WO2001013804A1 - Instrument chirurgical coelioscopique et procede - Google Patents

Instrument chirurgical coelioscopique et procede Download PDF

Info

Publication number
WO2001013804A1
WO2001013804A1 PCT/US2000/023022 US0023022W WO0113804A1 WO 2001013804 A1 WO2001013804 A1 WO 2001013804A1 US 0023022 W US0023022 W US 0023022W WO 0113804 A1 WO0113804 A1 WO 0113804A1
Authority
WO
WIPO (PCT)
Prior art keywords
jaws
handle
anatomical cavity
surgical instrument
trocar
Prior art date
Application number
PCT/US2000/023022
Other languages
English (en)
Inventor
Randy S. Haluck
Original Assignee
The Penn State Research Foundation
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 The Penn State Research Foundation filed Critical The Penn State Research Foundation
Priority to AU67961/00A priority Critical patent/AU6796100A/en
Publication of WO2001013804A1 publication Critical patent/WO2001013804A1/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
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in 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
    • A61B17/34—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
    • 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
    • A61B17/3421—Cannulas
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • A61B2017/00473—Distal part, e.g. tip or head
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B17/2909—Handles
    • A61B2017/2912—Handles transmission of forces to actuating rod or piston
    • A61B2017/2923—Toothed members, e.g. rack and pinion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws

Definitions

  • the present invention relates generally to medical instruments and
  • access to the peritoneal cavity is to insert a small needle through the abdominal
  • peritoneal cavity is usually inflated to a pressure of about 14cm H 2 0.
  • An automatic insufflation pump keeps C0 2 flowing to maintain a
  • abdominal wall to provide a path for the introduction, removal, and exchange of
  • the trocar is then removed from the lumen of the port.
  • Instruments may be exchanged
  • hernia repair including hernia repair, appendectomy, stomach surgery, and gynecologic
  • Endoscop c instruments are often designed to perform only one of the above functions,
  • a surgical instrument for use in
  • a handle and an elongate member having a proximal end coupled w e an e or e ng spose ex erna y o e ana om ca cav y an a s a end for being disposed within the anatomical cavity.
  • the releasable trocar comprises a shank that is adapted for grasping, a
  • relatively sharp tip may include a pair of blunt-edge tissue separators that
  • the relatively movable jaws define (i) a
  • the jaws so that when the jaws are in a closed position they may be used for
  • a portal tube is
  • e orego ng method may include the step of positioning a portal between the separated tissue
  • tissue while maintaining the jaws at the operative site may also be
  • Fig. 1 is a perspective view an endoscopic instrument according to one
  • Fig. 2 is a partially broken away, elevational view of the endoscopic
  • Fig. 3 is a partially broken away, elevational view of the endoscopic
  • Fig. 4 is a perspective view of an endoscopic instrument according to an
  • Fig. 5 is an elevational view of an endoscopic instrument according to
  • FIG. 6 is a cross-sectional view of the optional use portal sleeve shown in Fig. 5, as taken along line 6-6 in Fig. 5;
  • Fig. 7 is an elevational view of an endoscopic instrument according to a
  • the endoscopic instrument of the present invention can be utilized in any combination
  • the invention can be used with catheters and other small or large diameter tubular or hollow, cylindrical members providing access to small cavities, such as veins and arteries as well
  • an endoscopic instrument 10 formed in
  • a housing 12 includes a housing 12, an outer tubular
  • housing 12 includes longitudinally spaced front and rear
  • a top wall 32 is disposed in substantially parallel
  • a bottom wall 34 includes a concave forward
  • portion 36 that curves downwardly from front wall 28 to connect with an upper
  • a rearward portion 38 of housing 12 extends proximally
  • Movable handle 26 is pivotally mounted on a pin 42 proximally spaced
  • lower end of handle 26 is configured as a finger loop 44 to accommodate one or
  • handle 26 includes an arcuate end portion 50 disposed within housing 12 and defining a plurality of gear teeth 52 on a side of pin 42 opposite finger loop 44.
  • Outer tubular member 14 is open at both ends and extends distally from
  • member 14 can be blunt as shown, tapered, beveled, slotted or chamfered as
  • member 14 comprises a cylindrical cross-section along its length, and is formed
  • a substantially rigid material such as stainless steel or other biocompatible
  • Proximal end 56 of outer tubular member 14 is
  • a pinion gear 60 engages rack 58, and is
  • toothed end portion 50 of handle 12 to convert relatively small rotary or pivotal
  • movable handle 26 is biased in a clockwise direction toward fixed
  • the handles can have
  • any configuration to actuate the jaws including, but not limited to, configurations employing a pair of pivotally connected arms, one fixed and one pivoted arm, a pistol grip with a movable trigger, or resilient U-shaped handle members.
  • handle portion of the instrument can be configured to rotate relative
  • Inner member 16 includes a tubular portion 64 telescopically fitted within
  • outer tubular member 14 and defining a lumen or channel 66 through
  • tubular portion 64 distal end of tubular portion 64 is bifurcated or split longitudinally to form integral
  • Tubular body 64 is preferably formed with jaws 18 and
  • jaws 18 and 20 cooperate
  • Jaws 18 and 20 include means 81 for grasping a releasable trocar 83.
  • grasping means 81 may include a combination of indentation, recess, protrusions or teeth that are arranged for securely holding releasable trocar 83 when closed.
  • Releasable trocar 83 preferably comprises a conical
  • Shank 87 comprises a relatively elongate shaft
  • Base 90 has a diameter substantially equivalent to that of inner
  • blades 94 or tissue separators, are positioned on the outer conical surface of
  • Blunt-edged blades 94 are arranged in circumferentially spaced
  • housing 12 actuation of jaws 18 and 20 is controlled by moving outer tubular
  • jaws 18 and 20 can be
  • Pinion 60 is of greater diameter than
  • Pinion 60 engages the gear teeth of rack 58 to cause proximal movement of outer tubular member 14 relative to jaws 18 and 20 thereby permitting the jaws to move resiliently to the open position
  • jaws 18 and 20 are biased apart such that
  • grasping means 81 are angularly spaced from one another allowing shank 87 of
  • trocar 83 to be positioned between jaws 18 and 20. Clockwise rotation of
  • grasping means 81 rotate toward one another to grasp
  • protrusions or teeth engage one another to securely clamp trocar 83 between
  • instrument 10 may be guided, by hand, to the
  • Instrument 10 is advanced distally through the
  • the instrument can be manipulated externally of the body to position
  • trocar 83 may be released and removed from the operative site
  • Movable handle 26 is preferably proximally spaced from fixed handle 24
  • Movable handle 26 is preferably biased in a clockwise
  • outer tubular member 14 will be automatically
  • an instrument 100 is provided with a pair of jaws 118 and 120 comprising a pair
  • blunt-edged blades 124 or tissue separators, that are positioned on the outer
  • each jaw 118 and 120 The respective tip portion 126 of jaws
  • 118 and 120 may be complementarily conically shaped so that when jaws 118
  • instrument 100 is guided to the wall of an anatomical cavity, with
  • Instrument 100 is advanced distally
  • grasping and/or cutting functions can be performed at the operative site using
  • jaws 118 open and close the jaws. It will be understood that the inner surfaces of jaws 118
  • and 120 may include blades, teeth, indentations, or the like that are adapted for
  • laparoscopic instruments 10 and 100 allow for easier axial manipulation, and at
  • invention provides an optional portal 200 that is slidably and sealingly positioned
  • portal 200 comprises an elongate cannula 215, a frusto-conical tip 218, and a
  • Cannula 215 is formed from a relatively rigid, biocompatible metal or
  • Frusto-conical tip 218 is formed on the distal end of cannula 215 and surrounds
  • Hub 221 projects radially outwardly from the proximal end of
  • O-ring seal 236 comprises an inner diameter that is smaller than the diameter of outer tubular member 14, and is securely fastened to the inner surface of cannula 215 so as to be fixed in place.
  • Portal 200 is positioned on the outer surface of outer tubular member 14
  • o-ring seal 236 sealingly engages outer tubular
  • outer surface of portal 200 is preferably textured to enhance engagement with
  • Portal 200 within the pneumoperitoneum. Portal 200 allows for easy instrument
  • FIGS. 5 and 7 show embodiments of the present invention wherein a
  • blades or tissue separators are combined with a portal 200.

Landscapes

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

Abstract

L'invention concerne un instrument chirurgical (10), destiné à être utilisé dans l'exécution de procédures endoscopiques, présentant une poignée (24, 26) ainsi qu'un élément oblong tubulaire (14) ayant une extrémité proximale couplée à la poignée destinée à être située à l'extérieur de la cavité anatomique ainsi qu'une extrémité distale destinée à être située à l'intérieur de la cavité anatomique. L'extrémité distale comprend également une paire de mâchoires (18, 20) opposées mobiles l'une par rapport à l'autre, lesquelles forment une partie de préhension pouvant être commandée par manipulation de la poignée afin de prendre de manière libérable un trocart libérable (83). Le trocart libérable (83) présente une tige (87) de forme complémentaire, une pointe relativement effilée (92) et il peut comprendre une paire de séparateurs (94) de tissu à bords émoussés dépassant à l'extérieur de la surface extérieure du trocart (83). Dans un autre mode de réalisation, les mâchoires (118, 120) mobiles l'une par rapport à l'autre définissent (i) une partie de préhension pouvant être commandée par la manipulation de la poignée (24, 26) pour saisir ou couper des objets; et (ii) une paire de séparateurs (124) de tissus à bords émoussés dépassant à l'extérieur de la surface extérieure des mâchoires (118, 120) de manière que, lorsque les mâchoires sont en position fermée, ils puissent être utilisés en tant que trocart.
PCT/US2000/023022 1999-08-24 2000-08-22 Instrument chirurgical coelioscopique et procede WO2001013804A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU67961/00A AU6796100A (en) 1999-08-24 2000-08-22 Laparoscopic surgical instrument and method

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US15061399P 1999-08-24 1999-08-24
US60/150,613 1999-08-24

Publications (1)

Publication Number Publication Date
WO2001013804A1 true WO2001013804A1 (fr) 2001-03-01

Family

ID=22535311

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2000/023022 WO2001013804A1 (fr) 1999-08-24 2000-08-22 Instrument chirurgical coelioscopique et procede

Country Status (2)

Country Link
AU (1) AU6796100A (fr)
WO (1) WO2001013804A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2003045260A1 (fr) * 2001-11-26 2003-06-05 Neosurg Technologies Trocart a pointe de perçage amelioree
WO2011154086A1 (fr) * 2010-06-11 2011-12-15 Olympus Winter & Ibe Gmbh Instrument chirurgical à effecteur terminal

Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5766205A (en) * 1992-02-12 1998-06-16 United States Surgical Corporation Articulating endoscopic surgical apparatus

Patent Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5766205A (en) * 1992-02-12 1998-06-16 United States Surgical Corporation Articulating endoscopic surgical apparatus

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2003045260A1 (fr) * 2001-11-26 2003-06-05 Neosurg Technologies Trocart a pointe de perçage amelioree
WO2011154086A1 (fr) * 2010-06-11 2011-12-15 Olympus Winter & Ibe Gmbh Instrument chirurgical à effecteur terminal

Also Published As

Publication number Publication date
AU6796100A (en) 2001-03-19

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