Surgical trocars having optical tips defining one or more viewing ports

• US 5,445,142 A
• Filed: 03/15/1994
• Issued: 08/29/1995
• Est. Priority Date: 03/15/1994
• Status: Expired due to Term

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Hassler, William L. Jr.
• Primary Examiner(s): Apley, Richard J.
• Assistant Examiner(s): Leubecker, John P.
• Application Number:
  US08/213,044
• Time in Patent Office: 532 Days
• Field of Search: 128/3-10, 606/28, 606/37, 606/39, 606/41, 606/45-48, 606/185, 604/264, 604/164
• US Class Current: 600/105
• CPC Class Codes: A61B 1/00087 Tools A61B17/00234 takes precedence
• CPC Class Codes: A61B 1/00096 Optical elements
• CPC Class Codes: A61B 1/00135 Oversleeves mounted on the endoscope prior to insertion
• CPC Class Codes: A61B 1/00165 with light-conductive means, e.g. fibre optics A61B1/07 takes precedence
• CPC Class Codes: A61B 1/3132 for laparoscopy
• 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 17/3476 Powered trocars, e.g. electrosurgical cutting, lasers, powered knives
• CPC Class Codes: A61B 18/1402 Probes for open surgery
• CPC Class Codes: A61B 18/1487 Trocar-like, i.e. devices producing an enlarged transcutaneous opening
• CPC Class Codes: A61B 2017/347 Locking means, e.g. for locking instrument in cannula
• CPC Class Codes: A61B 2018/1495 Electrodes being detachable from a support structure
• CPC Class Codes: A61B 2090/3614 using optical fibre
• CPC Class Codes: A61B 90/361 Image-producing devices, e.g. surgical cameras

Abstract

A trocar obturator includes a hollow tube having a substantially solid, optically clear tip attached thereto. A distal cutting end of the tip is formed by a pair of opposing, angularly oriented surfaces which converge to a line at that point with a cutting element disposed along the line. For electrosurgical operation, an electrode is positioned along the line. The tip serves as a viewing window and defines a viewing port at its proximal end for an endoscope inserted into the hollow obturator tube for viewing a tissue wall as it is penetrated. The trocar obturator tip may include an axial bore extending between its proximal and distal ends with a viewing rod within the bore for viewing the area ahead of the tip. Here again, the distal cutting end of the tip may be formed by a pair of opposing angularly oriented surfaces which converge to a line. Two cutting elements extend linearly along the distal end of the tip, one on either side of the bore. For electrosurgical operation of the obturator, the cutting elements comprise electrodes. The distal end of the viewing rod may also be formed by a pair of opposing angularly oriented surfaces which converge to a line at its distal end. For best results, particularly with electrosurgical cutting, the distal end of the viewing rod extends slightly beyond the distal cutting end of the tip.

Claims

1. A surgical apparatus for inserting a cannula through tissue defining a wall of a body cavity, said surgical apparatus comprising:

a hollow axially elongated tube having a proximal end and a distal end;

a substantially solid optically clear tip, said tip having a distal cutting end and a proximal base end secured to said distal end of said tube and including an axial bore extending from its proximal base end to its distal cutting end;

a viewing rod positioned within said axial bore of said tip, said viewing rod having a proximal end defining a viewing port at said proximal base end of said tip and a distal end defining a window at said distal cutting end of said tip for collecting light which is carried to said viewing port by said viewing rod; and

a cutting element disposed at the distal end of said tip for cutting said tissue for insertion of a cannula through said tissue into said body cavity, said cutting element comprising;

at least one electrode disposed at said distal cutting end of said tip; and

at least one electrical conductor extending from said proximal end of said tube to said distal end of said tube, said at least one electrical conductor being connected to said at least one electrode for conducting high frequency energy thereto for electrosurgically cutting said tissue to insert a cannula through said tissue into said body cavity.

2. A surgical apparatus as claimed in claim 1 wherein said at least one electrode comprises two electrodes extending on either side of said axial bore along said line of said tip and said at least one electrical conductor comprises two electrical conductors adapted at said proximal end of said tube for connection to a source of radio frequency energy, a first one of said two electrical conductors connected to a first one of said two electrodes and a second one of said two electrical conductors connected to a second one of said two electrodes.

3. A surgical apparatus as claimed in claim 1 wherein the distal cutting end of said substantially solid optically clear tip is formed by a pair of opposing angularly oriented surfaces which converge to a line at said distal cutting end of said tip, said at least one electrode being disposed along said line of said tip.

4. A surgical apparatus as claimed in claim 2 wherein said window at said distal end of said viewing rod comprises a pair of opposing angularly oriented surfaces which converge to a line at said distal end of said viewing rod.

5. A surgical apparatus as claimed in claim 4 wherein said line at said distal end of said viewing rod and said line at said distal end of said distal cutting end of said substantially solid optically clear tip are substantially parallel to one another.

6. A surgical apparatus as claimed in claim 5 wherein said distal end of said viewing rod distally extends beyond said distal cutting end of said substantially solid optically clear tip.

7. A surgical apparatus as claimed in claim 6 wherein said tube is made of polymeric material and said two electrical conductors are embedded in generally diametrically opposite outer sections of said tube to facilitate insertion of an endoscope into said tube and to insulate said two electrical conductors from said endoscope.

8. A surgical apparatus assembly for penetrating a tissue wall of a body cavity to provide an operative channel through said tissue wall into said body cavity, said assembly comprising:

a cannula having a distal end and a proximal end, and being adapted for insertion through said tissue wall with said distal end inside said body cavity and said proximal end outside said body cavity; and

an obturator removably disposed in said cannula and comprising;

a hollow axially elongated tube having a proximal end and a distal end;

a substantially solid optically clear tip, said tip having a distal cutting end and a proximal base end secured to said distal end of said tube and including an axial bore extending from its proximal base end to its distal cutting end; and

a cutting element disposed at the distal end of said tip for cutting said tissue wall for insertion of said cannula through said tissue wall into said body cavity, said cutting element comprising at least one electrode disposed at said distal cutting end of said tip, and at least one electrical conductor extending from said proximal end of said tube to said distal end of said tube, said at least one electrical conductor being connected to said at least one electrode for conducting high frequency energy thereto for electrosurgically cutting said tissue wall to insert said cannula through said tissue wall into said body cavity; and

a viewing rod positioned within said axial bore of said tip, said viewing rod having a proximal end defining a viewing port at said proximal base end of said tip and a distal end defining a window at said distal cutting end of said tip for collecting light which is carried to said viewing port by said viewing rod;

whereby said distal end of said obturator and the distal end of said cannula can be advanced through a tissue wall and the obturator can be removed from said cannula leaving said cannula inserted through said tissue wall.

9. A surgical apparatus assembly as claimed in claim 8 wherein said at least one electrode comprises two electrodes extending on either side of said axial bore along said line of said tip and said at least one electrical conductor comprises two electrical conductors adapted at said proximal end of said tube for connection to a source of radio frequency energy, a first one of said two electrical conductors connected to a first one of said two electrodes and a second one of said two electrical conductors connected to a second one of said two electrodes.

10. A surgical apparatus assembly as claimed in claim 8 wherein the distal cutting end of said substantially solid optically clear tip is formed by a pair of opposing angularly oriented surfaces which converge to a line at said distal cutting end of said tip, said at least one electrode being disposed along said line of said tip.

11. A surgical apparatus assembly as claimed in claim 9 wherein said window at said distal end of said viewing rod comprises a pair of opposing angularly oriented surfaces which converge to a line at said distal end of said viewing rod.

12. A surgical apparatus assembly as claimed in claim 11 wherein said line at said distal end of said viewing rod and said line at said distal end of said distal cutting end of said substantially solid optically clear tip are substantially parallel to one another.

13. A surgical apparatus assembly as claimed in claim 12 wherein said distal end of said viewing rod distally extends beyond said distal cutting end of said substantially solid optically clear tip.

14. A surgical apparatus assembly as claimed in claim 12 wherein said tube is made of polymeric material and said two electrical conductors are embedded in generally diametrically opposite outer sections of said tube to facilitate insertion of an endoscope into said tube and to insulate said two electrical conductors from said endoscope.

15. A surgical apparatus for inserting a cannula through tissue defining a wall of a body cavity, said surgical apparatus comprising:

a hollow axially elongated tube having a proximal end and a distal end;

a substantially solid optically clear tip having a distal cutting end and a proximal base end secured to said distal end of said tube, an axial bore extending from its proximal base end to its distal cutting end, and comprising;

a first pole; and

a second pole located proximally of said first pole and electrically isolated therefrom by an insulator, said first and second poles receiving bipolar energy for cutting said tissue for insertion of a cannula through said tissue into said body cavity;

a first electrical conductor extending from said proximal end of said tube to said distal end of said tube, said first electrical conductor being connected to said first pole;

a second electrical conductor extending from said proximal end of said tube to said distal end of said tube, said second electrical conductor being connected to said second pole, said first and second electrical conductors conducting high frequency energy to said first and second poles for electrosurgically cutting said tissue to insert a cannula through said tissue into said body cavity; and

a viewing rod positioned within said axial bore of said tip, said viewing rod having a proximal end defining a viewing port at said proximal base end of said tip and a distal end defining a window at said distal cutting end of said tip for collecting light which is carried to said viewing port by said viewing rod.

16. A surgical apparatus as claimed in claim 15 wherein said window at said distal end of said viewing rod comprises a pair of opposing angularly oriented surfaces which converge to a line at said distal end of said viewing rod.

17. A surgical apparatus as claimed in claim 15 wherein said first pole, said insulator and said second pole form a tapered tip having a substantially acute tip angle.

18. A surgical apparatus as claimed in claim 16 wherein said distal end of said viewing rod distally extends beyond said distal cutting end of said substantially solid optically clear tip.