Lipped cannula and methods of introducing surgical instruments in arthroscopic surgical procedures

• US 5,234,455 A
• Filed: 02/20/1992
• Issued: 08/10/1993
• Est. Priority Date: 02/20/1992
• Status: Expired due to Term

• Current Assignee: Arkansas Knee Clinic, P.A.
• Original Assignee: Arkansas Knee Clinic, P.A.
• Inventors: Mulhollan, James S.
• Primary Examiner(s): Pellegrino, Stephen C.
• Assistant Examiner(s): Lewis, William
• Application Number:
  US07/839,150
• Time in Patent Office: 537 Days
• Field of Search: 606/191, 606/185, 604/264, 604/164, 604/165, 604/174
• US Class Current: 606/191
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 2017/3484 Anchoring means, e.g. spreading-out umbrella-like structure
• CPC Class Codes: A61M 2039/027 having a particular valve, seal or septum
• CPC Class Codes: A61M 2039/0279 for introducing medical instruments into the body, e.g. endoscope, surgical tools
• 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 lipped cannula includes a cylindrical member having a distal end for being inserted through a portal of minimal size in anatomical tissue of a wall of the body, a proximal end and a lip spaced proximally from the distal end and a housing mounting the proximal end of the cylindrical member. The lip has a periphery that is spaced outwardly from the circumference of the cylindrical member allowing a surface of the lip to engage an internal surface of the anatomical tissue when the distal end of the cannula is inserted in the body to prevent the distal end from backing out of the body. A lumen of the lipped cannula allows various surgical instruments to be inserted at an operative site in the body through the lumen with the lipped cannula preventing extravasation. A method of introducing a surgical instrument at an operative site in the body in endoscopic procedures includes the steps of forming a portal of minimal size in tissue of a wall of the body adjacent the operative site, inserting an end of a cannula into the body through the portal, positioning a lip of the cannula within the body against an internal surface of the wall to prevent backing out of the cannula from the body and introducing a surgical instrument at the operative site through a lumen of the cannula.

Claims

1. A cannula for introducing surgical instruments in the body through a portal of minimal size formed in a wall of anatomical tissue including

an elongate member having a distal end to be inserted through the portal into the body, a proximal end and a cross-sectional configuration having a periphery;

a housing mounting said proximal end of said cylindrical member to be disposed externally of the body;

a lumen through said cylindrical member and said housing providing a passage for receiving surgical instruments to be introduced in the body; and

a lip on said elongate member proximally spaced from said distal end and having a periphery immovably spaced outwardly from said periphery of said elongate member to be disposed within the body, said lip including a substantially planar surface for engaging the wall of the body with said distal end inserted in the body to prevent backing out of said distal end from the body.

2. A cannula as recited in claim 1 wherein said periphery of said elongate member is disposed within said periphery of said lip.

3. A cannula as recited in claim 2 wherein said lip is defined by a protrusion on the elongate member, said protrusion tapering in a distal direction from said surface to said distal end.

4. A cannula for introducing surgical instruments in the body through a portal of minimal size formed in a wall of anatomical tissue including

an elongate member having a longitudinal axis, a distal end to be inserted through the portal into the body, a proximal end and a cross-sectional configuration having a periphery;

a housing mounting said proximal end of said cylindrical member to be disposed externally of the body;

a lumen through said cylindrical member and said housing providing a passage for receiving surgical instruments to be introduced in the body; and

a lip defined by a protrusion on said elongate member proximally spaced from said distal end, said protrusion tapering in a distal direction from said lip to said distal end and having a periphery spaced outwardly from said periphery of said elongate member to be disposed within the body, said elongate member periphery being disposed within said lip periphery, said lip including a surface substantially perpendicular to said longitudinal axis for engaging the wall of the body with said distal end inserted in the body to prevent backing out of said distal end from the body.

5. A cannula as recited in claim 4 wherein said lumen is substantially circular in cross-section and has a diameter for receiving various sizes of surgical instruments.

6. A cannula as recited in claim 5 further including a valve assembly mounted in said lumen within said housing and having means allowing passage therethrough of surgical instruments of various sizes.

7. A cannula as recited in claim 6 wherein said housing includes a forward section mounting said elongate member and a rearward section terminating at a rearward end and wherein said valve assembly is disposed in said rearward section.

8. A cannula as recited in claim 7 wherein said lumen includes a passage in said rearward section and a cavity in said forward section communicating with said passage and further including an annular ledge within said cavity for mounting said valve assembly.

9. A cannula as recited in claim 8 further including a cap mounted on said housing at said rearward end and having an aperture allowing passage therethrough of surgical instruments.

10. A cannula for introducing surgical instruments in the body through anatomical tissue of a wall of the body including

a tubular member having a distal end to be inserted through the wall of the body, a proximal end and a circumference;

a housing mounting said proximal end of said cylindrical member to be disposed externally of the body;

a lumen in said tubular member and said housing for receiving surgical instruments to be introduced in the body; and

a lip on said tubular member including a substantially flat surface spaced proximally of said distal end and having a periphery rigidly spaced outwardly of said circumference for being inserted through the wall of the body to engage the wall with said distal end disposed in the body to prevent backing out of said distal end from the wall.

11. A cannula as recited in claim 10 wherein said periphery is annular in configuration.

12. A cannula as recited in claim 11 wherein said circumference of said tubular member id disposed concentrically with said periphery of said surface.

13. A cannula as recited in claim 12 wherein the wall of the body includes an internal surface and said lip surface engages the internal surface.

14. A cannula as recited in claim 13 wherein the lip surface is spaced proximally from said distal end a minimal distance.

15. A cannula as recited in claim 14 further including a protrusion joining said lip surface to said tubular member, said protrusion tapering in a distal direction from said lip surface to said distal end.

16. A cannula for introducing surgical instruments in the body through anatomical tissue of a wall of the body having an internal surface including

a tubular member having a distal end to be inserted through the wall of the body, a proximal end and a circumference;

a housing mounting said proximal end of the cylindrical member to be disposed externally of the body;

a lumen in said tubular member and said housing for receiving surgical instruments to be introduced in the body;

an annular lip on said tubular member including a wall engaging surface spaced proximally of said distal end a minimal distance, said lip having a periphery, said circumference being disposed concentrically with said periphery, said periphery being spaced outwardly of said circumference for being inserted through the wall of the body to position said wall engaging surface in engagement with the internal surface of the wall with said distal end disposed in the body to prevent backing out of said distal end from the wall; and

a tapered surface having a truncated conical configuration joining said lip to said tubular member, said tapered surface tapering in a distal direction from said lip to said distal end.

17. A method of introducing a surgical instrument at an operative site in the body in endoscopic procedures including the steps of

forming a portal of minimal size in tissue of a wall of the body adjacent the operative site;

visualizing the operative site endoscopically;

inserting a lip on an end of a cannula into the body through the portal with a periphery of the lip rigidly disposed outwardly of a periphery of the cannula;

positioning a substantially planar surface of the lip against an internal surface of the wall to prevent backing out of the cannula from the body; and

introducing a surgical instrument at the operative site through a lumen of the cannula.

18. A method of introducing a surgical instrument as recited in claim 17 wherein said step of forming a portal includes forming the portal to be just large enough to receive the cannula.

19. A method of introducing a surgical instrument as recited in claim 18 wherein said step of inserting includes inserting the end of the cannula to protrude from the internal surface a minimal distance.

20. A method of introducing a surgical instrument as recited in claim 19 wherein said step of introducing includes introducing the surgical instrument through a valve assembly in the lumen of the cannula.

21. A method of introducing a surgical instrument as recited in claim 20 wherein said step of introducing includes, prior to introducing the surgical instrument through the valve assembly, the step of inserting the surgical instrument through a cap on the cannula.

22. A method of introducing a surgical instrument at the knee in arthroscopic procedures including the steps of

forming a portal of minimal size in tissue adjacent the knee;

visualizing the knee with an arthroscope;

inserting an end of a cannula through the portal;

positioning a lip on the end of the cannula against an internal surface of the tissue to prevent backing out of the cannula from the tissue; and

introducing a surgical instrument at the knee through a lumen of the cannula.

23. A method of introducing a surgical instrument at the knee as recited in claim 22 wherein said step of forming a portal includes forming a posteromedial portal.

24. A method of introducing a surgical instrument at the knee as recited in claim 22 wherein said step of forming a portal includes forming a posterolateral portal.

25. A method of preventing extravasation when introducing a surgical instrument at an operative site in the body through a portal of minimal size in endoscopic procedures including the steps of

forming a portal of minimal size through tissue forming a wall of the body adjacent the operative site;

visualizing the operative site endoscopically;

inserting an end of a cannula into the body through the portal;

positioning an annular, substantially planar lip on the end of the cannula disposed within the body in engagement with an internal surface of the wall; and

introducing a surgical instrument at the operative site through a lumen of the cannula.