Trocar assembly with pneumatic sealing

• US 20070088275A1
• Filed: 09/08/2006
• Published: 04/19/2007
• Est. Priority Date: 04/08/2003
• Status: Active Grant

• Current Assignee: Surgiquest, Inc. (Jefferies Financial Group, Inc.)
• Original Assignee: Surgiquest, Inc. (Jefferies Financial Group, Inc.)
• Inventors: Stearns, Ralph, Stubbs, Jack
• Granted Patent: US 7,854,724 B2
• Time in Patent Office: Days
• US Class Current: 604/164.10
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 17/3423 Access ports, e.g. toroid shape introducers for instruments or hands access sites for liquids A61M39/0247
• CPC Class Codes: A61B 17/3462 with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals expandable cannulas A61B17/3417
• CPC Class Codes: A61B 17/3474 Insufflating needles, e.g. Veress needles
• CPC Class Codes: A61B 17/3498 Valves therefor, e.g. flapper valves, slide valves haemostasis valves A61M39/06; check valves A61M39/24
• CPC Class Codes: A61B 2017/00265 Hand assisted surgery, i.e. minimally invasive surgery with at least part of an assisting hand inside the body
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61M 1/28 Peritoneal dialysis ; Other peritoneal treatment, e.g. oxygenation
• CPC Class Codes: A61M 13/003 Blowing gases other than for carrying powders, e.g. for inflating, dilating or rinsing
• CPC Class Codes: A61M 13/006 with gas recirculation
• CPC Class Codes: A61M 2202/0225 Carbon oxides, e.g. Carbon dioxide
• CPC Class Codes: A61M 2205/3344 Measuring or controlling pressure at the body treatment site

Abstract

A trocar for use in a minimally invasive surgical procedure includes an elongated body, nozzle means and means for delivering a pressurized flow of fluid to the nozzle means. The elongated body has a generally tubular configuration with coaxially arranged inner and outer walls and longitudinally opposed proximal and distal end portions, with the inner wall defining a lumen to accommodate passage of an instrument therethrough. The nozzle means is operatively associated with the inner wall of the body for directing pressurized fluid into the lumen to develop a pressure differential in an area within a region extending from a location adjacent a distal end portion of the lumen to a location adjacent a proximal end portion of the lumen, to form a fluid seal around an instrument passing therethrough.

Claims

1. A trocar for use in a minimally invasive surgical procedure, comprising:

a) an elongated body having a generally tubular configuration with coaxially arranged inner and outer walls, the body having longitudinally opposed proximal and distal end portions, the inner wall defining a lumen to accommodate passage of an instrument therethrough;

b) nozzle means operatively associated with the inner wall of the body for directing pressurized fluid into the lumen to develop a pressure differential in an area within a region extending from a location adjacent a distal end portion of the lumen to a location adjacent a proximal end portion of the lumen, to form a fluid seal around an instrument passing therethrough; and

c) means for delivering a pressurized flow of fluid to the nozzle means.

2. The trocar of claim 1, wherein the inner and outer walls of the trocar body are substantially cylindrical, having a substantially circular cross-section.

3. The trocar of claim 1, wherein the inner and outer walls of the trocar body have a substantially elliptical cross-section.

4. The trocar of claim 1, wherein the nozzle means is configured to direct the pressurized fluid at an angle of between about 0 and 10 degrees with respect to a longitudinal axis of the trocar.

5. The trocar of claim 1, wherein the nozzle means is provided at a point along a longitudinal axis of the trocar body such that a fluid stream maintains a pressure gradient substantially within the lumen of the trocar.

6. The trocar of claim 1, wherein the means for delivering a pressurized flow of fluid is a fluid passageway defined between the inner and outer walls.

7. The trocar of claim 1, wherein the nozzle means is a substantially annular nozzle defined in the inner wall of the body.

8. The trocar of claim 1, wherein the nozzle means is one or more nozzles, each shaped substantially as a frustoconical annulus.

9. The trocar of claim 1, wherein the nozzle means is provided in the distal end portion of the trocar body.

10. The trocar of claim 1, wherein the nozzle means is provided in the proximal end portion of the trocar body.

11. The trocar of claim 1, wherein the nozzle means comprises first and second substantially annular nozzles, longitudinally spaced from one another.

12. The trocar of claim 11, wherein the first nozzle is provided in the proximal end portion of the trocar body and the second nozzle is provided in the distal end portion of the trocar body.

13. The trocar of claim 1, wherein the nozzle means comprises first, second and third substantially annular nozzles longitudinally spaced from one another.

14. The trocar of claim 1, further comprising pressure sensing means for detecting a pressure within a cavity of a patient.

15. The trocar of claim 14, wherein the pressure sensing means comprises a fluid passageway carried by the trocar, configured and adapted to be in fluid communication with the cavity of a patient when in use, for measuring pressure within the cavity.

16. The trocar of claim 15, wherein the fluid passageway is defined on an outer surface of the outer wall of the trocar body.

17. The trocar of claim 15, wherein the fluid passageway is concentrically disposed around the outer wall of the trocar body, the second fluid passageway having a substantially annular cross-section.

18. The trocar of claim 15, wherein the fluid passageway is defined within the outer wall of the trocar and terminates in a substantially annular aperture defined in an outer surface of the outer wall of the trocar body.

19. The trocar of claim 1, further comprising a recirculation chamber defined in the proximal end region of the trocar body, the recirculation chamber being in fluid communication with the lumen, and configured and adapted to provide a collection region for recirculation of fluid flowing toward the proximal end of the trocar.

20. The trocar of claim 19, further comprising a collection conduit in fluid communication with an outer circumferential region of the recirculation chamber to carry fluid collected thereby to a treatment means or recirculation means.

21. The trocar of claim 1, further comprising:

a) a pressure chamber defined in the proximal end portion of the trocar body, the chamber being in fluid communication with the lumen, and configured and adapted to provide a region of increased pressure to inhibit flow of fluid flowing toward the proximal end of the trocar; and

b) a gas supply port in fluid communication with the pressure chamber, for connection to a supply line to provide a gas flow sufficient to maintain a predetermined pressure within the pressure chamber.

22. The trocar of claim 21, wherein the pressure within the pressure chamber is between about 40 mmHg and 3000 mmHg.

23. The trocar of claim 21, further comprising an exhaust port for connection to an exhaust line to carry fluid collected thereby to a treatment means or recirculation means.

24. The trocar of claim 1, wherein the inner wall of the trocar body comprises first and second substantially tubular members, held within the outer wall, a first nozzle being defined between the first and second substantially tubular members.

25. The trocar of claim 24, wherein a second substantially annular nozzle is defined between the first substantially tubular member and the outer wall.

26. The trocar of claim 1, further comprising a cap configured and adapted to secure to the proximal end portion of the trocar body.

27. The trocar of claim 26, wherein the cap includes a valve means.

28. The trocar of claim 26, wherein the cap includes a pressure sensing means.

29. The trocar of claim 26, wherein the cap comprises a lumen for insertion of a surgical instrument.

30. The trocar of claim 26, wherein the cap includes:

a) a cap lumen defined within a wall of the cap;

b) a chamber within the cap; and

c) a ball held within the chamber, the chamber being configured and adapted to accommodate the ball, such that gas flow from the trocar body urges the ball into a position at which the ball substantially occludes the cap lumen, and such that when an instrument is inserted through the cap lumen, the ball is urged away from the cap lumen toward a periphery of the chamber.

31. The trocar of claim 1, further comprising:

a) a chamber defined in the proximal end portion of the trocar body; and

b) a substantially spherical valve member held within the chamber, the chamber being configured and adapted to accommodate the valve member, such that the valve member can substantially occlude a proximal aperture of the lumen, and such that when an instrument is inserted into the lumen, the valve member is urged away from the proximal aperture of the lumen toward a periphery of the chamber.

32. A trocar for use in a surgical procedure, comprising:

a) a trocar body having a substantially tubular inner wall and a substantially tubular outer wall, the trocar body having a proximal end and a distal end, the inner wall defining a lumen to provide access through the trocar;

b) a first fluid passageway defined between the inner wall and the outer wall; and

c) a first substantially annular nozzle defined in the inner wall, in fluid communication with the first fluid passageway and configured and adapted to direct a pressurized fluid into the lumen to maintain a pressure differential within the lumen or proximate the distal end thereof, the pressure differential being capable of inhibiting proximal egress of insufflation gas from a body cavity of a patient.

33. The trocar of claim 32, wherein the tubular inner and outer walls are substantially elliptical in cross-section.

34. A method of sealing a pressurized cavity of a patient for a surgical procedure, the method comprising the steps of:

a) providing a trocar for use in a minimally invasive surgical procedure, the trocar including;

i) an elongated body having a generally tubular configuration with coaxially arranged inner and outer walls, the body having longitudinally opposed proximal and distal end portions, the inner wall defining a lumen to accommodate passage of an instrument therethrough;

ii) nozzle means operatively associated with the inner wall of the body for directing pressurized fluid into the lumen to develop a pressure differential in an area within a region extending from a location adjacent a distal end portion of the lumen to a location adjacent a proximal end portion of the lumen, to form a fluid seal around an instrument passing therethrough; and

iii) means for delivering a pressurized flow of fluid to the nozzle means.

c) supplying a flow of pressurized fluid to the trocar; and

d) inserting a surgical instrument through the lumen of the trocar, whereby the pressurized fluid supplied to the trocar forms a seal around the surgical instrument, thereby preventing loss of pressure within the cavity of the patient.

35. The method of claim 34, further comprising the step of:

inserting a second surgical instrument through the lumen of the trocar, whereby the pressurized fluid supplied to the trocar seals around and between the first and second surgical instruments, preventing loss of pressure within the cavity of the patient.

36. A method of sealing a pressurized cavity of a patient for a surgical procedure, the method comprising the steps of:

a) providing a trocar having means to direct a stream of fluid through a lumen of the trocar to prevent loss of pressure within the cavity of the patient, due to loss of insufflation fluid past a surgical instrument inserted therethrough;

b) supplying a pressurized fluid stream into the lumen of the trocar; and

c) inserting a surgical instrument through the lumen of the trocar, whereby the pressurized fluid supplied to the trocar seals around the surgical instrument, thereby preventing loss of pressure within the cavity of the patient.

37. The method of claim 36, further comprising the step of providing means to direct a stream of fluid that includes at least a first nozzle arranged in a proximal end portion of the trocar.

38. The method of claim 37, further comprising the step of providing means to direct a stream of fluid that includes at least a first nozzle arranged in a proximal end portion of the trocar and a second nozzle arranged in the trocar, axially spaced from the first nozzle.

39. The method of claim 37, further comprising the step of providing means to direct a stream of fluid that includes at least one nozzle which extends substantially circumferentially about the lumen of the trocar.

40. A system for providing pressurized fluid to an insufflation trocar, the system comprising:

a) a supply for providing insufflation fluid to the system;

b) pressure sensing means for taking a measurement indicative of a pressure inside a body cavity of a patient;

c) a pressure reservoir for storing pressurized fluid and for maintaining a constant output pressure to the insufflation trocar; and

d) pressure regulating means, for regulating pressure output from the reservoir to the trocar based upon a measured pressure detected by the pressure sensing means.

41. The system of claim 40, wherein the pressurization means and pressure sensing means are provided in a surgical insufflator.

42. The system of claim 40, wherein the pressurization means is a compressor.

43. The system of claim 40, wherein the pressure sensing means is an adjustable diaphragm-type pneumatic actuator.

44. The system of claim 40, wherein the pressure sensing means is an electro-pneumatic transducer.

45. The system of claim 40, wherein the pressure regulating means includes:

a) a control element, for setting by a user to select a desired pressure for the surgical cavity; and

b) an electromechanical flow-control valve for adjusting a flow of insufflation gas to maintain the desired pressure within the surgical cavity.

46. The system of claim 40, further comprising pressurization means for pressurizing the insufflation gas to a predetermined pressure.

47. The system of claim 40, wherein:

a) the gas supply is connected to a pressure reservoir, to supply insufflation gas thereto;

b) a surgical insufflator is configured and adapted to receive gas from the gas supply, pressurize the gas and supply the pressurized gas to the reservoir, the insufflator having a pressure sensing conduit in fluid communication with the surgical cavity;

c) the pressure reservoir is connected to and supplies pressurized insufflation gas through the pressure regulating means; and

d) the pressure regulating means allows an amount of insufflation gas into the trocar to maintain a predetermined pressure within the surgical cavity.

48. The system of claim 47, wherein a pressure sensing conduit is connected between the trocar and the pressure regulating means to control the volume of insufflation gas being provided to the trocar.

49. The system of claim 40, wherein:

a) the gas supply is connected to the pressurization means, to supply insufflation gas thereto;

b) the pressurization means is provided and is connected to the pressure reservoir to provide pressurized insufflation gas to the reservoir;

c) the pressure reservoir is connected to and supplies pressurized insufflation gas through the pressure regulating means;

d) the pressure regulating means allows an amount of insufflation gas into the trocar to maintain a predetermined pressure within the surgical cavity; and

wherein

e) a pressure sensing conduit is connected between the trocar and the pressure regulating means to control the volume of insufflation gas being provided to the trocar.

50. A connection kit for use in conjunction with a trocar assembly with pneumatic sealing, the kit comprising:

a) a first tube for connection between an insufflation port on the trocar and a fluid supply port on a pressure regulating means;

b) a second tube for connection between a pressure sense port on the trocar and a pressure sense port on the pressure regulating means; and

c) a sterile package containing the first and second tubes.

51. The connection kit of claim 50, wherein the first tube is coaxially arranged within the second tube, the kit further including a splitter on at least one end to separate the first and second tubes for connection to respective ports on the pressure regulating means.

52. The connection kit of claim 50, further including:

a third tube for connection between a proximally arranged pressure chamber on the trocar and a pressurized fluid supply.

53. The connection kit of claim 52, further including:

a fourth tube for connection to the proximally arranged pressure chamber and a recycling means for removal of fluid from the chamber.

54. The connection kit of claim 50, further comprising a reservoir for connection between the fluid supply port on the pressure regulating means and the first tube.