WO2010097365A2

WO2010097365A2 - Surgical device comprising a double entry trocar

Info

Publication number: WO2010097365A2
Application number: PCT/EP2010/052212
Authority: WO
Inventors: Alessandro Bulfoni
Original assignee: Alessandro Bulfoni
Priority date: 2009-02-26
Filing date: 2010-02-22
Publication date: 2010-09-02
Also published as: ITMI20090285A1; IT1398153B1; WO2010097365A3

Abstract

A surgical device in particular for endoscopic surgery, comprising a trocar (1), characterised in that said trocar (1) comprises at least two entry channels (2, 4), each adapted to at least partially house a separate endoscopic instrument (3, 5), said at least two entry channels converging into a single exit channel (6), such as to enable different instruments to be used through a single trocar, by alternating them according to operator requirements, so accelerating surgical passages and reducing operator times.

Description

SURGICAL DEVICE COMPRISING A DOUBLE ENTRY TROCAR

The present invention relates to a surgical device in particular for general and gynaecological endoscopic surgery, comprising a trocar. As known to the expert of the art, trocars are single- or multi-use operative channels which make it possible to introduce different endoscopic instruments into the abdominal cavity through the wall, or robotic devices. In the present context a surgical instrument means any usual known endoscopic instrument, such as forceps, wash systems, endobags, morcellators, endoloops, etc, or any commonly used robotic instrument. As known to the expert of the art, laparoscopy is a well established surgical technique routinely used in gynaecological environments. For example, creating a pneumoperitoneum enables the entire abdominal and pelvic cavity to be explored by a lens connected to a video camera and to a monitor.

As known to the expert of the art, endoscopic surgical forceps can access the abdominal and pelvic cavity by positioning trocars on the abdominal wall after making 5-10 mm cutaneous incisions. Usually the number of trocars positioned for surgical intervention is about 3 or 4 depending on the type and complexity of the intervention, one being for lens insertion for image transmission, usually at the umbilical level, the others for inserting gripping forceps, scissors, coagulation forceps and aspirators, and are positioned at the level of the lower abdomen quadrant. A technical problem with known surgical devices of the aforesaid type is related to the fact that in most interventions the devices, for example the forceps have to be alternated, as currently used available trocars enable only one instrument to be inserted at a time, hence increasing the inconvenience for the surgeon, who is compelled to extract and then reinsert the instrument, with time wastage and greater risk of complications.

An object of the present invention is to overcome the aforesaid technical problem. This and other objects which will be apparent to the expert of the art are attained by a surgical device comprising a trocar for general and gynaecological endoscopic surgery in accordance with the characterising part of the main claim. This device enables different surgical or robotic instruments to be used through a single trocar, by alternating them according to operator requirements, so accelerating surgical passages and reducing operator times.

The invention will be more apparent from the accompanying drawing, which is provided by way of non-limiting example and in which the single figure shows a device according to the invention.

The figure shows a single-use or multi-use trocar, definable as a "Bl- TROCAR", consisting of two entry channels 2, 4 for different surgical or robotic instruments 3, 5 (partially represented in the figure, but conventional to the expert of the art), which converge into a single exit channel 6.

The trocar of the invention preferably has a substantially Y-shape. The two entry channels 2, 4 preferably have a diameter D1 , D2 less than the diameter D3 of the single channel into which they converge; these channels could however all have the same diameter. The two entry channels 2 and 4 are preferably of equal diameter.

For example the diameter of the entry channels 2 and 4 and of the exit channel 6 is between 4 and 20 mm.

Preferably the diameter of the exit channel 6 is equal to that of trocars currently in use, i.e. between 5 and 16 mm, in this manner enabling a cutaneous incision to be made having the same dimensions as conventional trocars, hence preserving the mini-invasivity which is characteristic of this type of intervention.

The trocar of the invention enables the two different instruments 3, 5 (partially represented in the figure) to be maintained positioned in the same trocar, such that the surgeon is able to alternate the use of one or the other instrument already located in the trocar, so avoiding the need to completely extract the instrument and reposition it in the operative channel.

The instrument of the invention is useful both during the simplest laparoscopic interventions, such as salpingectomy, and in more complex interventions, such as hysterectomy, in which bipolar forceps, scissors and wash cannula have to be repeatedly changed and alternated, or in robotic intervention.

The trocar of the invention is used by inserting a substantially straight portion 7, 8 of the two surgical instruments 3 and 5 into one and the other of the two entry channels 2, 4 respectively, so that both instruments are always positioned in the trocar, and such that said instrument portions 7 and 8 do not come into mutual contact within the trocar. When the surgeon is to use one of the two instruments, he pushes it through the trocar so that it emerges from the mouth 6A of the exit channel 6. When he requires the other instrument, he withdraws that previously used, while maintaining it within the trocar in the relative entry channel and pushes the required instrument into the exit channel.

It should be noted that the trocar is preferably shaped such as to maintain the rectilinearity of the instrument portions 7, 8 inserted into the entry channels 2 and 4 even as they pass through the exit channel 6 to the outlet mouth 6A. For this purpose the trocar is shaped such that both the axis of symmetry A1 of the first entry channel 2 and the axis of symmetry A2 of the second entry channel 4 always lie within the interior of the exit channel 6 and sufficiently spaced from the inner walls of the exit channel 6 to enable the surgical instruments inserted into it to slide through.

Advantageously, the inlet mouths of the entry channels 2 and 4 each comprise a plug having a through hole of diameter less than the diameter D1 , D2 of said channels and substantially equal to the cross-section S1 , S2 of the surgical instruments, such as to exert on them a certain friction and prevent them from being able to accidentally escape from the trocar. The plugs 9 are preferably made of a plastic material of known type. The trocar of the invention can be made of any sterilizable material of the type usual in the surgical field, in order to form trocars of multi-use type, or can be made of other conventional materials for making single-use trocars. The provision of trocars with a double entry greatly aids the operator, who now has available two different instruments ready for use, within a single access port.

In this manner it is no longer necessary to completely extract the one or other instrument, but to merely retract it, to leave the distal portion of the instrument stem already inserted into the trocar and hence ready for use. In this manner, surgery times are definitely less, with consequent cost reduction, safer interventions because of the lesser number of instrument extractions and insertions with the risks connected with such an action, and a surgical technique which is definitely more comfortable for the operator.

Finally it should be noted that the aforedescribed embodiment is provided by way of example only, and that numerous variants are possible all falling within the same inventive concept. For example the device of the invention could comprise more than two entry channels.

Claims

1. A surgical device comprising a trocar (1 ), characterised in that said trocar (1 ) comprises at least two entry channels (2, 4), each adapted to at least partially house at least a portion of a separate instrument (3, 5), said at least two entry channels converging into a single exit channel (6), such as to enable different instruments to be used through a single trocar, by alternating them according to operator requirements, so accelerating surgical passages and reducing operator times.

2. A device as claimed in claim 1 , characterised in that the trocar is shaped such that both the axis of symmetry (A1 ) of the first entry channel

(2) and the axis of symmetry (A2) of the second entry channel (4) always lie within the interior of the exit channel (6), so as to be able to insert a substantially straight portion (7, 8) of the two surgical instruments (3, 5) into said entry channels, and also to insert said straight portions alternately into the exit channel (6), into which said two entry channels converge, so maintaining the rectilinearity of said portions (7, 8) at least as far as an outlet mouth (6A) of said channel (6).

3. A device as claimed in claim 1 , characterised in that the diameter of the entry channels (2, 4) and of the exit channel (6) is between 4 and 20 mm.

4. A device as claimed in claim 1 , characterised in that the entry channels (2, 4) and the exit channel (6) are substantially straight and are shaped such as to be able to insert a substantially straight portion (7, 8) of the two surgical instruments (3, 5) into said entry channels, and also to insert said portions into the exit channel (6), into which said two entry channels converge, so maintaining the rectilinearity of said portions (7, 8), at least as far as an outlet mouth (6A) of said channel (6).

5. A device as claimed in claim 1 , characterised in that the trocar (1 ) is substantially of Y-shape.

6. A device as claimed in claim 1 , characterised in that the two entry channels (2, 4) of the trocar (1 ) have a diameter (D1 , D2) which is less than the diameter (D3) of the single channel into which they converge.

7. A device as claimed in claim 1 , characterised in that the inlet mouths (9) of the entry channels (2, 4) each comprise a retention element (9) having a through hole of diameter less than the diameter (D1 , D2) of said channels and substantially equal to the cross-section (S1 , S2) of the surgical instruments (3, 5) to be inserted into said channels, such as to exert on said instruments a certain friction and prevent said instruments from being able to accidentally escape from said channels.

8. A device as claimed in claim 1 , characterised by being made of a sterilizable material and/or of being of single-use or multi-use type.

9. A device as claimed in claim 1 , characterised in that the instrument (3, 5) is an endoscopic or a robotic instrument.

10. A method for using a device claimed in one or more of the preceding claims, characterised by inserting a substantially straight portion (7, 8) of a surgical instrument (3, 5) into each of the two entry channels (2, 4), so that both instruments are always positioned in, and available within, the trocar, and such that said instrument portions (7, 8) do not come into mutual contact within the trocar, then, when the surgeon is to use one of the two instruments, pushing the required instrument through the exit channel (6) until it is made to emerge from the relative mouth (6A), then, when the other instrument is required, withdrawing that previously used, while maintaining it within the device in the relative entry channel, and pushing said other instrument into the exit channel (6).