Source: https://patents.google.com/patent/US10226589B2/en
Timestamp: 2019-04-25 20:57:57+00:00

Document:
An insufflating surgical instrument adapted for movement across an abdominal wall to insufflate an abdominal region of a patient is disclosed. The instrument comprises a shaft having an insufflation channel extending between a proximal end and a distal end, the insufflation channel being adapted for connection to a source of fluid under pressure at the proximal end. A tip is at the distal end and a vent hole is formed in the tip being in connection with the insufflation channel and adapted to expel fluid under pressure to insufflate the abdominal region. The tip is formed of a transparent material to facilitate visualization of the abdominal wall and region. The shaft includes a lumen extending along the axis between the proximal end and the distal end to enable insertion of a laparoscope. The lumen and insufflation channel may be formed as separate channels or as one shared channel.
This application is a continuation of co-pending U.S. patent application Ser. No. 13/356,260 filed on Jan. 23, 2012 now U.S. Pat. No. 9,155,558 issued Oct. 13, 2015 entitled “Insufflating Optical Surgical Instrument” which is a continuation of U.S. patent application Ser. No. 12/766,118, filed Apr. 23, 2010, now U.S. Pat. No. 8,128,590 issued Mar. 6, 2012 entitled “Insufflating Optical Surgical Instrument”, which is a continuation of U.S. patent application Ser. No. 11/170,567, filed Jun. 29, 2005, now U.S. Pat. No. 7,708,713, issued May 5, 2010, entitled “Insufflating Optical Surgical Instrument”, which is a non-provisional application claiming the priority and benefit of provisional application Ser. No. 60/584,302, filed on Jun. 29, 2004, entitled “Insufflating Optical Surgical Instrument” and is also a continuation-in-part of U.S. patent application Ser. No. 10/956,167, filed on Oct. 1, 2004, entitled “Bladeless Optical Obturator” now U.S. Pat. No. 7,947,058 issued on May 24, 2011 which claims benefit and priority to provisional application Ser. No. 60/508,390 filed on Oct. 3, 2003 all of which are fully incorporated herein by reference in their entireties.
FIG. 1 illustrates a typical laparoscopic abdominal surgery of the prior art.
FIG. 2 illustrates a perspective view of an insufflation needle of the prior art.
FIG. 3 illustrates a perspective view of an insufflating optical trocar in accordance with a first embodiment of the invention.
FIGS. 4(a) and 4(b) illustrate cross-sectional views of an insufflating optical trocar in accordance with another embodiment of the invention.
FIG. 5 illustrates a perspective view of a septum seal for use with the insufflating optical trocar of the invention.
FIG. 6(a)-6(d) illustrate cross-sectional views of the septum seal for use with the insufflating optical trocar of the invention.
FIGS. 7(a) and 7(b) illustrate the insufflating optical trocar and cannula of the invention.
FIGS. 8(a)-8(f) illustrate different geometric shapes and patterns of the vent hole of the invention.
FIG. 9 illustrates an insufflating needle having a transparent distal tip and insufflating vent in accordance with another embodiment of the invention.
FIG. 10 illustrates an insufflating scope having a transparent distal tip and insufflating vent in accordance with another embodiment of the invention.
FIG. 11 illustrates an insufflating scope sleeve having a transparent distal tip and insufflating vent in accordance with another embodiment of the invention.
FIGS. 12(a)-12(f) illustrate additional tip designs of an insufflating optical surgical instrument in accordance with additional aspects of the invention.
FIGS. 13(a) and 13(b) illustrate a coiled insufflating optical trocar and a coiled insufflating optical trocar with a coiled tip, respectively, in accordance with additional embodiments of the invention.
FIGS. 14(a)-14(c) illustrate flip-top or flip-tip designs of insufflating optical surgical instruments in accordance to additional embodiments of the invention.
FIGS. 15(a)-15(c) illustrate cross-sectional views of insufflating valve vents in accordance with additional embodiments of the invention.
FIG. 16 illustrates a blunt tip insufflating optical instrument having an advanceable lumen in accordance with another embodiment of the invention.
FIGS. 17(a) and 17(b) illustrate an insufflating surgical instrument including an insufflating optical trocar and a cannula having a gas channel for transferring insufflation gas to the trocar in accordance with another embodiment of the invention.
FIG. 18 illustrates an insufflating blade actuating optical trocar in accordance with another embodiment of the invention.
Referring to FIGS. 12(a)-12(f), there are shown additional tip designs 32 o-32 s in accordance with other aspects of the invention to facilitate penetration of a body tissue. FIG. 12(a) illustrates a spoon-shaped or asymmetric tip 32 o having at least one vent hole 36 o; FIGS. 12(b) and 12(c) illustrate a generally domed or conical shaped tip 32 p having plastic or metal blades 33 p along an axis of the shaft and at least one vent hole 36 p; FIG. 12(d) illustrates a blunt tip 32 q having at least one vent hole 36 q; FIG. 12(e) illustrates a generally domed or conical shaped tip 32 r having at least one bladed fin 33 r and at least one vent hole 36 r; and FIG. 12(f) illustrates a generally conical shaped tip 32 s having at least one vent hole 36 s at the distal tip. It is appreciated that tips 32 o, 32 p, 32 r and 32 s have a sharp, pointed or bladed tip and/or edge to facilitate penetration of body tissue. In yet other aspects of the invention, the surface of the tip may have at least one tissue engaging raised pattern on the surface. The surface operates to facilitate insertion of the insufflating surgical instrument or optical trocar with a reduced penetration force and minimize tenting of the body wall. The surface may further facilitate separation of different layers of the body wall and provides proper alignment of the tip between the layers. In another aspect of the invention, the tip may have an outer surface extending distally to a blunt point and includes a pair of side sections separated by an intermediate section, and wherein the side sections extend from the blunt point radially outwardly with progressive positions proximally along the axis. The side sections may include a distal portion in proximity to the blunt point and a proximal portion in proximity to the tubular body, and the distal portion of the side sections being twisted radially with respect to the proximal portion of the side sections.
FIGS. 15(a)-15(c) illustrate insufflating valve vents in accordance with additional aspects of the invention. More specifically, FIG. 15(a) illustrates an insufflating valve vent 300 formed at the distal end of the shaft 34. The insufflating valve vent 300 is formed of an elastic material to allow gas such as CO2 to be introduced from the inside of the shaft 34 to a body cavity. It is appreciated that when there is no gas, the elastic material of the insufflating valve vent 300 causes it to close so as to provide an airtight seal. FIG. 15(b) illustrates an insufflating flapper valve 310 formed at tip 32 y of an insufflating optical trocar. The insufflating flapper valve 310 comprises at least one flapper valve vent 312 that operates to open when a gas such as CO2 is introduced in the shaft 34. It is appreciated that when there is no gas, the flapper valve vent 312 closes to provide a tight seal. Similarly to FIG. 15(b), FIG. 15(c) illustrates an insufflating reverse flapper valve 320 formed at tip 32 z of an insufflating optical trocar. The insufflating reverse flapper valve 320 comprises at least one flapper valve vent 322 that remains close or shut by tissue during insertion, and once peritoneum is passed, pressure by a gas such as CO2 would then open the reverse flapper valve 320 to allow the transfer of the gas into a body cavity. It is appreciated that each of the above flapper valve vents may be spring loaded to operate like a Veress needle.
Referring to FIGS. 19(a)-19(i), there are shown additional tip designs 32 aa-32 ii in accordance to other aspects of the invention to facilitate penetration of a body tissue. Each of these tip designs includes at least one vent hole (36 aa-36 ii) at the distal tip to introduce insufflation gas into a body cavity. It is appreciated that some of these tips have a sharp, pointed or bladed tip and/or edge to facilitate penetration of body tissue.
a distal cannula seal positioned at the distal end of the cannula within the first lumen between the cannula and the trocar.
2. The insufflating surgical instrument of claim 1 further including the at least one vent hole formed at the tip being in connection with the insufflation channel and the at least one shaft vent being in connection with the insufflation channel and formed along the shaft.
3. The insufflating surgical instrument of claim 1 further including the at least one vent hole formed at the tip, the at least one vent hole being in connection with the insufflation channel and being adapted to expel the fluid under pressure to insufflate the abdominal region.
4. The insufflating surgical instrument of claim 1 wherein the shaft and the tip of the insufflating trocar have diameters sized to enable insertion of a laparoscope.
5. The insufflating surgical instrument of claim 1 wherein the first lumen and the insufflation channel are separated.
7. The insufflating surgical instrument of claim 6 wherein the insufflation channel is encased in the wall of the cannula.
10. The insufflating surgical instrument of claim 9 further including a vent hole formed in the tip and in connection with the insufflation channel.
11. The insufflating surgical instrument of claim 9 further including at least one shaft vent formed in the shaft and in connection with the insufflation channel.
12. The insufflating surgical instrument of claim 9 wherein the tip is tapered.
wherein the shaft further comprises a scope stop configured to prevent the laparoscope from being inserted too far into the shaft and blocking the at least one of the insufflation channel and the vent hole.
14. The insufflating surgical instrument of claim 13 wherein the scope stop includes a ledge.
15. The insufflating surgical instrument of claim 13 wherein the tip at the distal end includes a taper of an inner diameter of the trocar and the scope stop is configured to keep the laparoscope from being inserted into the taper of the inner diameter of the trocar.
16. The insufflating surgical instrument of claim 13 wherein the shaft and the tip are configured to enable insertion of a laparoscope.
17. The insufflating surgical instrument of claim 13 further including a distal cannula seal positioned at the distal end of the cannula within the first lumen between the cannula and the trocar.
18. The insufflating surgical instrument of claim 13 wherein the first lumen and the insufflation channel are combined as one channel.
19. The insufflating surgical instrument of claim 13 wherein the at least one vent hole is in connection with the insufflation channel and further including at least one shaft vent being in connection with the insufflation channel and formed along the shaft.
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