Trocar facilitator for endoscopic surgery

• US 5,407,427 A
• Filed: 03/10/1993
• Issued: 04/18/1995
• Est. Priority Date: 06/16/1992
• Status: Expired due to Term

• Current Assignee: LOMA Linda University Medical Center (Mission Healthcare Services LLC)
• Original Assignee: LOMA Linda University Medical Center (Mission Healthcare Services LLC)
• Inventors: Kirsch, Wolff M., Zhu, Yong H.
• Primary Examiner(s): Thaler, Michael H.
• Application Number:
  US08/029,116
• Time in Patent Office: 769 Days
• Field of Search: 606/185, 606/222, 604/26, 604/164, 604/272, 604/264
• US Class Current: 604/26
• CPC Class Codes: A61B 17/0281 Abdominal wall lifters
• CPC Class Codes: A61B 17/34 Trocars; Puncturing needles pointed biopsy instruments A61B10/0233; devices for piercing the ear-lobes A44C7/001; seals or hemostasis valves A61M39/06
• 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 17/3462 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 2017/349 Trocar with thread on outside

Abstract

A trocar system for assisting in the generation of endosurgical ports is disclosed in which a trocar facilitator is used to place the peritoneum in counter-traction to facilitate the penetration of the trocar. Peritoneal counter-traction results in increased surface tension which reduces the force and downward momentum necessary to achieve trocar penetration, thereby eliminating the risk of excess penetration and injury to internal organs. The facilitator is of a corkscrew-like design, with an attached support ring and a removable guide piece having a hollow, cylindrical passageway which aids in the insertion and support of the trocar, cannula, and other endoscopic surgical instruments. In another embodiment, the facilitator is configured to aid in the introduction of carbon dioxide gas into the abdominal cavity of the patient. An improved curved tip of the blade of the trocar facilitator is also disclosed.

Claims

1. A trocar facilitator for assisting in the establishment of a port for endoscopic surgery through the superficial tissue and peritoneum of a patient'"'"'s body and for achieving pneumoperitoneum in said body, said port being established by use of a trocar and a cannula, said facilitator comprising:

a guide portion for receiving said trocar and said cannula, said guide portion comprising two releasably engageable halves which form a hollow channel for slidably receiving said trocar and said cannula, said halves being removable from said port without removing said cannula;

a corkscrew-like blade portion removably connected to said guide portion for rotatably engaging said tissue to allow said tissue to be lifted away from vital organs of said patient, and for penetrating said peritoneum of said patient, said blade portion having a proximal and a distal end; and

a passageway through said guide and said blade portions, said passageway through said blade portion being helical, whereby gas may be administered through said passageway and into the body of said patient,

said passageway having a valve formed near said distal tip, said valve being closed during insertion of said blade portion but open following insertion whereby insufflation gas may pass into the body of the patient.

2. The trocar facilitator of claim 1, wherein said passageway comprises a hollow, flexible tube having a distal and a proximal end.

3. The trocar facilitator of claim 2, wherein said proximal end of said tube remains outside said patient'"'"'s body, and said distal end of said tube is placed beneath said peritoneum of said patient.

4. The trocar facilitator of claim 2, wherein said distal end of said tube extends distally past the distal end of said blade portion.

5. The trocar facilitator of claim 4, further comprising a spring near said distal end of said tube, such that resistance on said distal end of said tube causes said spring to compress such that said distal end of said tube is displaced proximally behind said distal end of said blade portion.

6. A method of establishing a port for endoscopic surgery through the peritoneum in a patient'"'"'s body and for achieving pneumoperitoneum in said body, said port being established by use of a trocar and a cannula, comprising:

incising superficial tissue of said body;

inserting a trocar facilitator into said incision, said trocar facilitator comprising;

a guide portion for slidably receiving a trocar and a cannula, said guide portion comprising two releasably engageable halves which form a hollow channel for slidably receiving said trocar and said cannula, whereby following establishment of said port said halves are removable from said port without removing said cannula;

a corkscrew-like blade portion removably connected to said guide portion for rotatably engaging said tissue to allow said tissue to be lifted away from vital organs of said patient, and for and penetrating said peritoneum of said patient, said blade portion having a proximal and a distal end; and

a helical passageway through said blade portion, whereby gas may be administered through said passageway and into the body of said patient, said passageway having a valve formed near said distal end, said valve being closed during insertion of said blade but open following insertion whereby insufflation gas may pass into the body of the patient;

rotating said blade portion of said facilitator such that tissue is threaded onto said blade portion and said blade portion remains imbedded in said tissue and said distal end of said blade portion penetrates said peritoneum of said patient;

administering gas through said passageway of said facilitator and beneath said peritoneum.

7. The method of claim 6, further comprising inserting a trocar through said guide and blade portions to further penetrate said superficial tissue and said peritoneum, and inserting a cannula over said trocar to establish said endosurgical port.

8. A trocar facilitator adapted for use with a trocar and a cannula for assisting in the establishment of a port for endoscopic surgery through the superficial tissue and peritoneum of a patient'"'"'s body and for achieving pneumoperitoneum in said body, comprising:

a guide portion for slidably receiving said trocar and said cannulla, said guide portion comprising a hollow channel for receiving said trocar and said cannula such that said trocar, cannula and guide portion remain slidable relative to each other; and

a corkscrew-like blade portion extending distally past said guide portion and removably connected to said guide portion for rotatably engaging said tissue to allow said tissue to be lifted away from vital organs of said patient, and for penetrating said peritoneum of said patient, said blade portion having a helical passageway formed therein;

said blade portion forming a passageway axially aligned with said channel to receive said trocar and said cannula, wherein said helical passageway has a distal end, and further comprises a valve formed near said distal end, said valve being closed during insertion of said blade portion but open following insertion whereby insufflation gas may pass into the body of said patient.

9. A method of establishing a port for endoscopic surgery through the peritoneum in a patient'"'"'s body and for achieving pneumoperitoneum in said body, said port being established by use of a trocar and a cannula, comprising:

incising superficial tissue of said body;

inserting a trocar facilitator according to claim 8 into said incision;

rotating said trocar facilitator such that tissue is threaded onto said blade portion and said blade portion remains imbedded in said tissue and said distal end of said blade portion penetrates said peritoneum of said patient;

lifting said tissue away from vital organs of said patient by pulling up on said trocar facilitator; and

sliding said trocar and then said cannula through said guide portion and through said peritoneum to establish said port.

10. The method of claim 9, further comprising allowing gas to pass through said helical passageway formed within said corkscrew-like blade portion, and below said peritoneum to produce pneumoperitoneum in said patient.