WO1994004082A1 - Trocart - Google Patents

Trocart Download PDF

Info

Publication number
WO1994004082A1
WO1994004082A1 PCT/GB1993/001712 GB9301712W WO9404082A1 WO 1994004082 A1 WO1994004082 A1 WO 1994004082A1 GB 9301712 W GB9301712 W GB 9301712W WO 9404082 A1 WO9404082 A1 WO 9404082A1
Authority
WO
WIPO (PCT)
Prior art keywords
guard
trocar
blades
support means
cutting means
Prior art date
Application number
PCT/GB1993/001712
Other languages
English (en)
Inventor
William John Hoskin
Nicholas Richard Kemp
Original Assignee
Advanced Surgical Ltd
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 Advanced Surgical Ltd filed Critical Advanced Surgical Ltd
Priority to EP93918010A priority Critical patent/EP0654977A1/fr
Publication of WO1994004082A1 publication Critical patent/WO1994004082A1/fr

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
    • A61B17/3494—Trocars; Puncturing needles with safety means for protection against accidental cutting or pricking, e.g. limiting insertion depth, pressure sensors
    • A61B17/3496—Protecting sleeves or inner probes; Retractable tips

Definitions

  • a trocar is a medical cutting tool used in Laparoscopy.
  • Laparoscopy a hollow tube or cannula is inserted through the wall of the abdominal cavity of a patient to allow surgical tools to be used within the abdominal cavity. The tools are inserted and withdrawn through the cannula. Any surplus tissue or organ can be withdrawn from the cavity through the cannula.
  • One or more cannulas can be inserted through the abdominal wall according to requirements.
  • a known trocar is in the form of an elongate shaft supporting at its free end, a head of circular cross-section, which is profiled at its free end portion to form a solid three sided pyramid defining three cutting edges leading away from the tip.
  • the shaft and head are encased in a retractable guard of plastics material.
  • the guard can be displaced longitudinally of the shaft to expose the head but is spring biased so as to envelop the head once any displacement force is removed.
  • the trocar In operation the trocar is inserted into the cannula until its free end projects from the forward end.
  • the cannula and trocar are then urged against the abdominal wall.
  • the resistance of the wall acts to displace the guard and so exposes the cutting edges.
  • the head pierces and cuts the abdominal wall until it emerges from the other side of the wall whereupon, with the resistance of the wall removed, the guard is resiliently displaced to once again cover the head so that the head is prevented from damaging any organs within the abdominal cavity. Continued penetration will allow the cannula to enter the abdominal cavity. It is an object of the present invention to provide a trocar with improved safety wherein the guard cannot normally be retracted to expose the cutting means and can only be so retracted after rotation of the handle of the trocar .
  • a generally cylindrical trocar for forming a hole in the abdominal wall of a patient to receive a cannula, comprising: cutting means; support means for the cutting means; a guard mounted on the support means for axial movement between a forward position in which the guard covers the cutting means and a retracted position in which the cutting means are exposed; and spring means acting between the support means and the guard to bias the guard towards its forward position; wherein stop means are provided on the support means and the guard to prevent movement of the guard from its forward position in a first rotary orientation of the guard relative to the support means but to allow movement of the guard from its forward position in a second rotary orientation of the guard relative to the support means, and wherein the spring means acting between the support means and the guard acts to bias the guard and support means into the first relative rotary orientation.
  • the abdominal cavity is inflated to provide room for the operation to take place. It is thus important that the abdominal wall forms a reasonably air-tight seal around the cannula.
  • a major problem with known trocars is that the solid pyramidal form of the cutting head presents a high resistance to penetration and this means that the surgeon has to apply considerable force before the trocar penetrates the abdominal wall. Often the surgeon will rotate the tool while pressing to achieve penetration and this action damages the tissue at the point of entry. Also penetration can occur suddenly after some hard pushing. Some surgeons will often effect a starter incision with a scalpel to ease penetration by the trocar.
  • the cutting head is surrounded by a relatively thick plastics sleeve and thus the diameter of the hole made by the cutting head is substantially less than that of the cannula to be inserted. This means that further hard pushing is required to force the cannula into the hole with consequent stretching and tearing of the tissue of the abdominal wall.
  • the cutting means comprises a plurality of laminar blades lying in angularly spaced radial planes and having cutting edges inclined to the axis of the trocar and extending rearwardly and radially outwardly from a common point on the axis of the trocar.
  • Figure 1 shows two blades used in a trocar
  • Figure 2 is a side view of a blade arrangement and a supporting rod
  • Figure 3 is a horizontal cross-sectional view of a supporting connector
  • Figure 4 is a side view of the supporting connector
  • Figure 5 is an end view of the supporting connector
  • Figure 6 is a vertical cross-sectional view of a guard
  • Figure 7 is a plan view of the guard
  • Figure 8 is an end view of the guard from its leading end
  • Figure 9 is a cross-sectional view of the assembled trocar with the guard in a forward position; and Figure 10 is a cross-sectional view of the assembled trocar with the guard in a retracted position.
  • the cutting means of the trocar is provided by two generally triangular laminar double blades 2 and 4 made, for example, of amorphous nickel, stainless steel or titanium.
  • the blades 2 and 4 have cutting edges 3.
  • a slot 5 extends from the apex of blade 2 and a slot 7 extends from the base of the blade 4.
  • a cruciform blade arrangement 6 is produced by fitting the blades 2 and 4 together by means of the slots.
  • the blade arrangement has, in effect, four blades which lie in radial planes spaced 90° apart around the axis of the trocar.
  • the cutting edges 3 of the blades are inclined to the axis of the trocar and extend rearwardly and radially outwardly from a common point on the axis of the trocar which defines the tip of the cutting means.
  • the blade arrangement may not comprise four blades but may comprise, for example, three, five, six or seven or more blades.
  • the blade arrangement as shown is inserted into cruciform slots provided in the head 8 of an elongate rod 10 so that the cutting edges project from the head.
  • the greatest diameter of the blade arrangement 6, ie the length of the base of each triangular blade, is much greater than the diameter of the head.
  • the diameter of the head is greater than the diameter of the shank of the rod.
  • the end of the shank remote from the head is provided with a screw thread 12 for receiving a nut.
  • the supporting means of the trocar includes a connector 14 shown in Figures 3 to 5.
  • the connector 14 comprises two coaxial generally cylindrical portions 16 and 18.
  • the leading cylindrical portion 16 has an external diameter smaller than that of the rear cylindrical portion 18.
  • the leading cylindrical portion 16 has an internal diameter substantially equal to the diameter of the elongate rod 10.
  • the leading cylindrical portion 16 includes a part-cylindrical projection 20.
  • the part-cylindrical projection is coaxial with the leading cylindrical portion 16 and has an equal external diameter.
  • the leading cylindrical portion 16 also includes a hole 22 bored parallel to the axis of the connector for receiving one end of a helical spring as described below.
  • the trocar includes a guard as shown in Figures
  • the guard 24 is generally cylindrical with a leading end 26 partly tapering towards the axis and towards the front end of the guard.
  • the guard includes three co-axial bores of different diameters.
  • the leading bore 28 has a diameter substantially equal to the diameter of the head portion 8 of the elongate rod 10.
  • the middle bore 30 has a diameter substantially equal to the diameter of the shank of the elongate rod 10.
  • the rear bore 32 has a diameter substantially equal to the external diameter of the leading cylindrical portion 16 of the connector 14.
  • the external diameter of the guard is substantially equal to the external diameter of the rear cylindrical body 18 of the connector 14.
  • the guard includes a hole 34 bored parallel to the middle bore for receiving one end of a helical spring, and a radial hole 36 for receiving a pin. A further radial hole 38 is provided for inspection purposes.
  • Cruciform slots 27 extend from the front of the leading end 26 towards the rear end of the guard for a distance approximately equal to the length of the leading bore 28.
  • the trocar is assembled as shown in Figures 9 and 10.
  • the leading cylindrical portion 16 of the connector 14 is inserted into the rear end of the guard 24 and comes to rest as the part cylindrical projection 20 abuts against a pin 40 located in hole 36 of the guard 24.
  • a helical spring 42 is connected between hole 22 in the connector and hole 34 in the guard and is located within the chamber formed by the insertion of the connector into the guard. The spring acts to bias the guard to a rotary orientation relative to the connector such that the projection 20 abuts against the pin 40.
  • the elongate rod 10 is inserted through the front end of the guard and comes to rest when its head 8 is stopped at the rear of the bore 28.
  • the elongate rod is therefore at rest with its shank located within the chamber formed by the guard and the connector and enclosed within the helical spring.
  • the end of the elongate rod extends into the rear cylindrical body 18 of the connector 14.
  • the end of the rod 10 is retained in the rear cylindrical portion 18 of the connector by a nut 44.
  • a handle 46 fitted into the rear cylindrical portion of the connector bears on the end of the rod 10.
  • the head 8 of the rod 10 is located solely within the leading end 26 of the guard 24.
  • the blade arrangement 6, fixed to the head 8 is also located within the leading end 26 of the guard 24.
  • the external diameter of the guard is substantially equal to the greatest diameter of the blade arrangement.
  • the leading end 26 of the guard 24 is scalloped and shaped such that it is recessed between each slot 27 and has a profile similar to the profile of the cruciform blade arrangement.
  • the trocar In operation, as shown in Figure 10, the trocar is pushed against the abdominal wall of a patient.
  • the handle 46 of the trocar is turned slightly and this in turn rotates the connector relative to the guard such that the guard and connector are rotated relative to each other by an angle of 180° to a second rotary orientation.
  • the part-cylindrical projection 20 is moved out of engagement with the pin 40.
  • the connector and rod are thus able to move axially forward with respect to the guard against the action of the spring 42.
  • the head of the rod is displaced axially forward, the cutting edges of the blades emerge through the slots 27 of the guard 24.
  • the four cutting edges 3 cut into the tissue much in the same way as four scalpels would, and sever the tissue along four radially outwardly extending lines from a central point to create four flaps.
  • the resilience of the compressed spring 42 urges the guard back to its forward position and returns the guard to its first rotary orientation relative to the connector.
  • the cutting edges are therefore immediately covered within the guard so that no damage can be done to other organs. This will also occur if the trocar is removed from the patient.
  • Part of the outer surface of the leading cylindrical portion 16 of the connector is coloured red so that when the guard is in its retracted position, a red colour can be viewed through the hole 38 indicating that the cutting edges 3 are exposed. This is an additional safety feature for the surgeon since he can check, before he applies further pressure to the trocar to introduce the cannula, that the cutting edges have been covered by the guard.
  • the body wall is hardly stretched and is not torn when the guard comes forward over the cutting blades.
  • the trocar should be used within a cannula having thin walls and having an internal diameter only slightly greater than the external diameter of the trocar so that the body wall is hardly stretched and is not torn by the insertion of the cannula.
  • the body wall thus maintains an airtight seal with the cannula and is cleanly cut by the trocar so that the healing process is much improved.
  • the sharpness of the blades of the trocar means that surgeons do not have to apply so much pressure in order to penetrate the abdominal wall. This prevents the trocar from being suddenly forced through the abdominal wall.
  • blade arrangements may be used.
  • two triangular planar blades (not shown) each bent through 90° along the perpendicular bisector of the base.
  • the blades are assembled by placing the perpendicular bisectors of the blades side by side so as to form a cruciform configuration when viewed from above. If the blade arrangement does not comprise four blades, the head of the rod and the guard will be modified to accommodate the number of blades provided.

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Pathology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

Un trocart généralement cylindrique servant à percer un trou dans la paroi abdominale d'un patient, afin de passer une canule, comprend: des moyens coupants (6); des moyens de support (10, 14) des moyens coupants; une garde (24) montée sur le moyen de support pour effectuer un déplacement axial entre une position vers l'avant, dans laquelle la garde recouvre les moyens coupants, et une position retirée, dans laquelle les moyens coupants sont découverts; ainsi qu'un ressort (42) agissant entre les moyens de support et la garde, de façon à solliciter celle-ci vers sa position avancée. Les moyens coupants sont constitués par deux lames (2, 4) généralement triangulaires formant une disposition cruciforme, dont les bords coupants (3) sont inclinés vers l'axe du trocart.
PCT/GB1993/001712 1992-08-13 1993-08-12 Trocart WO1994004082A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
EP93918010A EP0654977A1 (fr) 1992-08-13 1993-08-12 Trocart

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GB929217143A GB9217143D0 (en) 1992-08-13 1992-08-13 A trocar
GB9217143.8 1992-08-13

Publications (1)

Publication Number Publication Date
WO1994004082A1 true WO1994004082A1 (fr) 1994-03-03

Family

ID=10720247

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/GB1993/001712 WO1994004082A1 (fr) 1992-08-13 1993-08-12 Trocart

Country Status (3)

Country Link
EP (1) EP0654977A1 (fr)
GB (1) GB9217143D0 (fr)
WO (1) WO1994004082A1 (fr)

Cited By (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE4429744A1 (de) * 1994-08-22 1996-02-29 Martin Storz Chirurgischer Sicherheitstrokar
GB2295319A (en) * 1994-10-14 1996-05-29 Microsurgical Equipment Ltd Guarded cannula for a trocar system
ES2088372A1 (es) * 1994-04-12 1996-08-01 Wais Med Ltd Instrumento quirurgico para la insercion por impacto de una aguja trocar intraosea
EP0768064A1 (fr) * 1995-10-16 1997-04-16 Ethicon Endo-Surgery, Inc. Trocart avec un embout à configuration amélioré
EP0769278A3 (fr) * 1995-10-20 1997-05-21 United States Surgical Corporation Système de trocart modulaire et ses procédés d'assemblage
WO2001091653A3 (fr) * 2000-05-30 2002-05-16 Genicon Lc Systeme de trocart a trocart protege, canule a elements de prehension, logement d'extremite amovible, systeme de clapet souple, et methodes associees
US7063681B1 (en) 1998-04-23 2006-06-20 Alza Corporation Trocar for inserting implants
US8282663B2 (en) 2007-10-05 2012-10-09 Tyco Healthcare Group Lp Bladeless obturator for use in a surgical trocar assembly
US8845670B2 (en) 2006-12-15 2014-09-30 Covidien Lp Trocar assembly with obturator design
US8940007B2 (en) 2007-04-18 2015-01-27 Covidien Lp Trocar assembly with obturator dissector
US8961552B2 (en) 2010-09-21 2015-02-24 Covidien Lp Bladeless obturators and bladeless obturator members
US8979883B2 (en) 2009-12-17 2015-03-17 Covidien Lp Obturator tip
US9226774B2 (en) 2009-12-17 2016-01-05 Covidien Lp Visual obturator with tip openings

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR1487998A (fr) * 1966-07-28 1967-07-07 Brunswick Corp Ensemble de canule et de trocart, en particulier pour la cage thoracique
FR2293907A1 (fr) * 1974-12-14 1976-07-09 Henriquez De Gaztanondo Carlos Dispositif pour ponction, injection, drainage et catheterisation transcutanes
DE8511787U1 (de) * 1985-04-20 1986-08-14 Lindenberg, Josef, 7512 Rheinstetten Gerät zur Schaffung eines Weges im Hautgewebe
WO1992010141A1 (fr) * 1990-12-11 1992-06-25 Adair Edwin Lloyd Systeme de trocart pour laparoscopie
WO1992010974A1 (fr) * 1990-12-18 1992-07-09 Inbae Yoon Instrument penetrant de securite
EP0495634A2 (fr) * 1991-01-15 1992-07-22 Ethicon, Inc. Trocart

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR1487998A (fr) * 1966-07-28 1967-07-07 Brunswick Corp Ensemble de canule et de trocart, en particulier pour la cage thoracique
FR2293907A1 (fr) * 1974-12-14 1976-07-09 Henriquez De Gaztanondo Carlos Dispositif pour ponction, injection, drainage et catheterisation transcutanes
DE8511787U1 (de) * 1985-04-20 1986-08-14 Lindenberg, Josef, 7512 Rheinstetten Gerät zur Schaffung eines Weges im Hautgewebe
WO1992010141A1 (fr) * 1990-12-11 1992-06-25 Adair Edwin Lloyd Systeme de trocart pour laparoscopie
WO1992010974A1 (fr) * 1990-12-18 1992-07-09 Inbae Yoon Instrument penetrant de securite
EP0495634A2 (fr) * 1991-01-15 1992-07-22 Ethicon, Inc. Trocart

Cited By (24)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
ES2088372A1 (es) * 1994-04-12 1996-08-01 Wais Med Ltd Instrumento quirurgico para la insercion por impacto de una aguja trocar intraosea
DE4429744A1 (de) * 1994-08-22 1996-02-29 Martin Storz Chirurgischer Sicherheitstrokar
DE4429744C2 (de) * 1994-08-22 1999-10-21 Martin Storz Chirurgischer Sicherheitstrokar
GB2295319A (en) * 1994-10-14 1996-05-29 Microsurgical Equipment Ltd Guarded cannula for a trocar system
AU698515B2 (en) * 1995-10-16 1998-10-29 Ethicon Endo-Surgery, Inc. Trocar having improved tip configuration
EP0768064A1 (fr) * 1995-10-16 1997-04-16 Ethicon Endo-Surgery, Inc. Trocart avec un embout à configuration amélioré
US5709671A (en) * 1995-10-16 1998-01-20 Ethicon Endo-Surgery, Inc. Trocar having an improved tip configuration
US5776112A (en) * 1995-10-16 1998-07-07 Ethicon Endo-Surgery, Inc. Trocar having an improved tip configuration
EP1402827A1 (fr) * 1995-10-20 2004-03-31 United States Surgical Corporation Système de trocart modulaire
US5980493A (en) * 1995-10-20 1999-11-09 United States Surgical Corporation Modular trocar system and methods and assembly
EP0769278A3 (fr) * 1995-10-20 1997-05-21 United States Surgical Corporation Système de trocart modulaire et ses procédés d'assemblage
US5807338A (en) * 1995-10-20 1998-09-15 United States Surgical Corporation Modular trocar system and methods of assembly
US7063681B1 (en) 1998-04-23 2006-06-20 Alza Corporation Trocar for inserting implants
US7329242B2 (en) 1998-04-23 2008-02-12 Alza Corporation Trocar for inserting implants
WO2001091653A3 (fr) * 2000-05-30 2002-05-16 Genicon Lc Systeme de trocart a trocart protege, canule a elements de prehension, logement d'extremite amovible, systeme de clapet souple, et methodes associees
US8845670B2 (en) 2006-12-15 2014-09-30 Covidien Lp Trocar assembly with obturator design
US8940007B2 (en) 2007-04-18 2015-01-27 Covidien Lp Trocar assembly with obturator dissector
US8282663B2 (en) 2007-10-05 2012-10-09 Tyco Healthcare Group Lp Bladeless obturator for use in a surgical trocar assembly
US9078698B2 (en) 2007-10-05 2015-07-14 Covidien Lp Bladeless obturator for use in surgical trocar assembly
US8979883B2 (en) 2009-12-17 2015-03-17 Covidien Lp Obturator tip
US9226774B2 (en) 2009-12-17 2016-01-05 Covidien Lp Visual obturator with tip openings
US9301778B2 (en) 2009-12-17 2016-04-05 Covidien Lp Obturator tip
US8961552B2 (en) 2010-09-21 2015-02-24 Covidien Lp Bladeless obturators and bladeless obturator members
US10092321B2 (en) 2010-09-21 2018-10-09 Covidien Lp Bladeless obturators and bladeless obturator members

Also Published As

Publication number Publication date
EP0654977A1 (fr) 1995-05-31
GB9217143D0 (en) 1992-09-23

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