RU2656759C1 - Trocar with fixation - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medical technology, namely to surgical access instruments – trocars for fixing the walls of the hollow organ, and can be used in urology for carrying out minimally invasive endovideosurgical operations on the bladder using the pneumovesiscopy method. Trocar with fixation contains the endoscopic port and the stylet. Trocar port is made in the form of two coaxially spaced external and internal hollow tubes with the integral joint in the distal part, which is made by means of sealing the distal end of the outer tube into the stop brake annular groove, which is located on the outer surface of the inner tube. Fixed casing with the packing gland placed therein and with the connection for connecting the gas insufflation system is installed in the proximal part of the inner tube. Opening control unit for opening the umbrella, which is formed by the system of longitudinal slits that are located on its distal portion, by the movable limiter that separates the port into the intracavitary and outer parts, is located in the proximal part of the outer tube. Through holes are performed in the brake annular groove. Running groove, the flat, which is located in the plane that is parallel to the planes of the edges of the running groove, and the shoulder with the depth that is not less than the depth of the flat are performed on the surface of the proximal part of the inner tube. Flat is located within the length of the running groove, and the shoulder is outside the running groove at the distal distance from the above mentioned flats, which predetermines the diameter of the opening of the jaw. Jaw opening control unit is provided with the pin, one end of which is fixed in its body, and the other end of the pin is placed in the running groove.

EFFECT: use of the invention will allow to improve the reliability of the hollow organ wall fixing by means of the port, as well as the manufacturability of the system of structural elements.

1 cl, 10 dwg

Description

BACKGROUND OF THE INVENTION

The invention relates to the field of medical equipment, namely to surgical access instruments - trocars for fixing the walls of a hollow organ, and can be used in urology for minimally invasive endovideo surgical operations on the bladder by pneumovesikoscopy.

State of the art

Various trocar designs with the ability to fix to the anterior abdominal wall are known, such as the Hasson cannula, the trocar with the GIGI A retainer, the pneumofixer for the trocar with two inflated cuffs, the clamp type trocar with balloon fixation Balloon cannula (Origin; USSC). The effectiveness of the use of such instruments is ensured by a simple access device with a reliable system for fixing the ureter wall to the abdominal wall and a more reliable system for fixing the port between the peritoneum and the abdominal wall to create the best viewing angle for the surgical field during the formation and support of the operating cavity. A simplification of the design of the port is achieved, ensuring its reliable fixation on the wall of the hollow organ, ensuring maximum convenience for personnel when handling the trocar.

A trocar is known (patent application RU 2006122797, publ. 10.01.2008), in which it is fixed in dissected tissues of operative access at the level of the aponeurosis of the muscles of the anterior abdominal wall by means of two inflatable atraumatic cuffs isolated from each other, placed on a carrier tube, connected using channels in the carrier tube with a nipple system.

A disadvantage of the known trocar is the limited scope, due to the fact that the specific design of the retainer does not allow it to be used when accessing the bladder due to the large outer diameter of the cuff in the distal part both in the initial and in the working position. Also, there is no possibility of adjusting the distance between the inflated cuffs.

Known trocar (patent US 6325812, publ. 04.12.2001), which consists of two hollow tubes coaxially spaced with a gap with an integral connection in the distal part. The internal rigid tube is designed to hold a stylet or instrument, in the proximal part the handle is fixedly mounted with a fitting located in it for connecting a gas insufflation system. The outer movable tube is made of polymeric material, and in the proximal part of it is fixedly fixed the control unit of the device for fixing the trocar port on the wall of the hollow organ. The fixture for fixation is a system of longitudinal slots located at its distal end, due to the opening of the branches (by the type of "umbrella"), fixation is performed. A movable stop is located in the middle part, dividing the port into intracavitary and external parts.

A disadvantage of the known device is the insufficient viewing angle of the surgical field during the formation and support of the operating cavity, which is due to the significant length of the distal part of the port and one-piece connection of two hollow tubes coaxially located with the gap. The principle of operation of the control unit used is not optimal and promising in terms of minimizing the weight and size parameters of the device. The complex design of the control unit of the fixture for fixing by opening the port branch also requires more time to install and remove the trocar itself, while creating certain inconveniences for personnel when handling it.

Closest to the claimed invention in technical essence is a trocar for fixing the wall of a hollow organ (patent RU 2485901, publ. 06/27/2013), containing an endoscopic port and stylet. The trocar port is made in the form of two hollow tubes coaxially arranged with a gap with an integral connection in the distal part, an internal rigid tube intended for holding a stylet or working tools. In a stationary housing in its proximal part, a stuffing box seal and a fitting for connecting a gas insufflation system are placed. The outer movable tube is made of polymeric material, in its proximal part there is a control unit for opening the branches formed by a system of longitudinal slots located on its distal section. Four rectangular grooves are made on the surface of the proximal part of the inner tube, the first two grooves providing linear movement of the control unit body in the axial direction, made symmetrically and parallel to the axis of the inner tube, and the other two grooves fix the control unit for the open and closed states of the umbrella. The one-piece connection in the distal part of two hollow tubes coaxially arranged with a gap is made by sealing the distal end of the external movable polymer tube into a retaining ring-shaped groove located on the outer surface of the inner tube, and the control unit mechanism contains a button and a spring-loaded latch. A movable stop divides the port into intracavitary and external parts.

The disadvantages of the known device are:

- insufficient reliability of the fixation by the port of the wall of the hollow organ, due to the insufficient reliability of the one-piece connection made by sealing the distal end of the external movable polymer tube into a retaining ring-shaped groove located on the outer surface of the inner tube;

- low manufacturability of manufacturing a system of structural elements that provide linear movement of the control unit body in the axial direction to fix the open and closed states of the umbrella;

- the lack of sufficient tightness of the port during gas insufflation at the time of extraction of the stylet or change of working tools.

SUMMARY OF THE INVENTION

The technical problem to which the invention is directed is the development of a trocar with fixation, which allows to increase the reliability of fixation by a port of a wall of a hollow organ and to increase the manufacturability of manufacturing a system of structural elements.

The technical result is achieved in that in a trocar with a fixation containing an endoscopic port and a stylet, where the trocar port is made in the form of two coaxially arranged with a gap of the outer and inner hollow tubes with an integral connection in the distal part, made by sealing the distal end of the outer tube into a retaining ring-shaped a groove located on the outer surface of the inner tube, in the proximal part of the inner tube there is a fixed housing with an oil seal and a fitting for connecting a gas insufflation system, in the proximal part of the outer tube there is a control unit for opening the umbrella branches formed by a system of longitudinal slots located on its distal portion, a movable limiter dividing the port into intracavitary and outer parts, according to the proposed solution, in the retaining ring-shaped groove through holes are made, a running groove is made on the surface of the proximal portion of the inner tube, a flat located in a plane parallel to to the flanges of the edges of the groove, and the shoulder not less than the depth of the flange, and the flange is located within the length of the groove, and the shoulder is outside the groove distally from the aforementioned flat, which determines the opening diameter of the jaw, the jaw opening control unit is equipped with a pin, one end which is fixed in its housing, and the other end of the pin is placed in the running groove.

Brief Description of the Drawings

The invention is illustrated by figures of graphic images of the main nodes of the trocar.

In FIG. 1 shows a general view of the trocar in its initial position, FIG. 2 shows a general view of the hull of the trocar port; FIG. 3 shows the port housing in section AA, in FIG. 4 shows the port housing in section BB, in FIG. 5 is a perspective view of a port with an umbrella open; FIG. 6 shows a section BB of a port with an open umbrella; FIG. 7 shows the permanent connection of the outer polymer tube into the annular groove of the inner tube with holes, FIG. 8 shows a puncture of a tissue trocar; FIG. 9 shows the opening of an umbrella inside a hollow organ, FIG. 10 shows the port fixation of the wall of a hollow organ.

The implementation of the invention

The trocar consists of endoscopic port 1 and stylet 2. Port 1 contains an internal rigid tube 3, an external movable polymer tube 4, a device for fixing the port, which is a system of longitudinal slots 5, which form the branches 6 of the umbrella when the external movable tube 4 is displaced. One-piece connection in the distal part of the two hollow outer and inner tubes 3, 4 coaxially arranged with a gap; the distal end of the outer tube 4 is sealed in a retaining annular groove 7 with through holes 8 formed by the outer surface of the inner tube 3. In the instrument channel of port 1 there is a stylet 2 with a sharp end 9 and a handle 10. The movable housing 11 of the control unit includes a latch button 12, a spring 13, a pin 14. The flat 16, shoulder 17 and the running groove 18 are made on the surface of the proximal part of the inner tube 3. The stationary body 19 with the cover 20 is equipped with a check valve 21, an oil seal 22, a fitting 23 and a cap 24 for connecting a gas insufflation system, a movable limiter 25.

The device operates as follows.

In the assembled state, the trocar is mounted on the anterior abdominal wall through a 4-mm incision by piercing the tip 9 of the stylet 2 of the skin 26, the tissues 27 of the anterior abdominal wall and the wall of the bladder 28. When distally mixing the control unit 11 relative to the stationary body 19, the outer tube 4 is displaced relative to the inner tube 3, as a result of which the branch 6 of the umbrella is opened and the latch button 12 is activated at the moment of the shoulder transition, which secures the port from the inside a single organ for the time necessary for surgery. Then, the port is fixed from the outside by moving the movable limiter 25 to the surface of the skin. Similarly, another 2 or 3 trocars are installed to accommodate optics and other surgical instruments. Next, liquid is removed from the bladder and carbon dioxide is insufflated through the nozzle 23. After the operation is completed, the button 12 is pressed again and the control unit 11 is returned to its original position, which corresponds to holding the button flat, while the branches 6 are minimized and the ports are removed. The tightness of the port during gas insufflation is ensured by using a non-return valve 21. The wound channels are sutured.

When testing the product on the layout, the spatial location of the used endosurgical instruments was taken into account. The technical tests of experimental samples of the product showed good results.

Thus, the proposed device will improve the reliability of fixing the port of the trocar on the wall of the operated organ, increase the manufacturability of the device, and also ensure sufficient tightness of the port.

The presented design of the device allows to manufacture products for single use, delivered to the consumer in a sterile form.

Claims (1)

A fixed trocar containing an endoscopic port and a stylet, where the trocar port is made in the form of two coaxially arranged external and internal hollow tubes with a gap in the distal part, made by sealing the distal end of the outer tube into a retaining ring-shaped groove located on the outer surface of the inner tubes, in the proximal part of the inner tube there is a fixed housing with a stuffing box seal and a fitting for connecting a gas in suffixation, in the proximal part of the outer tube there is a control unit for opening the branches of the umbrella formed by a system of longitudinal slots located on its distal section, a movable limiter dividing the port into intracavitary and external parts, characterized in that through holes are made in the retaining annular groove on the surface a groove is made in the proximal portion of the inner tube, a flat located in a plane parallel to the planes of the edges of the groove, and the shoulder is not deep less than the depth of the flat, and the flat is located within the length of the running groove, and the shoulder is outside the running groove distally from the aforementioned flat, which determines the diameter of the opening of the jaw, the control unit for opening the jaw is equipped with a pin, one end of which is fixed in its body, and the other end the pin is placed in the running groove.

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