Trocar tube, Trocar, Obturator and/or Rectoscope for the Transluminal Endoscopic Surgery Via Natural Body Orifices

• US 20100280368A1
• Filed: 02/26/2010
• Published: 11/04/2010
• Est. Priority Date: 08/27/2007
• Status: Abandoned Application

• Current Assignee: Technische Universitat Munchen
• Original Assignee: Technische Universitat Munchen
• Inventors: Schneider, Armin, Feussner, Hubertus, Fiolka, Adam, CAN, Salman
• Application Number:
  US12/714,087
• Publication Number:
  US 20100280368A1
• Time in Patent Office: Days
• US Class Current: 600/431
• CPC Class Codes: A61B 1/00071 Insertion part of the endoscope body A61B1/0055 takes precedence
• CPC Class Codes: A61B 1/31 for the rectum, e.g. proctoscopes, sigmoidoscopes , colonoscopes
• CPC Class Codes: A61B 1/313 for introducing through surgical openings, e.g. laparoscopes
• CPC Class Codes: A61B 17/3417 Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating syringe needles A61M5/32; dilators A61M29/00
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 2017/00278 Transorgan operations, e.g. transgastric
• CPC Class Codes: A61B 2017/3449 whereby the instrument channels merge into one single channel
• CPC Class Codes: A61B 2017/3466 for simultaneous sealing of multiple instruments

Abstract

A trocar tube, trocar, obturator, rectoscope is suitable for transluminal endoscopic surgery via natural body cavities. A trocar tube (2) has a distal section (22) for positioning at least in the region of or outside the body cavity, and a proximal section (21) for positioning within the human or animal, wherein at least the proximal section has a substantially rigid or inflexible curvature. An obturator (3) and a rectoscope (5) may be adapted for use with such a trocar tube for this purpose.

Claims

1. A trocar tube for use in transluminal endoscopic surgery via a natural body orifice of a human or an animal, the trocar tube comprising:

a distal portion (22) to be positioned at least in the region of or outside the natural body orifice; and

a proximal portion (21) to be positioned within the human or animal, wherein;

at least the proximal portion (21) comprises at least partially an essentially non-deformable curvature.

2. The trocar tube according to claim 1, wherein the entire trocar tube (2) is essentially non-deformable.

3. The trocar tube according to claim 1, wherein the curvature of the proximal portion (21) is essentially constant and has a curvature radius at a middle axis of the proximal portion (21) of about 45-75 mm.

4. The trocar tube according to claim 1, wherein the trocar tube (2) has an inner diameter of about 2-22 mm over an at least substantial part of its entire length.

5. The trocar tube according to claim 1, wherein the trocar tube (2) has a wall thickness of about 0.2-2 mm over at least a substantial part of its entire length.

6. The trocar tube according to claim 1, wherein the trocar tube (2) has an entire length of about 230-400 mm.

7. The trocar tube according to claim 1, wherein the effective length of a straight section of the trocar tube is about 180-300 mm.

8. The trocar tube according to claim 1, wherein:

the proximal portion (21) has an absolute total deflection towards one side of about 15-18 mm; and

/or

the maximum angle between a longitudinal axis of a non-bent section of the trocar tube and the longitudinal axis of the most bent proximal section is about 20-70°

.

9. The trocar tube according to claim 1, wherein a free end (24) of the proximal portion (21) is tapered.

10. The trocar tube according to claim 1, wherein at least the proximal portion (21) has an essentially uniform cross-section that is oval or round.

11. The trocar tube according to claim 1, further comprising connection means (25) for the liquid-tight and/or gas-tight connection to a trocar head.

12. The trocar tube according to claim 11, wherein the connection means (25) is a radial bulging to enable elastic engagement behind said bulging in an interlocking manner.

13. The trocar tube according to claim 1, wherein the trocar tube (2) externally has markings for providing readings of the radial orientation and/or its inserted length.

14. The trocar tube according to claim 1, wherein the trocar tube (2) externally has at least one working channel.

15. A trocar comprising:

a trocar tube (2) for use in the transluminal endoscopic surgery via a natural body orifice of a human or an animal, the trocar tube comprising;

a distal portion (22) to be positioned at least in the region of or outside the natural body orifice and a proximal portion (21) to be positioned within the human or animal, wherein at least the proximal portion (21) comprises at least partially an essentially non-deformable curvature; and

a trocar head (1) connected to a proximal end of the trocar tube (2).

16. The trocar according to claim 15, wherein:

the trocar tube (2) and the trocar head (1) are connected to each other in a liquid-tight and/or gas-tight manner by providing a seal (4) in between.

17. The trocar according to claim 15, wherein:

the trocar tube (2) and the trocar head (1) are releasably connected to each other.

18. The trocar according to claim 15, wherein:

the trocar head (1) is provided with at least one gas-tight valve (12).

19. The trocar according to claim 15, wherein:

the trocar head (1) comprises at least one inlet and/or outlet for gas(es) and/or liquid(s).

20. The trocar according to claim 15, further comprising:

a trocar head body (13) for fixing the trocar to a holder or manipulator.

21. A trocar tube (2) in combination with an obturator (3), wherein:

the trocar tube is for use in transluminal endoscopic surgery via a natural body orifice of a human or an animal, and comprises;

a distal portion (22) to be positioned at least in the region of or outside the natural body orifice; and

a proximal portion (21) to be positioned within the human or animal, wherein;

at least the proximal portion (21) comprises at least partially an essentially non-deformable curvature; and

the obturator comprises a shaft having at least one proximal section (32) made of a flexible and compressible material so that it can adapt to the curvature of the proximal portion (21) of the trocar tube (2) when being introduced thereinto, said at least one proximal section (32) configured to undergo essentially no compression upon being introduced into the trocar tube.

22. The trocar tube (2) in combination with the obturator (3) according to claim 21, wherein

the obturator (3) comprises a tip (31) having a taper corresponding to the taper of the free end (24) of the proximal portion (21) of the trocar tube (2) to facilitate piercing an intestinal wall.

23. The trocar tube (2) in combination with the obturator (3) according to claim 21, wherein:

the tip (31) of the obturator (3) has a maximum outer diameter of about 2-21 mm.

24. The trocar tube (2) in combination with the obturator (3) according to claim 21, wherein a shaft (32) of the obturator arranged behind the tip (31) of the obturator (3) has a maximum outer diameter of about 6-19 mm.

25. The trocar tube (2) in combination with the obturator (3) according to claim 21, wherein the obturator (3) comprises a guide channel (83) configured essentially along the axial direction of the obturator in order to guide the obturator along a guide wire.

26. A system comprising:

a trocar comprising;

a trocar tube (2) for use in the transluminal endoscopic surgery via a natural body orifice of a human or an animal, the trocar tube comprising;

a distal portion (22) to be positioned at least in the region of or outside the natural body orifice and a proximal portion (21) to be positioned within the human or animal, wherein at least the proximal portion (21) comprises at least partially an essentially non-deformable curvature; and

a trocar head (1) connected to a proximal end of the trocar tube (2); and

an obturator (3) configured to be received into the trocar tube (2) and comprising;

a tip (31) and shaft (33) having at least one proximal section (32) made of a flexible and compressible material so that it can adapt to the curvature of the proximal portion (21) of the trocar tube (2) when being introduced thereinto, said at least one proximal section (32) configured to undergo essentially no compression upon being introduced into the trocar tube;

wherein;

when the obturator occupies the trocar tube (2), the system has a length of about 280-420 mm.

27. The system according to claim 26, wherein:

the obturator (3) is attached to the trocar by a retaining member (70) which preloads the obturator into a withdrawn position in order that the tip (31) of the obturator rests in a protected region within the trocar.

28. The system according to claim 27, wherein:

the retaining member (70) comprises a spring mechanism having at least one spring (71) for preloading.

29. A rectoscope (5) having incorporated therewith a trocar comprising:

a trocar tube (2) for use in the transluminal endoscopic surgery via a natural body orifice of a human or an animal, the trocar tube comprising;

a distal portion (22) to be positioned at least in the region of or outside the natural body orifice and a proximal portion (21) to be positioned within the human or animal, wherein at least the proximal portion (21) comprises at least partially an essentially non-deformable curvature; and

a trocar head (1) connected to a proximal end of the trocar tube (2);

wherein;

the rectoscope (5) comprises a port (55) into which the trocar is receivable, the port (55) being configured to enable a tilting movement of the trocar, a piercing of the intestinal wall, or both.

30. The rectoscope (5) according to claim 29, comprising:

a tube shaft (52) whose proximal end (51) comprises a chamfer and is aligned such that the chamfer further supports the tilting movement of the trocar.

31. The rectoscope (5) according to claim 30, wherein:

the chamfer of the proximal end (51) has an angle towards a middle axis (57) of the tube shaft of about 45°

-80°

.

32. The rectoscope (5) according to claim 29, comprising:

a tube shaft (52) and at least two different caps provided with a quick closure for distally closing the tube shaft (52) in a gas-tight manner.

33. The rectoscope (5) according to claim 29, having a length of about 150-250 mm.

34. A set comprising at least two of the following elements:

(a) a trocar tube (2) comprising;

a distal portion (22) to be positioned at least in the region of or outside a natural body orifice of a human or an animal; and

a proximal portion (21) to be positioned within the human or animal, wherein;

at least the proximal portion (21) comprises at least partially an essentially non-deformable curvature;

(b) a trocar comprising the trocar tube and a trocar head;

(c) an obturator (3) receivable into the trocar tube; and

(d) a rectoscope (5) having a port (55) into which the trocar is receivable.

35. A method for treatment and/or diagnosis of a human or an animal entailing transluminal endoscopic surgery via a natural body orifice of said human or animal, comprising the steps of:

introducing a taurolidine solution into the abdominal cavity of said human or animal;

putting said human or animal in an appropriate position in order to achieve the exposure of the rectosigmoidal transition; and

inserting at least one or more of the following into said natural body orifice with at least a portion extending past said rectosigmoidal transition;

(a) a trocar tube (2) comprising;

a distal portion (22) to be positioned at least in the region of or outside the body orifice; and

a proximal portion (21) to be positioned within the human or animal, wherein;

at least the proximal portion (21) comprises at least partially an essentially non-deformable curvature;

(b) a trocar comprising the trocar tube and a trocar head;

(c) an obturator (3) receivable into the trocar tube; and

(d) a rectoscope (5) having a port (55) into which the trocar is receivable.

36. The method for treatment and/or diagnosis according to claim 35, comprising the steps of:

(a) introducing the rectoscope (5) into the rectum;

(b) introducing an ultrasound probe (90) and a guide instrument (80) into the rectoscope;

(c) positioning a puncture needle with a guide wire at a desired site in the intestine by means of the guide instrument (80);

(d) removing the guide instrument and the ultrasound probe (90) and introducing the trocar comprising the obturator for piercing the intestine.

37. The method according to claim 36, further comprising:

leaving the guide wire in the rectoscope after step (c); and

steering the obturator along the guide wire to the desired site in the intestine.