Laparoscopic instrument and trocar systems for transumbilical laparoscopic surgery

• US 8,394,018 B2
• Filed: 12/11/2009
• Issued: 03/12/2013
• Est. Priority Date: 09/15/1998
• Status: Expired due to Fees

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Piskun, Gregory
• Primary Examiner(s): NGUYEN, TUAN VAN
• Application Number:
  US12/636,060
• Publication Number:
  US 20100130825A1
• Time in Patent Office: 1,187 Days
• Field of Search: 606/1, 606/151, 606/157, 606/158, 606/205, 604/164.01, 600/208, 600/206, 600/205, 600/204
• 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 MIS suturing instruments A61B17/0469; jaws of MIS forceps A61B2017/2926
• 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 catheters A61B2017/22072
• 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 for enabling access of multiple independent portals through a surgical incision in a subject comprising:

a lateral wall defining an upper aperture with a first diameter, a central aperture with a second diameter, and a lower aperture having a third diameter, wherein the diameters of the upper aperture and the lower aperture are each greater than the diameter of the central aperture, the lateral wall defining a surgical site;

an upper plate connected to said lateral wall at said upper aperture; and

a lower plate connected to said lateral wall at said lower aperture, the trocar configured such that the lateral wall is configured and dimensioned to form multiple diameters wherein the trocar is deformable from a pre-insertion configuration into a sealing configuration such that the diameters of the lateral wall between the upper plate and the lower plate are less than the diameter of the upper plate to enable multiple independent instruments to be disposed through said upper plate and through said lower plate to access said surgical site.

2. The trocar as in claim 1, wherein the lower aperture is defined by a distal end of the lateral wall, and wherein the central aperture is configured and dimensioned to enable access of multiple independent instruments to the surgical site when the distal end of the lateral wall is inserted through the surgical incision of a subject.

3. The trocar as in claim 2, wherein the upper aperture, the central aperture and the lower aperture are configured and dimensioned to define at least one passageway formed by the lateral wall, the at least one passageway extending from the upper aperture to the lower aperture.

4. The trocar as in claim 1, wherein the lateral wall defines a curved configuration, the curved configuration of the lateral wall defining the upper aperture, the central aperture, and the lower aperture.

5. The trocar as in claim 1, wherein the lateral wall is made from resilient material.

6. The trocar as in claim 1, wherein the lateral wall is configured and dimensioned to be positioned at least partially within the surgical incision in a subject.

7. The trocar as in claim 6, wherein the lateral wall is made from resilient material and wherein the lateral wall is configured and dimensioned to be positioned within the surgical incision in a subject with the upper plate disposed above the incision.

8. The trocar as in claim 6, wherein the lower aperture is defined by a distal end of the lateral wall, and wherein said distal end of the lateral wall is adapted to cooperate with said upper plate to seal the upper plate in position with respect to the surgical incision in the subject.

9. The trocar as in claim 1, wherein the upper plate, the lateral wall and the lower aperture together define multiple independent working access for surgical instruments positioned in said portals.

10. The trocar unit as in claim 9, wherein at least the lateral wall is deformable between a first position for insertion into the surgical incision and a second position in sealing contact with the surgical incision.

11. The trocar unit as in claim 9, wherein the trocar unit includes instruments each having a proximal portion and a distal portion and wherein the proximal portion extends proximally of the upper surface.

12. The trocar as in claim 1, wherein when the trocar is in a non-deformed configuration, a plane formed by the lower aperture at the distal end of the lateral wall is substantially parallel to the upper plate.

13. The trocar as in claim 1, wherein the lower aperture is defined by a distal end of the lateral wall, and wherein the trocar is configured such the at least one passageway enables the spaced apart multiple instruments to be inserted into the at least one passageway prior to insertion of the distal end of the lateral wall in the surgical incision of a subject.

14. The trocar as in claim 1, wherein the lower aperture is defined by a distal end of the lateral wall, and wherein the trocar is configured such that the at least one passageway enables the independent multiple trocars to be inserted into the at least one passageway after insertion of the distal end of the lateral wall in the surgical incision of a subject.

15. The trocar as in claim 1, wherein multiple independent instruments are disposed through said upper plate and through said lower plate to access said surgical site, and wherein at least one of the plurality of independent instruments has a straight configuration.

16. The trocar as in claim 1, wherein multiple independent instruments are disposed through said upper plate and through said lower plate to access said surgical site, and wherein at least one of the plurality of independent instruments extends above a portion of the upper plate outside the body of the subject.

17. The trocar as in claim 1, wherein the lateral wall defines a chamber being enclosed within said upper plate and said lateral wall.

18. The trocar as in claim 17, wherein the chamber is configured and dimensioned to assume a deformed position and a non-deformed position, wherein, when the chamber is in the deformed position, the trocar assumes a configuration facilitating insertion into the surgical incision of the patient.

19. The trocar as in claim 18, wherein, when the chamber is in the deformed position, the trocar is configured such that the upper plate remains outside the surgical incision.

20. The trocar as in claim 19, wherein, when the chamber is in the deformed position, the trocar is configured such that the distal end of the lateral wall is located at the surgical incision in proximity to the interior of the abdominal cavity.

21. The trocar as in claim 17, wherein multiple independent instruments are disposed through said upper plate and through said lower plate to access said surgical site, and wherein at least one of the plurality of independent instruments has a curved configuration and wherein the at least one of the plurality of independent instruments having a curved configuration is incorporated into a portion of the lateral wall.