CA1149697A - Laparoscope cannula with improved suture receiving means - Google Patents
Laparoscope cannula with improved suture receiving meansInfo
- Publication number
- CA1149697A CA1149697A CA000347822A CA347822A CA1149697A CA 1149697 A CA1149697 A CA 1149697A CA 000347822 A CA000347822 A CA 000347822A CA 347822 A CA347822 A CA 347822A CA 1149697 A CA1149697 A CA 1149697A
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- Prior art keywords
- cannula
- rigid members
- rigid
- shaft portion
- laparoscope
- Prior art date
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/313—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes
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- Radiology & Medical Imaging (AREA)
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- Engineering & Computer Science (AREA)
- Physics & Mathematics (AREA)
- Heart & Thoracic Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
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Abstract
LAPAROSCOPE CANNULA WITH IMPROVED
SUTURE RECEIVING MEANS
ABSTRACT OF THE DISCLOSURE
A laparoscope cannula including four rigid members extending from the cannula for receiving sutures to main-tain the cannula in place with respect to the patient's abdomen. Each of the rigid members defines a slot which opens to the outside and tapers inwardly toward the cannula. The rigid members extend parallel to the axis of the cannula and are fixed to gas valve means carried by the cannula.
SUTURE RECEIVING MEANS
ABSTRACT OF THE DISCLOSURE
A laparoscope cannula including four rigid members extending from the cannula for receiving sutures to main-tain the cannula in place with respect to the patient's abdomen. Each of the rigid members defines a slot which opens to the outside and tapers inwardly toward the cannula. The rigid members extend parallel to the axis of the cannula and are fixed to gas valve means carried by the cannula.
Description
B~CKGROUND O~ l'HE INV~I~TION
The laparoscope (peritoneoscope, celioscope) is an important tool of modern gynecologic diagnosis and surgical treatment. ~ prior art techni~le oE 1.~ co~ ni~-ec the intoduction of a needle into the peritoneal cavity to establish a pneumoperitoneum, and the abdominal wall is then punctured with a cannula, bearing a sharp trochar.
Both of these steps are performed blindly, and there is thus the possibility of accidentally puncturing a vital organ or a blood vessel. The trochar is subsequently withdrawtl, an(~ t~le li~l~t~l 1a~ o~;c~ ~ c i~ L~ IILO~
the cannula lnto the peritoneal cavity for visualization.
Another technique of performing laparoscopy is discussed in my article in~the American Journal of Obstetrics and Gynecology, St. Louis, Vol. 110, No. 6, pages 886-887, July 15, 1971. In this technique, a laparoscope cannula with a trumpet valve is fitted with a thin, cone-shaped steel sleeve, mounted on the cannula's shaft. The cone sleeve may be fitted with an extender to accommodate variations in the thickness of the abdominal wall and in the distance between the umbilicus and the symphysis pubis.
The purpose of the conical sleeve is to seal the peritoneal and fascial gap, by advc~ncing the cone deeper through the incisional opening. Although the use of such a cannula has been found generally satisfactory, certain problems were noted. These problems included the occa-sional occurrence of gas leaks, the need for an assistant to hold the cannula in place while the scope was being withdrawn or manipulated, and the need to use several ~ 96~7 cannulas o~ di~ferent sizes to accommodate inclividual vari-ations in the tllickness of the abdominal wall.
In my United States Patent No. 3,817,251, issued June 18, 1974, I disclosed a laparoscope cannula which alleviated tlle aforementioned problems by utilizing a generally truncated cone-shaped sleeve which is adjustably positioned on the distal shaft portion an~ by utilizing hooks carried by the cannula for receiving a suture, to maintain the cannula in place with respect to the patient's , 10 abdomen.
It has been found, howeve]., that the hool;s ilre difficult for some persons to utilize because on occasion the suture may loosen if the suture is not tied properly.
Further, the degree of tension is unpredictable, thereby leading to possible escape of the gas because the sleeve may not be in a snug position within the fascia. Further, with the use of hooks, it is necessary to tie a knot with the suture and the tying of the l;not may result in the breaking of the suture if excessive tension is applied.
Still further, the tying of the knot may take some persons a relatively long time and thus become inefficient in actual practice.
The present invention is an improvement upon the laparoscope cannula disclosed in my U.S. Patent No. 3,817,251, in that it provides novel suture-receivillg mealls thclt significantly alleviate the problems concomitant with the use of hooks.
``` ~1~9~97 BRIEF DESCRIPTION OF THE INVENTION
. . . _ . _ .
In accordance with the present invention, a laparoscope cannula is provided comprising a proximal shaft portion forming an inlet to receive a blunt obturator and a laparoscope.- The cannula includes a distal shaft portion for insertion into the abdominal cavity of a patient. Gas valve means couple the proximal shaft portion and the distal shaft portion. An adjustable sleeve is positioned on the distal shaft portion, and rigid means carried by the cannula are provided for receiving a suture to maintain the cannula in place with respect to the patient's abdomen. The invention is characterized in that the suture-receiving means comprises first, second, third and fourth rigid members extending from the cannula, with each of the four rigid members defining a slot which opens to the outside and tapers inwardly toward the cannula.
Each of the rigid members is fixed at one end thereof to the cannula and is adapted to grasp sutures between opposed walls defining the respective slot. The second and '~1 fourth rigi-l m-?mbers extend from the cannula on an opposite side from the first and third rigid members, with the four rigid members being symmetrical with respect to the distal shaft portion. The third rigid member is positioned coaxial with the first rigid member and the fourth rigid member is positioned coaxial with the second rigid member, the rigid members extending parallel to the axis of the cannula.
A more detailed explanation of the invention is provided in the following description and claims, and is illustrated in the accompanying drawings.
]~ ES~RIl''l'I~N ~)l''LIi~ lN~
_ _ FIGURE 1 is a front elevation of a laparoscope cannula constructed in accordance with the principles of the present invention, showing a blunt obturator extellding into the proximal shaft portion;
FIGURE 2 is a perspective view of the suture-receiv-ing means of the present invention, sllowing ~Ite sutuLes being attached initially;
FIGURE 3 is a perspective view similar to the view of FIGURE 2, but showlng the sutures in a more complete attachment mode; and FIGURE 4 is a greatly enlarged elevational view of two of the rigid members of~the suture-receivin~ means, taken along the plane of the line 4-4 of l~IGURE 3.
DETAILED DESCRIPTIOII OE TIIE
ILLUSTRATIVE EMBODIl~lENT
. . ~
Referring to FIG~'~E 1 in particular, the cannula 10 shown therein includes a proximal shaft portion 12, a distal shaft portion 14, and gas valve means 16 which couple the proximal shaft portion 12 and the distal shaft portion 14. The shaft portions 12 and 14 are preferably stainless steel or chrome-plated steel. Gas valve means 16 comprises a trumpet valve conventionally used in laparoscope carmulas.
The front of proximal shaft portion 12 comprises a rubber inlet 18 which defines a central opening that is no ~1~9697 smaller thatl the external diameter of a conventional blunt obturator 20. The front end 22 of inlet 18 is of a size to provide an abutting relationship with end 24 of handle 26 of blullt obturator 20.
A sleeve 34, in the form of a truncated cone, is provided on distal shaft portion 14 and is slidable with respect thereto. Sleeve 34 is preferably formed of stain-less steel or chrome-plated steel, with thc base 36 Eacing the proximal shaft portion 12. ~ rubber washer-type member 38 is connected to the sleeve 34, to achieve a snug, frictional fit with respect to the outer surface of distal shaft 14. Sleeve 34 may be loclced in place in the manner described in U.S. Patent No. 3,817,251 or a set screw type means may be utilized, if desired.
Rigid means are carried by the cannula for receiving a suture to maintain the cannula in place with respect to the patient's abdomen. The suture-receivin(g meal-s com~rises a first rigid member 41 extending Erom the gas valve means 16, a second rigid member 42 extending from the ~,as valve means 16, a third rigid member 43 extending Erom tl~e gas valve means 16 and a fourth rigid member 44 extending from the gas valve means 16. ~ach of the members 41, 42, 43 and 44 has one end fixed to the gas valve means 16, preferably by means of internal threads whicll coopel-ate with tlle external threads of bolts that are attached to gas valve means 16.
It can be seen that rigid members 41 and 43 are coaxial, and that rigid members 42 and 44 are coaxial, with coaxial members 41, 43 positioned on the opposite side of ~9697 gas valve means 16 from coaxial rigid members 42 and 44.
Referring to FIGURE 4 in particular, it can be seen that rigid member 41 defines a slot 41' which opens to the outside and tapers inwardly toward gas valve means 16.
Likewise, rigid member 43 defines a slot 43' which opens to the outside and tapers inwardly toward gas valve means 16. In the same manner, second rigid member 42 and fourth rigid member 44 also define similar slots, as illustrated in FIGURES 1-3.
The opposed walls which define the slots of the rigid members are dimensioned to receive and hold a suture therein. As illustrated in FIGURE 2, the two ends of a suture 50 brought up from the pati-ent are inserted into slot 41' and FIGURE 3 illustrates how the suture is locked in place by bringing it around gas valve means 16 and into slot 43'. The tapered shape of the slot enables sutures having different gauges (diameters) to be held in place by wedging between the walls defining the slots. There is no need to tie a knot because the suture effectively locks in place because of the grasping effect resulting from the tapered construction.
Although suture 50 is illustrated in FIGURE 3 in connection with rigid members 41 and 43, another suture would also be taken from the patient and likewise connected to rigid members 42 and 44. As illustrated, the rigid members are symmetrical with respect to the cannula and a taut connection of the sutures to both of the coaxial sets of rigid members maintains the cannula in place in a balanced manner. Thus there is no need for an assistant to hold the cannula in place when the scope is manipulated.
The operation is performed in the following manner.
~ General anesthesia with endotracheal intubation is employed. A small curvilinear incision, two to four centimeters lonr,, is made thl-o~ e sl;in~ o~ t.lle alltclior abdominal wall 0.5 to 1 centimeter below the lower edge of the umbilical fossa. The skin edges are retracted with two Allis clamps, then with a set of two small retractors.
The subcutaneous adipose tissues are reflected ~o expose the linea alba.
Dissection is carried out mostly bluntly with the handle of the knife, sweepirlg the adipo~e ~issues inferiorl~, away from the umbilicus. The exposed deep fascia is then grasped with two Kocher clamps placed side by side trans-versely. The fascia is held forcibly upwards and incised transversely, ~or approximately 1.5 centimeters, a short distance below the aponeurotic umbilical ring. Two sutures are passed, one tbrough each fascial edge; and tagged. The fascial sutures are held upwards and apart, and two retractors are placed laterally inside the fascial incision, creating a system of Pour-way retraction.
At this point, the properitoneal layer of adipose tissue can be clearly viewed in most multiparous women.
HGwever, in many patients, usually nulliparous, a distinct fasciaI layer is present which has to be incised to e~pose the properitoneal adipose layer.
Blunt dissection of the adipose tissue followed by thrusting a small hemostat against the peritoneum is usually sufficient to create an opening in the peritoneal cavity. Occasionally, however, the peritoneunl has to be picked up and incised because of increased tensile strength.
~1~9697 A clear, adequate opening in the peritoneum, con-firmed by viewing the small bowel and/or the omentum, is a useful step in the procedure. The peritoneal opening should be over one centimeter in diameter. The cannula 10 is then readied by fixing the sleeve 34 in position depend-ing upon the thickness of the abdominal wall.
One edge of the peritoneum is held with a small hemostat to guide the cannula 10 carrying the blunt obturator 20 as it is inserted through the opening into the peritoneal cavity. The hemostat is then removed, allowing the peritoneal defect to slide freely downwards, as the cannula is placed through the abdominal wall in an obliquely slanted position. Alternatively, two small retractors may be placed inside the peritoneal defect and the cannula 10 inserted through the opening between the retractors. If the cannula is not guided in its peritoneal insertion, it may slip away from the peritoneal opening into the properi-toneal space.
The retractors are removed and the ends of the fascial sutures are pulled snugly into the rigid members as illustrated in FIGURES 2 and 3, with the suture ends first being pulled into the upper rigid members 41 and 42 (FIGURE 2) and then into lower rigid members 43 and 44 for secure locking. This maneuver pulls the fas~ia firmly against sleeve 34 and provides an airtight seal. Thus escape of the gas is prevented.
The fixed sutures also maintain the cannula in position, preventing movement of the cannula during manipulation of the laparoscope. It is important to ~ ~ ~9 ~9 ~
stabilize the cannula downward while pulling the ~ascial _ sutures into the rigid members to prevent displacement of the cannula. Gas is insufflated through the valve 52 of the canllula to create a pneumoperitoneum. Insufflation is initiated while the sutures are being fixed. The blunt obturator 20 is withdrawn to permit a more rapid flcw of gas.
With the establishment of an adequate pneumoperi-toneum the lighted laparoscope is introduced, and the procedure continues as usual. I~llen laT-al-oscclpy is com pleted, the instrument is withdrawn, the cavity deflated and the abdominal wall closed in layers.
It is seen that a device has been provided which does not require that the sutuJ.es be tied and the ri~id members enable a rapid, secure connection.
Although .m illustrative embodiment of the invention has been shown and described, it is to be Ulldel'S~OOd ~ha~
various modifications and substitutions may be made by those skilled in the art without departing from the novel spirit and scope of the present invention.
.,
The laparoscope (peritoneoscope, celioscope) is an important tool of modern gynecologic diagnosis and surgical treatment. ~ prior art techni~le oE 1.~ co~ ni~-ec the intoduction of a needle into the peritoneal cavity to establish a pneumoperitoneum, and the abdominal wall is then punctured with a cannula, bearing a sharp trochar.
Both of these steps are performed blindly, and there is thus the possibility of accidentally puncturing a vital organ or a blood vessel. The trochar is subsequently withdrawtl, an(~ t~le li~l~t~l 1a~ o~;c~ ~ c i~ L~ IILO~
the cannula lnto the peritoneal cavity for visualization.
Another technique of performing laparoscopy is discussed in my article in~the American Journal of Obstetrics and Gynecology, St. Louis, Vol. 110, No. 6, pages 886-887, July 15, 1971. In this technique, a laparoscope cannula with a trumpet valve is fitted with a thin, cone-shaped steel sleeve, mounted on the cannula's shaft. The cone sleeve may be fitted with an extender to accommodate variations in the thickness of the abdominal wall and in the distance between the umbilicus and the symphysis pubis.
The purpose of the conical sleeve is to seal the peritoneal and fascial gap, by advc~ncing the cone deeper through the incisional opening. Although the use of such a cannula has been found generally satisfactory, certain problems were noted. These problems included the occa-sional occurrence of gas leaks, the need for an assistant to hold the cannula in place while the scope was being withdrawn or manipulated, and the need to use several ~ 96~7 cannulas o~ di~ferent sizes to accommodate inclividual vari-ations in the tllickness of the abdominal wall.
In my United States Patent No. 3,817,251, issued June 18, 1974, I disclosed a laparoscope cannula which alleviated tlle aforementioned problems by utilizing a generally truncated cone-shaped sleeve which is adjustably positioned on the distal shaft portion an~ by utilizing hooks carried by the cannula for receiving a suture, to maintain the cannula in place with respect to the patient's , 10 abdomen.
It has been found, howeve]., that the hool;s ilre difficult for some persons to utilize because on occasion the suture may loosen if the suture is not tied properly.
Further, the degree of tension is unpredictable, thereby leading to possible escape of the gas because the sleeve may not be in a snug position within the fascia. Further, with the use of hooks, it is necessary to tie a knot with the suture and the tying of the l;not may result in the breaking of the suture if excessive tension is applied.
Still further, the tying of the knot may take some persons a relatively long time and thus become inefficient in actual practice.
The present invention is an improvement upon the laparoscope cannula disclosed in my U.S. Patent No. 3,817,251, in that it provides novel suture-receivillg mealls thclt significantly alleviate the problems concomitant with the use of hooks.
``` ~1~9~97 BRIEF DESCRIPTION OF THE INVENTION
. . . _ . _ .
In accordance with the present invention, a laparoscope cannula is provided comprising a proximal shaft portion forming an inlet to receive a blunt obturator and a laparoscope.- The cannula includes a distal shaft portion for insertion into the abdominal cavity of a patient. Gas valve means couple the proximal shaft portion and the distal shaft portion. An adjustable sleeve is positioned on the distal shaft portion, and rigid means carried by the cannula are provided for receiving a suture to maintain the cannula in place with respect to the patient's abdomen. The invention is characterized in that the suture-receiving means comprises first, second, third and fourth rigid members extending from the cannula, with each of the four rigid members defining a slot which opens to the outside and tapers inwardly toward the cannula.
Each of the rigid members is fixed at one end thereof to the cannula and is adapted to grasp sutures between opposed walls defining the respective slot. The second and '~1 fourth rigi-l m-?mbers extend from the cannula on an opposite side from the first and third rigid members, with the four rigid members being symmetrical with respect to the distal shaft portion. The third rigid member is positioned coaxial with the first rigid member and the fourth rigid member is positioned coaxial with the second rigid member, the rigid members extending parallel to the axis of the cannula.
A more detailed explanation of the invention is provided in the following description and claims, and is illustrated in the accompanying drawings.
]~ ES~RIl''l'I~N ~)l''LIi~ lN~
_ _ FIGURE 1 is a front elevation of a laparoscope cannula constructed in accordance with the principles of the present invention, showing a blunt obturator extellding into the proximal shaft portion;
FIGURE 2 is a perspective view of the suture-receiv-ing means of the present invention, sllowing ~Ite sutuLes being attached initially;
FIGURE 3 is a perspective view similar to the view of FIGURE 2, but showlng the sutures in a more complete attachment mode; and FIGURE 4 is a greatly enlarged elevational view of two of the rigid members of~the suture-receivin~ means, taken along the plane of the line 4-4 of l~IGURE 3.
DETAILED DESCRIPTIOII OE TIIE
ILLUSTRATIVE EMBODIl~lENT
. . ~
Referring to FIG~'~E 1 in particular, the cannula 10 shown therein includes a proximal shaft portion 12, a distal shaft portion 14, and gas valve means 16 which couple the proximal shaft portion 12 and the distal shaft portion 14. The shaft portions 12 and 14 are preferably stainless steel or chrome-plated steel. Gas valve means 16 comprises a trumpet valve conventionally used in laparoscope carmulas.
The front of proximal shaft portion 12 comprises a rubber inlet 18 which defines a central opening that is no ~1~9697 smaller thatl the external diameter of a conventional blunt obturator 20. The front end 22 of inlet 18 is of a size to provide an abutting relationship with end 24 of handle 26 of blullt obturator 20.
A sleeve 34, in the form of a truncated cone, is provided on distal shaft portion 14 and is slidable with respect thereto. Sleeve 34 is preferably formed of stain-less steel or chrome-plated steel, with thc base 36 Eacing the proximal shaft portion 12. ~ rubber washer-type member 38 is connected to the sleeve 34, to achieve a snug, frictional fit with respect to the outer surface of distal shaft 14. Sleeve 34 may be loclced in place in the manner described in U.S. Patent No. 3,817,251 or a set screw type means may be utilized, if desired.
Rigid means are carried by the cannula for receiving a suture to maintain the cannula in place with respect to the patient's abdomen. The suture-receivin(g meal-s com~rises a first rigid member 41 extending Erom the gas valve means 16, a second rigid member 42 extending from the ~,as valve means 16, a third rigid member 43 extending Erom tl~e gas valve means 16 and a fourth rigid member 44 extending from the gas valve means 16. ~ach of the members 41, 42, 43 and 44 has one end fixed to the gas valve means 16, preferably by means of internal threads whicll coopel-ate with tlle external threads of bolts that are attached to gas valve means 16.
It can be seen that rigid members 41 and 43 are coaxial, and that rigid members 42 and 44 are coaxial, with coaxial members 41, 43 positioned on the opposite side of ~9697 gas valve means 16 from coaxial rigid members 42 and 44.
Referring to FIGURE 4 in particular, it can be seen that rigid member 41 defines a slot 41' which opens to the outside and tapers inwardly toward gas valve means 16.
Likewise, rigid member 43 defines a slot 43' which opens to the outside and tapers inwardly toward gas valve means 16. In the same manner, second rigid member 42 and fourth rigid member 44 also define similar slots, as illustrated in FIGURES 1-3.
The opposed walls which define the slots of the rigid members are dimensioned to receive and hold a suture therein. As illustrated in FIGURE 2, the two ends of a suture 50 brought up from the pati-ent are inserted into slot 41' and FIGURE 3 illustrates how the suture is locked in place by bringing it around gas valve means 16 and into slot 43'. The tapered shape of the slot enables sutures having different gauges (diameters) to be held in place by wedging between the walls defining the slots. There is no need to tie a knot because the suture effectively locks in place because of the grasping effect resulting from the tapered construction.
Although suture 50 is illustrated in FIGURE 3 in connection with rigid members 41 and 43, another suture would also be taken from the patient and likewise connected to rigid members 42 and 44. As illustrated, the rigid members are symmetrical with respect to the cannula and a taut connection of the sutures to both of the coaxial sets of rigid members maintains the cannula in place in a balanced manner. Thus there is no need for an assistant to hold the cannula in place when the scope is manipulated.
The operation is performed in the following manner.
~ General anesthesia with endotracheal intubation is employed. A small curvilinear incision, two to four centimeters lonr,, is made thl-o~ e sl;in~ o~ t.lle alltclior abdominal wall 0.5 to 1 centimeter below the lower edge of the umbilical fossa. The skin edges are retracted with two Allis clamps, then with a set of two small retractors.
The subcutaneous adipose tissues are reflected ~o expose the linea alba.
Dissection is carried out mostly bluntly with the handle of the knife, sweepirlg the adipo~e ~issues inferiorl~, away from the umbilicus. The exposed deep fascia is then grasped with two Kocher clamps placed side by side trans-versely. The fascia is held forcibly upwards and incised transversely, ~or approximately 1.5 centimeters, a short distance below the aponeurotic umbilical ring. Two sutures are passed, one tbrough each fascial edge; and tagged. The fascial sutures are held upwards and apart, and two retractors are placed laterally inside the fascial incision, creating a system of Pour-way retraction.
At this point, the properitoneal layer of adipose tissue can be clearly viewed in most multiparous women.
HGwever, in many patients, usually nulliparous, a distinct fasciaI layer is present which has to be incised to e~pose the properitoneal adipose layer.
Blunt dissection of the adipose tissue followed by thrusting a small hemostat against the peritoneum is usually sufficient to create an opening in the peritoneal cavity. Occasionally, however, the peritoneunl has to be picked up and incised because of increased tensile strength.
~1~9697 A clear, adequate opening in the peritoneum, con-firmed by viewing the small bowel and/or the omentum, is a useful step in the procedure. The peritoneal opening should be over one centimeter in diameter. The cannula 10 is then readied by fixing the sleeve 34 in position depend-ing upon the thickness of the abdominal wall.
One edge of the peritoneum is held with a small hemostat to guide the cannula 10 carrying the blunt obturator 20 as it is inserted through the opening into the peritoneal cavity. The hemostat is then removed, allowing the peritoneal defect to slide freely downwards, as the cannula is placed through the abdominal wall in an obliquely slanted position. Alternatively, two small retractors may be placed inside the peritoneal defect and the cannula 10 inserted through the opening between the retractors. If the cannula is not guided in its peritoneal insertion, it may slip away from the peritoneal opening into the properi-toneal space.
The retractors are removed and the ends of the fascial sutures are pulled snugly into the rigid members as illustrated in FIGURES 2 and 3, with the suture ends first being pulled into the upper rigid members 41 and 42 (FIGURE 2) and then into lower rigid members 43 and 44 for secure locking. This maneuver pulls the fas~ia firmly against sleeve 34 and provides an airtight seal. Thus escape of the gas is prevented.
The fixed sutures also maintain the cannula in position, preventing movement of the cannula during manipulation of the laparoscope. It is important to ~ ~ ~9 ~9 ~
stabilize the cannula downward while pulling the ~ascial _ sutures into the rigid members to prevent displacement of the cannula. Gas is insufflated through the valve 52 of the canllula to create a pneumoperitoneum. Insufflation is initiated while the sutures are being fixed. The blunt obturator 20 is withdrawn to permit a more rapid flcw of gas.
With the establishment of an adequate pneumoperi-toneum the lighted laparoscope is introduced, and the procedure continues as usual. I~llen laT-al-oscclpy is com pleted, the instrument is withdrawn, the cavity deflated and the abdominal wall closed in layers.
It is seen that a device has been provided which does not require that the sutuJ.es be tied and the ri~id members enable a rapid, secure connection.
Although .m illustrative embodiment of the invention has been shown and described, it is to be Ulldel'S~OOd ~ha~
various modifications and substitutions may be made by those skilled in the art without departing from the novel spirit and scope of the present invention.
.,
Claims (2)
1. A laparoscope cannula comprising a proximal shaft portion forming an inlet to receive a blunt obturator and a laparoscope, a distal shaft portion for insertion into the abdominal cavity of a patient, gas valve means coupling the proximal shaft portion and the distal shaft portion, an adjustable sleeve positioned on the distal shaft portion, and rigid means carried by the cannula for receiving a suture to maintain the cannula in place with respect to the patient's abdomen; characterized in that the suture-receiving means comprises first, second, third and fourth rigid members extending from the cannula, with each of said four rigid members defining a slot which opens to the outside and tapers inwardly toward the cannula, each of said rigid members being fixed at one end thereof to the cannula and being adapted to grasp sutures between opposed walls defining the respective slot, said second and fourth rigid members extending from the cannula on an opposite side from said first and third rigid members, with the four rigid members being symmetrical with respect to the distal shaft portion, said third rigid member being positioned coaxial with said first rigid member and said fourth rigid member being positioned coaxial with said second rigid member, said rigid members extending parallel to the axis of the cannula.
2. A laparoscope cannula as described in Claim 1 said rigid members being fixed to said gas valve means.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US122,240 | 1980-02-19 | ||
| US06/122,240 US4617933A (en) | 1980-02-19 | 1980-02-19 | Laparoscope cannula with improved suture receiving means |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA1149697A true CA1149697A (en) | 1983-07-12 |
Family
ID=22401533
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA000347822A Expired CA1149697A (en) | 1980-02-19 | 1980-03-17 | Laparoscope cannula with improved suture receiving means |
Country Status (6)
| Country | Link |
|---|---|
| US (1) | US4617933A (en) |
| JP (1) | JPS56121534A (en) |
| CA (1) | CA1149697A (en) |
| DE (1) | DE3011069A1 (en) |
| FR (1) | FR2475887A1 (en) |
| GB (1) | GB2069337B (en) |
Families Citing this family (32)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| DE3915597C1 (en) * | 1989-05-12 | 1990-05-10 | Richard Wolf Gmbh, 7134 Knittlingen, De | |
| US4997419A (en) * | 1989-06-01 | 1991-03-05 | Edward Weck Incoporated | Laparoscopy cannula |
| US5152754A (en) * | 1991-02-15 | 1992-10-06 | Minnesota Mining And Manufacturing Company | Trocar |
| AU651745B2 (en) * | 1991-12-13 | 1994-07-28 | Covidien Ag | Locking pneumoneedle |
| US5257973A (en) * | 1992-02-05 | 1993-11-02 | Raul Villasuso | Sealing sleeve and method for laparoscopy |
| US5415666A (en) * | 1992-03-23 | 1995-05-16 | Advanced Surgical, Inc. | Tethered clamp retractor |
| CA2106236A1 (en) * | 1992-09-23 | 1994-03-24 | Jude S. Sauer | Apparatus and method for anchoring surgical instrumentation |
| CA2107852C (en) * | 1992-10-09 | 2004-09-07 | Gerald Leigh Metcalf | Trocar |
| WO1994009694A1 (en) * | 1992-10-28 | 1994-05-11 | Arsenault, Dennis, J. | Electronic endoscope |
| US5346459A (en) * | 1993-04-14 | 1994-09-13 | Minnesota Mining And Manufacturing Company | Trocar |
| US5364367A (en) * | 1993-04-30 | 1994-11-15 | Minnesota Mining And Manufacturing Company | Cannula anchor |
| US6629984B1 (en) * | 1998-07-07 | 2003-10-07 | Kwan-Ho Chan | Surgical repair kit and its method of use |
| US5437682A (en) * | 1993-07-20 | 1995-08-01 | Ideas For Medicine, Inc. | Medical knot tying instrument and method for use thereof |
| US5405354A (en) * | 1993-08-06 | 1995-04-11 | Vance Products Inc. | Suture driver |
| US5453094A (en) * | 1993-09-17 | 1995-09-26 | Minnesota Mining And Manufacturing Company | Kit assembly for use during a laparoscopic surgical procedure |
| US5425736A (en) * | 1993-11-09 | 1995-06-20 | Wadsworth; Legrand D. | Ligature tool to tension and fasten clips on surgical tubing |
| US5849005A (en) * | 1995-06-07 | 1998-12-15 | Heartport, Inc. | Method and apparatus for minimizing the risk of air embolism when performing a procedure in a patient's thoracic cavity |
| US5954713A (en) | 1996-07-12 | 1999-09-21 | Newman; Fredric A. | Endarterectomy surgical instruments and procedure |
| US5836913A (en) * | 1997-05-02 | 1998-11-17 | Innerdyne, Inc. | Device and method for accessing a body cavity |
| US6723088B2 (en) | 2001-12-20 | 2004-04-20 | Board Of Regents, The University Of Texas | Laparoscopic porting |
| US7316699B2 (en) * | 2002-02-08 | 2008-01-08 | Teleflex Medical Incorporated | Introducer assembly for medical instruments |
| US7122039B2 (en) * | 2002-05-01 | 2006-10-17 | Boston Scientific Scimed, Inc. | Tying knots |
| US7160245B2 (en) * | 2003-11-17 | 2007-01-09 | Virginijus Burneikis | Method and device for umbilicus protection during abdominal surgery |
| US7811251B2 (en) * | 2005-10-13 | 2010-10-12 | Tyco Healthcare Group Lp | Trocar anchor |
| CA2594239A1 (en) * | 2006-08-02 | 2008-02-02 | Tyco Healthcare Group Lp | Stabilization assist device for trocar |
| US8162893B2 (en) | 2008-01-15 | 2012-04-24 | Applied Medical Resources Corporation | Trocar stability assembly |
| US20100249498A1 (en) * | 2009-03-24 | 2010-09-30 | Tyco Healthcare Group Lp | Endoscopic Apparatus for Manipulating Tissue |
| US8403837B2 (en) * | 2009-08-13 | 2013-03-26 | Covidien Lp | Deployable jaws retraction device |
| WO2013106775A1 (en) * | 2012-01-13 | 2013-07-18 | Dallen Medical, Inc. | Actuator for band tensioning system |
| WO2014003838A1 (en) * | 2012-06-25 | 2014-01-03 | Emory University | Catheter system for delivery of solutions |
| US9687413B2 (en) | 2014-02-18 | 2017-06-27 | Covidien Lp | Compression garment inflation |
| WO2021242875A1 (en) * | 2020-05-26 | 2021-12-02 | Subir Ray | Devices and methods for laparoscopic access and wound closure |
Family Cites Families (10)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US4520A (en) * | 1846-05-16 | Cooking-stove | ||
| US1547677A (en) * | 1924-08-18 | 1925-07-28 | Ouellet Arthur | Cord-gripping device |
| US2246229A (en) * | 1939-06-14 | 1941-06-17 | Henry Wagerer | Meat tying and supporting hanger |
| GB1102994A (en) * | 1966-02-04 | 1968-02-14 | Reginald Harrison Smythe | Improved device for the prevention of bloat in cattle |
| US3817251A (en) * | 1972-10-04 | 1974-06-18 | H Hasson | Laparoscope cannula |
| US3831608A (en) * | 1972-11-24 | 1974-08-27 | Bio Medicus Inc | Suture bridges |
| US3931821A (en) * | 1972-11-24 | 1976-01-13 | Bio-Medicus, Inc. | Suture bridges |
| US3910281A (en) * | 1973-10-09 | 1975-10-07 | Bio Medicus Inc | Suture anchor |
| US3877434A (en) * | 1974-02-11 | 1975-04-15 | Sherwood Medical Ind Inc | Vascular tourniquet |
| US4185636A (en) * | 1977-12-29 | 1980-01-29 | Albert Einstein College Of Medicine Of Yeshiva University | Suture organizer, prosthetic device holder, and related surgical procedures |
-
1980
- 1980-02-19 US US06/122,240 patent/US4617933A/en not_active Expired - Lifetime
- 1980-03-17 CA CA000347822A patent/CA1149697A/en not_active Expired
- 1980-03-19 JP JP3570980A patent/JPS56121534A/en active Pending
- 1980-03-21 DE DE19803011069 patent/DE3011069A1/en active Granted
- 1980-04-03 GB GB8011341A patent/GB2069337B/en not_active Expired
- 1980-04-17 FR FR8008583A patent/FR2475887A1/en active Granted
Also Published As
| Publication number | Publication date |
|---|---|
| GB2069337A (en) | 1981-08-26 |
| GB2069337B (en) | 1984-02-08 |
| DE3011069C2 (en) | 1988-06-30 |
| US4617933A (en) | 1986-10-21 |
| JPS56121534A (en) | 1981-09-24 |
| FR2475887A1 (en) | 1981-08-21 |
| DE3011069A1 (en) | 1981-08-20 |
| FR2475887B3 (en) | 1982-12-17 |
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| Date | Code | Title | Description |
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| MKEX | Expiry |