WO1994007552A1 - Protection for septum seal of a trocar - Google Patents
Protection for septum seal of a trocar Download PDFInfo
- Publication number
- WO1994007552A1 WO1994007552A1 PCT/US1993/009067 US9309067W WO9407552A1 WO 1994007552 A1 WO1994007552 A1 WO 1994007552A1 US 9309067 W US9309067 W US 9309067W WO 9407552 A1 WO9407552 A1 WO 9407552A1
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- WO
- WIPO (PCT)
- Prior art keywords
- valve
- instrument
- portions
- axis
- trocar
- Prior art date
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
- A61M39/02—Access sites
- A61M39/06—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof
-
- 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
- A61B17/3462—Trocars; Puncturing needles with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals
-
- 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
- A61B17/3498—Valves therefor, e.g. flapper valves, slide valves
-
- 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
- A61B17/3462—Trocars; Puncturing needles with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals
- A61B2017/3464—Trocars; Puncturing needles with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals with means acting on inner surface of valve or seal for expanding or protecting, e.g. inner pivoting fingers
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
- A61M39/02—Access sites
- A61M39/06—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof
- A61M2039/0626—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof used with other surgical instruments, e.g. endoscope, trocar
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
- A61M39/02—Access sites
- A61M39/06—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof
- A61M2039/0633—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof the seal being a passive seal made of a resilient material with or without an opening
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
- A61M39/02—Access sites
- A61M39/06—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof
- A61M2039/0633—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof the seal being a passive seal made of a resilient material with or without an opening
- A61M2039/0653—Perforated disc
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
- A61M39/02—Access sites
- A61M39/06—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof
- A61M2039/0633—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof the seal being a passive seal made of a resilient material with or without an opening
- A61M2039/066—Septum-like element
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
- A61M39/02—Access sites
- A61M39/06—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof
- A61M2039/0633—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof the seal being a passive seal made of a resilient material with or without an opening
- A61M2039/0666—Flap-valve
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
- A61M39/02—Access sites
- A61M39/06—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof
- A61M2039/0673—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof comprising means actively pressing on the device passing through the seal, e.g. inflatable seals, diaphragms, clamps
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
- A61M39/02—Access sites
- A61M39/06—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof
- A61M2039/0686—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof comprising more than one seal
Definitions
- This invention relates generally to access devices, such as trocars, and more specifically to access devices including at least one septum valve.
- Laparoscopic surgery is conducted through trocars which extend across the abdominal wall and provide channels through which instruments such as scopes, retractors and staplers can be inserted to perform surgery in the abdominal cavity.
- the abdomen is inflated with an insufflation gas to maintain the abdomen in a distended state.
- Valves are typically provided in the trocars to form seals around the instruments in order to prevent leakage of this insufflation gas.
- a variable diameter septum valve is of particular advantage for this purpose as it is able to conform to any size of instrument, regardless of its diameter, without increasing the friction or drag on the instrument.
- a variable diameter septum valve of this nature is disclosed and claimed by applicant in the parent application Serial No.
- Variable diameter seals have a high degree of compliance which is of particular advantage in accommodating different sizes of instruments. However, this compliance can present a problem if a particular instrument is bifurcated or is inserted off center. Under these circumstances, the sharp point of the instrument can localize forces along the side of the valve providing undesirable cupping and perhaps tearing of the seal. This can occur with any septum seal, although the highly compliant variable diameter seals appear to be most susceptible to damage.
- a protection mechanism has the configuration of a funnel extending along the axis of the trocar.
- this mechanism engages the instrument in an extended position but is movable with the instrument distally axially into close proximity with the septum valve. In this distal position, the mechanism extends between the instrument and at least the outer portions of the seal. In a preferred embodiment, the mechanism actually extends through an aperture in the seal as the instrument passes through an aperture.
- the elastomeric characteristics of the seal radially compress the protection mechanism and tend to move it rearwardly to its initial proximal position. This movement can be assisted by a slight withdrawal of the instrument if necessary. With the protection mechanism disposed in the proximal position, the septum valve is free to form a seal with the instrument.
- This seal mechanism is effective in trocars having any form of septum valve, although it is particularly valuable where the septum valve is highly compliant as is the case with a variable diameter seal.
- the lever arms which are normally associated with a variable diameter seal can actually assist in radially spreading the valve during insertion of the instrument, and in returning the mechanism to the proximal position when the instrument has been operatively positioned.
- the invention includes an access device having an axis extending between the proximal end and an opposing distal end, and properties facilitating introduction into the body of an instrument having a sharp distal tip.
- the device includes a housing having walls defining a channel and a septum valve disposed across the channel to form a seal with an instrument extending through the channel.
- the valve includes inner portions defining an aperture and outer portions extending radially outwardly of the inner portions.
- Means is disposed between the instrument and at least the outer portion of the seal for isolating the seal from the sharp distal tip of the instrument.
- the present invention also includes the concept of a floating septum seal which provides for movement of the septum orifice to an off-axis position without deformation.
- the inner portions which define the orifice are moved substantially intact so that the orifice does not change from its circular configuration as it moves laterally to accommodate the off-axis insertion of an instrument.
- the septum valve is formed with outer portions having a reduced resiliency compared to the that of the inner portions which define the orifice. This encourages the outer portions to deform first pulling the inner portions substantially undeformed to an off-axis position.
- lever actuators are pivotally mounted on a ring which floats in an enlarged annular recess.
- the lateral force on the levers moves the inner portions of the valve laterally but undeformed as the outer portions are stretched.
- a trocar is adapted to form an access channel across a body wall and configured to receive a surgical instrument.
- the trocar includes a cannula having an axis with a seal housing disposed at the distal end of the cannula and defining with the cannula the access channel.
- a flexible valve is disposed across the access channel and provided with elastomeric properties for forming a seal with the instrument. First portions of the valve define an orifice which is normally concentric with the axis of the cannula.
- Second portions of the valve disposed circumferentially outwardly of the first portions facilitate movement of the orifice from a first position generally concentric with the axis of the cannula to a second position generally removed from the axis of the cannula in response to insertion of the instrument along a line removed from the axis of the cannula.
- Fig. 1 is a side elevation of a trocar assembly operatively positioned to penetrate a tissue barrier
- Fig. 2 is an axial cross-section view of the trocar, showing details of a variable diameter septum valve assembly prior to insertion of a surgical instrument therein;
- Fig. 3 is an axial cross-section view similar to that of Fig. 2, showing details of the same embodiment of the trocar valve assembly during insertion of the surgical instrument;
- Fig. 4 is a side elevation view of a trocar extending across the abdominal wall and including one embodiment of a seal protection mechanism of the present invention
- Fig. 5 is a side elevation view of a trocar of the prior art illustrating a cupping problem associated with some instruments
- Fig. 6 is an axial cross-section view of a trocar and a further embodiment of the seal protection mechanism of the present invention
- Fig. 7 is an axial cross-section view similar to Fig. 3 illustrating the seal protection mechanism in a distal position as the instrument is being inserted into the trocar;
- Fig. 8 is an axial cross-section view illustrating the instrument slightly retracted to return the protection mechanism to a proximal position;
- Fig. 9 is an end view of one embodiment of the seal protection mechanism
- Fig. 10 is an axial cross-section view of the seal protection mechanism of Fig. 9;
- Fig. 11 is an end view of the seal protection mechanism similar to Fig. 10 but illustrating an instrument extending through the mechanism as illustrated in Fig. 8;
- Fig. 12 is a side-view partially in phantom of the trocar and a floating septum valve of the present invention
- Fig. 13 is a radial view taken along lines 13-13 of Fig. 12;
- Fig. 14 is a radial cross-section view similar to Fig. 12 and illustrating the septum valve with its undeformed orifice displaced off-axis.
- a surgical trocar is illustrated in Figure 1 and designated generally by the reference numeral 10.
- the trocar 10 is representative of any elongate access device having a distal end 12 and a proximal end 14. It is typically configured along a longitudinal axis 16 and is generally circular in radial cross-section.
- the tissue barrier may include an abdominal wall 18 which defines an abdominal cavity 20.
- the trocar 10 typically includes an elongate tube or cannula 22 having a cylindrical configuration and a wall thickness which may be on the order of .015 or .030 inches.
- the cannula 22 has an interior bore or channel 24 which may have a diameter in a range between 5 and 12 millimeters.
- the trocar 10 is designed to pierce, cut, incise, or otherwise puncture the tissue barrier, such as the abdominal wall 18, and to leave the cannula 22 extending through the incision.
- An elongate surgical instrument 26 is representative of various cutters, clamps, traction devices, visualization devices, aspirators and irrigators as well as other types of instrument, which have different diameters.
- the instrument 26 is positioned through the channel 24 of the trocar 10 and manipulated to perform a particular surgical procedure within the cavity 20.
- the trocar 10 rncludes a valve housing 28 which encloses a valve mechanism 30 such as that shown in Figures 2-4. These figures illustrate the trocar 10 at a point in time after it has been inserted through the abdominal wall 18 leaving the cannula 22 to provide access to the abdominal cavity 20.
- the valving mechanism 30 includes a septum valve 36, which is preferably molded from an elastomeric material such as C-flex®, a low durometer polymer manufactured by Concept Polymer Technologies. This material is chosen for its high degree of compliance which makes it particularly adaptable to instruments having different diameters. Of course, other known elastomeric materials could be used instead to accomplish the objectives of the invention.
- a septum valve 36 which is preferably molded from an elastomeric material such as C-flex®, a low durometer polymer manufactured by Concept Polymer Technologies. This material is chosen for its high degree of compliance which makes it particularly adaptable to instruments having different diameters. Of course, other known elastomeric materials could be used instead to accomplish the objectives of the invention.
- the valve 36 which is characterized as a septum valve, is deemed to include any valve which has properties for radially compressing against the outer surface of an instrument, such as the instrument 26. Included in this definition without limitation is the valve disclosed and claimed in applicant's U. S. Patent No. 5,127,626, issued on July 7, 1992, and entitled Apparatus for Sealing Around Members Extending Therethrough, which is incorporated herein by reference.
- the septum valve 36 includes inner portions 37 which define a central orifice or aperture 38 that is preferably centered about the axis 16 of the trocar 10.
- the aperture 38 in a relaxed state has a cross-sectional area which, in one embodiment may be substantially zero, and in a different embodiment may be small, but greater than zero.
- the septum valve 36 also includes outer portions 39 which extend radially outwardly from the inner portions 37.
- the septum valve 36 also includes an annular flange or lip 40 which is preferably concentric with the aperture 38 and may be disposed in either the inner portions 37 or outer portions 39.
- the septum valve 36 in the illustrated embodiment also includes seating portions 46 which are clamped between the valve housing 28 and a transition housing 52.
- a plurality of levers 54 are disposed outwardly of the elongate axis 16, in such a manner as to define a continuation of the channel 24.
- four such levers 54 are provided, but any number of levers could be employed, with suitable modifications in design.
- Each lever 54 can be mounted on a pivot 58 at its proximal end 60, with the pivotal axis being transverse to the elongate axis 16.
- At least one tooth member 62 can be provided at a distal end 64 of each lever 54. This tooth member 62 is adapted to engage and interlock with the lip 40.
- the lever teeth 62 collectively form a substantially circular tooth member which engages the circular lip 40 about it circumference.
- each of the levers 54 extends radially inwardly to define a throat 66 of the channel 24.
- An open space 68 lies radially outwardly of both the levers 54 and the annular flange or lip 40, within the valve housing 28. This space 68 accommodates outward expansion of the levers 54 and the septum valve 36.
- the surgical instrument 26 In operation, it may be desired to insert the surgical instrument 26 through the channel 24 and into the body cavity 18. To do so, the instrument 26 is first inserted into the valve housing 28 as shown in Figure 3.
- the instrument 26 has a particular cross-sectional diameter which may vary according to the type of instrument, but it must be greater than the radial distance separating the levers 54 in order for the levers 54 to be actuated.
- the expansion of the lip 40 in turn stretches the septum 36, causing the radial width of the aperture 38 to be expanded, as shown by the arrows 67.
- the aperture is preferably expanded to a cross-sectional diameter which is slightly smaller than the cross-sectional diameter of the instrument 26. This will enable the instrument 26 to pass easily through the aperture 8 while the valve 36 engages the instrument with a force sufficient to create a seal. With the valve 36 prestressed by the levers 54, this sealing force will not create significant frictional resistance between the instrument 26 and the septum 38. Such resistance is to be avoided since it not only opposes forward movement of the instrument 26, but also tends to tear the valve 38.
- FIG. 4 Of particular interest to the present invention is an embodiment illustrated in Figure 4 wherein the trocar 10 is provided with a proximal end cap 74 which can be held in a snap fit relationship with the valve housing 28.
- This end cap 74 includes an annular flange 76 which extends axially proximally of the trocar 10. This flange 76 is adapted to receive a seal protector 81 which is of particular interest to the present invention.
- the protector 81 is movable axially within the flange 76 between a proximal position illustrated in Figure 4 and a distal position discussed in greater detail below. This protector 81 is particularly advantageous when the trocar 10 is used in conjunction with an instrument 26 having sharp points at its distal tip.
- an instrument 26 might include a clip applier having a bifurcated distal end with pointed tips 83.
- the seal protector 81 isolates the outer portions 39 of the septum valve 36 from damaging contact with a pointed instrument tip, such as the tip 83.
- a pointed instrument tip such as the tip 83.
- the inner portions 37 and outer portions 39 of the valve 36 are separated based on the response of a particular valve 36 to a pointed tip 83. If the tip 83 contacts the valve 36 at a point on the valve 36 where cupping would occur, this point is deemed to be within the outer portions 39. In contradistinction, if the pointed tip 83 of an instrument 26 contacts the valve 36 at a point on the valve which would not produce cupping, that point is deemed to be within the inner portions 37.
- inner portions 37 and outer portions 39 will vary for different septum valves 36 depending upon the shape and material of the valve 36 as well as the configuration of the tip 83 of the instrument 26.
- the compliance of the material forming the valve will be a primary consideration, but other physical characteristics of the valve 36 may also contrtibute to cupping at a particular point on the valve 36.
- the valving mechanism 30 includes not only the septum valve 36 but also a flapper valve 90 which is of no particular interest to the present invention.
- the levers 54 are illustrated to have a more narrow configuration, they still rotate on the pivots 58 and include the tooth members 62.
- the septum valve 36 has a different configuration, but it also extends across the channel 24 and includes the inner portions 37 which define the aperture 38 and the outer portions 39 which form a seal with the housing 28.
- the annular flange 76 of the end cap 74 includes an inner shoulder and an outer surface 94.
- the seal protector 81 which is mounted on the trocar 10 in Figure 6, is shown in an enlarged isolated view in Figure 10.
- This enlarged view illustrates an embodiment, wherein the seal protector 81 is formed in two sections.
- a distal section 101 has an outer cylinder 103 and a pair of integral outer leaves 105 and 107.
- the distal section 101 also includes an integral annular flange 108 which extends radially outwardly and defines with the cylinder 103 a pair of windows 109.
- the outer leaves 105 and 107 include funnel portions 110 and 112, respectively, which extend radially distally inwardly from the cylinder 103.
- the leaves 105 and 107 also include distal portions 114 and 116, respectfully, which may also have the configuration of a cylinder.
- a proximal section 121 of the seal protector 81 also includes an outer cylinder 123 and a pair of integral inner leaves 125 and 127 ( Figure 9) . These leaves 125 and 127 are configured similar to the leaves 105 and 107. Thus the inner leaf 125 includes a funnel section 130 and a distal section 132 while the inner leaf 127 includes a funnel section 134 and a distal section 136. These two sections of the seal protector 81, the distal section 101 and the proximal section 121, are intended to be disposed in fixed relationship with the inner leaves 125, 127 disposed inwardly of the outer leaves 105, 107.
- This fixed relationship between the distal section 101 and the proximal section 121 can be accomplished by bonding alternatively the outer cylinder 123 of the proximal section 121 can be provided with a pair of snap flanges 145 which are configured to seat in the windows 129.
- the outer leaves 105 and 107 are separated by a radial slot 141 which permits these leaves to be individually moved in opposite directions as the instrument 26 is inserted.
- the inner leaves 125 and 127 are separated by a radial slot 143 which is disposed transverse, perpendicular in a preferred embodiment, to the slot 141.
- the seal protector 81 is preferably molded from a strong, tough material.
- characteristics facilitating formation of a living hinge or a lubricious surface may also be of interest. Based on these considerations, materials such as high density polyethylene, Hytrel (a trademark of DuPont) , and Valox (a trademark of General Electric) might be considered. The Valox material was chosen for a preferred embodiment.
- FIG. 11 These living hinges are best illustrated in Figure 11 and designated by the reference numerals 152 and 154 for the respective leaves 105 and 107.
- This end view of Figure 11 also illustrates the configuration of the seal protector 81 with the instrument 26 inserted. The accommodating separation of the respective leaves 105, 107 and 125, 127 is apparent from this view.
- the seal protector 81 disclosed in these Figures 9-11 is illustrated in Figure 6 mounted to the proximal end of the trocar 10. As illustrated, the protector 81 is preferably mounted co-axially with the aperture 38 with the leaves 105, 107 and 125, 127 functioning as a funnel to guide the instrument 26 toward the aperture 38. In this location, the protector 81 in a preferred embodiment is movable axially between a proximal position, illustrated in Figure 6, and a distal position illustrated in Figure 7. These respective positions are defined by interlocking parts of the protector 81 and the annular flange 76 of the end cap 74.
- the cylinder 103 is provided with an annular snap ring having a proximally facing shoulder 158.
- the cylinder 108 has a distally facing surface 161.
- the protector 81 is preferably mounted with the cylinder 103 disposed in sliding engagement with the annular flange 76.
- the shoulder 158 and surface 161 are separated an axial distance greater than the axial length of the flange 76. This permits the protector 81 to move axially between the proximal and distal positions.
- the proximal position illustrated in Figure 6
- further proximal movement of the protector 81 is prevented by contact between the shoulder 9-. on the flange 76 and the shoulder 158 on the cylinder 103.
- the distal position illustrated in Figure 7
- further distal movement of the protector 81 is prevented by contact between the surface 161 of the flange 108 and the surface 94 of the flange 76.
- the instrument 26 is inserted into the funnel formed by the protector 81.
- the instrument contacts the inner leaves 125, 127, it moves the protector 81 to the distal position.
- the leaves extend between the pointed points 83 of the instrument 26 and the outer portions 39 of the septum valve 36.
- the distal sections 114, 116 and 132, 136 may actually contact the proximal side of the septum valve 36 although this is not required by the present invention. Nevertheless, this contact is encouraged as it permits the protector 81 to actually engage the septum valve 36.
- the instrument 26 is further inserted and the leaves 105, 107 and 125, 127 expand radially outwardly, they will also spread the inner portions 37 of the valve 36, thereby enlarging the aperture 38.
- the distal sections 114, 116 and 132, 136 of the leaves actually extend into the aperture 38 in the distal position. This insures that the aperture 38 is spread at least as far as the leaves of the protector 81. In this case, the protector 81 extends between the instrument 26 and all portions of the septum valve 36.
- valve 36 be permitted to engage the outer surface of the instrument in order to form the desired seal and prevent the escape of insufflation gasses.
- this will require that the seal protector 81 be separated from the septum valve 36 for example by returning the protector 81 to the proximal position.
- This movement of the protector 81 from the distal position to the proximal position may occur automatically when the instrument is in place and the protector 81 is no longer subjected to insertion forces.
- the automatic return of the protector 81 would result from the elastomeric forces of the septum valve 36 which compress the leaves 105, 107 and 125, 127 radially inwardly. This compression may result from contact between the valve 36 and the leaves, or contact between the levers 54 and the leaves.
- the protector 81 could also be formed from more than the two sections 101 and 121.
- An embodiment including a different number of the leaves 105, 107 and 125, 127 may offer certain advantages in other configurations. It is also particularly advantageous if the protector 81 can protect the valve 36 during insertion of the instrument 26, but also permit the valve 36 to form a seal with the instrument when it has achieved its ultimate position. While these features may be available in an embodiment providing for axial movement of the protector 81, such movement may not be required in other embodiments of the invention.
- the septum valve 36 illustrated in Figure 2 and 3, is of particular interest due to the floating characteristics provided by the outer portion 39. These characteristics are further described with reference to Figure 12.
- both the cannula 22 and the housing 28, are illustrated along with the septum valve 36.
- the annular lip 40 which defines the central orifice of 38, and the seating portion 46 which circumferentially attaches the septum 36 to the housing 28, are also shown in this view.
- the letter "A” designates a point on the lip 48 which defines the orifice 38.
- the reference letter “B” designates a point on the seating portion 46.
- the instrument 26 is also illustrated in Figure 12 but with its axis 170 offset from the normal axis 96 of the orifice 38, as well as the axis 16a of the cannula 22. This offset of the instrument 26 is also shown in the radial cross section view of Figure 13. From this view it will be apparent that the function of the floating outer portions 39 of the septum 36 is based primarily on the configuration of the septum between the orifice 38 and the seating portion 46. This region is further defined as the region between the reference points "A" and "B” in the axial view of Figure 12, and the region A-B between the reference circles "A" and "B” in the radial view of Figure 13.
- the outer portions 39 have a resiliency which is reduced relative to that of the inner portions 37.
- this difference in the resiliency of the inner portons 37 and the outer portions 39 means that an instrument, such as the instrument 26, which is inserted off-axis as illustrated in Figures 12 and 13, will tend to deflect the outer portions 39 before it deflects the inner portions 37.
- the reduced resiliency of the outer portions 39 may be characterized as a higher elasticity or higher flexibility than that of the inner portions 37.
- the inner portions 37 can move off-axis without deforming the orifice 38.
- the orifice 38 maintains its generally circular configuration without producing the "cat-eye” effect which would result otherwise in a leak between the instrument 26 and the septum 36.
- the term "off-axis" when applied to the instrument 26, means that the axis 94 of the instrument 26 is removed from the axis 16 of the cannula 22.
- the term when applied to the septum 36, it means that the axis 96 of the orifice 38 is removed from the axis 16a of the cannula 22.
- the region A-B which has a reduced resiliency relative to the lip 40, can be embodied in many different forms.
- the septum 36 can be formed with different rings of material, one ring for the inner portions 37 and another ring for the outer portions 39.
- the ring associated with the outer portion 39 can be formed from a material having increased elastomeric properties relative to the material forming the ring of the inner portions 37.
- the reduced resiliency of the outer portion 39 is provided by an excess of material between the circles "A" and "B". This excess of material enables the inner portions 37 to easily move off axis without deforming the associated orifice 38.
- This excess of material in the region A-B can best be defined with reference to Figure 12.
- the excess of material in the region A-B is illustrated by the septum 36a having a radial length between the reference points "A" and “B", which is greater than the radial distance between the points "A” and "B".
- the ratio of this radial length to radial distance is greater than one. While this excess of material will generally be disposed in a uniform circular configuration around the orifice 38, the reduced resiliency could vary around the circumference of the septum 36 in order to encourage off-axis movement of the orifice 38a in a particular direction.
- the region A-B of reduced resiliency could also be formed by a reduction in the thickness of the septum 36a. With a reduced thickness of material, the region A-B would be more easily stretched than the inner portion 37. The same effect would result, namely the inner portion 37 would move off-axis without significantly deforming the orifice 38.
- the region A-B of reduced resiliency functions in two manners. That portion of the region A-B which is disposed in the direction of orifice movement, shown by an arrow 180, is placed in compression. In an embodiment providing an excess of material, this compression at the arrow 180 tends to gather the material thereby offering no resistance to the movement of the orifice 38. At the same time, that portion of the region A-B which is disposed away from the direction of orifice movement, shown by an arrow 182, is placed in tension. In an embodiment providing an excess of material, this tension at the arrow 182 merely tends to unfold the material thereby offering substantially no resistance to movement of the inner portions 37 and the associated orifice 38.
- the instrument 26 If the instrument 26 is inserted off-axis, as illustrated in Figure 12, it contacts the side of • he seal protector 81 which transfers that off-axis force to the levers 54. Since the levers 54 float with the ring 180, they tend to move off-axis carrying the inner portions 37 of the septum valve 36 with them. This stretches the outer portions 39 which are away from the direction of movement and compresses the outer portions 39 which are in the direction of the movement. During this process, the inner portions 37 which are supported on the tooth l ⁇ embers 62 of the levers 54 are entirely isolated from the off-axis, deflection forces. This isolation automatically occurs with the floating characteristics of the ring 180.
- the resiliency of the outer portions 39 is less than that of the inner portions 37 because of the force isolation provided by the levers 54.
- This same concept of a floating ring would also be present in an embodiment which did not include the seal protector 81.
- the instrument would immediately contact the levers 54 supported on the ring 180 and thereby provide the desired deformation of the outer portions 38 without deforming the inner portions 37.
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- Health & Medical Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Public Health (AREA)
- Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Veterinary Medicine (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Anesthesiology (AREA)
- Hematology (AREA)
- Pathology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Pulmonology (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Surgical Instruments (AREA)
- Endoscopes (AREA)
Abstract
Description
Claims
Priority Applications (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
CA002118889A CA2118889C (en) | 1992-09-28 | 1993-09-23 | Trocar with floating septum seal and protection thereof |
JP50917994A JP3315409B2 (en) | 1992-09-28 | 1993-09-23 | Trocar with floating diaphragm seal and its protection |
EP93922363A EP0614384B1 (en) | 1992-09-28 | 1993-09-23 | Protection for septum seal of a trocar |
DE69327841T DE69327841T2 (en) | 1992-09-28 | 1993-09-23 | PROTECTION FOR A SEALING SEPTUM OF A TROCAR |
Applications Claiming Priority (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US95230092A | 1992-09-28 | 1992-09-28 | |
US07/952,300 | 1992-09-28 | ||
US08/077,005 US5385553A (en) | 1991-07-18 | 1993-06-15 | Trocar with floating septum seal |
US08/077,005 | 1993-06-15 |
Publications (1)
Publication Number | Publication Date |
---|---|
WO1994007552A1 true WO1994007552A1 (en) | 1994-04-14 |
Family
ID=26758757
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US1993/009067 WO1994007552A1 (en) | 1992-09-28 | 1993-09-23 | Protection for septum seal of a trocar |
Country Status (6)
Country | Link |
---|---|
US (1) | US5385553A (en) |
EP (1) | EP0614384B1 (en) |
JP (1) | JP3315409B2 (en) |
CA (1) | CA2118889C (en) |
DE (1) | DE69327841T2 (en) |
WO (1) | WO1994007552A1 (en) |
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US10052088B2 (en) | 2010-01-20 | 2018-08-21 | EON Surgical Ltd. | System and method of deploying an elongate unit in a body cavity |
US10028652B2 (en) | 2010-01-20 | 2018-07-24 | EON Surgical Ltd. | Rapid laparoscopy exchange system and method of use thereof |
US10390694B2 (en) | 2010-09-19 | 2019-08-27 | Eon Surgical, Ltd. | Micro laparoscopy devices and deployments thereof |
Also Published As
Publication number | Publication date |
---|---|
CA2118889A1 (en) | 1994-04-14 |
CA2118889C (en) | 1999-12-28 |
EP0614384B1 (en) | 2000-02-09 |
DE69327841D1 (en) | 2000-03-16 |
EP0614384A4 (en) | 1995-11-08 |
JPH07501739A (en) | 1995-02-23 |
JP3315409B2 (en) | 2002-08-19 |
US5385553A (en) | 1995-01-31 |
EP0614384A1 (en) | 1994-09-14 |
DE69327841T2 (en) | 2000-10-26 |
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