Balloon trocar

• US 9,259,238 B2
• Filed: 01/26/2015
• Issued: 02/16/2016
• Est. Priority Date: 03/13/2006
• Status: Active Grant

• Current Assignee: Applied Medical Resources Corporation (Applied Medical Corporation)
• Original Assignee: Applied Medical Resources Corporation (Applied Medical Corporation)
• Inventors: Albrecht, Jeremy J., Nguyen, Eric, Gadberry, Donald L., Brustad, John R., Johnson, Gary M., Hart, Charles C., Au, Gigi
• Primary Examiner(s): Mehta, Bhisma
• Assistant Examiner(s): Zhang, Jenna
• Application Number:
  US14/605,536
• Publication Number:
  US 20150141916A1
• Time in Patent Office: 386 Days
• US Class Current: 1/1
• 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 17/3415 for introducing tubes or catheters, e.g. gastrostomy tubes, drain catheters A61B17/3417 takes precedence; body piercing catheter guide needles A61M25/06
• 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 17/3421 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 17/3498 Valves therefor, e.g. flapper valves, slide valves haemostasis valves A61M39/06; check valves A61M39/24
• CPC Class Codes: A61B 2017/00477 Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/22051 with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation A61B2017/22048, A61B2017/3486 take precedence
• CPC Class Codes: A61B 2017/3419 Sealing means between cannula and body
• CPC Class Codes: A61B 2017/3433 with different outer diameters of the cannula
• CPC Class Codes: A61B 2017/3445 used as instrument channel for multiple instruments
• CPC Class Codes: A61B 2017/347 Locking means, e.g. for locking instrument in cannula
• CPC Class Codes: A61B 2017/3486 Balloon
• CPC Class Codes: A61B 2017/3488 Fixation to inner organ or inner body tissue
• CPC Class Codes: A61B 2017/349 Trocar with thread on outside
• CPC Class Codes: A61J 15/0053 Means for fixing the tube outside of the body, e.g. by a special shape, by fixing it to the skin holding devices, e.g. on the body A61M25/02, mouthpieces for tracheal tubes A61M16/0488; transcutaneous access sites A61M39/0247
• CPC Class Codes: A61M 2039/0261 Means for anchoring port to the body, or ports having a special shape or being made of a specific material to allow easy implantation/integration in the body
• CPC Class Codes: A61M 2039/0273 for introducing catheters into the body
• CPC Class Codes: A61M 2039/0279 for introducing medical instruments into the body, e.g. endoscope, surgical tools
• CPC Class Codes: A61M 2039/0294 : having a specific shape matching the shape of a tool to be inserted therein, e.g. for easy introduction, for sealing purposes, guide
• CPC Class Codes: A61M 2039/062 : used with a catheter
• CPC Class Codes: A61M 2039/0626 : used with other surgical instruments, e.g. endoscope, trocar
• CPC Class Codes: A61M 2039/0686 : comprising more than one seal
• CPC Class Codes: A61M 25/04 : in the body, e.g. expansible A61M25/10, A61M16/0488 take precedence
• CPC Class Codes: A61M 39/0247 : Semi-permanent or permanent transcutaneous or percutaneous access sites to the inside of the body peritoneal dialysis catheters A61M1/285; tracheostomy devices A61M16/0465; measuring pressure within the body A61B5/03; colostomy devices A61F5/445; gastrotomy feeding tubes A61J15/0015; means for fixing a feeding tube outside of the body A61J15/0053
• CPC Class Codes: A61M 39/06 : Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof

Abstract

A balloon trocar includes a cannula assembly including a cannula and an outer sleeve fitting over the cannula. The distal end of the outer sleeve is proximal to the distal end of the cannula. A balloon is coupled to a distal portion of the sleeve and a distal portion of the cannula. The outer surface of the cannula includes a plurality of longitudinal channels for transmitting gas or fluid to the balloon. A bolster having a gel pad at its distal portion is slidably mounted to the cannula assembly and may be locked in a desired position. In use, the trocar is inserted into an incision through a body wall and into a body cavity. The balloon is inflated and the cannula assembly pulled proximally against the incision while the bolster is slid distally to the body wall and locked in place to seal the incision with the compressed balloon.

Claims

1. A balloon trocar system comprising:

a cannula assembly comprising;

a cannula having a proximal end, a distal end, a lumen extending between the proximal end and the distal end, a proximal portion having a first, larger periphery, a distal portion having a second, smaller periphery, and an annular groove on an outer surface of the distal portion of the cannula toward the distal end of the cannula;

an outer sleeve comprising;

a substantially longitudinal tube having a proximal end, a distal end, a lumen extending between the proximal end and the distal end, a proximal portion having a first, larger periphery, a distal portion having a second, smaller periphery; and

a balloon extending distally from the distal end of the longitudinal tube; and

wherein the outer sleeve is positioned around the cannula such that the proximal portion of the longitudinal tube of the outer sleeve is coupled to the proximal portion of the cannula and the balloon is coupled with the annular groove of the cannula to define a substantially closed chamber between the outer surface of the cannula, an inner surface of the outer sleeve from the proximal end of the longitudinal tube to the annular groove of the cannula;

a trocar seal removably couplable to the proximal end of the cannula; and

an obturator comprising an elongate shaft extending along a substantially longitudinal axis between a proximal end and a distal end, the obturator positionable through the trocar seal and lumen of the cannula such that the proximal end of the obturator is proximal to the trocar seal and the distal end of the obturator is distal to the distal end of the cannula.

2. The balloon trocar system of claim 1, wherein the elongate shaft of the obturator has a first periphery sized to be slidable within the lumen of the cannula and wherein the obturator further comprises:

a handle positioned at the proximal end of the elongate shaft, the handle having a second periphery larger than the first periphery of the elongate shaft; and

a distal tip at the distal end of the elongate shaft, the distal tip having a prolate spheroid shape.

3. The balloon trocar system of claim 1, wherein the balloon is inflatable from a deflated condition in which the balloon is foldable onto the cannula and longitudinal tube to an inflated configuration having a relatively large profile.

4. The balloon trocar system of claim 3, wherein the balloon has a toroid profile in the inflated configuration.

5. The balloon trocar system of claim 1, wherein the lumen of the longitudinal tube is configured to provide minimal space between the distal portion of longitudinal tube and the distal portion of the cannula.

6. The balloon trocar system of claim 1, wherein the balloon is substantially flush with the cannula at the annular groove.

7. A cannula assembly comprising:

a cannula having a proximal end, a distal end, a lumen extending between the proximal end and the distal end, a proximal portion having a first, larger periphery, a distal portion having a second, smaller periphery, a transition region between the proximal portion and the distal portion, a plurality of longitudinal channels extending along the length of the cannula, and an annular groove on an outer surface of the distal portion of the cannula distal of the plurality of longitudinal channels adjacent the distal end of the cannula;

an outer sleeve comprising;

a substantially longitudinal tube having a proximal end, a distal end, a lumen extending between the proximal end and the distal end, a proximal portion having a first, larger periphery, a distal portion having a second, smaller periphery, and a transition region between the proximal portion and the distal portion, the lumen of the sleeve being configured to accept the cannula such that the proximal portion of the longitudinal tube fits over and sealingly engages with the proximal portion of the cannula and the distal portion of the longitudinal tube fits over the distal portion of the cannula providing minimal space therebetween; and

a balloon extending distally from the distal end of the longitudinal tube and coupled with the annular groove of the cannula such that a closed chamber is defined by a space between the outer surface of the cannula and an inner surface of the outer sleeve extending from the sealing engagement of the proximal portion of the cannula and the proximal portion of the longitudinal tube distally to the coupling of the balloon and the annular groove; and

an inflation port providing a fluid pathway for fluid to be introduced and removed from the closed chamber.

8. The cannula assembly of claim 7, wherein the inflation port comprises a check valve having a spring-loaded plunger.

9. The cannula assembly of claim 8, wherein the check valve further comprises a luer lock.

10. The cannula assembly of claim 7, wherein the inflation port is disposed on the outer sleeve.

11. The cannula assembly of claim 7, wherein the inflation port is disposed distal of the sealing engagement between the proximal portion of the longitudinal tube and the proximal portion of the cannula.

12. The cannula assembly of claim 7, wherein the lumen of the longitudinal tube is configured to define a gap between the transition region of the longitudinal tube and the transition region of the cannula, wherein the gap is larger than the space between the distal portion of the longitudinal tube and the distal portion of the cannula.

13. The cannula assembly of claim 7, wherein the cannula has a generally tubular wall with a thickness and wherein the plurality of longitudinal channels are formed recessed into the generally tubular wall of the cannula such that the thickness of the wall is not increased by the plurality of longitudinal channels.

14. The cannula assembly of claim 7, further comprising an O-ring positioned between the proximal portion of the longitudinal tube and the proximal portion of the cannula to provide the sealing engagement therebetween.

15. A cannula assembly comprising:

a cannula having a proximal end, a distal end, a lumen extending between the proximal end and the distal end, and an annular groove on an outer surface of the cannula adjacent the distal end;

a sleeve positioned over the cannula, the sleeve comprising;

a substantially longitudinal tube having a proximal end, a distal end, and a lumen extending between the proximal end and the distal end;

a balloon extending distally from the distal end of the longitudinal tube; and

wherein the sleeve is positioned around the cannula such that the proximal end of the longitudinal tube is coupled to the cannula adjacent the proximal end of the cannula and the balloon is fixed in place within the annular groove of the cannula such that the balloon is substantially flush with the cannula at the annular groove; and

a bolster slidably adjustable along the length of the cannula and the sleeve proximal to the balloon.

16. The cannula assembly of claim 15, further comprising thread wound around the balloon at the annular groove to force the balloon into the annular groove.

17. The cannula assembly of claim 15, wherein the bolster comprises:

a base having a lumen sized to receive and slidingly engage the sleeve;

a clamping mechanism coupled to the base, the clamping mechanism actuatable between a first position in which the bolster is slidable relative to the cannula and a second position in which the clamping mechanism maintains a location of the bolster relative to the sleeve; and

a gel pad coupled to the base.

18. The cannula assembly of claim 17, wherein the gel pad comprises a substantially incompressible gel material.

19. The cannula assembly of claim 17, wherein the base comprises a clamp receptacle, and wherein the clamping mechanism comprises:

a collar positioned in the clamp receptacle, the collar having a first end, a second end, and an inner surface; and

a lever coupled to the first end and the second end of the collar, the lever pivotable between a first position in which the first end and the second end of the collar are spread apart to allow the bolster to slide along the sleeve and a second position in which the first end and the second end of the collar are closer together to fix the bolster in place relative to the sleeve.