Abstract:
The invention provides a combination surgical trocar housing and selective reducer sleeve assembly in which the sleeve assembly members may be telescopically received within the trocar housing to reduce the diameter therethrough. The sleeve members provide a seal to prevent transmission of fluid within the annular area between internal and external diameters of respective members and may be latchingly secured relative to one another to resist telescopic expansive movement to stabilize the sleeve assembly relative to the trocar housing. The sleeve assembly permits acceptance through a single trocar housing of a number of auxiliary surgical instruments having serially smaller diameters, thus enabling performance of the surgical operation using each such instrument, without removal from the body wall of the original trocar housing.

Description:
BACKGROUND OF THE INVENTION 
     (1) Field of the Invention 
     The invention relates to a combination surgical trocar housing and selective reducer sleeve assembly. 
     (2) Brief Description of the Prior Art 
     Surgical endoscopic procedures typically follow three steps. First, a cannula, such as a Veress cannula, is inserted through the abdominal cavity through the abdominal wall and the cavity is inflated with insufflating gas which is passed through the cannula tubular housing. After insufflating, a small incision is made in the skin and a standard trocar spike is thrust into the inflated abdomen through the bore of the trocar tube. The spike is inserted for purposes of puncturing or cutting of the abdominal wall and piercing the fascia and peritoneum inside the cavity. After removal of the spike, a suction/irrigation cannula is re-inserted through the trocar housing and into the opening so that fluids may be drained from the body cavity. 
     Endoscopic surgery also includes the introduction through a trocar tube of a number of auxiliary surgical instruments such as, for example, a laparoscope, or the like. It is not uncommon during endoscopic surgical operations to utilize several instruments which are introduced through a particularly sized trocar housing. If the diameter of the respective instruments to be utilized to the surgical operations are not substantially identical for companion sealing receipt within the trocar housing, the trocar housing must be removed from the abdominal cavity position, and replaced with a smaller (or larger) diameter trocar housing for diametric compatability with the respective surgical instruments. Such removal and re-insertion of the trocar housing is time comsuming and further complicates the surgical operation. 
     The present invention addresses the deficiencies above described in such surgical instruments. 
     SUMMARY OF THE INVENTION 
     The present invention is directed to a combination surgical trocar housing and selective reducer sleeve assembly. The device includes an elongated trocar tubular housing of a first internal diameter and having a first open end portion for positioning through a body wall, such as a human abdomen. The trocar tubular housing has an open end portion for introduction and removal of auxiliary surgical devices therethrough, such as an endoscope, while the first open end portion is positioned through the body wall. An insert sleeve assembly is concentrically introducable through the second opposite open end portion of the trocar housing and includes a cylindrical housing of a second external diameter less than the said internal diameter of the trocar housing. Means for placing the sleeve cylindrical housing in a limited telescopically contracted position relative to the trocar housing is also provided, as well as means for selectively securing the sleeve cylindrical housing in the telescopically contracted position. 
     The device may also include a first seal means for sealing the opening through the outboard-most end of the cylindrical housing, the seal means being formed of a resilient material, such as an elastomer, having a concave curvature facing the first open end portion of the trocar tubular housing, as well as a slit formed through the seal to define first and second seal lips facing each other and placable in sealing relationship around the exterior of the sleeve as the sleeve housing is placed through the trocar tubular housing. The lips move into sealing contact with one another when the sleeve housing is not therebetween to seal the opening of the sleeve housing. Second seal means are provided outboard of the first seal means for sealing around the sleeve housing as the sleeve housing is placed through the trocar tubular housing. 
     Thus, the invention provides a sleeve assembly for selective sealing placement interior of the trocar housing through which the auxiliary surgical instruments may be introduced, without removal and reinsertion of the trocar housing. Thus, the invention compensates for diameter variations of various surgical instruments for acceptance and use within only one trocar housing while, at the same time, providing a seal to prevent fluid flow from, for example, the interior to the exterior of the trocar housing, and through the annular area defined between the surgical instrument and the respective sleeve member and/or trocar housing. 
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS 
     FIG. 1 is an isometric view of the device of the present invention held in the hand of a surgeon with an auxiliary surgical device being disposed therethrough. 
     FIG. 2 is a cross sectional view schematically illustrating the trocar housing of the present invention accepting a sleeve housing therethrough. 
     FIG. 3 is an isometric view of the trocar housing with a series of first and second sleeve members being positioned for introduction into the trocar housing. 
     FIG. 4 is a partial sectional view of a sleeve member illustrating portions of the latching members, as well as the seal means for sealing against the external diameter of a second sleeve member introduced therethrough. 
     FIG. 5 is an isometric view showing the exterior of first and second sleeve members with the second or smaller member being telescopically received within the first or larger member. 
     FIG. 6 is a partial sectional view similar to that of FIG. 4, illustrating the second sleeve member being telescopically contractedly placed within the first sleeve member and without means to resist subsequent telescopic expansion. 
     FIG. 7 is a cross-sectional illustration of the sealing means of an alternative sleeve member including means for resisting telescopic expansion subsequent to introduction into another sleeve member. 
    
    
     DESCRIPTION OF THE PREFERRED EMBODIMENTS 
     With first reference to FIG. 1, there is shown the apparatus of the present invention 100 in isometric view with an auxiliary surgical device A being disposed through a trocar housing 10 concentrically receiving a sleeve cylindrical housing 21. The trocar housing 10 is held in position for introduction into the body walls, such as an abdomen, for performance of surgical procedures, and is held in the position, as shown, in a surgeon&#39;s hand H, between fingers F, with the surgeon&#39;s thumb T controlling the movement of the auxiliary surgical device A or in the palm of the surgeon. 
     The trocar housing 10 has a first open end 11 for insertion into the abdomen or other body wall (prior to introduction of the auxiliary surgical device A through the trocar housing 10), and a second open end 12 through which is received the sleeve housing 21, as shown. The trocar housing 10 has an internal diameter 13. 
     As shown in FIG. 2, a sleeve assembly 20 includes a sleeve cylindrical housing 21 shown concentrically received through the internal diameter 13 of the trocar housing 10. The sleeve cylindrical housing 21 has an outer diameter 22 (FIG. 4) smaller than the internal diameter 13 of the trocar housing 10 At the outboard most end of the sleeve cylindrical housing 21 is a cap portion 23 having an outer diameter larger than the diameter of the second open end 12 of the trocar housing 10 such that the inwardly facing face 23a of the cap port-ion 23 will come into abutting relationship with a companion frontal housing 23b of the trocar housing 10 when the sleeve cylindrical housing 21 is concentrically received within the trocar housing 10 to limit telescopic contraction of the sleeve housing 21 relative to the trocar housing 10. 
     Means for selective securement 24 are provided to secure the sleeve cylindrical housing 21 relative to the trocar housing 10 in telescopically contracted position and includes a snap groove 24a profiled around the sleeve cylindrical housing 21 and providing inner and outer shoulders 24b, 24c for receipt of a latch head portion 24e of a circumferentially extending flexible latch finger or ring 24d circumscribed interiorly within the trocar housing 10 outer most end and interior of the frontal housing 23b. Thus, as the sleeve cylindrical housing 21 is introduced into the trocar housing 10, the flexible latch fingers 24d will be biased radially outwardly, somewhat, as they pass around the outer diameter 22 of the sleeve cylindrical housing 21 until such time as the latch head portions 24e come into alignment with the snap groove 24a, such alignment permitting the flexible latch finger or ring 24d to radially contract to its normal radius and flex inwardly within the groove 24a such that the interengagement of the latch head 24e relative to the shoulder 24b resists telescopic expansion of the sleeve housing 21 relative to the trocar housing 10. Additionally, the interrelationship between the shoulder 24c and the head 24e resists further telescopic contraction of the members 21, 10 relative to one another (alone or in combination with the contact of the face 23a on the frontal housing 23b). 
     Now with reference to FIG. 7, the sleeve cylindrical housing 21 is shown with its passageway 26 therein outwardly terminating an opening 27. A first seal means is housed within the cap portion 23 and may be composed of an elastomeric or similar substance and is held in position within the cap portion 23 by means of a doughnut-shaped seal retainer 29 which, in turn, also secures within the cap portion 23 a second seal 34. 
     The first seal means 28 has a concave curvature 30 facing inwardly within the passageway 26. A central slit 31 is provided in the first seal means 28 for defining first and second seal lips 32, 33 (FIG. 6). The second seal means 34 has a small diameter opening 34a such that when a subsequent sleeve cylindrical housing 21 is introduced within the first housing 21, as in FIG. 6, the second seal means will sealingly engage around the exterior diameter of the second sleeve cylindrical housing 21. 
     Of course, when no device is inserted within the sleeve cylindrical housing 21, the first and second seal lips 32, 33 will come into sealing contact with one another (FIG. 7) to prevent fluid communication across the passageway 26. 
     In some instances, it may not be necessary for a second or other subsequential sleeve cylindrical housing 21 to be latchingly secured within its sleeve housing 21 or the trocar housing 10. In such instance, a contoured sealing surface 25 may be provided through the opening 27 by means of provision of a conically shaped ring profile 25a on the sleeve housing 21 just inboard of the cap portion 23 for receipt within a respectively bevelled or profiled seal groove element 25b on the cap portion 23 such that the interalignment between the members 25, 25b will provide a relatively tight seal therebetween and will at least satisfactorily resist fluid flow therebetween from the interior of either the trocar housing 10 or the sleeve cylindrical housing 21. 
     OPERATION 
     When it is anticipated during a surgical procedure that a plurality of auxiliary surgical devices A will be utilized during the operation, the trocar housing 10 will be introduced into the body cavity such that the first open end 11 is placed therethrough. A sleeve housing 21 may be introduced into the trocar housing 10 prior to or subsequent to such introduction of the housing 10 into the body cavity. Typically, the sleeve housing 21 will not have been previously introduced into the trocar housing 10. After, for example, a trocar spike has been thrust through the housing 10, it will be retrieved therefrom. A sleeve cylindrical housing 21, as described, will be introduced through the second open end 12 of the trocar housing 10 until the latch fingers 24d are then placed within the groove 24a and the cap portion 23 encounters the face 23a. Now, the first and second seal lips 32, 33 will be sealingly engaged around the exterior of the sleeve cylindrical housing 21 and the housing 21 will be latchingly secured within the trocar housing 10 in telescopically retracted position. A deliberate, but slight pull by the surgeon through application of the fingers F onto the cap portion 23 will overcome the interengagement of the latch fingers 24d in the groove 24a to remove the sleeve cylindrical housing 21 from the trocar housing 10, if and when desired. 
     Subsequent to introduction of the sleeve cylindrical housing 21 into the trocar housing 10, as described, the apparatus 100 will be in position as shown in FIG. 2. Now, the auxiliary surgical device A may be introduced through the cap portion 23 of the sleeve cylindrical housing 21 such that it travels through the opening 27 into the passageway 26 and out the first open end 11 of the trocar housing 10 into the body cavity (FIG. 1). 
     Subsequent to performing the surgical operating procedure with the auxiliary surgical device A as shown in FIG. such device A may be retrieved from the interior of the sleeve cylindrical housing 21 and a second sleeve cylindrical housing 21 may be introduced through the first sleeve cylindrical housing 21 in similar fashion, as shown in FIGS. 3 and 5. 
     It will be appreciated that provision of the present apparatus 100 enables the trocar housing 10 which is originally utilized to always remain within the body wall during the entire surgical procedure, while permitting the trocar housing 10 to always be in sealed relation to prevent fluid communication therein between the exterior and the interior thereof, as well as through the respective sleeve cylindrical housings 21. Additionally, it is not necessary for the trocar housing 10 to be removed and a subsequent smaller internal diameter trocar housing reintroduced into the body cavity slit for introduction of second, smaller, auxiliary surgical devices A. 
     Although the invention has been described in terms of specified embodiments which are set forth in detail, it should be understood that this is by illustration only and that the invention is not necessarily limited thereto, since alternative embodiments and operating techniques will become apparent to those skilled in the art in view of the disclosure. Accordingly, modificatins are contemplated which can be made without departing frm the spirit of the described invention.