WO1995007661A1 - Instrument chirurgical - Google Patents

Instrument chirurgical Download PDF

Info

Publication number
WO1995007661A1
WO1995007661A1 PCT/GB1994/001969 GB9401969W WO9507661A1 WO 1995007661 A1 WO1995007661 A1 WO 1995007661A1 GB 9401969 W GB9401969 W GB 9401969W WO 9507661 A1 WO9507661 A1 WO 9507661A1
Authority
WO
WIPO (PCT)
Prior art keywords
instrument
pressure applying
applying portion
inflatable
pressure
Prior art date
Application number
PCT/GB1994/001969
Other languages
English (en)
Inventor
Michael John Mcmahon
Peter Moran
Original Assignee
Surgical Innovations Limited
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 Surgical Innovations Limited filed Critical Surgical Innovations Limited
Publication of WO1995007661A1 publication Critical patent/WO1995007661A1/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
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/132—Tourniquets
    • A61B17/1322—Tourniquets comprising a flexible encircling member
    • A61B17/1325—Tourniquets comprising a flexible encircling member with means for applying local pressure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/132—Tourniquets
    • A61B17/135—Tourniquets inflatable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00535—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
    • A61B2017/00557—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated inflatable

Definitions

  • the present invention relates to surgical instruments and in particular, although not exclusively, to instruments for use in endoscopic surgery.
  • Endoscopic surgery comprises the technique of making small holes in a persons body. Instruments are passed through those holes in order to operate on organs within the body. The operation is viewed on a screen which is supplied with an image of the cavity in the body from a camera which is manoeuvred within the cavity.
  • a surgical instrument includes a handle arranged, in use, to be located outside of a patient's body, and an elongate portion to which is connected a pressure applying portion, the pressure applying portion being movable between a first position in which the pressure applying portion can be inserted through a restricted cavity in the wall of a patient's body and a second position in which the pressure applying portion has an increased surface area in a direction transverse to the longitudinal extent of the elongate portion.
  • the pressure applying portion may comprise an inflatable portion.
  • a surgical instrument includes a handle arranged, in use, to be located outside of a patient's body, and an elongate portion connected to an inflatable pressure applying portion, the pressure applying portion being arranged, in use, to be inflated when within a patient's body in order to provide a surface which can be urged against a part of a body within a cavity by exerting a force with the handle.
  • the force may be arranged to extend in the general direction of the elongate portion.
  • the surface area of the pressure applying portion When inflated, the surface area of the pressure applying portion may be increased in a direction transverse to the longitudinal extent of the elongate portion and may be so increased in two perpendicular directions transverse to the longitudinal extent of the elongate portion.
  • the force being applied by the handle to the pressure applying portion nay be arranged to be a pushing force.
  • the inflatable portion nay be non-elastic.
  • the instrument may include inflation means arranged to be located outside of a body which means are arranged to cause the pressure applying portion to be inflated.
  • the inflation means may comprise manual means such as a hand held pump. Alternatively or additionally, the inflation means may comprise automatic inflation means such as provided by a compressed gas source.
  • the inflation means may include a pressure limiting valve and may also include a pressure release means such as to allow deflation of the pressure applying portion.
  • the instrument may include a conduit extending through the elongate portion which the inflation media is arranged to communicate with the pressure applying portion.
  • the pressure applying portion may be arranged to be deflated or returned from the second to the first position when located within a body.
  • the inflatable pressure applying portion may be locatable within a sleeve and there may be means for causing relative sliding movement between the sleeve and the pressure applying portion when the pressure applying portion is located within the body to substantially expose the pressure applying portion.
  • the instrument may include indication means arranged to indicate when sufficient relative sliding movement has occurred between the sleeve and the pressure applying portion.
  • Pressure should be such that the inflatable part can be pressed against the bleeding part with sufficient force that the bleeding is stopped.
  • Inflation may be with gas or liquid.
  • the pressure applying portion when inflated or when in the second position may be arranged to provide a substantially flat surface.
  • the present invention includes any combination of the herein referred to features and limitations.
  • Figure 1 is a schematic side view of the end of an endoscopic haemostat 10 being shown in a stored, non- operational configuration
  • Figure 2 is a view similar to Figure 1 with the endoscopic haemostat being prepared for use;
  • Figure 3 is a view of the complete endoscopic haemostat ready for use.
  • FIG 4 is a detailed view of an alternative way of operating the haemostat.
  • the instrument 10 comprises a tube 12 which is approximately 11 mm thick. This tube 12 can be inserted through and removed from a port in a body.
  • the tube 12 is provided with an integral gas seal 11 which cooperates with the port leading into the body.
  • the tube 12 surrounds, as shown in Figure 1, an inflatable flexible sack 13.
  • the sack is connected to an inner tube 14 at a sealed connection point 15.
  • the sack 13 can be exposed, for instance by causing relative sliding movement between the tubes 12 and 14, with that sliding movement being controlled from outside of the body. With the seal 11 cooperating with the port, the tube 14 is pushed into the body to achieve this relative movement. An indication is given to the user of the instrument that sufficient relative sliding movement has occurred, for instance by causing a coloured portion on one of the tubes to be uncovered when the sliding movement is sufficient or by providing a mechanical "click", for instance by a notch in one of the tubes sliding over a recess in the other tube. The sack can then be inflated.
  • inflation can take place for instance by having a bladder with a one way valve provided on the outside of the instrument which is connected through the interior of the inner tube 14 to the sack.
  • the bladder can be provided with a release tap to allow the sack to be collapsed after it has been used and to allow relative sliding movement of the tubes to occur again until the tube 14 and sack 13 are back within the outer tube 12.
  • the inner tube 14 can be connected to a carbon dioxide source which can fill the sack directly to the required pressure.
  • a vent valve which limits the pressure may be provided on the supply line for the carbon dioxide.
  • the handle 13 which is located outside of the body may also comprise a cylinder that contains a saline solution. If a lever 19 is then moved in the direction of arrow 20 a pivoted link 21 urges a piston 22 down within the cylinder to displace the liquid down the tube 14 thus causing the balloon or sack 13 to inflate.
  • the haemostat can be arranged so that when the lever 19 is pushed fully home the balloon is at the required pressure. Alternatively, or additionally, the pressure within the balloon upon activation of the lever can be caused to be varied by adjusting the link 21.
  • the pressure within the sack is likely to be in the region of 1.5 to 2 lb sq. in.
  • the pressure is sufficient to cause the sack to be rigid and retain its form even though the force being applied to the handle may be very significant.
  • the balloon is made out of non elastic material and accordingly it has a fixed volume and takes up a fixed shape, as shown in Figure 3.
  • the instrument 10 can be inserted through a port in the body, the balloon can be exposed and inflated. Once inflated, then pressure can be applied to the leaking vessel by the substantially flat end face 16 of the balloon.
  • the end of the instrument which is located outside of the body and which is provided with the handle 18 can be used to manoeuvre the pressure face 16 and to apply pressure over the area required.
  • the force which can be applied to the handle can be quite significant because of the large surface area of the face 16. Thus a significant pressure over a large area is applied, rather than applying a very high pressure to a very small area, which nay ir. itself cause damage, as would be the case if it were attempted to push an item having a diameter of 11 mm against the bleeding area.
  • the actual source of the leak in the vessel 11 may not be readily apparent and accordingly, by affording the large area of the face 16, even though the surgeon may not be entirely certain that the centre of the cut in the vessel 11 is aligned with the centre of the instrument which is pushing against the cut, the surgeon can nevertheless be reasonably sure that the cut is located somewhere under the face 16.
  • the damaged vessel is frequently surrounded by tissue which does not allow convenient access to the sight of the hole in the vessel. Accordingly it is important to be able to provide a large area to push against the damaged tissue.
  • the diameter of the face 16 may be in the region of 2 to 8 cm.
  • the blood flow may be stemmed either allowing the operation to be satisfactorily continued with the bleeding ceasing by itself, or the stemming of the flow may allow time for an emergency cut to be made in the cavity wall, at relative leisure, before more traditional methods are used to stem the blood loss.

Abstract

On insère un tube (12) par un orifice dans un corps lors d'un saignement. Le tube (12) est alors glissé en arrière pour libérer un sac (13). Le sac (13) est alors gonflé et poussé contre la région qui saigne, afin de réduire la vitesse de saignement.
PCT/GB1994/001969 1993-09-15 1994-09-09 Instrument chirurgical WO1995007661A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GB939319056A GB9319056D0 (en) 1993-09-15 1993-09-15 Haemostat
GB9319056.9 1993-09-15

Publications (1)

Publication Number Publication Date
WO1995007661A1 true WO1995007661A1 (fr) 1995-03-23

Family

ID=10742009

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/GB1994/001969 WO1995007661A1 (fr) 1993-09-15 1994-09-09 Instrument chirurgical

Country Status (2)

Country Link
GB (1) GB9319056D0 (fr)
WO (1) WO1995007661A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2005107604A1 (fr) * 2004-05-03 2005-11-17 Doare Michel Systeme pour l'obturation d'un vaisseau sanguin, en particulier apres une intervention arterielle par catheter

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0141589A1 (fr) * 1983-10-21 1985-05-15 Avvari Rangaswamy Appareil d'hémostase gonflable pour l'utérus
FR2668695A1 (fr) * 1990-11-06 1992-05-07 Ethnor Instrument chirurgical endoscopique pour le deplacement de tissus ou organes.
US5163949A (en) * 1990-03-02 1992-11-17 Bonutti Peter M Fluid operated retractors
WO1992021295A1 (fr) * 1991-05-29 1992-12-10 Origin Medsystems, Inc. Dispositifs endoscopiques et gonflables de retraction, procedes d'utilisation, et procede de fabrication

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0141589A1 (fr) * 1983-10-21 1985-05-15 Avvari Rangaswamy Appareil d'hémostase gonflable pour l'utérus
US5163949A (en) * 1990-03-02 1992-11-17 Bonutti Peter M Fluid operated retractors
FR2668695A1 (fr) * 1990-11-06 1992-05-07 Ethnor Instrument chirurgical endoscopique pour le deplacement de tissus ou organes.
WO1992021295A1 (fr) * 1991-05-29 1992-12-10 Origin Medsystems, Inc. Dispositifs endoscopiques et gonflables de retraction, procedes d'utilisation, et procede de fabrication

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2005107604A1 (fr) * 2004-05-03 2005-11-17 Doare Michel Systeme pour l'obturation d'un vaisseau sanguin, en particulier apres une intervention arterielle par catheter

Also Published As

Publication number Publication date
GB9319056D0 (en) 1993-11-03

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