Laparoscopic instrument and trocar systems and related surgical method

• US 9,539,027 B2
• Filed: 03/23/2015
• Issued: 01/10/2017
• 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): Philogene, Pedro
• Application Number:
  US14/665,091
• Publication Number:
  US 20150190171A1
• Time in Patent Office: 659 Days
• Field of Search: 600204-208, 606/1, 606/185, 606/186, 606/215, 606/144, 606/139, 606/191, 606/205, 604/174, 604/206, 604/208, 604/264, 604/175, 604/284
• 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 17/0469 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 holder for holding multiple spaced-apart trocars comprising:

an upper plate;

a separate lower plate spaced from and disposed below the upper plate; and

an outer wall connected between the upper plate and the lower plate, the outer wall defining a cavity, a flexible distal portion of which forms a portion of the surgical site,

multiple spaced apart passageways independent of the outer wall and defined through the upper plate and the lower plate that are configured to enable multiple trocars to be disposed through the upper plate, and wherein at least one of the multiple trocars has a straight configuration,

wherein the upper and lower plates are configured such that the multiple trocars can move in relation to the outer wall, and

wherein the multiple trocars each have a proximal portion and a distal portion and wherein the proximal portion extends proximally of the upper plate.

2. The trocar holder as in claim 1, wherein the at least one passageway is formed by resilient material.

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

4. The trocar holder as in claim 3, wherein the lower plate cooperates with the outer wall to seal the upper plate in position with respect to a surgical incision in the subject.

5. The trocar holder as in claim 4, wherein the upper plate, the outer wall and the lower plate together define a working access for surgical instruments positioned in the multiple trocars.

6. The trocar holder as in claim 5, wherein at least the outer wall is 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 holder as in claim 1, wherein the trocar holder is configured such that the multiple trocars define spaced apart trocars and the at least one passageway enables the spaced apart multiple trocars to be inserted into the at least one passageway prior to insertion of the lower plate in a surgical incision of a subject.

8. The trocar holder as in claim 7, wherein the trocar holder is configured such that the at least one passageway enables the spaced apart multiple trocars to be inserted into the at least one passageway after insertion of the lower plate in a surgical incision of a subject.

9. A trocar holder for holding multiple spaced-apart trocars comprising:

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

an upper plate;

a separate lower plate spaced from and disposed below the upper plate; and

an outer wall connected between the upper plate and the lower plate,

at least one passageway defined by the upper plate, the lower plate and the outer wall, the trocar holder upper plate having multiple spaced-apart openings configured to enable multiple trocars to be disposed through the upper plate,

wherein at least one of the trocars has a straight configuration, and wherein the at least one of the trocars having a straight configuration is at least partially disposed, at the upper plate, through the at least one passageway,

wherein the upper and lower plates are configured such that the trocars can move in relation to the outer wall, and

wherein the trocars each have a proximal portion and a distal portion and wherein the proximal portion extends proximally of the upper plate.

10. The trocar holder as in claim 9, wherein the at least one passageway is formed by resilient material.

11. The trocar holder as in claim 10, wherein the at least one passageway extends from the upper plate to the lower plate.

12. The trocar holder as in claim 9, wherein the outer wall is configured and dimensioned to be positioned within a surgical incision in a subject.

13. The trocar holder as in claim 12, wherein the lower plate cooperates with the outer wall to seal the upper plate in position with respect to the surgical incision in the subject.