Flexible trocar with an upturning tube system

• US 6,554,793 B1
• Filed: 02/23/2000
• Issued: 04/29/2003
• Est. Priority Date: 04/07/1998
• Status: Expired due to Term

• Current Assignee: STM Medizintechnik Starnberg GmbH
• Original Assignee: STM Medizintechnik Starnberg GmbH
• Inventors: Pauker, Fritz, Weiglhofer, Gerhard, Pauker, Robert, Viehbach, Thomas
• Primary Examiner(s): MENDEZ, MANUEL A
• Application Number:
  US09/445,534
• Time in Patent Office: 1,161 Days
• Field of Search: 604/95.01, 604/95.02, 604/95.03, 604/95.04, 604/95.05, 604/264, 604/164.01, 604/158
• US Class Current: 604/95.01
• CPC Class Codes: A61B 1/00151 using everted tubes
• CPC Class Codes: A61B 1/00154 using guiding arrangements for insertion
• CPC Class Codes: A61B 1/0057 Constructional details of force transmission elements, e.g. control wires
• CPC Class Codes: A61B 1/018 for receiving instruments
• CPC Class Codes: A61B 1/0605 for spatially modulated illumination
• CPC Class Codes: A61B 1/12 with cooling or rinsing arrangements
• CPC Class Codes: A61B 1/31 for the rectum, e.g. proctoscopes, sigmoidoscopes , colonoscopes
• 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 2017/003 Steerable
• CPC Class Codes: A61B 2017/3445 used as instrument channel for multiple instruments catheters A61B2017/22072
• CPC Class Codes: A61B 2017/3452 for the rectum, e.g. for hemorrhoid surgery
• CPC Class Codes: A61B 90/361 Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61M 2025/0062 having features to improve the sliding of one part within another by using lubricants or surfaces with low friction coatings A61M2025/0046

Abstract

A flexible trocar assembly includes an inner flexible tube and a concentric outer flexible tube. The flexible tubes are spaced apart from each other so as to form an open ended annular space in the trocar assembly. The annular space contains surgical instrumentation and passages for inflation gases, trocar assembly rigidifying gases or materials, and trocar manipulating mechanisms. For example, fiber optic light transmitters associated with camera-related fiber optics can be disposed in the annular space so that an area in a body cavity being examined can be illuminated and observed. Trocar manipulating mechanisms such as Bowden cables can also be disposed in the annular space. Liquid flushing tubes can be positioned in the annular space. Carbon dioxide or air injecting tubes can be positioned in the annular space. The inner flexible tube defines a central trocar assembly passage through which surgical instruments can be inserted into the body cavity. The trocar assembly is particularly useful in performing surgical procedures in the colon. An invertable tube assembly is associated with the trocar assembly and is used to move the trocar assembly into and out of the body cavity. The invertible tube embraces the trocar assembly and the invertible tube is moved forward and backward by a controlled drive mechanism. Lubrication is provided between the invertible tube and the trocar assembly so as to reduce friction between the invertible tube drive mechanism and the trocar assembly.

Claims

1. A flexible surgical trocar assembly having opposite proximal and distal ends, said trocar assembly comprising:

a) an outer flexible tubular jacket having a through bore which extends from said proximal end to said distal end of said trocar assembly, said outer flexible jacket forming an outer side wall on said trocar assembly;

b) an inner flexible jacket, said inner flexible jacket having a through bore which extends from said proximal end to said distal end of said trocar assembly, said inner flexible jacket being disposed in said through bore of said outer flexible jacket, said outer and inner flexible jackets combining to form an intervening annular space which extends from said proximal end to said distal end of said trocar assembly;

c) a plurality of surgical instrumentalities disposed in said annular space, at least some of said surgical instrumentalities extending from said proximal end to said distal end of said trocar assembly;

d) an invertible drive tube disposed about said outer flexible jacket, said invertible drive tube including a proximal inversion end, a distal inversion end, an inner wall which contacts said outer flexible jacket, and an outer wall which is outwardly spaced from said inner wall;

e) a distal clamping collar which is fixed to said outer flexible jacket and which is contacted by said distal inversion end of said invertible drive tube;

f) a proximal clamping collar which is fixed to said outer flexible jacket and which is contacted by said proximal inversion end of said invertible drive tube; and

g) a drive mechanism contacting said inner wall of said invertible drive tube, said drive mechanism being selectively operable to move said inner wall of said invertible drive tube in the distal direction, or in the proximal direction, whereby said distal inversion and said proximal inversion ends of said invertible drive tube are selectively moved against said distal or proximal clamping collars, respectively, so as to selectively move the flexible jackets in the distal and proximal directions.

2. The trocar assembly of claim 1 further comprising first means for supplying a lubricant to an area of contact between said invertible tube and said outer flexible jacket.

3. The trocar assembly of claim 2 further comprising second means for supplying a lubricant to an area between said inner and outer walls of said invertible tube.

4. The trocar assembly of claim 2 wherein said drive assembly includes friction rollers which contact said inner wall of said invertible tube.

5. The trocar assembly of claim 2 wherein said drive assembly includes a movable endless belt which contacts said inner wall of said invertible tube.

6. The trocar assembly of claim 5 wherein said endless belt is perforated.

7. The trocar assembly of claim 6 wherein said endless belt is disposed in a sealed housing which can be selectively evacuated so as to cause said inner wall of said invertible tube to be pulled against and gripped by said endless belt.

8. The trocar assembly of claim 2 wherein said drive assembly includes at least one reciprocally movable suction cup which can selectively grip said inner wall of said invertible tube.

9. The trocar assembly of claim 8 wherein said suction cup is evacuated to grip said inner wall of said invertible tube during invertible tube-driving movement of said suction cup, and is devacuated to release said inner wall of said invertible tube during invertible tube non-driving movement of said suction cup.