Surgical access apparatus and method

• US 8,105,285 B2
• Filed: 02/18/2005
• Issued: 01/31/2012
• Est. Priority Date: 01/17/2003
• Status: Active Grant

• Current Assignee: Applied Medical Resources Corporation (Applied Medical Corporation)
• Original Assignee: Applied Medical Resources Corporation (Applied Medical Corporation)
• Inventors: Hart, Charles C., Brustad, John R.
• Primary Examiner(s): Sirmons, Kevin C
• Assistant Examiner(s): Hall, Deanna K
• Application Number:
  US11/062,022
• Publication Number:
  US 20050159647A1
• Time in Patent Office: 2,538 Days
• Field of Search: 604/164.01, 604/264, 604/272, 600/153, 600/129, 600/127, 600/114, 600/101
• US Class Current: 604/164.01
• CPC Class Codes: A61B 1/3132 for laparoscopy
• 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 17/3474 Insufflating needles, e.g. Veress needles
• CPC Class Codes: A61B 2017/320044 Blunt dissectors blunt suture needles A61B2017/06085
• CPC Class Codes: A61B 2017/349 Trocar with thread on outside
• CPC Class Codes: A61B 2090/08021 of the patient or his organs
• CPC Class Codes: A61B 2090/373 using light, e.g. by using optical scanners
• CPC Class Codes: A61B 90/30 Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure

Abstract

A laparoscopic insufflation device is provided in the configuration of a coil with a blunt tip. The device is capable of passing through the abdominal wall without cutting tissue, and exiting the abdominal wall substantially parallel to the inner surface. While rotation of the coiled device results in forward movement through the abdominal wall, a counter force can be applied to the device to create a safety space between the wall and the interior organs. With the blunt distal tip, parallel exit angle, and safety space, there is substantially no threat to the interior organs during placement of the device. Further space can be generated with the use of pressured gas to produce an abdominal cavity for the subsequent placement of trocars. By rotatably attaching the coiled insufflation device to a trocar, the advantage of a counter force can be used not only to establish the safety space but also to pull the trocar into the abdominal wall with a counterforce which resists tenting.

Claims

1. A surgical device adapted to provide access across an abdominal wall and into an abdominal region of a patient, comprising:

a trocar including a cannula; and

a shaft having a proximal end and a distal end;

wherein

the shaft comprising a coil with a coil axis, the coil facilitating rotational movement of the shaft across the abdominal wall;

the proximal end of the shaft is fixedly axially coupled and freely rotatably coupled to the trocar about the coil axis so that movement by the shaft across the abdominal wall is accompanied by movement of the trocar into the abdominal wall;

the distal end of the shaft terminates in a distal tip that is stationary relative to the shaft; and

the distal tip of the shaft is blunt and free of sharp edges.

2. The surgical device recited in claim 1, wherein:

the trocar has an axis; and

the trocar axis is generally coincident with the coil axis.

3. The surgical device recited in claim 2, wherein:

the trocar has a cannula with a distal tip forming a trocar exit angle with the abdominal wall;

the shaft has a distal tip forming a shaft exit angle with the abdominal wall; and

the trocar exit angle is greater than the shaft exit angle.

4. The surgical device recited in claim 3, wherein the distal tip of the cannula is generally perpendicular to the distal tip of the shaft.

5. The surgical device recited in claim 4, wherein the distal tip of the cannula is dimensioned and configured to be generally normal to the abdominal wall.

6. The surgical device recited in claim 1, wherein the shaft is dimensioned and configured such that a rotational movement of the shaft across the abdominal wall provides a mechanical advantage greater than unity to facilitate movement of the shaft across the abdominal wall, thereby providing provides a mechanical advantage greater than unity to facilitate movement of the trocar into the abdominal wall.

7. The surgical device recited in claim 1, further comprising a rotation ring carried by the trocar, wherein the proximal end of the shaft having a fixed relationship with the ring and a rotational relationship with the trocar.

8. The surgical device recited in claim 7, wherein the trocar has a cannula and the ring is rotationally supported by the cannula.

9. The surgical device recited in claim 7, wherein the distal tip of the cannula has a blunt configuration.

10. The surgical device recited in claim 1 wherein the shaft is hollow having a lumen extending from the proximal end to the distal end of the shaft.

11. The surgical device recited in claim 10 wherein the cannula of the trocar is hollow having lumen extending from a proximal end of the cannula to a distal end of the cannula.

12. The surgical device recited in claim 11 wherein the lumen of the cannula has a first diameter and the lumen of the shaft has a second diameter smaller than the first diameter.

13. The surgical device recited in claim 11 further comprising a trocar valve housing attached to the proximal end of the cannula and an obturator removable from and insertable into the lumen of the cannula through the distal end of the cannula.

14. The surgical device recited in claim 11, wherein

the lumen of the shaft has a diameter substantially smaller than a diameter of the lumen of the cannula, and

the diameter of the lumen of the shaft is dimensioned and configured to obstruct passage of an obturator through the lumen of the shaft and to allow passage of gas through the lumen of the shaft.

15. The surgical device recited in claim 10 further comprising a distal tip of the shaft dimensioned and configured to enclose the distal end and the lumen of the shaft.

16. The surgical device recited in claim 1 wherein the shaft extends along an entire length of the cannula to a distal end of the cannula.

17. The surgical device recited in claim 13 wherein the obturator has a proximal end and a distal end with a blunt hemispherical distal tip extending from the distal end of the obturator.

18. The surgical device recited in claim 3 wherein a fixed distance is maintained between the distal tip of the cannula and the distal tip of the shaft throughout operation of the device through the abdominal wall.

19. The surgical device recited in claim 15 wherein the shaft further comprises at least one side port on the distal end of the shaft.

20. The surgical device recited in claim 19, wherein the side port is fluidly coupled to the lumen of the shaft.