Abstract:
A cannula adapter for converting a trocar insufflator into a two-phase or two-mode insufflation system. In the needle insufflation mode the insufflation gas flows through a trocar cannula, a cannula adapter and an insufflation needle before entering a body cavity and in the trocar insufflation mode gas flows directly into the body cavity from the trocar cannula. The cannula adapter although sealingly attachable to the trocar cannula during the needle insufflation mode is removable therefrom for a seamless transfer between the needle insufflation mode and the trocar insufflation mode.

Description:
CROSS REFERENCE TO RELATED APPLICATIONS 
       [0001]    This application is a continuation in part of U.S. patent application Ser. No. 13/065,438 filed Mar. 22, 2011. 
     
    
     STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT 
       [0002]    None 
       REFERENCE TO A MICROFICHE APPENDIX 
       [0003]    None 
       BACKGROUND OF THE INVENTION 
       [0004]    The concept of a medical apparatus for humidifying or otherwise treating a gas from an insufflator during surgery is described in Douglas Ott et al. U.S. Pat. No. 5,411,474; 6,068,609 and 7,066,902. Briefly, an insufflation gas is heated and hydrated i.e. conditioned, before the gas is directed into a body cavity through a device such as a trocar. In order to hydrate the insufflation gas a charge of hydration fluid is typically injected into a device where the hydration fluid can humidify the insufflation gas and a heater can bring the insufflation gas to a temperature near body temperature. The conditioned insufflation gas is then sent to a trocar for injection into a body cavity of a patient. 
         [0005]    One of the requirements for delivery of insufflation gas to a patient&#39;s body cavity is to maintain the proper flow of insufflation gas into the body cavity. Normally, gas flows from a high-pressure gas source, which is remote from the patient, through an insufflation device and finally into a trocar where the gas is injected into the patient&#39;s body cavity. Typically, the insufflation gas is stored in high-pressure containers and a pressure regulator reduces the pressure of the gas to a lower pressure. The low pressure gas is typically delivered to the trocar through an insufflation device containing a set of inline end connectors that couple the source of insufflation gas, the pressure regulator, the filter, the heater, or heater and hydrator to trocar to each other. During the insufflation process the insufflation gas, which is conditioned by filtering, heating and or hydrating before delivery flows through a number of inline end connectors, which are typically connected by flexible tubing. 
         [0006]    The conditioned gas is then delivered to the patient through a trocar cannula that extends into the body cavity of a patient, however, in some cases it is preferred to begin the insufflation process with an insufflation needle rather than the larger trocar cannula since the insufflation needle has a smaller profile than the trocar cannula. In these cases one set of insufflation devices may be used with the insufflation needle and another set of insufflation devices may be used with the trocar. The present invention eliminates the need for separate insufflation systems. 
         [0007]    Recommend 
       SUMMARY OF THE INVENTION 
       [0008]    A cannula adapter for converting a trocar insufflator into a two-phase or two-mode insufflation system comprising a needle insufflation mode and a trocar insufflation mode. In the needle insufflation mode the insufflation gas flows through a trocar cannula, a cannula adapter and an insufflation needle before entering a body cavity. The cannula adapter has a first end located in sealing engagement with the trocar cannula with the second end of the cannula adapter supporting an insufflation needle that flows insufflation gas into a body cavity. In the trocar insufflation mode one removes the cannula adapter and the insufflation needle from the insufflation system and inserts the trocar cannula directly into the body cavity. In this condition insufflation gas flows directly into the body cavity from the trocar cannula. The cannula adapter although sealingly attachable to the trocar cannula during the needle insufflation mode is preferably hand removable therefrom for a seamless transfer between the needle insufflation mode and the trocar insufflation mode. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0009]      FIG. 1  is an exploded view showing an insufflation apparatus comprising a cannula adapter having one end of a tubing secured thereto with the other end of the tubing in sealing engagement with an insufflation needle; 
           [0010]      FIG. 2  is a front view of the cannula adapter of  FIG. 1  without the tubing attached thereto; 
           [0011]      FIG. 3  is an end view of the cannula adapter of  FIG. 1  without the tubing attached thereto; 
           [0012]      FIG. 4  is a sectional view taken along lines  4 - 4  of  FIG. 2 ; 
           [0013]      FIG. 5  is an enlarged view of an annular resilient member for forming sealing engagement with a trocar cannula; 
           [0014]      FIG. 6  shows a double lumen cannula in sealing engagement with the cannula adapter of  FIG. 1 ; 
           [0015]      FIG. 7  is a sectional view of a single lumen cannula with a cannula adapter mounted in sealing engagement on the end of the single lumen cannula; 
           [0016]      FIG. 8  is a perspective view of an insufflation needle and control valve; and 
           [0017]      FIG. 9  is a front view of a two-phase insufflation apparatus in a needle inflation mode. 
       
    
    
     DESCRIPTION OF THE PREFERRED EMBODIMENT 
       [0018]      FIG. 1  is an exploded view showing a cannula attachable insufflation apparatus  10  comprising a cannula adapter  11 , a tube  13 , a fitting  30  and an insufflation needle  40 . In the example shown the cannula adapter  11  comprises a rigid elongated tube  12  with one end for internal sealable, frictional engagement with an exterior surface of a trocar cannula and the other end of tube  12  having an annular band  14  for sealable, frictional engagement to a cylindrical interior surface  13   c  of a flexible tube  13 . Sealingly and frictionally secured to the opposite end of tube  13  is a cylindrical fitting  30  having an outer cylindrical surface  30   a  in sealable frictional engagement with the cylindrical interior surface  13   c  of tubing  13 . Fitting  30  comprises a collar having an internal fastener, such as female threads, for engagement with a hub  42  of an insufflation needle  40 . The insufflation needle comprises an elongated tube  41  having an angled end for insertion through body tissue of a patient and a base  43  that connects hub  42  to tube  41 . 
         [0019]    In the example shown cannula adapter  11 , insufflation needle  40 , fitting  30  and tubing  13  are shown as a hand assembled insufflation apparatus with the individual components in sealable engagement with each other through frictional contact therebetween, however, other means of attachment may be used without departing from the spirit and scope of the invention. For example, in some case one may form the cannula adapter  11  the tubing  13 , the fitting  30  and the insufflation needle  40  as one unit. In other cases one or more of the components may be removable. For example the fitting and the needle  40  may be removable to permit attachment of a different needle thereto. An example of suitable commercially available inflation needle is a verres needle although other needle inflation devices may be used with the system described herein. 
         [0020]      FIG. 2  is an isolated front view of cannula adapter  11  comprising a rigid elongated tube  12  with a resilient band  20  on one end and an annular end  14   a  on the opposite end. Located proximate annular end  14   a  is annular band  14 , which forms a tubing engaging surface for frictionally and sealingly supporting a flexible medical grade tubing or the like thereon. Although a rigid tube is shown a non-rigid tube may be used without departure from the spirit and scope of the invention. 
         [0021]      FIG. 3  shows an end view of cannula adapter  11  revealing a set of gas ports  16  circumferentially spaced around end member  17  to permit flow of insufflation gas therethrough. An annular shoulder  15  forms a stop to limit insertion of tube  13  on band  14  as well as providing a depth guide as to the distance that a tube should be in frictional engagement with the surface  14  in order to prevent the insufflation gas pressure from dislodging or blowing the tube  13  free of cannula adapter  11  during the needle insufflation phase. 
         [0022]      FIG. 4 , which is a sectional view taken along lines  4 - 4  of  FIG. 2  and  FIG. 4 , shows a sectional view of cannula adapter  11  taken along lines  4 - 4  of  FIG. 2  revealing a cylindrical chamber  25  for receiving a trocar cannula. One end of cannula adapter  11  includes an internal dome shaped resilient band  20  that is supported by ribs  11   b  ( FIG. 5 ) that extend from housing  12 . 
         [0023]      FIG. 6  shows a sectional view of cannula adapter  11  having one end in frictional, sealing engagement with a double lumen cannula  45  and the other end in frictional, sealing engagement with tubing  13 . In the example shown in  FIG. 6  the cannula adapter  11  comprises a hollow elongated rigid member  12  having an annular shoulder or band  14  on one end for frictional, sealing engagement with an interior surface  13   c  of inflation tube  13  with the diameter D 1  of resilient band  14  such that it forms frictional, sealing engagement through an interference fit with the interior cylindrical surface  13   a  (diameter D 2 ) to prevent the inflation tube  13  from becoming dislodged during the needle insufflation mode. The other end of cannula adapter includes  11  an internal resilient member  20  having a dome shape that is shapingly and frictionally mateable with the anti-removal annular serrations  66  on the exterior surface of cannula  45  to retain the cannula adapter  11  on the cannula  45  during the needle insufflation mode. 
         [0024]    In the example shown the resilient band extends a distance L with the distance L such that the resilient band  20  can form frictional and shape mateable engagement over an extended cylindrical region of the trocar cannula  45  to maintain the cannula adapter  11  on the cannula  45  during a needle insufflation mode, yet allows the cannula adapter  11  to be quickly removed by medical persons when insufflation is switched from the needle insufflation mode to the trocar insufflation mode. 
         [0025]    Extending upward from base  17  of cannula adapter  11  is a cylindrical post or locater  40  having an outer cylindrical surface  41  that is alignable with a central passage in a trocar cannula  45  to hold the trocar cannula  45  in axial alignment with the cannula adapter  11  as insufflation gas flows thorough gas ports  16  in end plate  17 . Maintaining axial alignment between the cannula adapter  11  and the cannula  45  inhibits and prevents leakage therebetween during the needle insufflation phase since it limits movement of the seal  20  with respect to the trocar cannula  45 . 
         [0026]      FIG. 6  shows that the double lumen cannula  45  having an inner cylindrical wall  31  and an outer cylindrical wall  32  that coact to form an annular insufflation gas flow passage  35  therebetween. The resilient band  20  is shown located in sealing and shape mateable engagement with an anti-removal annular serrations  66  that extend around cannula  45 . Although the band  20  and the anti-removal annular serrations  66  form shape mateable engagement as well as an interference fit the resilient band  20  the engagement pressure therebetween is such that one can with hand pressure slide the cannula adapter  11  onto or off the cannula  45 . Once the cannula adapter  11  is in position the resilient force of band  20  forms sealing engagement between the cannula  45  and the adapter  11  to prevent the cannula from being dislodged from trocar cannula  45  as insufflation gas flows through trocar cannula  45  and into an insufflation needle, which is located downstream of the cannula adapter  11 . 
         [0027]      FIG. 6  shows cannula  45  contains a conical tapered end  37 , which extends around post  40 , with the inner cylindrical cannula surface  31   a  in locating engagement with the external cylindrical wall  41  of post  40  to maintain the cannula adapter  11  and the cannula  45  in axial alignment with each other to facilitate and retain sealing engagement between cannula  45  and cannula adapter  11 . 
         [0028]      FIG. 6  shows a set of flow arrows that illustrate how insufflation gas flows during the needle insufflation phase. More specifically, the insufflation gas flows into an annular chamber  32 , radially outward through gas ports  33  and into a further annular chamber  36  located between the outer wall  32  of trocar cannula  45  and the internal cylindrical wall  11   a  of cannula adapter  11 . The insufflation gas then flows through tube  13 , fitting  30  and is discharged through insufflation needle  41 . 
         [0029]      FIG. 7  shows a sectional view of a cannula adapter  90  attached to a single lumen cannula  61  and  FIG. 9  shows a dual mode insufflation apparatus  110  with the cannula adapter  90 . In the example shown in  FIG. 7  the cannula adapter  90  is frictionally mounted on the distal end of trocar cannula  61  with a frictional, fluid seal formed between the engaging surfaces of the cannula adapter  90  and the cannula  61 . Insufflation adapter  90  allows one to use the insufflation apparatus  40  ( FIG. 9 ) in two different insufflation modes. In the trocar cannula inflation mode the cannula  61  directs insufflation gas directly into the body cavity through side ports on the cannula. In the needle insufflation mode the cannula directs the insufflation gas into the body cavity through an insufflation needle, which is temporarily attached to the cannula  41  through cannula adapter  90 . 
         [0030]      FIG. 7  shows a sectional view of the cannula adapter  90  comprising an elongated tube  90   a  having a first end with an annular member or sleeve  91  that fits over the distal end of the cannula  61  and a second end having a sleeve or connector  93  forming sealing attachment to an insufflation needle or the like. Located partially in one end of adapter  90  is a hollow plug or post  92  having one end extending into tube  90   a  and the other end into the distal end of cannula  61 . The outside cylindrical surface of portion of plug  62 , which extends into tube  90   a,  forms a fluid seal between adapter  90   a  and cannula  61 . Plug  92  may be made from a resilient material to enable the resilience of the plug to form a pressure seal although other methods of sealing plug  92  to tube  90   a  may be used. The plug  92  includes a fluid passage  92   a  extending threrethrough that allows insufflation gas to flow from cannula lumen  61   b  into adapter  90  and from there to an insufflation needle or the like attached thereto. The arrows indicate the direction of flow through the cannula  61 , the plug  92  and the cannula adapter  90 . 
         [0031]    To prevent leakage of insufflation fluids the outside diameter of the plug  92  is such that it forms a snug fit with the cylindrical interior surfaces of cannula  61 . If the cannula includes side ports for introduction of insufflation gas the annular sleeve  91  is of sufficient length to cover the side ports on the cannula to prevent flow therepast. To prevent leakage of fluid from the side ports of the cannula annular sleeve  61  the adapter sleeve  91   a  should form a snug fit, i.e. an interference fit, with the outer surface of the cannula  61 . If desired a resilient material may be included on the inside surface of annular sleeve  91  with the interior surface of sleeve  91  forming a slight interference fit with the outside surface of the cannula  61 . As an alternate sleeve  91  may be made from a resilient material to allow a snug leak proof connection to be formed with the distal end of the cannula. Thus the adapter  90  allows one to seal lateral ports on the cannula to prevent flow threrethrough when the cannula adapter  90  is in use. 
         [0032]    The distal end of adapter  90  includes a fitting  93  suitable for attachment to conventional insufflation needles, for example a verres needle. Fitting  93  may comprise a Leur fitting or the like to enable coupling with existing insufflation needles. With the insufflation apparatus  110  as described herein one has the option of using needle insufflation, which is smaller than the trocar, to initiate insufflation and when the initial needle insufflation is completed one can convert from a needle insufflation mode to a trocar insufflation mode by merely removing the adapter  90  and the insufflation needle from the end of cannula  61 . The cannula  61  can then be used for direct insufflation of the body cavity of a patient. Thus, the cannula adapter  90  eliminates the need for a separate insufflation apparatus for trocar insufflation and needle insufflation since the trocar insufflation apparatus can be used during needle insufflation. 
         [0033]      FIG. 8  shows an example of a typical insufflation needle  100  for initial delivery of an insufflation gas to a body cavity. Insufflation needle  100  contains an elongated tube  101  with a pointed end  102  for piercing through body tissue and into a body cavity to enable one to begin the process of insufflating a body cavity. A housing  105  for grasping and manipulating the insufflation needle  100  supports one end of the elongated tube  101  and a valve  107  having a handle  105  to open and close the fluid path  103  through the tube  101 , which extends from the other end of the housing  105 . A fluid connector  104  extends from valve  107  to permit attachment of the insufflation needle  100  directly or indirectly to the cannula adapter  90  of  FIG. 10 . Connection to adapter  90  may be made through frictional engagement of connector  104  with connector  93  although other types of connections may be used for example, threaded or locking connectors. 
         [0034]      FIG. 9  shows components of an insufflation apparatus  110  in an assembled ready to use state. In the assembled condition a fluid stabilizer  50  extends laterally from trocar  45  and the cannula adapter  90  connects to the cannula  41  of the trocar  45 . The insufflation needle  100  extends outward from the adapter  90  to enable one to insufflating a body cavity from the insufflation gas delivered to fluid stabilizer  50 . In this example the obturator has been removed since an inflation needle will be used to imitate the tissue piercing proximate the body cavity. 
         [0035]    Insufflation apparatus  110  enables a user to insufflate a body cavity through either an insufflation needle or a trocar as well as to make an on-the-go change between the needle insufflation mode and a trocar insufflation mode. For example, insufflation needle  100  may be used for initial insufflation of the body cavity. When one needs to use the trocar to contain the instruments and maintain insufflation one can merely disconnect and remove the insufflation needle  100  and cannula adapter  90  from cannula  41 . One can then insert cannula  41  directly into the body cavity without having to replace upstream devices. Not only can time be saved but also the use of separate insufflation apparatus for both the insufflation needle and the trocar is eliminated since the same fluid stabilizer and trocar can be used with trocar insufflation as well as needle insufflation. Thus, the method eliminates separate sterilizing or resterilization of the insufflation apparatus. 
         [0036]    In the example shown all of the components such as the cannula adapter, the tubing, the fitting and the insufflation needle may be rigidly connected to each other so that the insufflation apparatus can be manipulated as a unit. In other cases only some of the components may be rigidly connected and others flexibly connected, for example one may want the insufflation needle to be separately manipulated from the trocar through use of a flexible tubing connected to the cannula adapter. 
         [0037]    Consequences