 18 ), Ring, or as one or more flat, wing-like elements extending from the proximal end of the tube web-like radially away from the proximal tube opening is formed. Trocar sleeve ( 12 ) according to one of claims 1 to 4, characterized in that the trocar sleeve ( 12 ) at its proximal end portion one or more recordings ( 30 ) for releasably fixable mounting of an insertion instrument ( 14 ) having. Trocar sleeve ( 12 ) according to one of claims 1 to 5, characterized in that the trocar sleeve ( 12 ) a seal ( 36 ) for sealing the hose ( 16 ). Trocar sleeve ( 12 ) according to one of claims 1 to 6, characterized in that the trocar sleeve ( 12 ) a plug ( 32 ) for closing the hose ( 16 ). System ( 10 ) for introducing a trocar sleeve ( 12 ) in body tissue and / or holding an endoscopic instrument, characterized in that it comprises an endoscopic trocar sleeve ( 12 ) according to one of claims 1 to 7 and an introduction instrument ( 14 ) for insertion of the trocar sleeve ( 12 ) in a body tissue or in an opening in a body tissue. System ( 10 ) according to claim 8 for use in a surgical procedure for passing an endoscopic instrument through body tissue.

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