LAPAROSCOPIC SYSTEM

• US 20140066953A1
• Filed: 10/03/2013
• Published: 03/06/2014
• Est. Priority Date: 10/13/2011
• Status: Active Grant

• Current Assignee: Sharp Fluidics, LLC
• Original Assignee: Neosurgical Limited
• Inventors: Keating, Ronan, Rabbitte, Gerard, Russell, Barry
• Granted Patent: US 9,668,723 B2
• Time in Patent Office: Days
• US Class Current: 606/130
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0206 with antagonistic arms as supports for retractor elements
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• 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 17/3439 with means for changing the inner diameter of the cannula, e.g. expandable A61B17/3423, A61B17/3431 take precedence; catheters A61M25/0662
• 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 2017/347 Locking means, e.g. for locking instrument in cannula
• CPC Class Codes: A61B 2017/349 Trocar with thread on outside
• CPC Class Codes: A61B 2017/3492 against the outside of the body
• CPC Class Codes: A61M 2039/0279 for introducing medical instruments into the body, e.g. endoscope, surgical tools
• CPC Class Codes: A61M 2039/0673 comprising means actively pressing on the device passing through the seal, e.g. inflatable seals, diaphragms, clamps
• CPC Class Codes: A61M 39/0247 Semi-permanent or permanent transcutaneous or percutaneous access sites to the inside of the body peritoneal dialysis catheters A61M1/285; tracheostomy devices A61M16/0465; measuring pressure within the body A61B5/03; colostomy devices A61F5/445; gastrotomy feeding tubes A61J15/0015; means for fixing a feeding tube outside of the body A61J15/0053

Abstract

A laparoscopic surgical system configured for cooperation with a trocar is described. In one configuration, the system is configured to expand to accommodate trocars of varying dimensions. In another configuration, which is not necessarily exclusive of the first configuration, the system may function to provide an anchoring and closure system for use in laparoscopic surgery.

Claims

1. A laparoscopic system configured for engagement with an aperture provided in an abdominal wall, the system comprising:

an expandable housing defining a lumen for receipt of surgical instrumentation, the housing comprising an outer resting portion which in use will rest against an outer surface of the abdominal wall, the outer resting portion comprising a first and a second part which are moveable relative to each other and are arranged to extend circumferentially about the lumen; and

wherein an expansion of the housing operably accommodates surgical instrumentation of different dimensions.

2. The system of claim 1 comprising at least a first needle guide channel having an entry port for receiving a needle driver and an exit port through which suture may exit the housing, the needle guide channel operably allowing for delivery of suture or an anchor through the system.

3. The system of claim 2 comprising a second needle guide channel, the first and second needle guide channels being provided on opposite sides of the lumen respectively

4. The system of claim 2 wherein the needle guide channel(s) comprise a convex surface proximal to the lumen such that the suture will exit away from the lumen on being displaced out of the needle guide channel.

5. The system of claim 2 wherein the needle guide channel(s) and lumen are separate and distinct such that suture does not operably pass through the lumen on delivery through the system.

6. The system of claim 1 wherein the lumen is dimensioned for receiving a trocar.

7. The system of claim 1 comprising an abdominal wall contacting or engaging portion.

8. The system of claim 1 wherein the outer resting portion operably defines a complete collar, the surgical instrumentation operably being presented through the collar and into the lumen in a direction parallel to its longitudinal axis.

9. The system of claim 1 wherein the outer resting portion comprises a first and a second part which are separate to each other, the first and second part operably being secured to one another to extend circumferentially about the lumen.

10. The system of claim 9 wherein the first and second part defining a mouth therebetween through which the surgical instrument may be presented into the lumen in a direction transverse to a longitudinal axis of the lumen.

11. The system of claim 8 wherein the first and second part are secured to one another using securing member which mates with each of the first and second parts.

12. The system of claim 11 wherein the securing member is received within a body portion of the first and second parts.

13. The system of claim 11 wherein the securing member is secured about an exterior surface of the first and second parts.

14. The system of claim 11 wherein comprising first and second securing members which are operably located on opposing sides of the lumen.

15. The system of claim 11 wherein the first and second parts are hinged relative to one another.

16. The system of claim 1 wherein the housing is provided in a multi-part construction comprising first and second lumen defining parts that are co-operable with one another to define the lumen.

17. The system of claim 16 wherein on bringing the first and second lumen defining parts together the housing defines a continuous inner surface which operably engages with the surgical instrumentation.

18. The system of claim 16 wherein on bringing the first and second lumen defining parts together the housing defines a discontinuous inner surface which operably engages with the surgical instrumentation.

19. The system of claim 18 wherein the first and second parts lumen defining overlap with one another.

20. The system of claim 16 wherein the first and second lumen defining parts are at least partially flexible.

21. The system of claim 20 wherein the first and second lumen defining parts are at least partially corrugated.

22. The system of claim 1 wherein the housing comprises a continuous surface formed from a single piece which operably provides a contact surface for engaging with the surgical instrument.

23. The system of claim 22 wherein the single piece is at least partially corrugated to improve the flexibility of the piece.

24. The system of claim 7 wherein the housing is provided in a multi-part construction comprising first and second lumen defining parts that are co-operable with one another to define the lumen, the first and second parts being coupled to the outer resting portion.

25. The system of claim 7 wherein the housing is provided in a multi-part construction comprising first and second lumen defining parts that are co-operable with one another to define the lumen, the first and second parts being integrally formed with the outer resting portion.

26. The system of claim 1 comprising a flexible sleeve.

27. The system of claim 26 wherein the flexible sleeve comprises an outer and an inner surface, the outer surface operably defining an abdominal wall contacting portion of the system.

28. The system of claim 27 wherein the sleeve is expandable to accommodate surgical instrumentation of different dimensions.

29. The system of claim 28 wherein the sleeve defines a ring through which the surgical instrumentation may operably pass, the ring having a diameter corresponding substantially with the smallest diameter of instrumentation with which the system is intended for use.

30. The system of claim 29 wherein the ring is configured to expand to accommodate surgical instrumentation of larger diameter.

31. The system of claim 28 wherein the sleeve has a first and second configuration, wherein in the first configuration the outer surface tapers inwardly towards the ring.

32. The system of claim 31 wherein in the second configuration the outer surface comprises a first region that tapers inwardly towards the ring and a second region substantially parallel with the longitudinal axis of the lumen.

33. The system of claim 26 wherein the sleeve comprises a ribbed surface.

34. The system of claim 26 wherein the sleeve is operably engageable with and removable from the outer resting portion.

35. The system of claim 26 whereby the sleeve comprises a sealing and trocar retention ring which accommodates a variety of trocar diameters and trocar surface finishes.

36. The system of claim 34 wherein the sleeve comprises retention clips which operably couple with the outer resting portion and allow the sleeve be pulled away from the outer resting portion on application of a force by the surgeon.

37. The system of claim 34 wherein the sleeve comprises projection surfaces which are receivable within a volume defined by the outer resting portion and prevent the sleeve rotating relative to the outer resting portion.

38. The system of claim 37 wherein the projection surfaces pinchably engage with the outer resting portion.

39. The system of claim 25 wherein the sleeve comprises an upper and lower region, the upper region comprises a ribbed outer surface and the lower region a smooth outer surface.

40. The system of claim 39 wherein the lower region is tapered at a different angle to the upper region.

41. The system of claim 25 wherein the sleeve is elliptical.

42. The system of claim 41 wherein needle exit ports are provided within the sleeve parallel to a minor radius of the ellipse defining the sleeve.

43. The system of claim 1 wherein the lumen is dimensioned for receiving a trocar and further comprising at least a first needle guide channel having an entry port for receiving a needle driver and an exit port through which suture may exit the housing, the needle guide channel operably allowing for delivery of suture or an anchor through the system and wherein the guide channel(s) comprises an entry and an exit port each located on the same side of the lumen, the exit port being located in the abdominal wall engaging portion.

44. The system of claim 1 comprising a suture securement feature for securing a suture relative to the housing.

45. The system of claim 40 wherein the suture securement feature comprises two opposing faces which when brought together form a clamp.

46. The system of claim 6 wherein the abdominal wall engaging surface comprises first and second cut-away portions provided in faces transverse to exit ports of the needle guide channels, the cut away portions defining a tissue invagination zone within the abdominal wall engaging portion into which tissue may extend inwardly towards the lumen.

47. The system of claim 6 wherein the outer resting portion comprises first and second portions having surfaces which operably extend circumferentially about an entry port whereby a trocar may be presented to the lumen and pass into the abdominal cavity.

48. The system of claim 43 comprising expansion struts configured to allow an expansion of the outer resting portion.

49. The system of claim 44 wherein each of the first and second portions comprise expansion struts which operably extend linearly and advantageously allows for each of the two portions to expand to the same level so as to retain a level of symmetry about the lumen.

50. The system of claim 26 wherein the sleeve comprises a sealing surface which provides a curved surface extending circumferentially about the housing and which in use is located against the abdominal wall.

51. The system of claim 46 wherein the sleeve extends inwardly from the resting portion and is defined by a hollow conical structure having side walls that taper inwardly.

52. The system of claim 47 wherein the sleeve comprises one or more engagement surfaces provided on an outer surface thereof, the engagement surface operably providing anchoring against the abdominal wall.

53. The system of claim 1 wherein the housing comprises at least one adhesive pad.

54. The system of claim 26 comprising legs, the sleeve being receivable over the legs.

55. The system of claim 54 wherein the legs comprise a biasing element that projects above an upper surface of the first and second parts.

56. The system of claim 1 wherein the lumen is dimensioned for receiving a trocar and wherein the system further comprises at least one locking surface configured to operably engage with a received trocar.

57. The system of claim 56 wherein the expandable housing is configured to bias the at least one locking surface into positive contact with the received trocar.

58. The system of claim 56 wherein the expandable housing comprising first and second locking surfaces provided on opposite sides of the lumen.

59. The system of claim 58 wherein each of the first and second locking surfaces comprise an arcuate surface which operably contacts an outer surface of the trocar.

60. The system of claim 57 comprising at least one expansion strut, the at least one expansion strut being operably pinchable by an operator to facilitate disengagement of the locking surface from the received trocar.

61. The system of claim 60 comprising first and second expansion struts provided on opposite sides of the lumen to one another.

62. The system of claim 56 wherein the at least one locking surface is integrally formed with the expandable housing.

63. The system of claim 56 wherein the at least one locking surface is formed separately to the expandable housing.

64. The system of claim 63 wherein the at least one locking surface comprises a curved surface.

65. The system of claim 63 wherein the at least one locking surface comprises a wire.

66. The system of claim 65 wherein the wire extends through the expandable housing to define first and second contact points for a received trocar on opposite sides of the lumen.

67. The system of claim 66 wherein the wire defines a curved actuation surface located externally to the lumen.

68. The system of claim 67 wherein compression of the curved actuation surface effects a release of the locking surface from a received trocar.

69. The system of claim 56 wherein the locking surface is activated by rotation of cam surface.