U.S. patent application number 17/211263 was filed with the patent office on 2021-07-08 for trocar with reduced profile.
The applicant listed for this patent is Ethicon LLC. Invention is credited to Jeffery Kirk, Katherine J. Schmid.
Application Number | 20210204978 17/211263 |
Document ID | / |
Family ID | 1000005478624 |
Filed Date | 2021-07-08 |
United States Patent
Application |
20210204978 |
Kind Code |
A1 |
Schmid; Katherine J. ; et
al. |
July 8, 2021 |
Trocar with Reduced Profile
Abstract
Methods and devices are provided for various insufflation
sealing approaches for a trocar. For example, a trocar is provided
that has a housing and a cannula extending therefrom. The housing
and the cannula have a tool pathway extending therethrough for
receiving a surgical tool, and the housing has an insufflation port
therein. A variety of seal elements are provided that seal the
insufflation port to prevent fluid flow into the port. The port and
seal elements are configured to have a reduced profile to prevent
interference between the trocar and a tissue surface during
use.
Inventors: |
Schmid; Katherine J.;
(Loveland, OH) ; Kirk; Jeffery; (Liberty Township,
OH) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Ethicon LLC |
Guaynabo |
PR |
US |
|
|
Family ID: |
1000005478624 |
Appl. No.: |
17/211263 |
Filed: |
March 24, 2021 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
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15380483 |
Dec 15, 2016 |
10959756 |
|
|
17211263 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 34/35 20160201;
A61M 2205/0216 20130101; A61M 2039/229 20130101; A61B 34/72
20160201; A61M 13/003 20130101; A61B 17/3474 20130101; A61B
2017/3419 20130101; A61B 17/3498 20130101; A61M 39/10 20130101;
A61M 39/24 20130101; A61B 17/3462 20130101 |
International
Class: |
A61B 17/34 20060101
A61B017/34; A61B 34/00 20060101 A61B034/00; A61B 34/35 20060101
A61B034/35; A61M 13/00 20060101 A61M013/00; A61M 39/10 20060101
A61M039/10; A61M 39/24 20060101 A61M039/24 |
Claims
1. A trocar assembly, comprising: a trocar having a housing and a
cannula extending distally from the housing, the housing and the
cannula having a tool pathway extending therethrough for receiving
a tool; at least one seal disposed within the housing and extending
across the pathway, the at least one seal being configured to form
at least one of a seal across the pathway when no tool is disposed
therethrough and a seal around a tool when a tool is inserted
therethrough to thereby seal an insufflation fluid within the
housing; and a port formed in a sidewall of the housing at a
location distal of the at least one seal, the port being in fluid
communication with the tool pathway; a stopcock assembly removably
matable to the port for allowing the delivery of insufflation fluid
to the tool pathway; and a plug removably matable to the port for
sealing the port when the stopcock assembly is removed from the
port.
2. The trocar assembly of claim 1, wherein the port includes a
female luer connector formed therein and configured to receive a
male luer connector formed on the stopcock assembly.
3. The trocar assembly of claim 1, wherein the stopcock assembly
includes a valve for selectively opening and closing a fluid flow
path extending through the stopcock assembly.
4. The trocar assembly of claim 1, wherein the plug is
elastomeric.
5. The trocar assembly of claim 1, wherein the plug is configured
to be held within the port by a friction fit.
6. The trocar assembly of claim 1, wherein the port is fully
disposed without the housing and does not project outward from a
sidewall of the housing.
7. A trocar assembly, comprising: a trocar having a housing and a
cannula extending distally from the housing, the housing and the
cannula having a tool pathway extending therethrough for receiving
a tool; at least one seal disposed within the housing and extending
across the pathway, the at least one seal being configured to form
at least one of a seal across the pathway when no tool is disposed
therethrough and a seal around a tool when a tool is inserted
therethrough to thereby seal an insufflation fluid within the
housing; and a port formed in a sidewall of the housing at a
location distal of the at least one seal, the port being in fluid
communication with the tool pathway; a flapper door extending
across the port and movable between a closed position, in which the
flapper door forms a seal across the port, and an open position in
which the flapper door is configured to mate to an insufflation
tubing assembly for the delivery of insufflation fluid into the
tool pathway.
8. The trocar assembly of claim 7, wherein the flapper door is
biased to the closed position, and is configured to automatically
move to an open position when an insufflation tubing assembly is
coupled thereto.
9. The trocar assembly of claim 7, wherein the port includes a
female luer connector for receiving a male luer connector on an
insufflation tubing assembly.
10. The trocar assembly of claim 7, further comprising an
insufflation tubing assembly having a mating element formed on an
end thereof and configured to be received within the port for
mating the insufflation tubing to the port.
11. The trocar assembly of claim 7, wherein the port is fully
disposed without the housing and does not project outward from a
sidewall of the housing.
12. A trocar assembly, comprising: a trocar having a housing and a
cannula extending distally from the housing, the housing and the
cannula having a tool pathway extending therethrough for receiving
a tool; at least one seal disposed within the housing and extending
across the pathway, the at least one seal being configured to form
at least one of a seal across the pathway when no tool is disposed
therethrough and a seal around a tool when a tool is inserted
therethrough to thereby seal an insufflation fluid within the
housing; and a port formed in a sidewall of the housing at a
location distal of the at least one seal, the port being in fluid
communication with the tool pathway; a one-time seal extending
across the port to seal the port, the one-time seal being
configured to be punctured when an insufflation tubing is mated to
the port.
13. The trocar assembly of claim 12, wherein the port is fully
disposed without the housing and does not project outward from a
sidewall of the housing.
14. The trocar assembly of claim 12, wherein the one-time seal
comprises a film.
15. The trocar assembly of claim 12, wherein the port includes a
female luer fitting formed therein and configured to receive a male
luer fitting formed on an insufflation tubing.
16. The trocar assembly of claim 12, further comprising an
insufflation tubing assembly having a mating element formed on an
end thereof and configured to be received within the port for
mating the insufflation tubing to the port.
Description
CROSS REFERENCE TO RELATED APPLICATIONS
[0001] This application is a continuation from U.S. patent
application Ser. No. 15/380,483 filed on Dec. 15, 2016, entitled
"Trocar with Reduced Profile," which is hereby incorporated herein
by reference in its entirety.
FIELD
[0002] Trocars having a reduced profile, and methods for using such
a trocar, are provided.
BACKGROUND
[0003] Minimally invasive surgical (MIS) instruments are often
preferred over traditional open surgical devices due to the reduced
post-operative recovery time and minimal scarring. Laparoscopic
surgery is one type of MIS procedure in which one or more small
incisions are formed in the abdomen and a trocar is inserted
through the incision to form a pathway that provides access to the
abdominal cavity. The trocar is used to introduce various
instruments and tools into the abdominal cavity, as well as to
provide insufflation to elevate the abdominal wall above the
organs. The instruments and tools can be used to engage and/or
treat tissue in a number of ways to achieve a diagnostic or
therapeutic effect. Endoscopic surgery is another type of MIS
procedure in which elongate flexible shafts are introduced into the
body through a natural orifice.
[0004] Although traditional minimally invasive surgical instruments
and techniques have proven highly effective, newer systems may
provide even further advantages. For example, traditional minimally
invasive surgical instruments often deny the surgeon the
flexibility of tool placement found in open surgery. Difficulty is
experienced in approaching the surgical site with the instruments
through the small incisions. Additionally, the added length of
typical endoscopic instruments often reduces the surgeon's ability
to feel forces exerted by tissues and organs on the end effector.
Furthermore, coordination of the movement of the end effector of
the instrument as viewed in the image on the television monitor
with actual end effector movement is particularly difficult, since
the movement as perceived in the image normally does not correspond
intuitively with the actual end effector movement. Accordingly,
lack of intuitive response to surgical instrument movement input is
often experienced. Such a lack of intuitiveness, dexterity, and
sensitivity of endoscopic tools has been found to be an impediment
in the increased the use of minimally invasive surgery.
[0005] Over the years a variety of minimally invasive robotic
systems have been developed to increase surgical dexterity as well
as to permit a surgeon to operate on a patient in an intuitive
manner. Telesurgery is a general term for surgical operations using
systems where the surgeon uses some form of remote control, e.g., a
servomechanism, or the like, to manipulate surgical instrument
movements, rather than directly holding and moving the tools by
hand. In such a telesurgery system, the surgeon is typically
provided with an image of the surgical site on a visual display at
a location remote from the patient. The surgeon can typically
perform the surgical procedure at the location remote from the
patient whilst viewing the end effector movement on the visual
display during the surgical procedure. While viewing typically a
three-dimensional image of the surgical site on the visual display,
the surgeon performs the surgical procedures on the patient by
manipulating master control devices at the remote location, which
master control devices control motion of the remotely controlled
instruments.
[0006] While significant advances have been made in the field of
robotic surgery, there remains a need for improved methods,
systems, and devices for use in robotic surgery.
SUMMARY
[0007] Trocars are provided having various insufflation port
configurations. In one embodiment, a trocar assembly is provided
and includes a trocar having a housing and a cannula extending
distally from the housing. The housing and the cannula have a tool
pathway extending therethrough for receiving a tool. At least one
seal is disposed within the housing and extending across the
pathway, the at least one seal being configured to form at least
one of a seal across the pathway when no tool is disposed
therethrough and a seal around a tool when a tool is inserted
therethrough to thereby seal an insufflation fluid within the
housing. The trocar further includes a port formed in a sidewall of
the housing at a location distal of the at least one seal. The port
is in fluid communication with the tool pathway.
[0008] In one embodiment, the trocar includes a stopcock assembly
removably matable to the port for allowing the delivery of
insufflation fluid to the tool pathway, and a plug removably
matable to the port for sealing the port when the stopcock assembly
is removed from the port. In certain aspects, the port can include
a female luer connector formed therein and configured to receive a
male luer connector formed on the stopcock assembly. The stopcock
assembly can include a valve for selectively opening and closing a
fluid flow path extending through the stopcock assembly.
[0009] The plug can have a variety of configurations, but in one
embodiment the plug is elastomeric. The plug can be configured to
be held within the port by a friction fit.
[0010] In other aspects, the port can be fully disposed without the
housing and does not project outward from a sidewall of the
housing.
[0011] In another embodiment, a trocar assembly is provided and
includes a trocar having a housing and a cannula extending distally
from the housing. The housing and the cannula have a tool pathway
extending therethrough for receiving a tool. At least one seal is
disposed within the housing and extends across the pathway. The at
least one seal is configured to form at least one of a seal across
the pathway when no tool is disposed therethrough and a seal around
a tool when a tool is inserted therethrough to thereby seal an
insufflation fluid within the housing. The trocar also includes a
port formed in a sidewall of the housing at a location distal of
the at least one seal. The port is in fluid communication with the
tool pathway.
[0012] In one embodiment, a flapper door extends across the port
and is movable between a closed position, in which the flapper door
forms a seal across the port, and an open position in which the
flapper door is configured to mate to an insufflation tubing
assembly for the delivery of insufflation fluid into the tool
pathway. In certain aspects, the flapper door can be biased to the
closed position, and is configured to automatically move to an open
position when an insufflation tubing assembly is coupled
thereto.
[0013] The port can have various configurations, and can include a
female luer connector for receiving a male luer connector on an
insufflation tubing assembly. The port can be fully disposed
without the housing and does not project outward from a sidewall of
the housing.
[0014] The trocar can also include an insufflation tubing assembly
having a mating element formed on an end thereof and configured to
be received within the port for mating the insufflation tubing to
the port.
[0015] In another embodiment, a trocar assembly is provided and
includes a trocar having a housing and a cannula extending distally
from the housing. The housing and the cannula have a tool pathway
extending therethrough for receiving a tool. At least one seal is
disposed within the housing and extends across the pathway. The at
least one seal is configured to form at least one of a seal across
the pathway when no tool is disposed therethrough and a seal around
a tool when a tool is inserted therethrough to thereby seal an
insufflation fluid within the housing. A port is formed in a
sidewall of the housing at a location distal of the at least one
seal. The port is in fluid communication with the tool pathway.
[0016] In an exemplary embodiment, a one-time seal extends across
the port to seal the port. The one-time seal is configured to be
punctured when an insufflation tubing is mated to the port. The
one-time seal can be, for example, a film
[0017] In certain aspects, the port is fully disposed without the
housing and does not project outward from a sidewall of the
housing. The port can include a female luer fitting formed therein
and configured to receive a male luer fitting formed on an
insufflation tubing. In a further embodiment, the trocar can
include an insufflation tubing assembly having a mating element
formed on an end thereof and configured to be received within the
port for mating the insufflation tubing to the port.
[0018] Methods for using the above devices are also disclosed
herein.
BRIEF DESCRIPTION OF THE DRAWINGS
[0019] The invention will be more fully understood from the
following detailed description taken in conjunction with the
accompanying drawings, in which:
[0020] FIG. 1 is a perspective view of one embodiment of a surgical
robotic system that includes a patient-side portion and a user-side
portion;
[0021] FIG. 2A is a cross-sectional view of one embodiment of a
trocar with a removable stopcock assembly;
[0022] FIG. 2B is a cross-sectional view of the trocar of FIG. 2A
with a removable plug;
[0023] FIG. 3A is a cross-sectional, exploded view of another
embodiment of a trocar with a removable stopcock assembly;
[0024] FIG. 3B is a perspective, exploded view of the trocar of
FIG. 3A;
[0025] FIG. 4 is a cross-sectional view of a portion of a trocar
having a port with a spring-loaded flapper valve shown in a closed
configuration;
[0026] FIG. 5 is a cross-sectional view of the trocar of FIG. 4
with the spring-loaded flapper valve in an open configuration and
having an insufflation tubing inserted therein;
[0027] FIG. 6 is a front view of the trocar port of FIG. 4 with the
spring-loaded flapper valve closed;
[0028] FIG. 7 is a perspective view of a trocar with a port having
a one-time seal and showing an insufflation tube about to be passed
into the port; and
[0029] FIG. 8 is a perspective view of the port and one-time seal
of FIG. 7.
DETAILED DESCRIPTION
[0030] Certain exemplary embodiments will now be described to
provide an overall understanding of the principles of the
structure, function, manufacture, and use of the devices and
methods disclosed herein. One or more examples of these embodiments
are illustrated in the accompanying drawings. Those skilled in the
art will understand that the devices and methods specifically
described herein and illustrated in the accompanying drawings are
non-limiting exemplary embodiments and that the scope of the
present invention is defined solely by the claims. The features
illustrated or described in connection with one exemplary
embodiment may be combined with the features of other embodiments.
Such modifications and variations are intended to be included
within the scope of the present invention.
[0031] Further, in the present disclosure, like-named components of
the embodiments generally have similar features, and thus within a
particular embodiment each feature of each like-named component is
not necessarily fully elaborated upon. Additionally, to the extent
that linear or circular dimensions are used in the description of
the disclosed systems, devices, and methods, such dimensions are
not intended to limit the types of shapes that can be used in
conjunction with such systems, devices, and methods. A person
skilled in the art will recognize that an equivalent to such linear
and circular dimensions can easily be determined for any geometric
shape. Sizes and shapes of the systems and devices, and the
components thereof, can depend at least on the anatomy of the
subject in which the systems and devices will be used, the size and
shape of components with which the systems and devices will be
used, and the methods and procedures in which the systems and
devices will be used.
[0032] Various surgical tools and methods are provided that are
configured to prevent interference between an insufflation port and
a tissue surface during use of a trocar. Trocars generally have a
housing and a cannula extending from the housing with a tool
pathway extending through the housing and the cannula to receive a
surgical tool. A seal is formed across the tool pathway, and the
housing is able to connect to an insufflation pathway, for example
through insufflation tubing, to deliver insufflation through the
trocar and cannula and into a body cavity of a patient. A typical
trocar has a stopcock assembly formed on and projecting from a
sidewall of the housing for mating to an insufflation tube. One
problem with current trocars is that the stopcock assembly has a
high profile which can increase a risk that the stopcock assembly
will interfere with use of the device. This is especially the case
in robotic surgery, wherein multiple tools extending through
multiple trocars are manipulated simultaneously. The stopcock
assembly on each trocar has been known to "crash" into the tissue
surface or other trocars and tool. While the stopcock assembly can
be oriented during setup to avoid such collisions, this can
undesirably add additional time to the procedure. Trocars having a
low profile and alternative configurations for coupling to an
insufflation tubing are thus provided.
[0033] FIG. 1 is a perspective vies of one embodiment of a surgical
robotic system 100 that includes a patient-side portion 102 that is
positioned adjacent to a patient 104, and a user-side portion 106
that is located a distance from the patient, either in the same
room and/or in a remote location. The patient-side portion 102
generally includes one or more robotic arms 108 and one or more
surgical tools and/or tool assemblies 110 that are configured to
releasably couple to a robotic arm 108. The user-side portion 106
generally includes a vision system 112 for viewing the patient 104
and/or surgical site, and a control system 114 for controlling the
movement of the robotic arms 108 and each surgical tool 110 during
a surgical procedure. A person skilled in the art will appreciate
that the surgical robotic system can have a variety of
configurations. One exemplary system is disclosed in WIPO Patent
Publication No. WO2014/151621, filed on Mar. 13, 2014 and entitled
"Hyperdexterous Surgical System," which is incorporated herein by
reference in its entirety.
[0034] The patient-side portion 102 can have a variety of
configurations. As illustrated in FIG. 1A the patient-side portion
102 is coupled to an operating table 116. However, in other
embodiments, the patient-side portion 102 can be mounted to a wall,
to the ceiling, to the floor, or to other operating room equipment.
Further, while the patient-side portion 102 is shown as including
two robotic arms 108, more or fewer robotic arms 108 may be
included. Furthermore, the patient-side portion 102 can include
separate robotic arms 108 mounted in various positions, such as
relative to the surgical table 116 (as shown in FIG. 1A).
Alternatively, the patient-side portion 102 can include a single
assembly that includes one or more robotic arms 108 extending
therefrom.
[0035] The surgical tool 110 includes an elongate shaft 122, an end
effector 124, and a tool housing 128 coupled to a proximal end of
the shaft 122. The shaft 122 can have any of a variety of
configurations. In general, the shaft 122 is an elongate member
extending distally from the housing 128 and having at least one
inner lumen extending therethrough. The shaft 122 is fixed to the
housing 128, but in other embodiment the shaft 122 can be
releasably coupled to the housing 128 such that the shaft 122 can
be interchangeable with other shafts. This may allow a single
housing 128 to be adaptable to various shafts having different end
effectors. The end effector 124 can also have a variety of sizes,
shapes, and configurations. The end effector 124 can be configured
to move relative to the shaft 122, e.g., by rotating and/or
articulating, to position the end effector 124 at a desired
location relative to a surgical site during use of the tool 110.
The housing 128 includes various components (e.g., gears and/or
actuators) configured to control the operation various features
associated with the end effector 124 (e.g., any one or more of
clamping, firing, rotation, articulation, energy delivery, etc.).
In at least some embodiments, as in this illustrated embodiment,
the surgical tool 110 is configured to releasably couple to a tool
driver 129 mounted on a carrier 130 on the distal end of the
robotic arm 108. The tool housing 128 can include coupling features
configured to allow the releasable coupling of the tool 110 to the
tool driver 129. The carrier 130 can also include a trocar or a
trocar support 132 mounted on a distal end thereof and configured
to receive a shaft 122 of the tool 110 therethrough. A person
skilled in the art will appreciate that the surgical tool 110 can
have any of a variety of configurations, and it can be configured
to perform at least one surgical function. The surgical tool can
be, for example, a stapler, a clip applier, forceps, a grasper, a
needle driver, scissors, an electrocautery tool that applies
energy, a suction tool, an irrigation tool, an imaging device
(e.g., an endoscope or ultrasonic probe), etc.
[0036] The control system 114 can have a variety of configurations
and can be located adjacent to the patient (e.g., in the operating
room), remote from the patient (e.g., in a separate control room),
or distributed at two or more locations (e.g., the operating room
and/or separate control room(s)). As an example of a distributed
system, a dedicated system control console can be located in the
operating room, and a separate console can be located in a remote
location. The control system 114 can include components that enable
a user to view a surgical site of the patient 104 being operated on
by the patient-side portion 102 and/or to control one or more parts
of the patient-side portion 102 (e.g., to perform a surgical
procedure at the surgical site). In some embodiments, the control
system 114 can also include one or more manually-operated input
devices, such as a joystick, exoskeletal glove, a powered and
gravity-compensated manipulator, or the like. The one or more input
devices can control teleoperated motors which, in turn, control the
movement of the surgical system, including the robotic arms 108 and
surgical tools 110.
[0037] As indicated above, in an exemplary embodiment the trocar
has a low profile to prevent collisions during use with other tools
and/or the tissue surface. In general, the trocar includes a
housing and a cannula extending distally therefrom. A tool pathway
extends through the housing and the cannula for receiving an
elongate shaft of a surgical tool, such as the shaft 122 of
surgical tool 110, to allow an end effector on the tool to be
positioned within a body cavity.
[0038] In order to facilitate viewing within the body cavity and
manipulation of the end effector, the trocar can be configured to
allow an insufflation fluid to be passed therethrough and into a
body cavity to inflate the body cavity. In order to present escape
of the insufflation fluid through the proximal opening in the
trocar, the trocar can include any numbers of seals disposed
therein and configured to form a seal across the tool pathway when
no tool is present and/or when a tool is disposed through the
pathway. By way of example, a trocar can include a first seal that
seals across the channel when no instrument is present. The first
seal can be, for example, a channel seal such as zero-closure seal
or flapper valve. The trocar can also include a second seal, such
as an instrument seal, that forms a seal around a shaft of a tool
passed through the tool pathway. The second seal can be, for
example, a duckbill seal, a multilayer seal, etc.
[0039] In order to allow delivery of an insufflation fluid into the
housing of the trocar, the housing can further include an
insufflation port formed therein. In an exemplary embodiment, the
insufflation port is configured so as to have a low profile and to
allow for rapid connection and disconnected of an insufflation
tubing assembly.
[0040] FIG. 2A illustrates one embodiment of a trocar 200 with a
housing 202 and a cannula 204 extending distally from the housing.
A tool pathway extends through an opening 206 in the housing 202
and through the cannula 204 along a longitudinal axis A1. The
housing 202 has a top portion 202t and a bottom portion 202b with a
first seal, e.g., an instrument seal 207, extending therebetween to
provide a seal across the tool pathway. A second seal, such as a
channel seal 209, is disposed within the housing distal of the
instrument seal 207, and the channel seal 209 forms a seal across
the channel with no tool is inserted through the trocar.
[0041] As further shown in FIG. 2A, an insufflation port 208 is
formed within a sidewall of the housing 202 such that it is
fully-contained within and does not project from the housing 202.
The port 208 is in the form of an opening extending through the
sidewall and in fluid communication with the tool pathway. In this
embodiment, the trocar includes a stopcock 220 that can be
removably mated to the port 208. Insufflation tubing can be
connected to the stopcock 220 for delivering an insufflation fluid
through the port 208 and into the tool pathway for delivering into
a body cavity of a patient during use. If the stopcock 220 is not
needed, the stopcock 220 can be removed and a plug 222 can be
inserted into the port 208, as illustrated in FIG. 2B. The plug 222
can seal the port 208 and allow the trocar 200 to operate as usual.
If insufflation is needed during use, a user can remove the plug
222 and attach the removable stopcock 220 as desired. If
insufflation is not needed, for example if multiple trocars are in
use and another trocar is providing insufflation, the user can
insert the plug 222. The removable stopcock 220 and the plug 222
provide the freedom to choose between a low profile configuration
during use of the plug 222, and selectively using the stopcock 220
with insufflation as needed.
[0042] The stopcock 220 can be mated to the port 208 using a
variety of techniques. In the illustrated embodiment, the port 208
is tapered and thus forms a female luer fitting. The stopcock 220
has a corresponding male luer formed thereon that is received
within the port for mating the stopcock 220 to the port. The
stopcock 220 can, however, be attached to the port 208 in a variety
of ways, such as by press-fit, a mechanical connection, a clasp or
other locking feature, etc. The plug 222 can also mate to the port
208 using a variety of techniques. In the illustrated embodiment,
the plug is elastomeric and thus compresses when it is inserted
into the port to form a seal while also maintaining the plug
therein by friction fit. The plug 222 can have a tapered
configuration as well, as shown in FIG. 2B, to facilitate mating a
formation of a secure seal. The plug can be entirely disposed
within the port 208 to be unobtrusive or it can partially extend
from the port 208 radially outward to allow easier manipulation and
removal. The plug can take a variety of forms and be made of a
variety of materials. For example, the plug can be square,
rectangular, cylindrical, etc., and the plug can be made from an
elastomer or other sealing material.
[0043] The stopcock 220 can have a variety of configurations, but
in generally should have a fluid pathway formed therethrough and
configured to communicate with the port 208 for allowing the
delivery of insufflation fluid into the trocar. The stopcock 220
can optionally include a lever 221 coupled thereto for opening and
closing the insufflation pathway extending through the stopcock
220.
[0044] FIGS. 3A-3B illustrate another embodiment of a trocar 250
with an outer housing 252 and a cannula 254 extending distally from
the housing. The outer housing 252 and the cannula 254 are modular
and are capable of being coupled and uncoupled from one another.
The cannula 254 is in the form of a hollow elongate tube having a
plurality of ribs 254r formed along an outer surface thereof and an
inner housing 255 at its proximal end. The outer housing includes a
top portion 252t and a bottom portion 252b that seat and engage the
inner housing 255 therebetween. A tool pathway extends through an
opening 256 in the outer housing 252 and through the cannula 254
along a longitudinal axis A2. A first seal, e.g., an instrument
seal 257, is disposed within the top portion 252t of the outer
housing 252 and forms a seal across the tool pathway. A second
seal, such as a channel seal 259, is disposed within the top
portion 252t of the outer housing distal of the instrument seal
257, and forms a seal across the channel when no tool is inserted
through the trocar.
[0045] An insufflation port 258 is formed within a sidewall of the
inner housing 255. The port 258 is in the form of an opening
extending through the sidewall and in fluid communication with the
tool pathway. The trocar 250 can include a stopcock assembly 270
that can be removably mated to the port 258. Insufflation tubing
can be connected to the stopcock assembly 270 for delivering an
insufflation fluid through the port 258 and into the tool pathway
and into a body cavity of a patient during use. If the stopcock
assembly 270 is not needed, the stopcock assembly 270 can be
removed and a plug 272 can be inserted into the port 258. The plug
272 can seal the port 258 and allow the trocar 250 to operate as
usual. If insufflation is needed during use, a user can remove the
plug 272 and attach the removable stopcock assembly 270 as desired.
If insufflation is not needed, for example if multiple trocars are
in use and another trocar is providing insufflation, the user can
insert the plug 272. The removable stopcock assembly 270 and the
plug 272 provide the freedom to choose between a low profile
configuration during use of the plug 272, and selectively using the
stopcock 270 with insufflation as needed. A trocar support 280 can
be used to support and hold the trocar 250, and the trocar support
280 can have a cut-out 282 that receives the port 258 and the
stopcock 270 or the plug 272.
[0046] FIGS. 4-6 illustrate a portion of another embodiment of a
trocar housing having an insufflation port 308 formed therein.
While the port 308 is shown fully disposed within a sidewall of the
housing such that it does not project from the housing, the port
308 in other embodiments can project from the housing by a certain
distance. The trocar and the port can have a configuration similar
to that described above with respect to FIGS. 2 and 3. In this
embodiment, the port 308 has a spring-loaded flapper valve 310 that
closes over and seals the port 308. The valve 310 can be biased to
the closed configuration, shown in FIG. 4, to seal the port 308
when not in use. The flapper valve 310 generally includes a solid
door 312, such as a piece of rigid plastic, that is on a
spring-loaded hinge 314. The spring-loaded hinge 314 biases the
door 312 closed. In one embodiment, an outer perimeter of the door
312 can be surrounded by an elastomeric seal 316 that, combined
with the door 312 in its closed position, seals the port 308. The
elastomeric seal 316 can be made from a flexible material, such as
an elastomeric material, to allow movement of the seal.
[0047] During use, a stopcock (such as stopcock 220) or an
insufflation tube 320 can be inserted into the port 308, causing
the door 312 to move to an open configuration thereby allowing the
tube 320 to mate to the port 308, as illustrated in FIG. 5. In an
exemplary embodiment, the door 312 moves into the port 308 as it
transitions from the closed position to the open position so as to
allow the door 312 to move in response to insertion of the
insufflation tubing or stopcock therein. The elastomeric seal 316
will seal around the tube 320, and the tube 320 can provide
insufflation through the port 308. Insertion of the tube 320 into
the port 308 will thus automatically connect the insufflation
pathway. When the tube 320 is removed, the spring bias can cause
the door to return to the closed position, thereby automatically
disconnecting the insufflation pathway and sealing the port
308.
[0048] Various techniques can be used to coupling an insufflation
tube to the port 308, including those described above with respect
to FIGS. 2 and 3. In the illustrated embodiment, the insufflation
tube 320 has a male mating member 322 on a distal end that is
configured and shaped to push the door 312 open. The male mating
member 322 is press-fit into the port 308. A variety of other
mating configurations can be used. For example, the insufflation
tube and the insufflation port can use a luer twist connection,
press-fit, a male and female mating mechanism, etc. A stopcock
lever and/or valve can be disposed on the insufflation tubing 320,
which would provide a user a way to open and close the insufflation
pathway created by connecting the tubing 320 and the port 308, but
a lever and/or valve is not required. Insufflation ports can be
embedded, recessed, and/or fully contained within a trocar to
reduce a profile of the trocar or can extend therefrom to allow
easier access and use of the port.
[0049] FIGS. 7 and 8 illustrate another embodiment of a trocar
having a housing 402 and a cannula 404 extending distally
therefrom. The housing has insufflation port 408 projecting from
the sidewall thereof, however the port 408 can be fully recessed
and contained within the sidewall similar to ports 208, 308. A tool
pathway extends through an opening 406 in the housing 402 and
through the cannula 404, and at least one seal is disposed within
the housing 402 to provide a seal across the tool pathway. The
insufflation port 408 has a sealing film 410 (represented by
cross-hatching in FIG. 8) that extends across an opening in the
port 408 to seal the port 408. The sealing film can be made from a
variety of materials and can take a variety of forms, such as a
cellophane membrane, a gel, an elastomeric plug, a cap, etc. The
sealing film 410 is preferably configured for one-time use, such
that it is incapable of forming a seal after an insufflation tubing
is mated to the port.
[0050] During use, an insufflation tube 420 can be inserted into
the port 408, piercing the sealing film 410 that extends across the
port 408, thus allowing entry of the tube 420 into the port 408.
The tube 420 forms a seal with the port 408 and provides an
insufflation pathway through the trocar 400. The illustrated
insufflation tube 420 has a male mating member 422 on a distal end
that is configured and shaped to pierce the sealing film 410. The
male mating member 422 can be press-fit within the port 408 to
create a seal. A variety of different mating connections can be
used, such as a male and female luers or other male and female
mating mechanism, clasps or latches, press-fit, friction fit,
etc.
[0051] As indicated above, the sealing film 410 is a one-time use
film, which cannot be resealed once the tube 420 is inserted into
the port 408 and the male mating member 422 pierces the film 410.
However, other embodiments can have a sealing film, such as a gel
membrane, that could re-seal and re-open as the insufflation tube
was detached and re-attached as needed.
[0052] A stopcock lever 424 can be disposed on the insufflation
tube 420, which allows a user to selectively open and close the
insufflation pathway created by connecting the tube 420 and the
port 408. A variety of opening and closing valves, levers, etc.,
can be used, but a stopcock and/or lever and/or valve is not
required.
[0053] As will be appreciated by a person skilled in the art,
electronic communication between various components of a robotic
surgical system can be wired or wireless. A person skilled in the
art will also appreciate that all electronic communication in the
system can be wired, all electronic communication in the system can
be wireless, or some portions of the system can be in wired
communication and other portions of the system can be in wireless
communication.
[0054] The systems, devices, and methods disclosed herein can be
implemented using one or more computer systems, which may also be
referred to herein as digital data processing systems and
programmable systems.
[0055] A computer system can also include any of a variety of other
software and/or hardware components, including by way of
non-limiting example, operating systems and database management
systems. Although an exemplary computer system is depicted and
described herein, it will be appreciated that this is for sake of
generality and convenience. In other embodiments, the computer
system may differ in architecture and operation from that shown and
described here.
[0056] Preferably, components of the invention described herein
will be processed before use. First, a new or used instrument is
obtained and if necessary cleaned. The instrument can then be
sterilized. In one sterilization technique, the instrument is
placed in a closed and sealed container, such as a plastic or TYVEK
bag. The container and instrument are then placed in a field of
radiation that can penetrate the container, such as gamma
radiation, x-rays, or high energy electrons. The radiation kills
bacteria on the instrument and in the container. The sterilized
instrument can then be stored in the sterile container. The sealed
container keeps the instrument sterile until it is opened in the
medical facility.
[0057] Typically, the device is sterilized. This can be done by any
number of ways known to those skilled in the art including beta or
gamma radiation, ethylene oxide, steam, and a liquid bath (e.g.,
cold soak). An exemplary embodiment of sterilizing a device
including internal circuitry is described in more detail in U.S.
Pat. No. 8,114,345 filed Feb. 8, 2008 and entitled "System And
Method Of Sterilizing An Implantable Medical Device." It is
preferred that device, if implanted, is hermetically sealed. This
can be done by any number of ways known to those skilled in the
art.
[0058] One skilled in the art will appreciate further features and
advantages of the invention based on the above-described
embodiments. Accordingly, the invention is not to be limited by
what has been particularly shown and described, except as indicated
by the appended claims. All publications and references cited
herein are expressly incorporated herein by reference in their
entirety.
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