Trocar system and method of use
A trocar system including a cannula and an obturator assembly being at least partially insertable through the cannula. The obturator assembly including a housing, a penetrating tip disposed at a distal end, an elongated shield including a guard extending from a shaft are movable relative to the penetrating tip, and a latch mechanism disposed generally within the housing. The latch mechanism facilitates changing the configuration of the obturator assembly between a fixed-shield orientation, wherein at least a portion of the guard is maintained to extend at least partially distal of the penetrating tip to prevent puncturing of tissue by the penetrating tip, to a non-fixed shield orientation whereby upon application of force to the distal end of the obturator assembly, the guard and penetrating tip are permitted to move relative one another to facilitate puncturing of tissue by the penetrating tip.
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1. Technical Field
The present disclosure relates to trocar systems for inserting cannulas into patients, and more particularly to modular trocar systems and methods of assembly of trocar systems.
2. Background of Related Art
Minimally invasive procedures are continually increasing in number and variation. Forming a relatively small diameter temporary pathway to the surgical site is the key feature of most minimally invasive surgical procedures. The most common method of providing such a pathway is by inserting a trocar assembly through the skin. In many procedures the trocar is inserted into an insufflated body cavity of a patient. In such procedures, trocar assemblies with seal mechanisms are utilized to provide the necessary pathway to the surgical site while minimizing leakage of insufflation gases through the inserted cannula.
Trocar assemblies typically include an obturator removably inserted through a cannula assembly. The obturator is assembled with the cannula portion such that the obturator's sharp tip portion extends from a distal end opening of the cannula to facilitate insertion of the cannula through the body wall of the patient. Trocar assemblies are commonly provided with a safety shield of some fashion which protects against unintentional puncturing by the sharpened tip of the obturator. Mechanisms which control the relative movement and locking of the safety shield and the obturator's penetrating tip exist. Such mechanisms can be complex and often require numerous moving parts to accomplish the release and resetting of a the safety shield lock feature so as to permit the obturator's penetrating tip to function only when desired to facilitate insertion of the trocar assembly and placement of the cannula portion thereof.
A continuing need exists for novel trocar assemblies which provide safety shield latch mechanisms which require fewer component parts while providing increased reliability before, during and after insertion of the trocar assembly in a patient.
SUMMARYThe present disclosure provides a modular trocar system which overcomes disadvantages associated with previous trocar systems. The presently disclosed modular trocar system satisfies the need for more reliable trocar assemblies while improving manufacturing efficiencies.
In particular, the present disclosure provides trocar system including a cannula and an obturator assembly being at least partially insertable through the cannula. The obturator assembly including a housing, a penetrating tip disposed at a distal end, an elongated shield including a guard extending from a shaft are movable relative to the penetrating tip, and a latch mechanism disposed generally within the housing. The latch mechanism facilitates changing the configuration of the obturator assembly between a fixed-shield orientation, wherein at least a portion of the guard is maintained to extend at least partially distal of the penetrating tip to prevent puncturing of tissue by the penetrating tip, to a non-fixed shield orientation whereby upon application of force to the distal end of the obturator assembly, the guard and penetrating tip are permitted to move relative one another to facilitate puncturing of tissue by the penetrating tip.
BRIEF DESCRIPTION OF THE DRAWINGSVarious embodiments are described herein with reference to the drawings, wherein:
Referring initially to
Except where noted otherwise, the materials utilized in the components of the presently disclosed modular trocar system generally include materials such as either ABS or polycarbonate for housing sections and related components and stainless steel for components that are required to cut tissue. A preferred ABS material is CYCOLAC which is available from General Electric. A preferred polycarbonate material is also available from General Electric under the trademark LEXAN. An alternative polycarbonate material which may be utilized is CALIBRE polycarbonate available from Dow Chemical Company. The polycarbonate materials may be partially glass filled for added strength.
Referring now to
When fully assembled, obturator assembly 110 includes a safety shield assembly that is movable with respect to a penetrating tip such as, for example, knife blade 125. The safety shield assembly includes a shaft formed from an elongated hollow shield member 126 and a shield extension 127. A distal guard member 128 is attached to the distal end of shield extension 127. Preferably, all of the safety shield assembly components are molded from a polycarbonate material. Guard member 128 is preferably formed as a “dolphin nose” to help minimize the force necessary to penetrate the body. As shown in
Elongated shield member 126 is disposed within a longitudinal throughbore 136,
The safety shield assembly further includes a coil spring 140 the distal end of which is seated in shield member 126 in an opening formed at the proximal end of collar 130. Referring temporarily to
Housing cover 120 is further provided with an open ended slot 146 (
As noted above, the shield member 126 (and therefore the entire shield assembly) is biased in a distal-most position by coil spring 140. A latching mechanism is provided as part of obturator assembly 110 to prevent proximal movement of the shield assembly until such a time as obturator assembly 110 is inserted in a cannula assembly, e.g., cannula assembly 112, and the surgeon is prepared to begin trocar entry.
As best shown in
A release member such as slider 156 is distally biased by a coil spring 158 which is maintained in axial alignment with a lower end of slider 156 by a post 160. The proximal end of coil spring 158 bears against the inner surface of housing cover 120 and is maintained in position between a post 162 and a cylindrical base 164 formed in housing cover 120 (
In a preferred embodiment, the components described above, namely housing base 119, housing cover 120, the latching mechanism components, coil spring 140, cylindrical extended portion 138 and elongated shield member 126 constitute a first modular subassembly that may be advantageously manufactured in large quantities and inventoried for use across a wide range of trocar assembly sizes. As noted hereinbelow, other modular subassemblies may be manufactured to different size specifications, e.g., 5 mm, 10 mm, 15 mm, but all would be functionally operable with the first modular subassembly disclosed herein.
Referring to
A proximally extending elongated portion 168 is provided to facilitate attachment of knife blade 125 to a knife rod 170. Elongated proximal portion 168 is provided with a slot 172 and a notch 174. Preferably, knife rod 170 is formed by injection molding. Knife blade 125 is positioned in the injection mold such that when the rod material is injected into the mold, the material flows around a web portion 176,
Referring to
Referring now to
Referring to
Referring to
As shown in
For larger diameter trocar assemblies, each of the components of obturator assembly 110 are the same except a larger sized knife blade and guard member are attached to knife rod 170. Also, a larger cannula is attached to the cannula body. This interchangeability of different sized knives and guard members with standard sized components located proximally thereof obviates the need to manufacture and inventory both the components and whole units of non-modular, conventional trocar systems. In particular, the more complex and, therefore, more expensive size-specific elements located in the obturator housing need not be manufactured and inventoried. The manufacturer or distributor need only assemble the appropriate sized knife and guard member with the otherwise standard sized control components as demand dictates.
Referring now to
Slots 222 are particularly advantageous in two respects. First, in assembling cannula assembly 112, there are three basic principle components: cylindrical base portion 216 having outwardly directing finger grips 218, a duck bill valve element 224 having a flange 226 which is configured and dimensioned to rest on annular flange 220 of cylindrical base portion 216 and a cannula housing cover portion such as proximal housing element 228 which is configured and dimensioned to rest on duck bill flange 226 and within the outwardly directed finger grips 218. It has been found that by coring out the underside of outwardly extending finger grips 218 with parallel slots 222, molding sinks which had been previously forming on the proximal side of outwardly extending fingers 218 of cylindrical base portion 216 were significantly reduced, thereby providing a much more reliable flat surface, as best shown in
This greater cooperation between the two cannula housing elements reduces the force which must be applied as between the two housing elements during the welding process, thereby reducing the likelihood that the duck bill valve 224 will be torqued. Torquing of the duck bill valve 224 can potentially reduce the sealing function of the element in the absence of a surgical instrument inserted therethrough.
The second respect in which slots 222 are advantageous is that on the underside of the cylindrical base portion 216 is normally the place where the user grips the cannula the cylindrical base portion 216. Accordingly, the slots provide an improved gripping surface to the user.
A further feature of cannula assembly 112 is the provision of a detachable cannula 116 which readily connects and disconnects from cylindrical base portion 216. Cannula 116 is preferably molded with a substantially constant inner and outer diameter. However, cannula 116 preferably includes a slightly larger inner diameter at its proximal end, e.g., of 2-3 cms length, to facilitate introduction of instrumentation, and a tapered outer diameter at its distal-most portion, e.g. over the distal-most 2-3 cms of length, the tapered outer diameter being largest at a proximal end thereof and smallest at a distal end thereof. In this way, molding is facilitated while penetration force is minimized by reducing the outer diameter of cannula 116 in the region where tissue first makes contact and by providing a gradual taper to the outside diameter to assist in dilation of tissue as it passes proximally along the outer wall of cannula 116.
An elastomeric O-ring may be interposed between cylindrical base portion 216 and cannula 116 to maintain a fluid-type seal between cannula 116 and cylindrical base portion 216. Cannula 116 is formed of a predetermined diameter so as to form a longitudinal throughbore 232 in communication with a passageway formed through cylindrical base portion 216 and proximal housing element 228. Cannula 116 is further provided with an annular flange 234 which is particularly sized to be received in the distal end of cylindrical base portion 216. Flange 234 is preferably a standard size such that cannulas having different sized diameter passageways formed therethrough may be formed with a flange that has the same configuration and dimension as flange 234. In this manner, cannulas of varying sized and dimensions may be interchangeably attached to a given cylindrical base portion such as cylindrical base portion 216.
To facilitate the interconnectability of cannula 116 and cylindrical base portion 216, a quick connect mechanism is provided which, for example, may be by a series of engageable mating members (not shown) formed on cannula 116 proximal of flange 234 which interconnect cannula 116 with cylindrical base portion 216 by way of a series of mating indented surfaces (not shown) formed along the inner wall of cylindrical base portion 216. The two elements are brought into engagement with each other by inserting the proximal end of cannula 116 into the distal end of cylindrical base portion 216 and rotating cannula 116 clockwise until the mating members engage and lock into the mating surfaces. The two elements may be disengaged by applying a proximally directed force to the cannula toward cylindrical base portion 216 and rotating cannula 116 counterclockwise. This feature is particularly advantageous during manufacture and assembly of cannula assembly 112 in that it facilitates inventory management and manufacturing efficiencies due to the cylindrical base portion 216 now being a single component which is able to be utilized across multiple cannula diameter products, the only difference being the cannula which is ultimately secured to the cylindrical base portions at the final stage of manufacture.
Also provided on cannula assembly 112 is a seal assembly 240 which generally includes a housing 242 and a seal member 244. A similar seal assembly is disclosed in copending PCT Application Serial No. PCT/US98/08970 filed May 1, 1998 by Racenet et al., the entire contents of which are hereby incorporated by reference.
As another feature, cannula assembly 112 may be provided with suture anchoring structure, for example suture anchor holes 219 on finger grips 218 or devises 221 formed near the proximal end of cannula 116.
In usage, as shown in
It will be understood that various modifications may be made to the embodiments disclosed herein. Therefore, the above description should not be construed as limiting, but merely as exemplifications of preferred embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the present disclosure.
Claims
1. A trocar system which comprises:
- a cannula forming an opening longitudinally therethrough and having a proximally facing surface disposed near a proximal end thereof; and
- an obturator assembly being at least partially insertable through the cannula and including: a housing disposed at a proximal end, the housing including a base portion having a distally facing end surface configured and dimensioned to facilitate close proximate positioning thereof with the proximally facing surface of the cannula; a penetrating tip disposed at a distal end; an elongated shield including a guard extending from a shaft, the penetrating tip and guard being movable relative one another; and a latch mechanism disposed generally within the housing, which facilitates changing the configuration of the obturator assembly between a fixed-shield orientation, wherein at least a portion of the guard is maintained to extend at least partially distal of the penetrating tip to prevent puncturing of tissue by the penetrating tip, to a non-fixed shield orientation whereby upon application of force to the distal end of the obturator assembly, the guard and penetrating tip are permitted to move relative one another to facilitate puncturing of tissue by the penetrating tip, the latch mechanism including: a release member having a button portion and a camming surface; and a latch operatively associated with the release member, the latch having a blocking surface and a mating surface, the mating surface cooperating with the camming surface of the release member such that upon movement of the release member the camming surface biases the mating surface to move the latch such that the blocking surface permits axial movement of the shield.
2. A trocar system as recited in claim 1 wherein movement of the release member causes the blocking surface to be displaced out of axial alignment with the shield.
3. A trocar system as recited in claim 1 wherein the button portion protrudes at least partially through an opening formed in the distally facing end surface of the obturator housing.
4. A trocar system as recited in claim 1 wherein the latch is biased such that the blocking surface is normally disposed in axial alignment with at least a portion of the shield to prevent axial movement thereof.
5. A trocar system as recited in claim 2 wherein the blocking surface is disposed proximal of the at least a portion of the shield.
6. A trocar system as recited in claim 1 wherein the release member is configured and dimensioned such that axial movement of the release member imparts lateral movement of the blocking surface of the latch member.
7. A trocar system as recited in claim 1 wherein the obturator includes a shaft fixed relative to the housing and the penetrating tip is a flat knife blade secured to the shaft.
8. A trocar system as recited in claim 1 wherein the shield includes an extended surface which is disposed on the shield such that upon axial movement of the shield, the extended surface biases the actuator member away from the latch to permit the latch to return to its original orientation.
9. A trocar system as recited in claim 1 wherein the guard is configured and dimensioned to completely enclose the penetrating tip.
10. A trocar system as recited in claim 1, wherein the shield and guard are separate elements fitted together during assembly of the obturator.
11. A method of inserting a trocar assembly into a patient comprising the steps of:
- approximating an obturator assembly with a cannula assembly such that a button portion of a release member is urged proximally and a camming surface of the release member imparts lateral movement of a blocking surface of a latch such that the blocking surface is moved to permit relative movement of the shield and a penetrating tip of the obturator assembly; and
- inserting the trocar assembly through the body wall of a patient by pushing the trocar assembly toward the body wall such that a guard of the shield is urged proximally to reveal the penetrating tip and permit passage of the trocar assembly through the body wall.
12. A method of inserting a trocar assembly as recited in claim 11 wherein lateral movement of the blocking member moves the blocking member out of axial alignment with the shield.
13. A method of inserting a trocar assembly as recited in claim 11, further including the step of resetting the shield to a fixed orientation distal of the penetrating tip upon passage of the penetrating tip through the body wall and into a cavity of the patient's body, such resetting being facilitated by axial movement of the shield and resilient bias of the latch to a position wherein the blocking surface is axially aligned with at least a portion of the shield.
Type: Application
Filed: Sep 12, 2007
Publication Date: Jan 10, 2008
Applicant:
Inventors: Gene Stellon (Southington, CT), David Racenet (Southbury, CT), Ralph Stearns (Bozrah, CT), Adam Lehman (Wallingford, CT)
Application Number: 11/900,459
International Classification: A61B 17/34 (20060101);