EP1489978A2 - Dispositif de fixation d'un trocart, tuyau ou catheter - Google Patents

Dispositif de fixation d'un trocart, tuyau ou catheter

Info

Publication number
EP1489978A2
EP1489978A2 EP03722358A EP03722358A EP1489978A2 EP 1489978 A2 EP1489978 A2 EP 1489978A2 EP 03722358 A EP03722358 A EP 03722358A EP 03722358 A EP03722358 A EP 03722358A EP 1489978 A2 EP1489978 A2 EP 1489978A2
Authority
EP
European Patent Office
Prior art keywords
trocar
leg
tube
catheter
retaining element
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.)
Withdrawn
Application number
EP03722358A
Other languages
German (de)
English (en)
Inventor
Delia Schinkel-Fleitmann
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.)
Individual
Original Assignee
Individual
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 Individual filed Critical Individual
Publication of EP1489978A2 publication Critical patent/EP1489978A2/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/02—Holding devices, e.g. on the body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00477—Coupling
    • 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
    • A61B2017/347—Locking means, e.g. for locking instrument in cannula
    • 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
    • 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
    • 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
    • A61B2017/3484—Anchoring means, e.g. spreading-out umbrella-like structure
    • 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
    • A61B2017/3492—Means for supporting the trocar against the body or retaining the trocar inside the body against the outside of the body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/02—Holding devices, e.g. on the body
    • A61M2025/024—Holding devices, e.g. on the body having a clip or clamp system

Definitions

  • the invention relates to a device for fixing a trocar, a tube or a catheter with a smooth wall in a hole in a tissue layer having an outside and an inside, in particular in a skin or body cover.
  • trocars In endoscopic operations such as laparoscopy, e.g. H. abdominal mirroring, metal or plastic sleeves, called trocars, are inserted through the skin and the adjacent abdominal wall into the interior of the body to form a working channel.
  • the surgeon can insert an optical or surgical instrument, for example an endoscope or scissors, into the abdominal cavity through the trocar.
  • the trocar is subjected to considerable mechanical stress by changing the instruments, for example scissors for pliers, and moving the instruments back and forth.
  • an assistant to the surgeon usually records the trocars used.
  • Known devices for fixing trocars have a thread on the outside of the trocars, with which the respective trocar is screwed into the tissue layer delimiting the hole like a screw.
  • additional trocars of various sizes, the actual smooth-walled trocar receiving the instruments being inserted into the additional trocar and then being inserted into the hole in the tissue layer.
  • the trocar can be fixed in different relative positions with respect to the additional trocar. But this is bought with the exception of the additional Traumatization of the skin over its entire thickness due to the "screwing" of the additional trocar also requires a larger cut for a larger hole, which in addition to the trocar also has to accommodate the additional trocar. Regardless of whether it is trocars with an external thread or additional trocars with an external thread, these are only available at relatively high costs.
  • Atraumatic trocar fixation devices i. H. So far, those who work without injuries are not available.
  • Another area of the invention is the fixation of tubes and catheters, in particular drainage tubes and indwelling catheters. So far there has been a need to sew the tube or catheter onto the skin.
  • the invention is therefore based on the object of demonstrating a device of the type described above for minimally traumatizing fixation of a trocar, a tube or a catheter with a smooth wall, which can be used in conjunction with existing smooth trocars and existing tubes or catheters and as such is inexpensive ,
  • the invention is described below with reference to the fixation of a trocar. These statements can be transferred to the fixation of a tube or catheter.
  • the core of the new device is an L-shaped retaining element.
  • This retaining element has two legs, one of which lies flat against the inside of the tissue layer when the trocar is fixed, and of which the other runs parallel to the trocar and is attached to it.
  • the tissue layer is usually the outermost tissue layer of the skin (cutis).
  • the one leg of the restraint that is supported on the fabric layer elements reliably prevents the trocar from being pulled out of the hole in the tissue layer.
  • the means for fixing the other leg of the retaining element on the trocar also prevent an undesired further insertion of the trocar into the hole.
  • the other leg or these means can also have special stops for contacting the outside of the fabric layer.
  • the trocar can first be inserted into the hole and then one leg of the L-shaped retaining element can be inserted through the hole parallel to the trocar and then folded onto the inside of the tissue layer on the tissue layer, so that the other Leg of the retaining element is aligned parallel to the trocar.
  • the trocar and the other leg of the retaining element aligned parallel to it are secured to one another, as a result of which the trocar is fixed relative to the hole.
  • An additional widening of the hole in the fabric layer is not necessary to a significant extent for the new device. There is also no significant additional stress on the fabric layer by the retention element.
  • the device can be provided inexpensively and used with existing smooth-walled trocars.
  • an adaptation of the device to the trocar used in each case makes sense, at least to a certain extent. At least an exact adaptation to the respective outer diameter of the trocar is not mandatory.
  • the one limb of the retaining element is flatly arch-shaped in cross section, a radius of curvature of the cross section on the underside of one limb facing away from the inside of the tissue layer corresponds to the outer radius of the trocar, the one limb can be particularly easily on the inside next to the trocar already inserted into the hole be brought to the fabric layer.
  • one leg only slightly increases the outer circumference of the trocar.
  • the one leg of the retaining element is of a flat profile with a small wall thickness, it is preferably designed such that there is no risk of breaking off on the inside of the fabric layer.
  • the cross-sectional shape of the leg results in a high degree of dimensional stability even when the one leg is made of plastic. If the one leg of the retaining element has a profiling on its upper side facing the inside of the tissue layer, which counteracts the slipping of the tissue layer, the retention of the trocar in the hole can be ensured to an even greater extent.
  • the other leg of the retaining element preferably has a groove for receiving and for contacting the trocar. This supports the parallel arrangement of the other leg and the trocar by positive locking. This is ideal if the surface radius of curvature of the channel in the other leg corresponds at least approximately to the outer radius of the trocar.
  • one end of a tensioning band can be anchored to the other leg, which can be looped around the trocar and then fastened under tension to the other leg.
  • the trocar is held in its position relative to the retaining element by the static friction between its surface and the other leg or the tightening strap.
  • the surface of the channel in which the trocar lies against the other leg can have a particularly high static friction with respect to the trocar due to a coating.
  • the tensioning strap can be an elastically stretchable perforated strap that can be hooked onto a hook on the other leg after it has been looped around the trocar. Specifically, a lateral opening can be provided on the other leg, the hook protruding into the area of the tension band which is looped around the trocar and passed through the opening.
  • the hooked-on tension band can be removed from the hook again by pulling in the opposite direction in order to release the tension band and thus ultimately the trocar for pulling out or repositioning.
  • the retaining element with both legs can be formed from a one-piece, dimensionally stable molded body made of plastic.
  • the new device can also have 2 L-shaped retaining elements, which lie opposite one another across the trocar when the trocar is fixed. In this way an even more secure anchoring of the trocar to the tissue layer is achieved.
  • Both L-shaped retaining elements are preferably molded articles made of plastic, which each form both legs of a retaining element.
  • the two molded bodies made of plastic are identical, and they are connected to one another by the tensioning strap already explained.
  • the two molded articles made of plastic hang together via a film hinge. So they are injection molded from the plastic in a common mold.
  • the film hinge forms a pivot axis which runs approximately parallel to the other two legs and thus to the main direction of extension of the trocar.
  • a latching connection is provided between the two other legs of the two mutually hanging molded bodies. This latching connection engages when the two shaped bodies are pressed together around the trocar and supports the pressing force of the shaped bodies on the trocar, which is necessary for applying the static friction which fixes the other swivels of the shaped bodies on the trocar.
  • This embodiment of the invention is particularly well suited for quickly fixing drainage hoses and also offers the possibility of quickly replacing the respective drainage hoses.
  • Fig. 1 is a separate perspective side view of the first
  • Fig. 2 is a side view of the first embodiment of the new
  • Fig. 3 is a separate perspective oblique view of the second
  • Fig. 4 shows the second embodiment of the new device in the same
  • Fig. 5 shows the second embodiment of the new device in a closed position in a view from below
  • Fig. 6 shows the second embodiment in the position shown in FIG. 5 in a perspective side view with a fixed drainage hose.
  • the device 7 shown in FIGS. 1 and 2 serves to fix a trocar 4 shown in FIG. 2 with respect to a tissue layer 1, for example a skin 2.
  • the trocar is a smooth-walled trocar.
  • a hole 3 is made in the tissue layer 1, that is, for example cut with a scalpel, through which the trocar 4 projects from an outer side 5 to an inner side 6 of the tissue layer 1.
  • the device 7 comprises an L-shaped retaining element 8 with two legs 9 and 10.
  • one leg 9 is arranged on the inside 6 of the fabric layer 1 and lies flat against the fabric layer 1 there. Specifically, it is located on the inside 6 of a cutis 12 made of epidermis 22 and corium 23 of the skin 2.
  • an upper side of the leg 9, as shown here, can be provided with a profile 11 in order to to prevent unwanted slipping of the fabric layer 1 from the leg 9.
  • the leg 9 is formed by a one-piece molded body 13 made of plastic, which also forms the leg 10.
  • the shaped body 12 is flat, the radius of curvature of the channel being adapted to the outside diameter of the trocar 4, around the leg 9 next to the trocar through the hole 3 on the inside 6 of the To bring tissue layer 1.
  • the Shaped body 13 on a channel 14 which partially receives the trocar 4 and which causes a parallel alignment of the trocar 4 to the leg 10.
  • a tensioning strap 15 is provided, which is an elastically stretchable perforated strap 16.
  • One end 17 of the strap 15 is firmly anchored to the molded body 13.
  • the trocar is wrapped around with the remaining strap.
  • the free end 18 is passed through an opening 19 in the molded body 13 and tightened.
  • the tightened strap 15 is fixed on a hook 20 which protrudes from the molded body 13. The trocar is thus held on the leg 10 of the retaining element 8 by means of static friction with respect to the tensioning band 15 and the molded body 13.
  • the use of the new device means that two opposing molded bodies 13 can be used in connection with a tensioning strap 15, a quick Fixation without sewing on the skin. This saves time and money.
  • the second exemplary embodiment of the new device shown in FIGS. 3 to 6 represents a further possibility, in particular for fixing drainage tubes and remaining catheters.
  • a section of such a drainage tube 25 is shown in FIG. 6.
  • the device according to FIGS. 3 to 6 consists of two differently shaped molded bodies 26 and 27 made of plastic which hang together via a film hinge 28 and each form an L-shaped retaining element 8. That is, each of the shaped bodies 26 and 27 has a leg 9, which is to be arranged on the inside 6 of the fabric layer 1, and a leg 10, which extends along the fixed drainage tube 25.
  • the grooves 14 of the legs 10 are designed here so that they almost completely enclose the drainage hose 25.
  • a small gap 29 remains on the side of the drain hose 25 opposite the film hinge 28 in order to be able to compress the two molded bodies 26 and 27 under tension around the drain hose 25 in the position of the device 7 according to FIGS. 5 and 6.
  • the two molded bodies 26 and 27 are held together by a latching connection 30, 31 made of sawtooth-shaped retaining elements 30 on the molded body 26 and a hook 31 which engages behind the retaining elements 30 and is elastically supported on the molded body 27. Due to the force exerted on the drainage hose 25 by the interlocking molded bodies 26 and 27, static friction is built up, which is further increased by an inner peripheral edge 32 in the groove 14 of the molded body 26.
  • the leg 9 of the molded body 26 of the opened device 7 is guided past the drainage tube 25 through the hole 3 in the fabric layer 1. Then the other leg 10 of the molded body 26 is placed on the hose. The leg 9 of the molded body 27 is also brought past the hose through the hole 3 under the fabric layer 1. The position assumed by the device 7, in which the leg 9 of the molded body 27 lies below the leg 10 of the molded body 26, can be seen particularly well from FIG. 4.
  • the two molded bodies 26 and 27 are then pivoted together around the film hinge 28 and a pivot axis 33 defined by the latter and running parallel to the two legs 10 until the hook 31 catches the latching elements 30 engages behind and a sufficient pre-tension is exerted on the drainage hose 25 in order to hold it by static friction on the device 7.
  • the hook 31 By lifting the hook 31 from the locking elements 30, the drainage hose is released again, and the device 7 can be removed from the hole 3.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Public Health (AREA)
  • Surgery (AREA)
  • Pathology (AREA)
  • Molecular Biology (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Biophysics (AREA)
  • Pulmonology (AREA)
  • Anesthesiology (AREA)
  • Hematology (AREA)
  • Surgical Instruments (AREA)
  • Media Introduction/Drainage Providing Device (AREA)
  • External Artificial Organs (AREA)

Abstract

L'invention concerne un dispositif permettant de fixer un trocart (4), tuyau ou cathéter à paroi lisse à l'intérieur d'un trou (3) formé dans une couche tissulaire (1) présentant une face extérieure (5) et une face intérieure (6), en particulier dans une peau ou une enveloppe corporelle. Ce dispositif présente au moins un élément de retenue en L, dont une branche (8) peut être introduite à travers le trou (3) depuis la face extérieure (5) et placée à plat contre la couche tissulaire (1) sur la face intérieure (6), l'autre branche (10) pouvant être fixée par adhérence à la paroi du trocart (4), tuyau ou cathéter sur la face extérieure (5).
EP03722358A 2002-03-30 2003-03-27 Dispositif de fixation d'un trocart, tuyau ou catheter Withdrawn EP1489978A2 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
DE10214414A DE10214414B4 (de) 2002-03-30 2002-03-30 Vorrichtung zur Fixierung eines Trokars, eines Schlauchs oder Katheters
DE10214414 2002-03-30
PCT/EP2003/003164 WO2003082071A2 (fr) 2002-03-30 2003-03-27 Dispositif de fixation d'un trocart, tuyau ou catheter

Publications (1)

Publication Number Publication Date
EP1489978A2 true EP1489978A2 (fr) 2004-12-29

Family

ID=28051014

Family Applications (1)

Application Number Title Priority Date Filing Date
EP03722358A Withdrawn EP1489978A2 (fr) 2002-03-30 2003-03-27 Dispositif de fixation d'un trocart, tuyau ou catheter

Country Status (5)

Country Link
US (1) US20050043685A1 (fr)
EP (1) EP1489978A2 (fr)
AU (1) AU2003229574A1 (fr)
DE (1) DE10214414B4 (fr)
WO (1) WO2003082071A2 (fr)

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US7931658B2 (en) 2002-09-20 2011-04-26 Interrad Medical, Inc. Temporary retention device
US8343028B2 (en) * 2005-10-19 2013-01-01 Thoratec Corporation Ventricular pump coupling
US9744279B2 (en) 2005-12-08 2017-08-29 Heartware, Inc. Implant connector
US8016794B2 (en) 2006-03-09 2011-09-13 Interrad Medical, Inc. Anchor device and method
US8235948B2 (en) 2008-06-27 2012-08-07 Interrad Medical, Inc. System for anchoring medical devices
US8038653B2 (en) 2008-07-16 2011-10-18 Interrad Medical, Inc. Anchor systems and methods
US8328764B2 (en) 2009-02-06 2012-12-11 Interrad Medical, Inc. System for anchoring medical devices
US8343108B2 (en) 2010-09-29 2013-01-01 Interrad Medical, Inc. Systems and methods for anchoring medical devices
US8936576B2 (en) 2011-09-15 2015-01-20 Interrad Medical, Inc. System for anchoring medical devices
US9314596B2 (en) 2012-10-11 2016-04-19 Interrad Medical, Inc. Systems and methods for anchoring medical devices
US9550043B2 (en) 2012-12-13 2017-01-24 Interrad Medical, Inc. Systems and methods for anchoring medical devices
US9415190B2 (en) 2013-02-13 2016-08-16 Interrad Medical, Inc. Systems and methods for anchoring medical devices
US9381321B2 (en) 2013-05-03 2016-07-05 Interrad Medical, Inc. Systems and methods for anchoring medical devices
KR101996121B1 (ko) * 2016-12-05 2019-07-03 인제대학교 산학협력단 뇌척수액 운송용 도관의 이탈 방지 장치
US11484337B2 (en) * 2020-02-06 2022-11-01 Covidien Lp Surgical access device including anchor with rachet mechanism
KR200496002Y1 (ko) * 2020-10-08 2022-10-11 이치영 카테터 고정장치
US11944348B2 (en) 2021-04-07 2024-04-02 Covidien Lp Surgical access device including an anchor having a suture retention mechanism
KR102540567B1 (ko) * 2022-06-10 2023-06-08 주식회사 애드고컴퍼니 락타입 카테터 고정장치

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Also Published As

Publication number Publication date
US20050043685A1 (en) 2005-02-24
DE10214414B4 (de) 2004-06-03
AU2003229574A1 (en) 2003-10-13
WO2003082071A2 (fr) 2003-10-09
DE10214414A1 (de) 2003-10-16
WO2003082071A3 (fr) 2004-03-11
AU2003229574A8 (en) 2003-10-13

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