Trocar insertion apparatus

• US 20050203565A1
• Filed: 09/16/2004
• Published: 09/15/2005
• Est. Priority Date: 09/19/2003
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Tyco Healthcare Group LP (Medtronic Plc)
• Inventors: Rethy, Csaba L., Azarbarzin, Kourosh, Wanchell, Thomas
• Granted Patent: US 7,479,150 B2
• Time in Patent Office: Days
• US Class Current: 606/198
• CPC Class Codes: A61B 17/3403 Needle locating or guiding means guides for suture needles A61B17/0482; guiding or tracking by nuclear magnetic resonance G01R33/285
• CPC Class Codes: A61B 17/3431 being collapsible, e.g. made of thin flexible material A61B17/3423 takes precedence
• CPC Class Codes: A61B 17/3474 Insufflating needles, e.g. Veress needles
• CPC Class Codes: A61B 17/3476 Powered trocars, e.g. electrosurgical cutting, lasers, powered knives
• CPC Class Codes: A61B 2017/00407 Ratchet means
• CPC Class Codes: A61B 2017/0046 with a releasable handle; with handle and operating part separable
• CPC Class Codes: A61B 2017/3405 using mechanical guide means

Abstract

Apparatus for forming and enlarging a percutaneous penetration are disclosed. The apparatus includes an elongate dilation member including a radially expandable member having a first cross-sectional area; and an elongate expansion member including a tubular element having a second cross-sectional area which is larger than the first cross-sectional area. The apparatus further includes an advancing apparatus having a first arm with a first engaging feature for engaging the handle of the dilation member; a second arm with a second engaging feature for engaging the handle of the expansion member; and an operation member; the first arm and the second arm being connected so that operation of the operation member approximates the first engaging feature and the second engaging feature together.

Claims

1. Apparatus for forming and enlarging a percutaneous penetration, the apparatus comprising:

an elongate dilation member including a radially expandable member having a proximal end with a handle, a distal end, and an axial lumen with a first cross-sectional area;

an elongate expansion member including a tubular element having a distal end, a proximal end with a handle, and an axial lumen with a second cross-sectional area which is larger than the first cross-sectional area;

the distal end of the expansion member being configured for facilitating insertion of the tubular element through the axial lumen of the dilation member; and

an advancing apparatus having;

a first arm with a first engaging feature for engaging the handle of the dilation member;

a second arm with a second engaging feature for engaging the handle of the expansion member; and

an operation member;

the first arm and the second arm being connected so that operation of the operation member approximates the first engaging feature and the second engaging feature together.

2. The apparatus of claim 1, wherein the radially expandable member comprises a braided sleeve.

3. The apparatus of claim 2, wherein the radially expandable member comprises a splittable sheath.

4. The apparatus of claim 1, wherein the operation member is attached to the second arm.

5. The apparatus of claim 4, wherein the second arm includes a passage for receiving the first arm.

6. The apparatus of claim 5, wherein the operation member is pivotally attached to the second arm and has a pivotal link engaging the first arm so that upon pressing the operation member, the link moves the first arm proximally.

7. The apparatus of claim 6, wherein the first arm extends parallel to the longitudinal axes of the dilation member and the expansion member.

8. The apparatus of claim 6, wherein the first arm and the second arm comprise inter-engaging ratchet teeth.

9. The apparatus of claim 4, wherein the first arm and the second arm are pivotally attached so that pressing the operation member toward the first arm approximates the first engaging feature and second engaging feature together.

10. An apparatus for facilitating the insertion of an expansion assembly distally through a radially expandable dilation assembly into a body cavity of a patient, the apparatus comprising:

a handle;

a trigger operatively coupled to the handle, the trigger being pivotable between a first position, spaced a distance from the handle, and a second position, in close proximity to the handle;

a spine member having a proximal end and a distal end, the spine member being slidably received within the handle, the spine member being axially moveable relative to the handle upon a manipulation of the trigger from the open position to the closed position;

an actuation mechanism in operative engagement with the handle, the trigger and the spine member, the actuation mechanism being releasably engagable with the spine member and, when engaged with the spine member, axially moves the spine member relative to the handle upon movement of the trigger to the closed position;

a retaining structure operatively coupled to the handle for holding the expansion assembly in place; and

a yoke provided at the distal end of the spine member for maintaining the dilation assembly aligned with the expansion assembly.

11. The apparatus of claim 10, wherein manipulation of the trigger towards the handle incrementally approximates the yoke toward the retaining structure.

12. The apparatus of claim 11, wherein the yoke defines a distal clevis and a proximal clevis, wherein tabs extending from opposite sides of a handle of the dilation assembly are positionable between the distal clevis and the proximal clevis.

13. The apparatus of claim 12, wherein the retaining structure includes at least one C-shaped cuff configured to operatively engage a handle of the expansion assembly in a snap-fit manner.

14. The apparatus of claim 13, wherein the actuation mechanism includes:

a driving lever operatively supported on the spine member;

a linkage member having a first end pivotally connected to the trigger and a second end slidably received within the handle and pivotally connected to the driving lever; and

a compression spring disposed between the driving lever and an inner surface of the handle, the compression spring biasing the driving lever to an orientation orthogonal to the spine member;

wherein actuation of the trigger toward the handle causes the driving lever to pivot and bind against the spine member.

15. The apparatus of claim 14, wherein the actuation mechanism further includes:

a braking lever operatively supported on the spine member, a first end of braking lever is pivotally positioned within a recess formed in the handle; and

a spring member disposed between braking lever and a surface formed in the handle, wherein the spring member biases a free end of the braking lever in a distal direction.

16. The apparatus of claim 15, wherein the proximal end of the spine member extends from a proximal end of the handle.

17. The apparatus of claim 16, further comprising:

an elongate dilation assembly operatively associatable with the yoke, the elongate dilation assembly including a handle, a radially expandable tubular sheath having a proximal end connected to the handle, a distal end, and defining an axial lumen with a first cross-sectional area.

18. The apparatus of claim 17, further comprising:

an elongate expansion assembly operatively connectable to the at least one cuff, the expansion assembly including a tubular element having a distal end, a proximal end with a handle, and an axial lumen with a second cross-sectional area which is larger than the first cross-sectional area of the elongate dilation assembly.

19. A kit for providing access to a target surgical site, comprising:

a radially expandable dilation assembly;

a pneumoperitoneum needle assembly;

a stylet;

an expansion assembly;

an obturator;

an expansion assembly insertion apparatus for forming and enlarging a percutaneous penetration; and

a package for enclosing the radially expandable dilation assembly, the pneumoperitoneum needle assembly, the stylet, the expansion assembly, the obturator, and the expansion assembly insertion apparatus.

20. The kit according to claim 19, further comprising:

a package insert including at least one of instructions on use and warnings of use.