U.S. patent application number 13/933631 was filed with the patent office on 2014-02-13 for surgical access device with adjustable cannula.
This patent application is currently assigned to Ethicon Endo-Surgery, Inc.. The applicant listed for this patent is Ethicon Endo-Surgery, Inc.. Invention is credited to Frederick E. Shelton, IV.
Application Number | 20140046299 13/933631 |
Document ID | / |
Family ID | 47744701 |
Filed Date | 2014-02-13 |
United States Patent
Application |
20140046299 |
Kind Code |
A1 |
Shelton, IV; Frederick E. |
February 13, 2014 |
Surgical Access Device with Adjustable Cannula
Abstract
A surgical access device is provided having a cannula and
obturator. The cannula has a housing and tube section with an
anchor located about the tube section. The obturator has a
mechanism to deploy the anchor and adjust the cannula length. The
anchor is moveable between a deployed and undeployed state where
the undeployed state facilitates insertion and removal of the
access device and the deployed state assists in fixation of the
cannula in an anatomic structure. Anchor deployment is independent
of cannula length adjustment.
Inventors: |
Shelton, IV; Frederick E.;
(Hillsboro, OH) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Ethicon Endo-Surgery, Inc. |
Cincinnati |
OH |
US |
|
|
Assignee: |
Ethicon Endo-Surgery, Inc.
Cincinnati
OH
|
Family ID: |
47744701 |
Appl. No.: |
13/933631 |
Filed: |
July 2, 2013 |
Related U.S. Patent Documents
|
|
|
|
|
|
Application
Number |
Filing Date |
Patent Number |
|
|
13217927 |
Aug 25, 2011 |
8496632 |
|
|
13933631 |
|
|
|
|
Current U.S.
Class: |
604/513 |
Current CPC
Class: |
A61B 2017/3443 20130101;
A61B 2017/00991 20130101; A61B 17/3439 20130101; A61B 17/3421
20130101; A61B 2017/3482 20130101 |
Class at
Publication: |
604/513 |
International
Class: |
A61B 17/34 20060101
A61B017/34 |
Claims
1-20. (canceled)
21. A method for accessing an anatomic structure, the method
comprising: a) obtaining a handle adapted to receive a cannula, the
cannula having an anchor disposed about its distal end; the handle
having an obturator adapted to engage the anchor; a button in
communication with the obturator wherein the button is adapted to
collapse the anchor about the cannula in a first position and
deploy the anchor in a second position; b) inserting the obturator
into the cannula; c) inserting the cannula through the wall of
anatomic structure; d) moving the button from the first position to
the second position to deploy the anchor.
22. The method of claim 21, further comprising the step of removing
the obturator from the cannula.
23. The method of claim 22, wherein the anchor is biased to a
deployed state.
24. The method of claim 23, wherein the cannula is flexible.
25. The method of claim 24, wherein the obturator has a detent in
communication with a lever lock on the handle.
26. The method of claim 21, wherein distal movement of the handle
relative to the cannula causes the cannula to expand radially.
27. A method of accessing an anatomic structure, the method
comprising: a) obtaining a surgical trocar comprising a handle, a
first button and a second button; a flexible cannula having a
length and a diameter wherein the cannula is biased to a first
length; an anchor disposed about the cannula; an obturator moveably
attached to the handle, the obturator adapted to engage the anchor
and cannula; the obturator having a pin to engage the first button;
b) inserting the obturator into the cannula until the obturator pin
engages the first button, thereby stretching the cannula to a
second length; e) inserting the cannula into an anatomic structure;
and f) depressing the first button wherein the cannula bias moves
the cannula from the second length the first length.
28. The method of claim 27, further comprising the step of removing
the handle from the cannula.
29. The method of claim 27, wherein the step of depressing the
first button deploys the anchor.
30. The method of claim 27, wherein the cannula has a housing and a
valve.
Description
RELATED APPLICATIONS
[0001] This is a continuation of application Ser. No. 13/217,927
filed Aug. 25, 2011, which is hereby incorporated by reference.
BACKGROUND
[0002] The present invention relates in general to surgical devices
and procedures, and more particularly to minimally invasive
surgery.
[0003] Surgical procedures are often used to treat and cure a wide
range of diseases, conditions, and injuries. Surgery often requires
access to internal tissue through open surgical procedures or
endoscopic surgical procedures. The term "endoscopic" refers to all
types of minimally invasive surgical procedures including
laparoscopic, arthroscopic, natural orifice intraluminal, and
natural orifice transluminal procedures. Endoscopic surgery has
numerous advantages compared to traditional open surgical
procedures, including reduced trauma, faster recovery, reduced risk
of infection, and reduced scarring. Endoscopic surgery is often
performed with an insufflatory fluid present within the body
cavity, such as carbon dioxide or saline, to provide adequate space
to perform the intended surgical procedures. The insufflated cavity
is generally under pressure and is sometimes referred to as being
in a state of pneumoperitoneum. Surgical access devices are often
used to facilitate surgical manipulation of internal tissue while
maintaining pneumoperitoneum. For example, trocars are often used
to provide a port through which endoscopic surgical instruments are
passed. Trocars generally have an instrument seal, which prevents
the insufflatory fluid from escaping while an instrument is
positioned in the trocar. Endoscopic surgery may also be performed
in the absence of insufflatory gas. For example, minimally invasive
thoracic surgery may be performed in the absence of insufflatory
gas.
[0004] While surgical access devices are known, no one has
previously made or used the surgical devices and methods in
accordance with the present invention.
BRIEF DESCRIPTION OF DRAWINGS
[0005] While the specification concludes with claims which
particularly point out and distinctly claim the invention, it is
believed the invention will be better understood from the following
description taken in conjunction with the accompanying drawings
illustrating some non-limiting examples of the invention. Unless
otherwise indicated, the figures are not necessarily drawn to
scale, but rather to illustrate the principles of the
invention.
[0006] FIG. 1 depicts is an isometric view of a surgical trocar
having a cannula and obturator with a cannula anchor in a deployed
state;
[0007] FIG. 2 is an exploded view of the surgical trocar of FIG.
1;
[0008] FIG. 3 is an isometric view of the FIG. 1 trocar
obturator;
[0009] FIG. 4 is a partial cross-sectional view of a surgical
trocar having a cannula anchor in a deployed state;
[0010] FIG. 5 is a partial cross-sectional view of a surgical
trocar with a cannula anchor in a deployed state and an obturator
in an unarmed state;
[0011] FIG. 6 is a partial cross-sectional view of a surgical
trocar with a cannula anchor in an undeployed state and an
obturator in an armed state;
[0012] FIG. 7 is a partial cross-sectional view of a surgical
trocar cannula housing with an obturator inserted into the housing,
further depicting rotation of the obturator to release the cannula
anchor;
[0013] FIG. 8 is a partial cross sectional view of a cannula in a
shortened state where the cannula anchor has deployed;
[0014] FIG. 9 depicts rotation of the cannula housing to change the
length of the surgical trocar cannula;
[0015] FIG. 10 depicts threads or raised surfaces of the exterior
cannula tube housing contacting operative site tissue;
[0016] FIG. 11 is an isometric view of another expression of the
surgical trocar access device depicting the cannula anchor in an
undeployed state and the obturator in an armed state;
[0017] FIG. 12 is an isometric view of a surgical trocar access
device obturator having a two-piece tube with a threaded length
adjustment feature;
[0018] FIG. 13 is a partial cross sectional view of the FIG. 12
trocar;
[0019] FIG. 14 is an exploded view of FIG. 13 obturator
components;
[0020] FIG. 15 is a partial cross sectional view of the FIG. 14
components;
[0021] FIG. 16 is an isometric view of an obturator shaft for use
with the FIG. 11 trocar;
[0022] FIG. 17 is another expression of a surgical trocar access
device depicting a surgical trocar cannula having a lower cannula
with a ribbed surface and further having cannula anchors in a fully
deployed state;
[0023] FIG. 18 is a partial cross-sectional view of the FIG. 17
cannula;
[0024] FIG. 19 is a partial cross-sectional view of the obturator
depicted in FIG. 16 inserted into the cannula depicted in FIG. 17
prior to insertion into an operative site;
[0025] FIG. 20 is a close up of the cannula tube and obturator
depicted in FIG. 19;
[0026] FIG. 21 is a partial cross-sectional view of the FIG. 19
assembly with the obturator shaft moved to the anchor deployment
detent and the cannula anchors in a deployed state;
[0027] FIG. 22 is a close up view of the FIG. 21 anchor and distal
end of the obturator;
[0028] FIG. 23 is a partial cross sectional view of the FIG. 21
surgical access device with the anchor deployed and the cannula
length reduced to its shortest length;
[0029] FIG. 24 is a close up of the distal end of the FIG. 23
surgical access device with the obturator shaft partially
removed;
[0030] FIG. 25 depicts another expression of a trocar cannula
length adjusting device;
[0031] FIGS. 26, 26A and 26B depict an exploded view of the FIG. 25
cannula housing assembly for performing cannula length adjustment;
and
[0032] FIGS. 27A, 27B, 27C, 27D, and 27E depict a mechanical
deployment apparatus for a trocar having an in vivo anchor
assembly.
DETAILED DESCRIPTION
[0033] The devices and methods disclosed herein relate to providing
access to an operative site and in particular to surgical trocar
access devices that provide access to the abdomen and thoracic
cavity. The trocars permit insertion and removal of surgical
instruments during an operative procedure and are particularly
suited for minimally invasive surgical procedures. Expressions of a
surgical trocar will be described in detail with reference to
drawings wherein like reference numerals designate identical or
corresponding elements in each of the several views.
[0034] For purpose of explanation and illustration and not
limitation, an isometric view of one expression of a surgical
trocar access device, or trocar, is shown in FIG. 1 and is
designated by reference number 100. Other expressions of surgical
trocars are presented in FIGS. 2-27, as will be described fully
herein.
[0035] Referring to FIG. 1, trocar 100 is comprised of a cannula
110 and an obturator 120 inserted in cannula 110. In one expression
of the trocar 100, the cannula is comprised of two cannula tubes,
130 and 140. Distal cannula tube 130 is adapted to receive proximal
cannula tube 140. In one expression of the trocar 100, distal
cannula tube 130 may be flexible and include impressed threads 160.
Proximal cannula tube 140, in one expression, is generally rigid in
its construction and may further include threads 150 which may be
adapted to mate with impressed threads 160. Trocar 100 also
includes a distal anchor 170 which assists in anchoring cannula 110
in an abdominal wall or any other suitable anatomy.
[0036] Referring now to FIG. 3, trocar obturator 120 is provided to
facilitate insertion of cannula 110 into an appropriate anatomic
structure. Obturator 120 is provided with an anchor deployment
button 210. Obturator 120 includes finger grip area 220 to
facilitate insertion and removal of obturator 120 from cannula 110.
Obturator 120 further includes obturator tube 260 and may further
include distal anti-rotation locks 230A and 230B and anchor
deployment shaft 240. Anti-rotation locks 230A and 230B, extend
distally from a distal end of obturator 120 in a cantilevered
manner and may be disposed about the medial surface of tube 260. In
one expression, locks 230A and 230B have a triangular shape
terminating in a peak. Locks 230A and 230B are in mechanical
communication with openings 340A and 340B in distal cannula tube
130, and may be spring-biased to facilitate insertion into cannula
110. Obturator 120 may further include a tip 250 to facilitate
insertion of the trocar 100 into an anatomic structure. Tip 250 may
comprise a flat blade, pyramidal blade, an optical dilation tip,
blunt tip or the like. Obturator 120 may be adapted to accommodate
an endoscopic camera system, as in known in the art.
[0037] Cannula 110 is provided with a seal 320 which may be located
in cannula housing 310, as seen in FIG. 4. Seal 320 may be
comprised of a duckbill valve and an elastomeric annular seal as
shown in FIG. 4. Seal 320 may be provided with a flapper valve in
place of the duckbill or may be provided with only an elastomeric
annular seal, or any combination thereof, as is known in the art or
any other seal to prevent the escape of insufflations gas. Seal 320
may be sized to accommodate various diameter surgical instruments
e.g. 3 mm to 12 mm.
[0038] Cannula housing 310 is generally cylindrical and sized to
provide a gripping surface for insertion of trocar 100 into an
anatomic structure. Housing 310 is also sized to contact the
exterior surface of an anatomic structure and is larger than an
incision through which the cannula tube 130, 140 is passed. Housing
310, in the present expression, is cylindrical in nature but may be
any shape or size such that it can be gripped and will not pass
into an incision. Cannula housing 310 and cannula tubes 130, 140
are hollow in nature and define a lumen 330. Lumen 330 is sized to
permit the passage of surgical instruments and may accommodate
surgical instruments of different diameters e.g. 3 mm to 12 mm.
Extending distally from cannula housing 310, cannula tube 140
contains threads 150 which are designed to mate with impressed
threads 160 on distal cannula tube 140. Cannula tube 140 is further
provided with openings 340A and 340B (not pictured) to mate with
distal anti-rotation locks 230A and 230B.
[0039] Distal cannula 130 further comprises cannula anchor 170,
located adjacent the distal end of cannula tube 130, but may be
located anywhere along cannula tube 130. Anchor 170 is, in one
expression, formed of pliable elastomer and may be deformed
longitudinally.
[0040] Referring now to FIG. 2, an exploded view of trocar 100 is
provided. Anchor deployment assembly 400 of obturator 120 is
arranged with anchor locks 410A and 410B disposed about anchor
shaft 240. Anchor spring 430 is further disposed about anchor shaft
240 and may move freely between locks 410A and 410B and tip 250.
Anchor deployment button 210 defines the proximal end of anchor
deployment shaft 240. Tip 250 defines the distal end of shaft 240
and may be removably attached to shaft 240 to permit attachment of
different trocar tips. Anchor locks 410A and 410B, in one
expression, extend distally from ring 405 in a proximal-to-distal
cantilevered manner along shaft 450 defining a gap such that the
anchors are medially resiliently deflectable and may further have
chamfered distal surfaces to facilitate insertion into obturator
120 and cannula housing 310. Anchor lock slots 420 are dimensioned
to accommodate anchor locks 410A and 410B and permit rotational
force transfer from housing 220 to anchor locks 410A and 410B.
Anchor deployment assembly further comprises an anchor shaft cap
440 that defines a medial annulus 460 dimensioned to mate with
button 210 such that button 210 protrudes from a proximal side of
cap 440.
[0041] FIG. 5 is a partial cross sectional view of trocar 100 in an
unarmed state. Anchor deployment assembly 400 is inserted through
obturator 120 and obturator 120 is inserted into cannula 110
forming trocar 100. Angled surface of anchor locks 230 creates
medial deflection of locks 230 upon insertion into cannula 110.
When locks engage openings 340, peak of locks 230 protrudes into
opening permitting the transfer of rotational force from the
obturator 120 to cannula tube 130 creating a spline-groove type
engagement.
[0042] A flange portion of tip 250 may engage anchor 170 when
obturator 120 is inserted, permitting tip 250 to extend a
predetermined distance beyond anchor 170. As shown, tip 250 engages
anchor 170 as obturator housing 220 abuts cannula housing 310.
Cannula housing 310 is provided with at least two anchor deployment
detents 510A and 510B to receive and hold locks 410A and 410B.
Detents 510A and 510B may be disposed in an annular fashion along
the medial surface of cannula housing 310 and in one expression,
span less than 90.degree. each. In an unarmed state, anchor locks
410A and 410B are disposed above detents 510A and 510B such that
obturator 120 is axially slideable with respect to cannula 110.
Spring 430 may be axially slideable along anchor tube 240 between
ring 405 and cannula flange 520 when trocar 100 is unarmed. Locks
230A and 230B engage cannula openings 340A and 340B and slide
axially within openings 340A and 340B, permitting obturator 120 to
move axially while locks 230 are engaged with openings 340.
[0043] When anchor deployment button 210 is depressed, anchor
deployment shaft 400 moves in a distal longitudinal direction
relative to obturator 120 and cannula 110. As button 210 is
depressed, lateral flange of tip 250 engages medial flange of
anchor 170 thereby transferring force from button 210 axially to
anchor 170. Anchor 170 extends distally and collapses into the
approximate diameter of cannula tube 130 as shown in FIG. 6. In one
expression of trocar 100, when anchor 170 is elongated such that
its diameter is appropriate for insertion through an incision,
chamfered surfaces of anchor locks 410A and 410B medially deflect
locks 410A and 410B against detents 510A and 510B until 410A and
410B are seated below detents 510A and 510B creating an
interference fit and preventing distal axial motion of obturator
120 relative to cannula 110. Openings 340A and 340B are dimensioned
such that rotation locks 230A and 230B remain engaged with openings
340A and 340B as obturator 120 is moved in a distal axial direction
from an unarmed to an armed state. In an armed state, spring 430 is
compressed between ring 405 and detents 510A and 510B, creating a
proximal axial force on anchor deployment assembly 400 relative to
obturator 120.
[0044] FIG. 7 is a partial cross sectional view of the proximal
portion of trocar 100 in an armed state. As described previously,
anchor locks 410A and 410B seat below detents 510A and 510B
preventing distal axial motion of obturator 120 relative to cannula
110. As depicted in FIG. 7, cannula housing 310 is provided with
detents 510 and detent openings 710A and 710B. After trocar 100 is
inserted through an incision into an anatomic structure in an armed
state, it is necessary to deploy anchor 170 to provide fixation in
the anatomic structure.
[0045] By rotating obturator housing 120, anchor locks 410A and
410B align with detent openings 710A and 710B; force from spring
430 exerts proximal axial force on ring 405 and moves anchor
deployment shaft 400 in a proximal direction away from anchor 170,
relieving tension on anchor 170 allowing anchor 170 to resume a
deployed shape as depicted in FIG. 1. Button 210 returns to an
unarmed position as depicted in FIG. 5 and trocar 100 is once again
in a unarmed state. In this state, should obturator tip 250 be
pressed axially against an anatomical structure, there is no
concomitant force to counteract the movement of anchor 400 from
moving in a manner away from the anatomic structure.
[0046] Once trocar 100 is inserted into an anatomic structure and
disarmed, it may be desirable to shorten the length of cannula 100.
By rotating obturator housing 220 in a counterclockwise manner
(depending upon the orientation of threads 150 and 160) while
holding cannula housing 310 stationary, rotational force is
transferred from housing 220 through locks 230A and 230B to distal
cannula openings 340A and 340B thereby rotating distal cannula 1130
in a counterclockwise manner. Obturator 220 may be held stationary
while housing 310 is rotated, as shown in FIG. 9. Threads 160
engage proximal cannula threads 1150 and drive distal cannula 130
proximally over proximal cannula 140, thereby shortening the in
vivo length of cannula 110. Once a desired in vivo length is
achieved, obturator 120 is removed from cannula 110 permitting
insertion and removal of surgical instruments. Anchor 170 provides
axial resistance to removal of cannula 110 by contacting the inner
surface of an anatomic structure when proximal axial force is
applied to cannula 110. Threads 150 and 160 contact the anatomic
structure wall 1010 (e.g. abdominal wall) as shown in FIG. 10,
further providing resistance to proximal and distal motion of
cannula 110 as instruments are inserted and removed from cannula
110.
[0047] Referring now to FIG. 11, another expression of a surgical
trocar 1100 is depicted. As shown, anchor 1170 is under tension in
a collapsed state. In this position, obturator shaft 1110 is fully
extended through cannula 1105 and trocar 1100 is in an armed state,
ready for insertion through an incision into an anatomic structure.
Cannula 1105 is comprised of two cannula tubes, proximal tube 1160
and distal tube 1180 to which anchor 1170 is attached. Anchor 1170
may be formed from tube 1180 thereby creating a contiguous
tube-anchor structure. Obturator housing 1115, in one expression,
is formed from three interleaved cylindrical housings 1120, 1130
and 1140, which are more fully depicted in FIG. 12.
[0048] FIG. 12 illustrates obturator housing 1115 with proximal
obturator tube 1210 attached thereto. In one expression of the
instant surgical access device, tube 1210 is provided with a
threaded surface designed to mate with a threaded interior on
distal obturator tube 1220 (see FIG. 13 tube 1220). When housing
1115 is rotated, tube 1210 is concomitantly rotated driving tube
1210 into distal tube 1220 when tube 1220 is held stationary
relative to tube's 1210 rotation. Tube 1220 is provided with
locking fingers 1230 at its distal end to engage obturator shaft
1110 when inserted into obturator housing 1115. Radial locks 1235
are formed on a lateral surface of fingers 1230 to engage anchor
1170 and distal cannula tube 1180. Obturator housing 1115 is
provided with a base 1250 to receive housing 1140. Base 1250
defines a medial opening 1240 which may be adapted to receive
cannula 1105 housing therein.
[0049] Partial cross sectional view of obturator housing 1115 in
FIG. 13 depicts the interleaved nature of cylindrical housings
1120, 1130 and 1140. Cylindrical housings 1120, 1130, 1140 engage
and may press fit onto obturator housing base 1250 to form a
contiguous surface. Proximal axial force exerted on proximal-most
housing 1120 in turn exerts axial force on housing 1130 which, in
turn, exerts axial force on housing 1140 facilitating removal of
obturator 1115 from cannula. Housing 1115 further contains
obturator shaft detent pin 1310 which engages detents on obturator
shaft 1110.
[0050] Referring now to FIGS. 14 and 15, housing 1130, in one
expression, is provided with a toothed distal medial surface 1410.
When housing 1115 is assembled, toothed surface 1410 engages pawls
1420A, 1420B, 1420C. When housing 1130 is rotated, pawls 1420
permit rotation in a single direction creating a slip clutch
arrangement. Rotation of housing 1130 in turn rotates housing 1120
which in turn rotates proximal obturator tube 1210.
[0051] Obturator 1115 is provided with obturator shaft 1110 as
shown in FIG. 16. Shaft 1110 is provided with a gripping surface
1610 and detents 1620 and 1630. The distal end of shaft 1110 is
provided with leaf spring anchor extension fingers 1640A and 1640B
adapted to engage a medial flange portion of anchor 1170. Shaft tip
1650 is provided at the distal end of shaft 1110 and may be an
optical tip, a bladed tip, a blunt tip or any other tip known in
the art.
[0052] FIG. 17 illustrates cannula 1105 of trocar 1100. In one
expression of trocar 1100, cannula 1105 is comprised of a housing
1710, a proximal cannula tube 1160, a distal cannula tube 1180
located adjacent tube 1160 and an anchor 1170 which may be located
at a distal end of tube 1180. Anchor 1170, in one expression, is
provided with proximal ring 1730 and distal ring 1720 and living
hinges 1740. Living hinges 1740 may be biased to an open position
as shown in FIG. 17. Distal ring 1720 includes a medial annular
flange adapted to engage fingers 1640A and 1640B of obturator shaft
1110 to facilitate collapsing the anchor 1170 for insertion into an
anatomic structure. As depicted in FIG. 17, distal tube 1180 is
provided with a corrugated surface which may reduce friction threes
during cannula tube 1180 retraction into cannula tube 1160. When
cannula tube 1180 is retracted into tube 1160, tube 1180 is held in
place through an interference fit provided by the reduced proximal
diameter of tube 1160, as is shown in FIG. 18. Housing 1710 may be
provided with a sealing system 1820 and 1830 to prevent the escape
of insufflatory gas where the seal 1820 is a duckbill valve and
1830 is a diaphragm seal. Any form of seal may be used to prevent
the escape of insufflatory gas, as is known and understood in the
art. Cannula 1105 is provided with chamfered opening 1830 to
facilitate insertion of obturator shaft 1110 as well as surgical
instruments.
[0053] FIG. 19 depicts a partial cross sectional view of trocar
1100 with obturator shaft 1110 inserted through obturator housing
1115 and obturator shaft detent 1620 engaged with detent pin 1310.
In this position, anchor extension fingers 1640A and 1640B engage
anchor ring 1720 (see FIG. 20) and push anchor 1170 distally
collapsing anchor 1170 about tube 1180. In this position, trocar
1100 is armed for insertion into an anatomic structure. Referring
to FIG. 20, obturator shaft 1110 engages distal tube locking
fingers 1310 biasing fingers 1310 laterally. In this biased
position, locking fingers 1310 radial teeth 1235 engage anchor
proximal ring 1730 permitting axial force transfer from obturator
shaft 1110 to cannula distal tube 1180.
[0054] Once inserted into an anatomic structure, it may be
desirable to deploy anchor 1170 as shown in FIGS. 21 and 22.
Applying proximal axial force on obturator shaft 1110 moves shaft
1110 detent 1620 out of engagement with pin 1230 and into
engagement with detent 1630. This movement removes fingers 1640A
and 1640B from engagement with anchor ring 1720 permitting anchor
1170 to bias to a deployed state. In this state, anchor 1170 may
engage the interior wall of an anatomic structure, preventing
inadvertent removal of cannula 1105 during surgical instrument
exchanges.
[0055] It may be desirable to reduce the overall length of cannula
1105. Cannula 1105 length change may be accomplished in vivo or ex
vivo, with the anchor 1170 in a collapsed state or deployed state.
With obturator shaft 1110 inserted into obturator housing 1115 such
that shaft detents 1620 or 1630 engage pin 1230, shaft 1110 engages
locking fingers 1230 such that shaft 1110 and tube 1220 create an
interlocking fit, or may couple in a locking fashion, and pin 1230
and detents 1620 or 1630 create an interference fit. This
interference fit permits transfer of force from housing 1120 to
shaft 1220. Similarly, engagement of toothed surface 1410 and pawls
1420A, 1420B, and 1420C permits the transfer of force (e.g.
rotational force) applied to housing 1130 to tube 1210. When
housing 1130 is rotated and housing 1120 is held in a stationary
position, threads on lateral surface of tube 1210 engage threads on
medial surface of 1220, rotating tube 1210 and thereby driving tube
1220 in a proximal direction. Radial teeth 1235 engage anchor ring
1730 transferring proximal axial force from tube 1220 to cannula
tube 1180 thereby moving cannula tube 1180 in a proximal direction
into tube 1160, shortening the length of cannula 1105. Cannula tube
1180 is held in position due to the friction between tube 1160 and
1180, as stated previously. Once a desired length is achieved,
obturator shaft 1110 is removed as shown in FIG. 23.
[0056] Upon shaft 1110 removal, locking fingers 1230 return to a
medially biased position as shown in FIG. 24. In this position,
radial teeth 1235 disengage from ring 1730 permitting removal of
obturator 1115 from cannula 1105. As shown in FIGS. 23 and 24,
cannula tube 1180 is fully withdrawn into tube 1160. It is
understood that tube 1180 may be withdrawn partially into tube 1160
as well.
[0057] Referring now to FIG. 25, another expression of a surgical
trocar is depicted. Trocar 2500 includes a collapsible segment 2510
which may be useful in making preliminary adjustments to overall
cannula 2505 length. Segment 2510 is located adjacent cannula tube
2515 and cannula housing 2520. Before inserting a trocar into an
anatomic structure, it may be desirable to approximate cannula
length which may reduce time taken to adjust cannula length in
vivo. As depicted in FIG. 25, preliminary adjustment may be
achieved by an accordion section 2510 which may be comprised of an
elastomer and be flexible in nature, or may be rigid, depending
upon application and need.
[0058] One expression of collapsible segment 2510 adjustment
mechanism depicted in FIG. 25 is shown in FIGS. 26, 26A and 26B.
Tension members 2620A and 2620B are affixed to cannula tube 2515 at
tension members 2620A and 2620B distal ends. Proximal ends of
members 2620A and 2620B are affixed to spool 2630. Spool 2630
includes a keyseat 2640 adapted to receive obturator 2650 key 2655.
Rotation of obturator 2650 transfers rotational force through key
2655 to keyseat 2640 thereby turning spool 2630 and winding tension
members 2620A and 2620B around spool 2640. This winding shortens
tension members 2620A and 2620B collapsing section 2510. As
depicted in FIG. 26, section 2510 is an accordion type housing
having lateral and medial surfaces with tension members 2620A and
2620B located in a plane between lateral and medial section 2510
segments. Members 2620A and 2620B may be located on a medial
surface or a lateral surface depending upon application and
need.
[0059] Cannula housing 2520 lateral surface, in one expression, is
provided with a lock 2660 adapted to hold spool 2630 in a fixed
position relative to housing 2520. Lock 2660 may be a camming lock
where annular movement drives a portion of lock medially onto a
lateral surface of spool 2630 holding spool 2630 and housing 2520
stationary relative to each other.
[0060] Referring now to FIGS. 27A, 27B, 27C, 27D, and 27E, a trocar
insertion handle 2700 is provided. Handle 2700 is adapted to
receive a surgical trocar 2740. Handle 2700 is further provided
with an obturator 2720. Obturator 2720 is adapted to receive and
engage cannula 2740. Anchor deployment button 2710 is provided at a
proximal end of obturator 2720 and is adapted to cooperate with
anchor 2770 located at cannula 2740 distal end. When button 2710 is
depressed distally, spring 2730 is collapsed between button 2710
and handle housing 2705, anchor 2770 is moved distally, collapsing
anchor 2770 around cannula 2740 placing trocar 2740 in an armed
state, ready for insertion into an anatomic structure. Obturator
2720 is provided with a decent in communication with button 2775 to
hold anchor 2770 in a collapsed state (not shown). Obturator 2720
may be provided with a tip 2750 suitable for insertion through an
anatomic structure (e.g. abdominal wall, etc.).
[0061] After insertion of trocar 2740 into an anatomic structure as
shown in FIG. 27B, it may be desirable to deploy anchor 2770.
Button 2775 is depressed allowing spring 2730 to bias obturator
2720 proximally, permitting anchor 2770 to assume a deployed state.
Depending upon the composition of anchor 2770, it may be necessary
to pull obturator button 2710 proximally to deploy anchor 2770.
Once anchor 2770 is deployed, handle 2700 may be removed as shown
in 27D. As shown, handle 2700 and obturator 2720 are of unitary
construction. It is contemplated that handle 2700 and obturator
2720 may comprise two or more separate components. Upon removal of
handle 2700, cannula 2740 may be shortened to an appropriate
length. It is also contemplated that handle 2700 may further
comprise a cannula adjustment mechanism such that cannula
adjustment is accomplished with handle 2700 attached to cannula
2740.
[0062] Having shown and described various embodiments and examples
of the present invention, further adaptations of the methods and
devices described herein can be accomplished by appropriate
modifications by one of ordinary skill in the art without departing
from the scope of the present invention. Several of such potential
modifications have been mentioned, and others will be apparent to
those skilled in the art. For instance, the specific materials,
dimensions, and the scale of drawings will be understood to be
non-limiting examples. Accordingly, the scope of the present
invention should be considered in terms of the following claims and
is understood not to be limited to the details of structure,
materials, or acts shown and described in the specification and
drawings.
* * * * *