CA2129332C - Retracting tip trocar assembly - Google Patents
Retracting tip trocar assembly Download PDFInfo
- Publication number
- CA2129332C CA2129332C CA002129332A CA2129332A CA2129332C CA 2129332 C CA2129332 C CA 2129332C CA 002129332 A CA002129332 A CA 002129332A CA 2129332 A CA2129332 A CA 2129332A CA 2129332 C CA2129332 C CA 2129332C
- Authority
- CA
- Canada
- Prior art keywords
- trocar
- piercing tip
- tip
- links
- retracting
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Lifetime
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3494—Trocars; Puncturing needles with safety means for protection against accidental cutting or pricking, e.g. limiting insertion depth, pressure sensors
- A61B17/3496—Protecting sleeves or inner probes; Retractable tips
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
- A61B2017/00473—Distal part, e.g. tip or head
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/08—Accessories or related features not otherwise provided for
- A61B2090/0801—Prevention of accidental cutting or pricking
- A61B2090/08021—Prevention of accidental cutting or pricking of the patient or his organs
Abstract
A retracting tip trocar assembly (1) including a trocar tube (4) and a shaft (3) having a piercing tip (5) at one end thereof.
The device includes a retracting mechanism (A) which allows the piercing tip (5) to be held in a cutting position upon application of an insertion force such as when the piercing tip (5) is pressed against a wall of a human body cavity. Upon release of the inser-tion force, such as when the piercing tip (5) passes through the wall, the retracting mechanism (A) causes the piercing tip (5) to be retracted into the trocar tube (4). The retracting mechanism includes two links (1) pivoting at one end to each other and at the other end respectively to the proximal end of the obturator shaft and to the handle housing (2a).
The device includes a retracting mechanism (A) which allows the piercing tip (5) to be held in a cutting position upon application of an insertion force such as when the piercing tip (5) is pressed against a wall of a human body cavity. Upon release of the inser-tion force, such as when the piercing tip (5) passes through the wall, the retracting mechanism (A) causes the piercing tip (5) to be retracted into the trocar tube (4). The retracting mechanism includes two links (1) pivoting at one end to each other and at the other end respectively to the proximal end of the obturator shaft and to the handle housing (2a).
Description
RETRACTING TIP TROCAR ASSEMBLY
FIELD OF THE INVENTION
The invention relates to surgical instruments.
More particularly, it relates to a retracting tip trocar assembly with an improved protective shield latch.
Trocars are sharp-pointed instruments used to puncture a body cavity. A body cavity is often punctured so that fluids may be drained using a cannula inserted into the opening. Trocars are also used during endoscopic procedures. A conventional endoscopic procedure follows three steps. The first step is the insertion of a Veress cannula into an abdominal cavity through a small incision in the abdominal wall. The second step is the inflation of the cavity with insufflating gas passed through the cannula.
After inflation, the Veress cannula is removed. The third step is the thrusting of standard trocars housed within the bore of a trocar tube into the inflated abdomen. Standard trocars are shaped like a large metal peg with a sharpened point. The trocar is then removed, and the endoscopic instrument is inserted into the abdominal cavity through the trocar tube.
U.S. Patent Nos. 4,601,710 (the '710 patent) and 4,654,030 (the '030 patent) describe embodiments of a trocar assembly having a spring-biased WO 93/17626 P~/U~93/017~t "....
tubular protective shield. one of the embodiments in the '71~ patent has a shield locking mechanism that comprises a slide valve-actuated locking tooth that engages a slot in the wall of the shield. The '~30 patent disclases an embodiment wherein the flap valve functions as a shield locking means wherein a tip seats against a recessed shoulder on the shield. The valve is manually controlled to release the shield.
Trocar assemblies having spring-biased ~ tubular protective shields include a tubular protective shield~within a trocar tube. In addition, once the piercing tip of the obturator penetrates a wall of a body cavity, the protective shield must further widen the opening created by the piercing tip before the protective sha,.elc~ can move outwardly of the.trocar tube to shield the piercing tip which remains in the body " av~ty. ~.~s latent ~oo ~,~~5,~~~ cthe '~~3 patent' ~
r~ o discloses a reusable trocar wherein the obturator can ;i be ret~'acted by deans of a spring and an electro-y, ~~ mechanical latching ~necha~iem. In particular, the .' p iercing tip of._the obturator includes pressure sensing means which transmits signals to activate a soleanoid which in turnr~leeses the obturator shaft so that it cars be rQtracted. The retractable obturator disclosed ., ~5 in the 'aT3 latent reguires a complex arrangement wherein slid3:ng-c~n~acts and circuitry are used to energise a sol~n~id which removes a detest which is biased into engagement with a sliding part of the obtearator. such en arrangement is costly and could be 3~ unreaiable due o bad connections in the electrical circuitry.
It would be desirable to provide a disposable trocar assembly wherein the piercing tip can be retracted automatically after piercing the wall of the ct~ ,~
WHO 93/17626 ~ ~ ~' ~ ~ ~ ~ PCI'/US93/017~!
_3_ ._ ..
body cavity by a purely mechanical arrangement. Such a retractable tip trocar assembly would provide advantages over the tubular protective shield arrangement of the '?10 and '030 patents since the trocar tube could be used to shield the obturat~r;
thereby eliminating the need for the protective tubular shield.
~~a 'The invention provides a retracting tip trocar assembly comprising an elongated trocar obturator extending in an a~ci~l direction and having a piercing tip at a distal end thereof and an elongated j tbocar tub in whdch the trocar obtaai.ator ~S housed.
The piercing tip is movable in the axial direction from a cutting position (at which the piercing tip is outside a distal end of the trocar tubej to a shielded p~sition (at which the piercing tip is entirely within the trocaac tube). the assembly includes retracting mss gor retracting the piercing tip from the cutting position to the shielded position when a force applied to the piercing tip is removed and a member which is movable from a first position (at which the member grevents ~n~vement of the trocar obturatorj to a second ., position (at which the member does not prevent movement Z5 ~f the trocar obturatcarj. The member is held in the first position when the piercing tip is pressed against an object with an axial force above a threshold value, d a assembly includes biasirsg means biasing the member in the sec~nd position. The biasing means applies a bias force on the member such that when the insertion force is below the threshold value, the member moves from the first position to the second position and the retracting means moves the piercing tip to the shielded position.
'WUt '93/1762,6 ' ' PCT/US93/01744 ~~.~~J~~
The retracting means can be activated by release of an insertion foxce load placed on the piercing tip during insertion of the piercing tip into a wall of a body cavity with release of the insertion force load activating the retracting means to automatically retract the piercing tip. The insertion force load can comprise a compressive load acting in an axial direction parallel to a longitudinal axis of the trocar tube.
Z0 The assembly can include a trocar handle housing, and the trocar obturator can include a shaft having a distal end thereof attached to the piercing tip and a proximal end thereof attached to the trocar handle housing. The retracting means can comprise spring means for biasing the piercing tip in the shielded position, and the member can c~mprise link means for holding the piercing tip in the cutting position while the insertion force load is placed on the piercing tip. The link means can comprise first 2~ and second links, the first link having one end ttaereof pivotally attached to the proximal end of the shaft and the other end thereof pivotally attached to one end of the second link: The other end of the second lime can be pivotally attached to the trocar handle housing such that the licks are in a first configuration when the piercing tip is in the cutting position and in a second configurati~n when the piercing tip is in the shielded position.
The spring means can comprise a sprang such 3~ as a torsion spring which moves the links into the second configuration when the insertion force load is released. The link means can include a stop means in the trocar handle housing for sustaining the insertion force load ~rhich acts axially on the piercing tip. The ~~~..~J~)l,.
PCT/U~9310174~
W~ 93/17626 ._ . . -5-shaft and the first and second links can ~ aligned axially to support the insertion force load when the piercing tip is in the cutting position and the piercing tip is pushed against a wall of a body cavity.
The first and second links can include abutting' surfaces which press against each other when 'the piercing tip is in the cutting position. For example, the first and second links comprise a single piece of plastic material, and the abutting surfaces can be connected by a bendable section of the plastic material.
The link means can comprise a deformable link which has a first configuration when the piercing tip is in the cutting position and a second configuration when the piercing tip is in the shielded position. The biasing means can comprise a spring which biases the deformable link in the second configuration. The deformaDal~ link can include two rigid sections hinged together intermediate opposite ends of the deformable 2~ lin& with the opposite ends of the deformable link being moved closer together when the piercing tip moves to the shielded position.
The retracting tip assembly can include latch WC193117626 ' PCT! US93l01744 )~
-6d ._ enlarged opening formed in part by a support surface against which the latch arm presses when the piercing tip is in an armed position. In this way, the piercing tip can be located further outside the distal end of the trocar tube in the armed position than when'the piercing tube is in the cutting position. ~rlso, the latch arm will automatically move from the support surface to a position in alignment with the cured slot when the piercing tip is pushed against an object such as a wall of a body cavity.
The trocar handle housing can include a track, and the shaft can include a slider which cooperates with the track to guide the shaft axially along the trocar tube. The spring can comprise a wire having first and second arms extending from a coiled portion crf the wire such that the first arm presses against the first link and the second arm presses against the second link. The spring can also comprise a torsion spring which applies a torsional restraining force on the piercing tip. In this case, the spring causes the piercing tip to rotate when the retracting means moves the piercing tip from the cutting position to the shielded position.
The invention also provides a method of puncturing a wall of a hu8aan body cavity, comprising a step of prodding a retractable tip trocar assembly having an elongated trocar obturator e~ctending in an axial direction and having a piercing tip at a distal end thereof, an elongated trocar tube in which the 3~ trocar obturator is housed such that the piercing tip is movable in the axial direction from a cutting position at which the piercing tip is outside the trocar tube to a shielded position at which the piercing tip is entirely within the tracer tube, P'f:TlUS93/0~ 744 'VI~O 93/1766 _~_ retracting means for retracting the piercing tip from the cutting position to the shielded position when the piercing tip punctures a wall of a human body cavity, a member movable from a first position at which the member prevents movement of the trocar obturator to a second position at which the member does not prevent movement of the trocar obturator and biasing means biasing the member in the second position. The member is held in the first position when the piercing tip is pressed against an object with an aacial force above a threshold value, and the biasing means applies a bias force on the member such that when the insertion force is below the threshold value the member moves from the first position to the second position and the retracting means moves the piercing tip to the shielded position. The method also includes a step of piercing the wall of a human body cavity by manually pushing the piercing tip against the wall of the human body cavity until-the piercing tip punctures the wall and the retracting means withdraws the piercing tip entirely into t3se trocar tube: The method can include insuf f lating he human i~ody cavity bef ore or after the piercing step.
The ~so~aEr ahsembl.y can include a housing, and the retractia~g means can include link means and spring means biasing the link means in a bent configuration, the link means being e~ctendible to a .
W straight configuration a~a including a latch arm e~cte~ading thrgugh a slot ' in the hs~using and the slot having a cauch al~ng,the length thereof. The method 'y~ , can include en arming step comprising moving the latch arm along the slot to extend the link means to the straight configuration and engaging the latch arm with the catch ~o hold the piercing tip in the cutting position.
PGT/LJS9~/01744 t~V~ 93/ 17686 ~ ~ ~ ~ ~ ~~ ~, , ~g~
The latch arm can be flexible and automatically disengaged with the catch dining the piercing step due to axial movement of the link means when an insertion load force is placed on the piercing tip. , .
The housing can include an upper housing and a lower housing with the trocar obturator and retracting means being supported by the upper housing.
The upper housing can be separable from the lower 1~ housing, and ttae lower housing can include a valve such as a trumpet valve or a flap valve for automatically sealing the trocar tie when the trocar obturator as removed from the trocar tube. The method can further include a step of separating the upper housing from the I5 l~wer housing much that the trdcar tube is sealed by the valve after the piercing step is performed.
Fl~. i sh~ws,a cross~section of a retractable t~,p ~ocar ass~ably in accordance with the invention;
FIG. ~ sh~ws a cutaway perspective view of the lower en~~of the oc~r assembly shown in FIG. 1;
FIG. ~ shops a partial cross-section of a y trumpet °valve forming part ~f the assembly shown in FIG. 1.0 ~; 25 FTG. ~ Frhows a cross~sefrt~.~n of an upper h~using of the trocar asse$ably shown' ~:n FIG. 1 wherein the piercing tip is in a shielded position;
FIG. 5 sows a perspective view of the upper housing wherein a catch arm is in a position PC I'/US93i0~ 744 e~a~ g3m ~~z6 _g_ , ._ ..
corresponding to the shielded position of the piercing tip~
FIG. ~ is a cross~section of the upper housing wherein the piercing tip is in a cutting .
position;
FIG. 7 shows a perspective view of the upper housing shown in FIG. 6 wherein the xatch arm is in a position corresp~nding to the cutting position;
FIGS. B-21 show various configurations for x0 the piercing tip;
FIG. 2.2 shows a xaterax cross-section of the upper housing wherein a deforanabxe xink is in a bent conf igurati~ra o FIG. 23 shows a perspective end view of the.
,~ .. . ~5 d~f ~r~~b~e x~n~~
FIG. ~4 shows a cross-sec~i~n of the defds~ab7:e link t else~
sxong the ~:irae 2~~24 in FIG.
s :FIG. 25 show6 8 sl.tle view, of 8 s~.~.,der~
~15 FIG. 2s ~ho~s a pexspect~tv~ axiax end view of ~~ the ~~~der s~ow~, ~~:FIG:x5 t~x~n ~x~n~ the x~.ne 2s-~~;
FIG.'27 is a'perspective a~ciax end view of the sxider shown in FIG. 25 taken axong the xine 27-27;
,. FIB. 2~ 3. a side vie6A of a spring$ and '~'Y
FIG. 29 is a front view of the spring shown ,;
25 in FIG. 2~.' W~ 93/ 17626 : PC'i'/lJS93/01744 ~1~~J~~
~~ ~~E~~~~~ ~~ ~E J
A tracer is a device for.introducing a sleeved portal into a body cavity. If the tracer has a piercing tip, the tip can Cause trauma to the Cavity tissues either by direct over thrust or by side-to-side laceration. The device Can be anade safer if, When the piercing tip penetrates through the Cavity Wall, the piercing tip Can be made to automatically and quickly retract into the tracer tube. , 1~ ~ne sway to trigger the retraction is to rely upon the release of the insertion force load on the piercing tip of the tracer assembly upon passage through the eavity Wall. ~nce this restraining load is released, the piercing tip is free to move through another position,to one Wherein a spring force can pull it back within the tracer tube. This restraining force acting on the pae~ccing tip Can be compressive along the p 1~ngitudinal axa,s of the tracer or torsional around the dame axis .
~~ ~ linear retracting tip tracer in accordance with the invention can be constricted as folloWS. The piercing tip is attached to a shaft that can translate '' lineagly in the troC~r tube. At the handle end, the shaft gs attached by a piv~t to a short link. The ~.~ ~~ Qther end of this link is pivotally attached to a '~ sic~nd link. The ot,.her end of this second lin3c is pivotally attached to the tracer handle. range of motion allowed by the geometrical set-up of the links grrarats fr~adoa~n ~f movement of the piercing tip from a 3~ retracted (°°sha.eld~d") position Well Within the Conf fines Of the trACar tube t0 an extended ( °' cutting'°
position With the tip extending beyond the end of the ,,tracer tube. ~ spring acts on the links to bias the .~ i W~ 93/17626 ~ ~ ~ ~ ~~ Pf'1'/1US93/01744 c. ~~ 4r ._ .. -1~-linkage such that.the piercing tip is in the shielded position.
of the shaft is e~ttended (against spring force) from the shielded position wherein the links are retractable to one wherein the links are fully e~etended and then is retracted a short distance but with the links buckled in the opposite direction against a stop, the shaft and piercing tip will sustain a compressive load. If this compressive load is maintained,.as in the instance of insertion of the piercing tip through a cavity wall tissue, when the restraint is re2eased (full insertion), the spring will cause the links to elongate and e3ctend the shaft a short distance before fully retracting the piecing tip into the trocar tube.
l5 This mechanism can be~simplified if the two ;~, '' links are constructed as a single "living hinge's r., r plastic part. Such a hinge should be sufficiently gl~~,g~le to hinge at the pivot positions yet sufficiently rigid'to sustain tie compressive insertion ~~ forces. However, any arrangement wherein a member ,supports tl~a~ inserti~sn force 1~ad in one position and is biassed t~ move to a position at which the obturator can be retl:'acted yothen fih~ ~Lnse~'t3on force f ells below a threshold value can be used in accordance with the 25 inventions The second link can include a spring latch 'arm which is stiff'in one directi~n of bedding so that i~ ~,1~.~~~ r~~~t3.ora of tie link and subsequent eactension ~f the shaft and piecing tip. This latch arm protrudes ~ through a curved sl~t in the trocar handle allowing manual access to the latch arm. The latch arm can spring in a direction no~nal to the actuating slot so that in the extended position it can be shifted into a WO 93/I76x6 < < Pt.T/~JS93101744 -22- .- . .
side latched position, thus holding the piercing tip in the extended position. This would be akin to an "armed" condition.
In usage, the user would manually slit~e the latch arm around the slot and into the latched "armed"
position. ~aen pressure is initially applied on the piercing tip against tissue, the latch will slide back into the main curved slot, but the compressive load applied to the point of the shaft will hold the shaft and links in a locked yet e~ctended positis~n. When the piercing tip breaks through the cavity wall, the compressive restraint force is rem~ved thereby allowing the spring to advance the piercing tip a small amount as the links bend and then to retract it into the trocar tube:
1,~ i~ within the scope of the invention to use a torsion acting device which would worDc in a~
similar fashion but wt~uld require a torsional restraining force on the piercing tip with a ~0 corresponding rotafii~nal displacement required to shift the shaft into a position whereiait could be withdrawn Z~to a trocartubeo. In~i~ base, 4.l~e p~.'~.rCoing t~.p will spin a~s it retracbs into the'trocar tube.
., ~~e retraction spring f~xce in either case Faust be sbrong enough ~o insure quick and positive retraction. The mechanism should be contained within .tee trocar handle so that the mechanism, the shaft, and the piercing ti.p caaa be removed ~s a unit from the ocar tubs when the-trocar tube ~s placed in position.
p The embodiments described above are ::t pmetastable retracting tip" type trocars. "Metastable"
~:gfers to the two stability points of the positions of :, W~ 93/17626 ~ 1 ~ ~ ~ ~ ~ . PCT/US93/01744 the piercing tap, the less stable being the extended position which goes to a more stable position, the retracted position, upon sensing a change in loading.
Various embodiments of the retractably t~ocar tip assembly will now be described with reference to FIGe7 s ~'~ ~ s FIG. Z shows a retractable tip trocar assembly 1 in accordance with the invention. The assembly 1 includes a housing ~ including an upper housing 2a and a lower housing 2b. The upper housing 2a supports a shaft ~ having a distal end 3a and a ' proximate end fib, and the lower housing ~b supports a trocar tube ~ such that the shaft 3 fits within the trocar tube ~. The upper housing 2a is separable from 1.5 the lower housing ~b so that the shaft 3 can be withdrawn from tlx~ rocar tube ~4. ~ mechanism ~ is pr~vided for regracting the shaft 3 during use of the assembly 1.
~ piercing dip 5 is provided at the distal ;, ag end 3a of the shaft 3. 'halve means such as a trumpet valve ~-or flap Valve (not shown) is provided in the ,~ ~~~e~, housing ~~b for automatically sealing the trocar tube 4 when the ~ha~t 3 is removed therefrom. FIG. 3 .shows a partial cross-section of the trumpet valve 6.
25 The piercing tip 5 can be integral with the hhaft 3 or caaa comprise ~ separate part, as shown in F°I~. 1. vari~us shapes of the piercing tap 5 are shown in FIGS. 8-~1. For instance, FIG. ~ shows a side view of a hypo-tip 5a, hnd FIG. 9 shows an axial end view thereof o FIG... ~~ shows a nall'°type p.ierc.bng t.ip 5b, and FIG. 11 shows an axial end view thereof. FICA 1~
shows a rounded chisel-tip 5c, and FIG. ~.3 shows an W~ 93/17626 ~ ~ ~ ~ ~ 3 ~ ~ PC1°/US93/01744 ._ .. -14-axial end view thereof. FIG. 1.4 shows an offset two-facet tip 5d, and FIG. 15 shows an axial end view thereof. FIG. 16 shows a pyramidal three-facet tip 5e, and FIG. 17 shows an axial end view thereof. FIG. 1~
shows a conical tip 5f, and FIG. 39 shows an axial end view thereof. FIG. 2o shows a bullet point tap 5g, and FIG. 21 shows an axial end view thereof.
FIG a ~ shows a cros s-sectson of one ' embodiment of the upper housing 2a wherein the.
'; 1.o retracting mechanism A includes retracting means, a member and biasing means. The retracting means moves the piercing tip from the cutt~.ng position to the shielded position. The member is movable from a first position (at which the member prevents movement of the 1.5 trocar obturator) to a second position (at which the member does not prevent movement of the trocar ;j obtur~t~r~, vthe member being held in the first position ,9 when tRae piercing tip is pressed against an ~bject with an axial farce above a thx°eshold value. The biasing 20 means biases the member in the second position, the b~,asing means applying a bias force on the member such that when tlae insertion force is helow tae threshold value the member ~cwee from the first position to the second p~sition end the retracting means moves the 25 piercing tip to the shieldedl position. For instance, member Can comprise fink means ~, and the retraction means and biasing means can comprise spring means ~s ~.s sho~na in FIG. ~4, the shaft 3 is movably ~o supps~~ted by mea~as ~f the link mans 'T ~ the sprang .
means ~ and a slider 9. The slider 9 slides in a track ;~ lo, and the link means 7 is bendable from a first bent configuration, as'shown in FIG. 4, to a second straight configuration, as shown in FIG. 6. The link means 7 ~1'O 93/1762b ~ ~ ~ ~ ~ '~ ~~~ P~'f/US93/Oi744 includes a latch arm 11 extending through a slot 12 in the upper housing 2a.
~s shown in FIG. 5, the slot 12 is curved and includes an enlarged portion 12a and a catch 12b. To arm the trocar assembly, the latch arm 11 is moved along the slot until it engages the catch lab, as shown in dotted lines in FIG. ?. However, when an insertion force load is applied to the shaft 3, the link means 7~
is compressed in the axial direction and the latch aran 11 disengages from the catch 12b and moves to a position at which it is free to move along the slot 12.
t~Thhen the piercing tip 5 punctures a wall of a cavity, the inserti~n force is released, and the force of the spring 8 deforms the link means 7 into the bent configuration uho~m in FIG. 4.
the link means '1 includes a first link 13 and ;;3 a sec~nd link 1~. Links 1~ and 1~ can comprise a single pied ~f material, such as a plastic material, ~r they can comprise two or amore discrete l n~cs which s 20 are connected 'together in a manner which will support the inse~ti~x~ f~rce l~ad but allow the shaft ~ to move axially when 'the in~ertior~ f~rce load falls below a threshold value, much as upon breakthrough of a cavity a wall.
,; 25 ~s shown in gags. 6 and 23, the upper housing 2a includes a stop l5 which engages one end of the link jeans 7 wk~e~a ara insertion force is applied to the piercing tip 5. the first link 13 includes a first end l~aand a .sec~ndend lobe In addi6ion, the link 1J x.s -a ~0V°'shaped, ~s~shown in. FIG. 2.7 s ~he l~.n~ ~~ ~.ntilude~J
.,:a surf$ces lad for engaging a coil of the spring means ~.
;~; The lick 13 also ihcludes an inclined surface 13d for engaging one arm of the spring means 5. In order to ~NV~ 93/17626 ' PGT/US93/01744 accommodate shrinkage and extension in the axial.
direction, the link 13 includes a flexible portion 13e.
The link 13 also includes a surface 13f for abutting a similar surface 14f on the link 14.
The link 1~ is similar to the link 13 and includes portions 14a-f as described above with reference to link 13. ~.s shown in FIG. 24, the spring means 8 is supported such that the coil thereof fits around surfaces 13c, ~4c and the arms of the spring press against surfaces 13d and 14d. The end 14a of link 14 fits into a corresponding recess in slider 9, and the end 13a of link 13 fits into a corresponding recess in the upper h~using 2a.
The ~ l ider 7 is shown in FIGS . b 5 - Z ' . AS can be seen in FIG. 25, the slider 9 includes a bore 9a in which the p~roxi~al end of the shaft 3 is f fixedly ;r, secured. The slider 9 also ihcludes recess 3b for '' receiving end lea of link 1~. The slider ~ also ancludes a~ f~ot 9c which rides in track 1~, as shown in ~~ FIG. ~2~ FIG. 26 is a front view Of the slider 9 from a direction facing recess 9b, aid FIG. 27 is a rear ~tiew of the slider 9 from the direction of the bore Via.
Details ~f the spring means 8 are shown 3.n FIGS. 28 and 29m In particular, the spring means 8 can comprise a tarsi~n spring formed from a coil of wire 8a and a pair of rectilinearly extending arms 8b, 8c, ,a e~ctending from mach end' of the coil ' 8a. ~.s shown in F'IGB: 28 and ~9, the arms 8b and 8c are parallel to each other; and each is tangentt~ the coil 8a on ' '" 3~ oppe~site sides of the coil 8a. ~s shown in FIG. 2~~
a arms fib, 8c are crossed such that they preen against surfaces 13d, 14d of links 13, 14. In this manner, the links 13, 14 are biased toward each other c, ~, ? .~., '1~() 93/17626 ~ ~ ~ ~ ~3 :-' ~~ P~'/L1~93/017~A
._ .. -17-so as to maintain the piercing tip 5 in the shielded position. However, when the piercing tip 5 is placed in the arm,~d or cutting position.,- the arms 8b, 8c are bent to the position shown in FIG. 6.
~s explained earlier, upon application of an insertion force to the piercing tip 5, the shaft 3 is retracted slightly in the axial direction so as to press the link means 7 against the stop 15. When the insertion force is released, such as when the piercing tip punctures a wall of a human body cavity, the force of the spring 8 deforms the link means 7 such that it assumes the position shown in FIG. 4. The link means 7 is capable of expending slightly when the piercing tip is in the armed position and sinking slightly when the piercing tip is in the cutting position due to the provision of flexible p~rtions 13e, 14e. During retraction ~f the piercing tip, the links 13, 14 will '~ extend slightly when ttae abutting surfaces 13f, i~f initially separate, after which tpae l.inlcs 13, 14 move a Zt9 toward each ~~.her to retract the shaft 3. ' r In the mechanism A described above, spring 8 is effective f~r bending links 13, 14 from a straight ;. configuration ~~s ~ho~rra in F3G. ~) to a bent c~nf~~urat~~nt~s~hown Zn F.iG. °m, s ~lternatl.vely, a ~5. diffg:rent type ~f ~e~rhanismA could be usedo For ,; instande, the r~echanis~n mould include a torsion spring which is arranged such that the spring is unwound in the aa~ial direction' when the piercing tip is placed iia a cutting or armed position. The device would operate as describedW arlier, that is, upon application of an insertion farce, the spring would be held in its extended position, but when the insertion force is released, the spring would retract in the axial .,:',.. s.... , , . ~. W';, f. .. '.' ,f , . r"',',. ' ' ' 1W0 93/17f26 .. P,~'/US93!~174~b direction while rotating and moving the piercing tip to the shielded position.
6TThile the invention has been described with reference to the foregoing embodiments, var~.o~ts' changes and modifications can be made thereto which fall within . the scope ~of the appended claims.
~i';~.... ' >,%~il.... :.. .
FIELD OF THE INVENTION
The invention relates to surgical instruments.
More particularly, it relates to a retracting tip trocar assembly with an improved protective shield latch.
Trocars are sharp-pointed instruments used to puncture a body cavity. A body cavity is often punctured so that fluids may be drained using a cannula inserted into the opening. Trocars are also used during endoscopic procedures. A conventional endoscopic procedure follows three steps. The first step is the insertion of a Veress cannula into an abdominal cavity through a small incision in the abdominal wall. The second step is the inflation of the cavity with insufflating gas passed through the cannula.
After inflation, the Veress cannula is removed. The third step is the thrusting of standard trocars housed within the bore of a trocar tube into the inflated abdomen. Standard trocars are shaped like a large metal peg with a sharpened point. The trocar is then removed, and the endoscopic instrument is inserted into the abdominal cavity through the trocar tube.
U.S. Patent Nos. 4,601,710 (the '710 patent) and 4,654,030 (the '030 patent) describe embodiments of a trocar assembly having a spring-biased WO 93/17626 P~/U~93/017~t "....
tubular protective shield. one of the embodiments in the '71~ patent has a shield locking mechanism that comprises a slide valve-actuated locking tooth that engages a slot in the wall of the shield. The '~30 patent disclases an embodiment wherein the flap valve functions as a shield locking means wherein a tip seats against a recessed shoulder on the shield. The valve is manually controlled to release the shield.
Trocar assemblies having spring-biased ~ tubular protective shields include a tubular protective shield~within a trocar tube. In addition, once the piercing tip of the obturator penetrates a wall of a body cavity, the protective shield must further widen the opening created by the piercing tip before the protective sha,.elc~ can move outwardly of the.trocar tube to shield the piercing tip which remains in the body " av~ty. ~.~s latent ~oo ~,~~5,~~~ cthe '~~3 patent' ~
r~ o discloses a reusable trocar wherein the obturator can ;i be ret~'acted by deans of a spring and an electro-y, ~~ mechanical latching ~necha~iem. In particular, the .' p iercing tip of._the obturator includes pressure sensing means which transmits signals to activate a soleanoid which in turnr~leeses the obturator shaft so that it cars be rQtracted. The retractable obturator disclosed ., ~5 in the 'aT3 latent reguires a complex arrangement wherein slid3:ng-c~n~acts and circuitry are used to energise a sol~n~id which removes a detest which is biased into engagement with a sliding part of the obtearator. such en arrangement is costly and could be 3~ unreaiable due o bad connections in the electrical circuitry.
It would be desirable to provide a disposable trocar assembly wherein the piercing tip can be retracted automatically after piercing the wall of the ct~ ,~
WHO 93/17626 ~ ~ ~' ~ ~ ~ ~ PCI'/US93/017~!
_3_ ._ ..
body cavity by a purely mechanical arrangement. Such a retractable tip trocar assembly would provide advantages over the tubular protective shield arrangement of the '?10 and '030 patents since the trocar tube could be used to shield the obturat~r;
thereby eliminating the need for the protective tubular shield.
~~a 'The invention provides a retracting tip trocar assembly comprising an elongated trocar obturator extending in an a~ci~l direction and having a piercing tip at a distal end thereof and an elongated j tbocar tub in whdch the trocar obtaai.ator ~S housed.
The piercing tip is movable in the axial direction from a cutting position (at which the piercing tip is outside a distal end of the trocar tubej to a shielded p~sition (at which the piercing tip is entirely within the trocaac tube). the assembly includes retracting mss gor retracting the piercing tip from the cutting position to the shielded position when a force applied to the piercing tip is removed and a member which is movable from a first position (at which the member grevents ~n~vement of the trocar obturatorj to a second ., position (at which the member does not prevent movement Z5 ~f the trocar obturatcarj. The member is held in the first position when the piercing tip is pressed against an object with an axial force above a threshold value, d a assembly includes biasirsg means biasing the member in the sec~nd position. The biasing means applies a bias force on the member such that when the insertion force is below the threshold value, the member moves from the first position to the second position and the retracting means moves the piercing tip to the shielded position.
'WUt '93/1762,6 ' ' PCT/US93/01744 ~~.~~J~~
The retracting means can be activated by release of an insertion foxce load placed on the piercing tip during insertion of the piercing tip into a wall of a body cavity with release of the insertion force load activating the retracting means to automatically retract the piercing tip. The insertion force load can comprise a compressive load acting in an axial direction parallel to a longitudinal axis of the trocar tube.
Z0 The assembly can include a trocar handle housing, and the trocar obturator can include a shaft having a distal end thereof attached to the piercing tip and a proximal end thereof attached to the trocar handle housing. The retracting means can comprise spring means for biasing the piercing tip in the shielded position, and the member can c~mprise link means for holding the piercing tip in the cutting position while the insertion force load is placed on the piercing tip. The link means can comprise first 2~ and second links, the first link having one end ttaereof pivotally attached to the proximal end of the shaft and the other end thereof pivotally attached to one end of the second link: The other end of the second lime can be pivotally attached to the trocar handle housing such that the licks are in a first configuration when the piercing tip is in the cutting position and in a second configurati~n when the piercing tip is in the shielded position.
The spring means can comprise a sprang such 3~ as a torsion spring which moves the links into the second configuration when the insertion force load is released. The link means can include a stop means in the trocar handle housing for sustaining the insertion force load ~rhich acts axially on the piercing tip. The ~~~..~J~)l,.
PCT/U~9310174~
W~ 93/17626 ._ . . -5-shaft and the first and second links can ~ aligned axially to support the insertion force load when the piercing tip is in the cutting position and the piercing tip is pushed against a wall of a body cavity.
The first and second links can include abutting' surfaces which press against each other when 'the piercing tip is in the cutting position. For example, the first and second links comprise a single piece of plastic material, and the abutting surfaces can be connected by a bendable section of the plastic material.
The link means can comprise a deformable link which has a first configuration when the piercing tip is in the cutting position and a second configuration when the piercing tip is in the shielded position. The biasing means can comprise a spring which biases the deformable link in the second configuration. The deformaDal~ link can include two rigid sections hinged together intermediate opposite ends of the deformable 2~ lin& with the opposite ends of the deformable link being moved closer together when the piercing tip moves to the shielded position.
The retracting tip assembly can include latch WC193117626 ' PCT! US93l01744 )~
-6d ._ enlarged opening formed in part by a support surface against which the latch arm presses when the piercing tip is in an armed position. In this way, the piercing tip can be located further outside the distal end of the trocar tube in the armed position than when'the piercing tube is in the cutting position. ~rlso, the latch arm will automatically move from the support surface to a position in alignment with the cured slot when the piercing tip is pushed against an object such as a wall of a body cavity.
The trocar handle housing can include a track, and the shaft can include a slider which cooperates with the track to guide the shaft axially along the trocar tube. The spring can comprise a wire having first and second arms extending from a coiled portion crf the wire such that the first arm presses against the first link and the second arm presses against the second link. The spring can also comprise a torsion spring which applies a torsional restraining force on the piercing tip. In this case, the spring causes the piercing tip to rotate when the retracting means moves the piercing tip from the cutting position to the shielded position.
The invention also provides a method of puncturing a wall of a hu8aan body cavity, comprising a step of prodding a retractable tip trocar assembly having an elongated trocar obturator e~ctending in an axial direction and having a piercing tip at a distal end thereof, an elongated trocar tube in which the 3~ trocar obturator is housed such that the piercing tip is movable in the axial direction from a cutting position at which the piercing tip is outside the trocar tube to a shielded position at which the piercing tip is entirely within the tracer tube, P'f:TlUS93/0~ 744 'VI~O 93/1766 _~_ retracting means for retracting the piercing tip from the cutting position to the shielded position when the piercing tip punctures a wall of a human body cavity, a member movable from a first position at which the member prevents movement of the trocar obturator to a second position at which the member does not prevent movement of the trocar obturator and biasing means biasing the member in the second position. The member is held in the first position when the piercing tip is pressed against an object with an aacial force above a threshold value, and the biasing means applies a bias force on the member such that when the insertion force is below the threshold value the member moves from the first position to the second position and the retracting means moves the piercing tip to the shielded position. The method also includes a step of piercing the wall of a human body cavity by manually pushing the piercing tip against the wall of the human body cavity until-the piercing tip punctures the wall and the retracting means withdraws the piercing tip entirely into t3se trocar tube: The method can include insuf f lating he human i~ody cavity bef ore or after the piercing step.
The ~so~aEr ahsembl.y can include a housing, and the retractia~g means can include link means and spring means biasing the link means in a bent configuration, the link means being e~ctendible to a .
W straight configuration a~a including a latch arm e~cte~ading thrgugh a slot ' in the hs~using and the slot having a cauch al~ng,the length thereof. The method 'y~ , can include en arming step comprising moving the latch arm along the slot to extend the link means to the straight configuration and engaging the latch arm with the catch ~o hold the piercing tip in the cutting position.
PGT/LJS9~/01744 t~V~ 93/ 17686 ~ ~ ~ ~ ~ ~~ ~, , ~g~
The latch arm can be flexible and automatically disengaged with the catch dining the piercing step due to axial movement of the link means when an insertion load force is placed on the piercing tip. , .
The housing can include an upper housing and a lower housing with the trocar obturator and retracting means being supported by the upper housing.
The upper housing can be separable from the lower 1~ housing, and ttae lower housing can include a valve such as a trumpet valve or a flap valve for automatically sealing the trocar tie when the trocar obturator as removed from the trocar tube. The method can further include a step of separating the upper housing from the I5 l~wer housing much that the trdcar tube is sealed by the valve after the piercing step is performed.
Fl~. i sh~ws,a cross~section of a retractable t~,p ~ocar ass~ably in accordance with the invention;
FIG. ~ sh~ws a cutaway perspective view of the lower en~~of the oc~r assembly shown in FIG. 1;
FIG. ~ shops a partial cross-section of a y trumpet °valve forming part ~f the assembly shown in FIG. 1.0 ~; 25 FTG. ~ Frhows a cross~sefrt~.~n of an upper h~using of the trocar asse$ably shown' ~:n FIG. 1 wherein the piercing tip is in a shielded position;
FIG. 5 sows a perspective view of the upper housing wherein a catch arm is in a position PC I'/US93i0~ 744 e~a~ g3m ~~z6 _g_ , ._ ..
corresponding to the shielded position of the piercing tip~
FIG. ~ is a cross~section of the upper housing wherein the piercing tip is in a cutting .
position;
FIG. 7 shows a perspective view of the upper housing shown in FIG. 6 wherein the xatch arm is in a position corresp~nding to the cutting position;
FIGS. B-21 show various configurations for x0 the piercing tip;
FIG. 2.2 shows a xaterax cross-section of the upper housing wherein a deforanabxe xink is in a bent conf igurati~ra o FIG. 23 shows a perspective end view of the.
,~ .. . ~5 d~f ~r~~b~e x~n~~
FIG. ~4 shows a cross-sec~i~n of the defds~ab7:e link t else~
sxong the ~:irae 2~~24 in FIG.
s :FIG. 25 show6 8 sl.tle view, of 8 s~.~.,der~
~15 FIG. 2s ~ho~s a pexspect~tv~ axiax end view of ~~ the ~~~der s~ow~, ~~:FIG:x5 t~x~n ~x~n~ the x~.ne 2s-~~;
FIG.'27 is a'perspective a~ciax end view of the sxider shown in FIG. 25 taken axong the xine 27-27;
,. FIB. 2~ 3. a side vie6A of a spring$ and '~'Y
FIG. 29 is a front view of the spring shown ,;
25 in FIG. 2~.' W~ 93/ 17626 : PC'i'/lJS93/01744 ~1~~J~~
~~ ~~E~~~~~ ~~ ~E J
A tracer is a device for.introducing a sleeved portal into a body cavity. If the tracer has a piercing tip, the tip can Cause trauma to the Cavity tissues either by direct over thrust or by side-to-side laceration. The device Can be anade safer if, When the piercing tip penetrates through the Cavity Wall, the piercing tip Can be made to automatically and quickly retract into the tracer tube. , 1~ ~ne sway to trigger the retraction is to rely upon the release of the insertion force load on the piercing tip of the tracer assembly upon passage through the eavity Wall. ~nce this restraining load is released, the piercing tip is free to move through another position,to one Wherein a spring force can pull it back within the tracer tube. This restraining force acting on the pae~ccing tip Can be compressive along the p 1~ngitudinal axa,s of the tracer or torsional around the dame axis .
~~ ~ linear retracting tip tracer in accordance with the invention can be constricted as folloWS. The piercing tip is attached to a shaft that can translate '' lineagly in the troC~r tube. At the handle end, the shaft gs attached by a piv~t to a short link. The ~.~ ~~ Qther end of this link is pivotally attached to a '~ sic~nd link. The ot,.her end of this second lin3c is pivotally attached to the tracer handle. range of motion allowed by the geometrical set-up of the links grrarats fr~adoa~n ~f movement of the piercing tip from a 3~ retracted (°°sha.eld~d") position Well Within the Conf fines Of the trACar tube t0 an extended ( °' cutting'°
position With the tip extending beyond the end of the ,,tracer tube. ~ spring acts on the links to bias the .~ i W~ 93/17626 ~ ~ ~ ~ ~~ Pf'1'/1US93/01744 c. ~~ 4r ._ .. -1~-linkage such that.the piercing tip is in the shielded position.
of the shaft is e~ttended (against spring force) from the shielded position wherein the links are retractable to one wherein the links are fully e~etended and then is retracted a short distance but with the links buckled in the opposite direction against a stop, the shaft and piercing tip will sustain a compressive load. If this compressive load is maintained,.as in the instance of insertion of the piercing tip through a cavity wall tissue, when the restraint is re2eased (full insertion), the spring will cause the links to elongate and e3ctend the shaft a short distance before fully retracting the piecing tip into the trocar tube.
l5 This mechanism can be~simplified if the two ;~, '' links are constructed as a single "living hinge's r., r plastic part. Such a hinge should be sufficiently gl~~,g~le to hinge at the pivot positions yet sufficiently rigid'to sustain tie compressive insertion ~~ forces. However, any arrangement wherein a member ,supports tl~a~ inserti~sn force 1~ad in one position and is biassed t~ move to a position at which the obturator can be retl:'acted yothen fih~ ~Lnse~'t3on force f ells below a threshold value can be used in accordance with the 25 inventions The second link can include a spring latch 'arm which is stiff'in one directi~n of bedding so that i~ ~,1~.~~~ r~~~t3.ora of tie link and subsequent eactension ~f the shaft and piecing tip. This latch arm protrudes ~ through a curved sl~t in the trocar handle allowing manual access to the latch arm. The latch arm can spring in a direction no~nal to the actuating slot so that in the extended position it can be shifted into a WO 93/I76x6 < < Pt.T/~JS93101744 -22- .- . .
side latched position, thus holding the piercing tip in the extended position. This would be akin to an "armed" condition.
In usage, the user would manually slit~e the latch arm around the slot and into the latched "armed"
position. ~aen pressure is initially applied on the piercing tip against tissue, the latch will slide back into the main curved slot, but the compressive load applied to the point of the shaft will hold the shaft and links in a locked yet e~ctended positis~n. When the piercing tip breaks through the cavity wall, the compressive restraint force is rem~ved thereby allowing the spring to advance the piercing tip a small amount as the links bend and then to retract it into the trocar tube:
1,~ i~ within the scope of the invention to use a torsion acting device which would worDc in a~
similar fashion but wt~uld require a torsional restraining force on the piercing tip with a ~0 corresponding rotafii~nal displacement required to shift the shaft into a position whereiait could be withdrawn Z~to a trocartubeo. In~i~ base, 4.l~e p~.'~.rCoing t~.p will spin a~s it retracbs into the'trocar tube.
., ~~e retraction spring f~xce in either case Faust be sbrong enough ~o insure quick and positive retraction. The mechanism should be contained within .tee trocar handle so that the mechanism, the shaft, and the piercing ti.p caaa be removed ~s a unit from the ocar tubs when the-trocar tube ~s placed in position.
p The embodiments described above are ::t pmetastable retracting tip" type trocars. "Metastable"
~:gfers to the two stability points of the positions of :, W~ 93/17626 ~ 1 ~ ~ ~ ~ ~ . PCT/US93/01744 the piercing tap, the less stable being the extended position which goes to a more stable position, the retracted position, upon sensing a change in loading.
Various embodiments of the retractably t~ocar tip assembly will now be described with reference to FIGe7 s ~'~ ~ s FIG. Z shows a retractable tip trocar assembly 1 in accordance with the invention. The assembly 1 includes a housing ~ including an upper housing 2a and a lower housing 2b. The upper housing 2a supports a shaft ~ having a distal end 3a and a ' proximate end fib, and the lower housing ~b supports a trocar tube ~ such that the shaft 3 fits within the trocar tube ~. The upper housing 2a is separable from 1.5 the lower housing ~b so that the shaft 3 can be withdrawn from tlx~ rocar tube ~4. ~ mechanism ~ is pr~vided for regracting the shaft 3 during use of the assembly 1.
~ piercing dip 5 is provided at the distal ;, ag end 3a of the shaft 3. 'halve means such as a trumpet valve ~-or flap Valve (not shown) is provided in the ,~ ~~~e~, housing ~~b for automatically sealing the trocar tube 4 when the ~ha~t 3 is removed therefrom. FIG. 3 .shows a partial cross-section of the trumpet valve 6.
25 The piercing tip 5 can be integral with the hhaft 3 or caaa comprise ~ separate part, as shown in F°I~. 1. vari~us shapes of the piercing tap 5 are shown in FIGS. 8-~1. For instance, FIG. ~ shows a side view of a hypo-tip 5a, hnd FIG. 9 shows an axial end view thereof o FIG... ~~ shows a nall'°type p.ierc.bng t.ip 5b, and FIG. 11 shows an axial end view thereof. FICA 1~
shows a rounded chisel-tip 5c, and FIG. ~.3 shows an W~ 93/17626 ~ ~ ~ ~ ~ 3 ~ ~ PC1°/US93/01744 ._ .. -14-axial end view thereof. FIG. 1.4 shows an offset two-facet tip 5d, and FIG. 15 shows an axial end view thereof. FIG. 16 shows a pyramidal three-facet tip 5e, and FIG. 17 shows an axial end view thereof. FIG. 1~
shows a conical tip 5f, and FIG. 39 shows an axial end view thereof. FIG. 2o shows a bullet point tap 5g, and FIG. 21 shows an axial end view thereof.
FIG a ~ shows a cros s-sectson of one ' embodiment of the upper housing 2a wherein the.
'; 1.o retracting mechanism A includes retracting means, a member and biasing means. The retracting means moves the piercing tip from the cutt~.ng position to the shielded position. The member is movable from a first position (at which the member prevents movement of the 1.5 trocar obturator) to a second position (at which the member does not prevent movement of the trocar ;j obtur~t~r~, vthe member being held in the first position ,9 when tRae piercing tip is pressed against an ~bject with an axial farce above a thx°eshold value. The biasing 20 means biases the member in the second position, the b~,asing means applying a bias force on the member such that when tlae insertion force is helow tae threshold value the member ~cwee from the first position to the second p~sition end the retracting means moves the 25 piercing tip to the shieldedl position. For instance, member Can comprise fink means ~, and the retraction means and biasing means can comprise spring means ~s ~.s sho~na in FIG. ~4, the shaft 3 is movably ~o supps~~ted by mea~as ~f the link mans 'T ~ the sprang .
means ~ and a slider 9. The slider 9 slides in a track ;~ lo, and the link means 7 is bendable from a first bent configuration, as'shown in FIG. 4, to a second straight configuration, as shown in FIG. 6. The link means 7 ~1'O 93/1762b ~ ~ ~ ~ ~ '~ ~~~ P~'f/US93/Oi744 includes a latch arm 11 extending through a slot 12 in the upper housing 2a.
~s shown in FIG. 5, the slot 12 is curved and includes an enlarged portion 12a and a catch 12b. To arm the trocar assembly, the latch arm 11 is moved along the slot until it engages the catch lab, as shown in dotted lines in FIG. ?. However, when an insertion force load is applied to the shaft 3, the link means 7~
is compressed in the axial direction and the latch aran 11 disengages from the catch 12b and moves to a position at which it is free to move along the slot 12.
t~Thhen the piercing tip 5 punctures a wall of a cavity, the inserti~n force is released, and the force of the spring 8 deforms the link means 7 into the bent configuration uho~m in FIG. 4.
the link means '1 includes a first link 13 and ;;3 a sec~nd link 1~. Links 1~ and 1~ can comprise a single pied ~f material, such as a plastic material, ~r they can comprise two or amore discrete l n~cs which s 20 are connected 'together in a manner which will support the inse~ti~x~ f~rce l~ad but allow the shaft ~ to move axially when 'the in~ertior~ f~rce load falls below a threshold value, much as upon breakthrough of a cavity a wall.
,; 25 ~s shown in gags. 6 and 23, the upper housing 2a includes a stop l5 which engages one end of the link jeans 7 wk~e~a ara insertion force is applied to the piercing tip 5. the first link 13 includes a first end l~aand a .sec~ndend lobe In addi6ion, the link 1J x.s -a ~0V°'shaped, ~s~shown in. FIG. 2.7 s ~he l~.n~ ~~ ~.ntilude~J
.,:a surf$ces lad for engaging a coil of the spring means ~.
;~; The lick 13 also ihcludes an inclined surface 13d for engaging one arm of the spring means 5. In order to ~NV~ 93/17626 ' PGT/US93/01744 accommodate shrinkage and extension in the axial.
direction, the link 13 includes a flexible portion 13e.
The link 13 also includes a surface 13f for abutting a similar surface 14f on the link 14.
The link 1~ is similar to the link 13 and includes portions 14a-f as described above with reference to link 13. ~.s shown in FIG. 24, the spring means 8 is supported such that the coil thereof fits around surfaces 13c, ~4c and the arms of the spring press against surfaces 13d and 14d. The end 14a of link 14 fits into a corresponding recess in slider 9, and the end 13a of link 13 fits into a corresponding recess in the upper h~using 2a.
The ~ l ider 7 is shown in FIGS . b 5 - Z ' . AS can be seen in FIG. 25, the slider 9 includes a bore 9a in which the p~roxi~al end of the shaft 3 is f fixedly ;r, secured. The slider 9 also ihcludes recess 3b for '' receiving end lea of link 1~. The slider ~ also ancludes a~ f~ot 9c which rides in track 1~, as shown in ~~ FIG. ~2~ FIG. 26 is a front view Of the slider 9 from a direction facing recess 9b, aid FIG. 27 is a rear ~tiew of the slider 9 from the direction of the bore Via.
Details ~f the spring means 8 are shown 3.n FIGS. 28 and 29m In particular, the spring means 8 can comprise a tarsi~n spring formed from a coil of wire 8a and a pair of rectilinearly extending arms 8b, 8c, ,a e~ctending from mach end' of the coil ' 8a. ~.s shown in F'IGB: 28 and ~9, the arms 8b and 8c are parallel to each other; and each is tangentt~ the coil 8a on ' '" 3~ oppe~site sides of the coil 8a. ~s shown in FIG. 2~~
a arms fib, 8c are crossed such that they preen against surfaces 13d, 14d of links 13, 14. In this manner, the links 13, 14 are biased toward each other c, ~, ? .~., '1~() 93/17626 ~ ~ ~ ~ ~3 :-' ~~ P~'/L1~93/017~A
._ .. -17-so as to maintain the piercing tip 5 in the shielded position. However, when the piercing tip 5 is placed in the arm,~d or cutting position.,- the arms 8b, 8c are bent to the position shown in FIG. 6.
~s explained earlier, upon application of an insertion force to the piercing tip 5, the shaft 3 is retracted slightly in the axial direction so as to press the link means 7 against the stop 15. When the insertion force is released, such as when the piercing tip punctures a wall of a human body cavity, the force of the spring 8 deforms the link means 7 such that it assumes the position shown in FIG. 4. The link means 7 is capable of expending slightly when the piercing tip is in the armed position and sinking slightly when the piercing tip is in the cutting position due to the provision of flexible p~rtions 13e, 14e. During retraction ~f the piercing tip, the links 13, 14 will '~ extend slightly when ttae abutting surfaces 13f, i~f initially separate, after which tpae l.inlcs 13, 14 move a Zt9 toward each ~~.her to retract the shaft 3. ' r In the mechanism A described above, spring 8 is effective f~r bending links 13, 14 from a straight ;. configuration ~~s ~ho~rra in F3G. ~) to a bent c~nf~~urat~~nt~s~hown Zn F.iG. °m, s ~lternatl.vely, a ~5. diffg:rent type ~f ~e~rhanismA could be usedo For ,; instande, the r~echanis~n mould include a torsion spring which is arranged such that the spring is unwound in the aa~ial direction' when the piercing tip is placed iia a cutting or armed position. The device would operate as describedW arlier, that is, upon application of an insertion farce, the spring would be held in its extended position, but when the insertion force is released, the spring would retract in the axial .,:',.. s.... , , . ~. W';, f. .. '.' ,f , . r"',',. ' ' ' 1W0 93/17f26 .. P,~'/US93!~174~b direction while rotating and moving the piercing tip to the shielded position.
6TThile the invention has been described with reference to the foregoing embodiments, var~.o~ts' changes and modifications can be made thereto which fall within . the scope ~of the appended claims.
~i';~.... ' >,%~il.... :.. .
Claims (20)
PROPERTY OR PRIVILEGE IS CLAIMED ARE DEFINED AS FOLLOWS:
1. A retracting tip trocar assembly comprising:
an elongated trocar obturator extending in a axial direction and having a proximal end and a piercing tip at a distal end thereof;
an elongated trocar tube in which the trocar obturator is housed, the piercing tip being movable in the axial direction from a cutting position at which the piercing tip is outside a distal end of the trocar tube to a shielded position at which the piercing tip is entirely within the trocar tube:
a trocar handle housing which receives the proximal end of the elongated trocar obturator and which includes a catch;
a first link pivotally attached to the trocar obturator and to a second link, the second link being pivotally attached to the trocar handle housing, the links being in a first configuration when the piercing tip is in a cutting position outside the distal end of the trocar tube and the links being in a second configuration when the piercing tip is in the shielded position; and retracting means mounted within the trocar handle for retracting the piercing tip from the cutting position to the shielded position, the retracting means acting on at least one of the first and second links;
wherein the catch releasably maintains the links in the first configuration.
an elongated trocar obturator extending in a axial direction and having a proximal end and a piercing tip at a distal end thereof;
an elongated trocar tube in which the trocar obturator is housed, the piercing tip being movable in the axial direction from a cutting position at which the piercing tip is outside a distal end of the trocar tube to a shielded position at which the piercing tip is entirely within the trocar tube:
a trocar handle housing which receives the proximal end of the elongated trocar obturator and which includes a catch;
a first link pivotally attached to the trocar obturator and to a second link, the second link being pivotally attached to the trocar handle housing, the links being in a first configuration when the piercing tip is in a cutting position outside the distal end of the trocar tube and the links being in a second configuration when the piercing tip is in the shielded position; and retracting means mounted within the trocar handle for retracting the piercing tip from the cutting position to the shielded position, the retracting means acting on at least one of the first and second links;
wherein the catch releasably maintains the links in the first configuration.
2. The retracting tip assembly of claim 1, wherein said links are movable from said first configuration, at which the links prevent movement of the trocar obturator, to said second configuration, at which the links do not prevent movement of the trocar obturator, the links being held in the first configuration when the piercing tip is pressed against an object with an axial insertion force above a threshold value;
said retracting means comprises biasing means for applying a bias force on at least one of said links such that the biasing means moves the at least one of said links from the first configuration to the second configuration when the axial insertion force is below the threshold value upon release of the axial insertion force placed upon the piercing tip while the piercing tip is in the cutting position, to retract the piercing tip to the shielded position.
said retracting means comprises biasing means for applying a bias force on at least one of said links such that the biasing means moves the at least one of said links from the first configuration to the second configuration when the axial insertion force is below the threshold value upon release of the axial insertion force placed upon the piercing tip while the piercing tip is in the cutting position, to retract the piercing tip to the shielded position.
3. The retracting tip assembly of claim 2, wherein the insertion force comprises a compressive load acting in an axial direction parallel to the axial direction of tip movement.
4. The retracting tip assembly of claim 1, wherein the retracting means comprises a spring engaged with at the least one of said links and biasing the links toward the second configuration, wherein one end of said first link is pivotally attached to a proximal end of said trocar obturator, another end of said first link is pivotally attached to an end of said second link, and another end of said second link is pivotally attached to said trocar housing.
5. A retracting tip trocar assembly comprising:
an elongated trocar obturator extending in an axial direction and having a proximal end and a piercing tip at a distal end thereof;
an elongated trocar tube in which the trocar obturator is housed, the piercing tip being movable in the axial direction from a cutting position at which the piercing tip is outside a distal end of the trocar tube to a shielded position at which the piercing tip is entirely within the trocar tube:
a trocar handle housing which receives the proximal end, the elongated trocar obturator and which includes a catch;
a member movable from a first position at which the member prevents movement of the trocar obturator to a second position at which the member does not prevent movement of the trocar obturator, the member being held in the first position when the piercing tip is held against an object with an axial force above a threshold value, wherein the member comprises first and second links for holding the piercing tip in the cutting position while the insertion force load is placed on the piercing tip, the first link pivotally attached to the trocar obturator and to the second link, the second link being pivotally attached to the trocar handle housing, the links being in a first configuration when the piercing tip is in the cutting position and the links being in a second configuration when the piercing tip is in the shielded position; and at least one spring mounted within the trocars handle housing for retracting the piercing tip from the cutting position to the shielded position;
wherein the catch releasably maintains the links in the first configuration and said at least one spring applies a bias force on at least one of said links such that when the insertion force is below the threshold value, upon release of the axial insertion force placed on the piercing tip while the piercing tip is in the cutting position, the links move from the first configuration to the second configuration and the piercing tip moves to the shielded position.
an elongated trocar obturator extending in an axial direction and having a proximal end and a piercing tip at a distal end thereof;
an elongated trocar tube in which the trocar obturator is housed, the piercing tip being movable in the axial direction from a cutting position at which the piercing tip is outside a distal end of the trocar tube to a shielded position at which the piercing tip is entirely within the trocar tube:
a trocar handle housing which receives the proximal end, the elongated trocar obturator and which includes a catch;
a member movable from a first position at which the member prevents movement of the trocar obturator to a second position at which the member does not prevent movement of the trocar obturator, the member being held in the first position when the piercing tip is held against an object with an axial force above a threshold value, wherein the member comprises first and second links for holding the piercing tip in the cutting position while the insertion force load is placed on the piercing tip, the first link pivotally attached to the trocar obturator and to the second link, the second link being pivotally attached to the trocar handle housing, the links being in a first configuration when the piercing tip is in the cutting position and the links being in a second configuration when the piercing tip is in the shielded position; and at least one spring mounted within the trocars handle housing for retracting the piercing tip from the cutting position to the shielded position;
wherein the catch releasably maintains the links in the first configuration and said at least one spring applies a bias force on at least one of said links such that when the insertion force is below the threshold value, upon release of the axial insertion force placed on the piercing tip while the piercing tip is in the cutting position, the links move from the first configuration to the second configuration and the piercing tip moves to the shielded position.
6. The retracting tip assembly of claim 5, wherein the spring is engaged with at least one of the links and biases the links toward the second configuration, wherein one end of said first link is pivotally attached to a proximal end of said trocar obturator, another end of said first link is pivotally attached to an end of said second link, and another end of said second link is pivotally attached to said trocar housing.
7. The retracting tip assembly of any one of claims 1 to 4, further comprising a stop in the trocar handle housing for sustaining the insertion force which acts axially on the piercing tip, the trocar obturator and the first and second links being aligned substantially axially and supporting the insertion force against the stop when the piercing tip is in the cutting position and the piercing tip is pushed against an object.
8. The retracting tip assembly of any one of claims 1 to 4, wherein the first and second links include abutting surfaces which press against each other when the piercing tip is in the cutting position.
9. The retracting tip assembly of claim 8, wherein the first and second links comprise a single piece of plastic material.
10. The retracting tip trocar assembly of claim 9, wherein the single piece of plastic comprises two plastic links connected by a bendable section of the plastic material.
11. A retracting tip trocar assembly comprising:
an elongated trocar obturator extending in an axial direction and having a proximal end and a piercing tip at a distal end thereof;
an elongated trocar tube in which the trocar obturator is housed, the piercing tip being movable in the axial direction from a cutting position at which the piercing tip is outside a distal end of the trocar tube to a shielded position at which the piercing tip is entirely within the trocar tube;
a trocar handle housing which receives the proximal end of the elongated trocar obturator and which includes a catch;
a member movable from a first position at which the member prevents movement of the trocar obturator to a second position at which the member does not prevent movement of the trocar obturator, the member being held in the first position when the piercing tip is held against an object with an axial force above a threshold value, wherein the member comprises a deformable link for holding the piercing tip in the cutting position while the insertion force is placed on the piercing tip, the deformable link having a first configuration when the piercing tip is in the cutting position and having a second configuration when the piercing tip is in the shielded position; and at least one spring for retracting the piercing tip from the cutting position to the shielded position;
wherein the catch releasably maintains the deformable link in the first configuration and said at least one spring applies a bias force on said link such that when the insertion force is below the threshold value, upon release of the axial insertion force placed on the piercing tip while the piercing tip is in the cutting position, the link moves from the first configuration to the second configuration and the piercing tip moves to the shielded position.
an elongated trocar obturator extending in an axial direction and having a proximal end and a piercing tip at a distal end thereof;
an elongated trocar tube in which the trocar obturator is housed, the piercing tip being movable in the axial direction from a cutting position at which the piercing tip is outside a distal end of the trocar tube to a shielded position at which the piercing tip is entirely within the trocar tube;
a trocar handle housing which receives the proximal end of the elongated trocar obturator and which includes a catch;
a member movable from a first position at which the member prevents movement of the trocar obturator to a second position at which the member does not prevent movement of the trocar obturator, the member being held in the first position when the piercing tip is held against an object with an axial force above a threshold value, wherein the member comprises a deformable link for holding the piercing tip in the cutting position while the insertion force is placed on the piercing tip, the deformable link having a first configuration when the piercing tip is in the cutting position and having a second configuration when the piercing tip is in the shielded position; and at least one spring for retracting the piercing tip from the cutting position to the shielded position;
wherein the catch releasably maintains the deformable link in the first configuration and said at least one spring applies a bias force on said link such that when the insertion force is below the threshold value, upon release of the axial insertion force placed on the piercing tip while the piercing tip is in the cutting position, the link moves from the first configuration to the second configuration and the piercing tip moves to the shielded position.
12. The retracting tip assembly of claim 6, wherein the spring comprises a torsion spring.
13. The retracting tip assembly of any one of claims 1 to 4, wherein the ends of the first and second links not pivotally connected to one another are closer together when the piercing tip moves to the shielded position.
14. The retracting tip assembly of claim 1, further comprising a latch arm on one of the links for manually moving the links to the first configuration, the trocar handle housing including catch means for holding the latch arm in an armed position at which the piercing tip is in the cutting position.
15. The retracting tip trocar assembly of claim 14, wherein one end of the latch arm is connected to one of the links and the other end thereof extends outwardly of the trocar handle, the catch means comprising a curved slot in the trocar handle, the latch arm being movable along the curved slot, the curved slot terminating in an enlarged opening formed in part by a support surface against which the latch arm presses when the piercing tip is in an armed position.
16. The retracting tip assembly of claim 15, wherein the piercing tip is located further outside the distal end of the trocar tube in the armed position than when the piercing tip is in the cutting position.
17. The retracting tip assembly of claim 16, wherein the latch arm automatically moves from the support surface to a position in alignment with the curved slot when the piercing tip is pushed against an object.
18. The retracting tip assembly of any one of claims 1 to 4, wherein the trocar handle housing includes a track and the obturator has a shaft which includes a slider, the slider cooperating with the track to guide the shaft axially along the trocar tube.
19. The retracting tip assembly of claim 6, wherein the torsion spring comprises a wire having first and second arms extending from a coiled portion of the wire, the first arm pressing against the first link and the second arm pressing against the second link.
20. Use of a retracting tip assembly of any one of claims 1 to 19 to puncture a wall of a body cavity.
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US07/850,089 US5441513A (en) | 1992-03-12 | 1992-03-12 | Retracting tip trocar assembly |
| US07/850,089 | 1992-03-12 | ||
| PCT/US1993/001744 WO1993017626A1 (en) | 1992-03-12 | 1993-03-01 | Retracting tip trocar assembly |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CA2129332A1 CA2129332A1 (en) | 1993-09-16 |
| CA2129332C true CA2129332C (en) | 2003-08-26 |
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Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA002129332A Expired - Lifetime CA2129332C (en) | 1992-03-12 | 1993-03-01 | Retracting tip trocar assembly |
Country Status (8)
| Country | Link |
|---|---|
| US (2) | US5441513A (en) |
| EP (1) | EP0630213B1 (en) |
| JP (1) | JP3307394B2 (en) |
| AU (1) | AU671821B2 (en) |
| CA (1) | CA2129332C (en) |
| DE (1) | DE69316740T2 (en) |
| ES (1) | ES2111739T3 (en) |
| WO (1) | WO1993017626A1 (en) |
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| WO1993004632A1 (en) * | 1991-08-30 | 1993-03-18 | Origin Medsystems, Inc. | Trocar with retracting tip and palm actuator mechanism |
| US5158552A (en) * | 1991-11-04 | 1992-10-27 | American Cyanamid Company | Safety trocar instrument having a retractable trocar actuated by relief of pressure on the trocar point |
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-
1992
- 1992-03-12 US US07/850,089 patent/US5441513A/en not_active Expired - Lifetime
-
1993
- 1993-03-01 DE DE69316740T patent/DE69316740T2/en not_active Expired - Lifetime
- 1993-03-01 EP EP93907059A patent/EP0630213B1/en not_active Expired - Lifetime
- 1993-03-01 ES ES93907059T patent/ES2111739T3/en not_active Expired - Lifetime
- 1993-03-01 CA CA002129332A patent/CA2129332C/en not_active Expired - Lifetime
- 1993-03-01 AU AU37797/93A patent/AU671821B2/en not_active Expired
- 1993-03-01 WO PCT/US1993/001744 patent/WO1993017626A1/en active IP Right Grant
- 1993-03-01 JP JP51577593A patent/JP3307394B2/en not_active Expired - Lifetime
-
1995
- 1995-04-12 US US08/421,354 patent/US5626598A/en not_active Expired - Lifetime
Also Published As
| Publication number | Publication date |
|---|---|
| CA2129332A1 (en) | 1993-09-16 |
| WO1993017626A1 (en) | 1993-09-16 |
| DE69316740T2 (en) | 1998-06-10 |
| EP0630213B1 (en) | 1998-01-28 |
| DE69316740D1 (en) | 1998-03-05 |
| EP0630213A1 (en) | 1994-12-28 |
| JP2000514315A (en) | 2000-10-31 |
| AU671821B2 (en) | 1996-09-12 |
| AU3779793A (en) | 1993-10-05 |
| JP3307394B2 (en) | 2002-07-24 |
| ES2111739T3 (en) | 1998-03-16 |
| US5441513A (en) | 1995-08-15 |
| US5626598A (en) | 1997-05-06 |
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Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| EEER | Examination request | ||
| MKEX | Expiry |
Effective date: 20130301 |