Laparoscopic instrument and trocar systems for trans-umbilical laparoscopic surgery

• US 8,257,254 B2
• Filed: 12/11/2009
• Issued: 09/04/2012
• Est. Priority Date: 09/15/1998
• Status: Expired due to Term

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Tyco Healthcare Group LP (Medtronic Plc)
• Inventors: Piskun, Gregory
• Primary Examiner(s): NGUYEN, TUAN VAN
• Application Number:
  US12/636,038
• Publication Number:
  US 20100130824A1
• Time in Patent Office: 998 Days
• Field of Search: 606/185, 606/1, 606/144, 606/139, 606/191, 606/205, 606/215, 604/174, 604/164.03
• US Class Current: 600/208
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/06066 Needles, e.g. needle tip configurations making needles B21G1/00
• 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 17/3403 Needle locating or guiding means guides for suture needles A61B17/0482; guiding or tracking by nuclear magnetic resonance G01R33/285
• CPC Class Codes: A61B 17/3421 Cannulas
• 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 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/0225 flexible, e.g. fabrics, meshes, or membranes
• CPC Class Codes: A61B 2017/06028 by means of a cylindrical longitudinal blind bore machined at the suture-receiving end of the needle, e.g. opposite to needle tip
• CPC Class Codes: A61B 2017/06047 located at the middle of the needle
• CPC Class Codes: A61B 2017/0609 having sharp tips at both ends, e.g. shuttle needle alternately retained and released by first and second facing jaws of a suturing instrument
• CPC Class Codes: A61B 2017/2904 curved, but rigid
• CPC Class Codes: A61B 2017/2905 flexible
• CPC Class Codes: A61B 2017/3419 Sealing means between cannula and body
• CPC Class Codes: A61B 2017/3445 used as instrument channel for multiple instruments
• CPC Class Codes: A61B 2017/3447 Linked multiple cannulas
• CPC Class Codes: A61B 2017/3486 Balloon
• CPC Class Codes: A61B 2017/3492 against the outside of the body
• CPC Class Codes: A61B 90/50 Supports for surgical instruments, e.g. articulated arms

Abstract

Laparoscopic instruments and trocars are provided for performing laparoscopic procedures entirely through the umbilicus. A generally C-shaped trocar provides increased work space between the hands of the surgeon as well as S-shaped laparoscopic instruments placed through the trocar when laparoscopic instrument-trocar units are placed through the umbilicus. In order to facilitate retraction of intra-abdominal structures during a laparoscopic procedure, an angulated needle and thread with either one- or two sharp ends is provided. Alternatively, an inflatable unit having at least one generally C-shaped trocar incorporated within the unit'"'"'s walls can be placed through the umbilicus following a single incision. Generally S-shaped laparoscopic instruments may be placed through the generally C-shaped trocars to facilitate access to intra-abdominal structures.

Claims

1. A trocar unit comprising:

a flexible lateral wall defining a cavity, a distal portion of which forms a surgical site, the cavity having a proximal end and an open distal end;

a flexible first plate configured to connect to a proximal portion of the flexible lateral wall;

a second plate configured to connect to a portion of the flexible lateral wall disposed distally with respect to the flexible first plate;

a plurality of independent portals extending through said plates, at least one of said independent portals extending through said plates in a direction transverse to said plates, said portals being configured and dimensioned for simultaneous accommodation of surgical instrumentation; and

sealing structure for sealing the plates wherein a portion of the flexible lateral wall is configured to seal the trocar unit within a surgical incision at the surgical site such that said flexible first plate is positioned above the surgical incision.

2. The trocar unit as in claim 1, wherein the sealing structure includes the flexible lateral wall configured and dimensioned to be positioned at least partially within the surgical incision.

3. The trocar unit as in claim 2, wherein the flexible lateral wall defines a sealed inflatable cavity, with the second plate oriented parallel to said flexible first plate, said second plate cooperating with said flexible lateral wall to seal the flexible first plate in position when the cavity is inflated.

4. The trocar unit as in claim 3, wherein the flexible first plate, the flexible lateral wall and the second plate together define a working access for surgical instruments positioned in said portals.

5. The trocar unit as in claim 4, wherein at least the flexible lateral wall is deformable between a first position for insertion into a surgical incision and a second position in sealing contact with the surgical incision.

6. The trocar unit as in claim 5, wherein at least the flexible lateral wall and the second plate are deformable between a first position for insertion into a surgical incision and a second position in sealing contact with the surgical incision.

7. The trocar unit as in claim 3, wherein the lateral wall, the flexible first plate and the second plate together define the sealed inflatable cavity.

8. The trocar unit as in claim 3, wherein the sealed inflatable cavity is configured and dimensioned to assume a deflated position and an inflated position, wherein, when the sealed inflatable cavity is in the deflated position, the trocar unit assumes a configuration facilitating insertion into the surgical incision of the patient.

9. The trocar unit as in claim 8, wherein, when the sealed inflatable cavity is in the deflated position, the trocar unit is configured such that the flexible first plate remains outside the surgical incision.

10. The trocar unit as in claim 8, wherein, when the sealed inflatable cavity is in the deflated position, the trocar unit is configured such that the second plate is located at the surgical incision in proximity to the interior of the abdominal cavity.

11. The trocar unit as in claim 1, wherein the portals include instrument trocars having a proximal portion and a distal portion and wherein the proximal portion extends proximally of the flexible first plate.

12. A trocar unit comprising:

an upper circumferential plate defining a first plane and having a fixed diameter;

a plurality of independent portals extending through said upper plate, said portals being configured and dimensioned for simultaneous accommodation of surgical instrumentation;

a second plate defining a second plane and forming a distal cavity therein; and

a flexible lateral wall extending between the upper plate and the second plate, the flexible lateral wall capable of forming multiple diameters wherein the trocar unit is deformable into a sealing portion such that at least a diameter of the multiple diameters of the flexible lateral wall is less than the fixed diameter of the upper plate and the second plane being parallel to said first plane.

13. The trocar unit as in claim 12, wherein at least one of the plurality of independent portals has a straight configuration.

14. The trocar unit as in claim 12, wherein at least one of the plurality of independent portals extends above a portion of the upper plate outside the body of the patient.

15. The trocar unit as in claim 12, wherein at least one of the plurality of independent portals has a curved configuration and wherein the at least one of the plurality of independent portals having a curved configuration is incorporated into a portion of the lateral wall.

16. A trocar unit comprising:

a flexible sleeve having a proximal portion and an open distal portion defining a cavity therein, said distal portion forming a portion of a surgical site;

an upper circumferential plate defining a first plane and having a fixed diameter;

a plurality of independent portals extending through said upper plate, said independent portals being configured and dimensioned for simultaneous accommodation of surgical instrumentation;

a second plate surrounding the cavity and defining a second plane; and

a flexible lateral wall extending between the upper plate and the second plate, the flexible lateral wall capable of forming multiple diameters wherein the trocar unit is deformable into a sealing portion such that at least a diameter of the multiple diameters of the flexible lateral wall is less than the fixed diameter of the upper plate and the second plane being parallel to said first plane, wherein at least one of the plurality of independent portals has a straight configuration.

17. The trocar unit as in claim 16, wherein at least one of the plurality of independent portals extends above a portion of the upper plate outside the body of the patient.

18. The trocar unit as in claim 17, wherein the flexible lateral wall defines a sealed inflatable cavity being enclosed within said upper plate, said second plate and said flexible lateral wall.

19. The trocar unit as in claim 18, wherein the sealed inflatable cavity is configured and dimensioned to assume a deflated position and an inflated position, wherein, when the sealed inflatable cavity is in the deflated position, the trocar unit assumes a configuration facilitating insertion into the surgical incision of the patient.

20. The trocar unit as in claim 18, wherein, when the sealed inflatable cavity is in the deflated position, the trocar unit is configured such that the upper plate remains outside the surgical incision.

21. The trocar unit as in claim 16, wherein at least the lateral wall is deformable between a first position for insertion into a surgical incision and a second position in sealing contact with the surgical incision.