TW202502276A - A laparoscopic applicator having a reservoir and a one-way valve - Google Patents

Abstract

A laparoscopic applicator for dispensing a substance, e.g. a substance comprising a haemostatic agent, at a selected site by means of a surgical robotic arm, the laparoscopic applicator comprising: a delivery tube; an applicator tip connected to a distal end of the delivery tube, the applicator tip configured for being controllably operated by the robotic arm by a grip section in axial extension of the delivery tube, the grip section having a perimeter transverse to the axis comprising an apex shaped section, such that the grip section is configured for being clamped and spatially manipulated by the robotic arm, a reservoir connected to a proximal end of the delivery tube, the reservoir having a fixed volume, and a one-way valve connected to a proximal end of the reservoir, wherein the one-way valve is configured to prevent flow of the substance through the one-way valve from the reservoir.

Description

A laparoscopic instrument with a reservoir and a one-way valve

The present disclosure relates to an instrument, and more particularly to a laparoscopic instrument for dispensing medical substances or fluids at a selected site with the aid of a surgical robot arm.

Robotic systems are increasingly used for minimally invasive surgical procedures to avoid the more invasive traditional open surgery techniques. The robotic system includes a plurality of robotic arms to which medical devices are connected, and wherein the robotic arms and medical devices are controlled and manipulated by the surgeon from a console, for example via control devices such as joysticks and foot pedals. Thus, the robotic arms are located at the surgical site instead of the surgeon's hands, and instead the surgeon is away from the patient and views the surgical site via a display showing a three-dimensional view of the surgical site.

Similar to traditional open surgery techniques, where an assistant provides the physically present surgeon with the required medical devices, in robotic surgery, an assistant is positioned close to the robotic arms to provide the required medical devices to the arms. For example, the assistant can replace the medical devices of the robotic arms and provide medical fluids to the robotic arms either directly as medical devices or through instrument tubes that are introduced into the body through trocar ports.

Surgical hemostats and other medical fluids and pastes are traditionally dispensed to a target site using a manually operated syringe containing the paste within the syringe barrel. However, for minimally invasive surgical procedures, the target site is not directly accessible to the syringe cannula or syringe tip. Therefore, in order to dispense the paste to a target site within a body cavity, an elongated instrument tube pre-injected with the paste is typically introduced into the body via a trocar port. Insertion of the elongated instrument tube occurs at the trocar port.

The invasiveness of a minimally invasive surgical procedure using trocars will depend on the diameter of the trocars and the number of trocars used. The smaller the diameter, the less invasive the procedure will be and the sooner the patient will recover.

The present disclosure relates to an instrument that is particularly suitable for robot-assisted surgery. In particular, the present disclosure provides an instrument that is suitable for insertion into a trocar port and has an instrument tip, wherein the orientation can be controlled via the distal end of the inserted instrument or the instrument tip. Therefore, the instrument can be controlled and activated via the instrument tip, and therefore it is particularly suitable for being controlled and activated by a robotic arm that interacts with the instrument distal end/tip at the surgical site (e.g., intra-abdominally) during a medical procedure, for example where the instrument is configured for intra-abdominal delivery of a medical substance. The medical substance can be a medical fluid, a medical paste and/or a medical powder.

A first aspect of the present disclosure relates to a laparoscopic instrument for dispensing or withdrawing a substance, such as a substance containing a hemostatic agent, at a selected site by means of a surgical robot arm, the laparoscopic instrument comprising: -   a delivery tube; -   an instrument tip connected to a distal end of the delivery tube, the instrument tip being configured to be controllably operated by the robot arm through a gripping portion in an axial extension of the delivery tube, the gripping portion having a periphery transverse to the axis, the gripping portion including a vertex-shaped portion such that the gripping portion is configured to be gripped and spatially manipulated by the robot arm; -  a reservoir connected to a proximal end of the delivery tube, the reservoir having a fixed volume; and -    optionally a check valve connected to a proximal end of the reservoir, wherein the check valve is configured to prevent the substance from flowing from the reservoir through the check valve.

Throughout this application, the terms substance, medicament or paste are to be understood as interchangeable terms.

The target volume of the device may be 8 mL, which may correspond to or be slightly smaller than the volume of a standard syringe. The device may be pre-filled with a substance such as a hemostatic agent by providing the substance from a syringe connected to the opening of the reservoir.

On the one hand, the inner diameter of the delivery tube must be as small as possible to keep the outer diameter of the device below a certain limit, so that it is compatible with, for example, a 5 mm trocar, which is considered a small trocar and is therefore not really invasive. On the other hand the inner diameter must be high enough so that the force required for pre-filling and dispensing the hemostatic agent does not exceed a certain level and the user feels uncomfortable pressing the syringe. By positioning the syringe in a pistol grip or power grip that fits the syringe, higher pressures can be provided and the inner diameter of the delivery tube can be made even smaller. The syringe can be operated by hand or by a clamp grip without a pistol grip and in the case of substances with a lower viscosity the inner diameter of the delivery tube can still be made smaller. A syringe that can be operated by hand without a pistol grip has the advantage of providing a substance to a surgical site, wherein the substance is provided at a constant rate. In order to be able to have a flexible delivery tube that can be manipulated by an external robotic arm, the delivery tube will have to be made of a material that will require thicker walls than if the delivery tube was made of metal. Preferably, the delivery tube includes a deformable portion or a portion of the delivery tube is configured to be tension-free flexible so that when the robotic arm moves the delivery tube and releases the delivery tube, the delivery tube will maintain the shape and will not bend back to the original shape. In the event that the robotic arm does not grasp the delivery tube, the risk of the delivery tube moving out of the view of the camera during laparoscopy is reduced. The material of the deformable portion or the portion of the conveying tube configured to be tension-free and flexible may be a vibration energy dissipating material selected from the group consisting of silicone elastomer, butyl rubber, polyurethane, thermoplastic elastomer, polyvinyl chloride, polypropylene and combinations thereof.

Such a delivery tube may also be achieved by having a delivery tube with an expandable wire or rod configured so that a deformable portion of the delivery tube can be bent into a desired shape, which is substantially maintained when the delivery tube is released.

A certain length of delivery tubing is required for the device to be maneuverable and to be able to access different areas within the patient. However, to provide the same volume, such as, for example, 8 mL, the delivery tubing must be made longer when the inner diameter is reduced. To address the problem of an overly long delivery tubing that is difficult to handle during preparation and when not inserted into a patient, the device may have a reservoir having a larger cross-section than the cross-section of the delivery tubing. The reservoir is preferably located at or near the proximal end of the device.

The reservoir should preferably be of fixed volume so that material from the syringe fills the reservoir and fills the delivery tube as the reservoir fills.

In addition, the reservoir creates a surface area that can be used as a gripping surface when attaching and detaching the syringe from the device. Finally, the surface area can be used to convey product information (e.g., brand name and product code).

During the pre-filling period of the device, the hemostatic agent flows from the syringe into the device.

As the hemostat enters the flexible tube, pressure gradually builds up and the hemostat is compressed in the rear portion of the tube.

When the device is fully pre-filled and the user releases pressure from the syringe piston, the compressed hemostat will push the syringe piston back and some hemostat will enter the syringe again. In addition, when the syringe is removed from the device, additional hemostat will flow out of the device and contaminate the opening where the syringe is connected to the reservoir.

To prevent the paste from flowing back into the syringe after pre-filling and discharging the paste when the syringe is disassembled, a non-return valve such as a duckbill valve, a cross-slit valve or a check valve such as a ball check valve can be installed at the proximal end of the reservoir.

When pressure is applied to the syringe plunger, the valve opens and the hemostat begins to flow.

When pressure is released from the syringe plunger, the valve closes and prevents the hemostat from flowing back into the reservoir.

The second aspect of the present disclosure is a method for dispensing a substance using an apparatus as described in any of the above technical solutions, wherein the method comprises the following steps: -   providing a first syringe containing the substance and a second syringe containing water or an aqueous solution such as saline, -   connecting the first syringe to the one-way valve, -   transferring the substance to the apparatus through the one-way valve, into the reservoir and the delivery tube, -   disconnecting the first syringe from the one-way valve, -   connecting the second syringe to the one-way valve, -   transferring the water or the aqueous solution to the apparatus through the one-way valve, into the reservoir and the delivery tube to dispense the substance outside the apparatus.

In this way, substances such as substances with high viscosity (such as pastes) can be easily distributed to a site such as a surgical site without wasting the substance.

The invention is described below with the aid of the accompanying drawings. A person skilled in the art will appreciate that the same features or components of the device are referred to by the same reference numerals in different drawings. Apparatus for dispensing a substance

For surgical procedures, and in particular minimally invasive procedures such as endoscopic and/or laparoscopic procedures, substances such as medical substances (such as, for example, surgical hemostatic substances in the form of powders, fluids or pastes) are distributed to target sites in a body cavity via an elongated instrument 1 , which comprises a flexible delivery tube 2 pre-filled with a medical fluid/paste/powder or configured to be filled with a medical fluid/paste/powder during surgery, as shown in FIG1. The delivery tube may also be referred to as a cannula, and the inner lumen of the tube or cannula may also be referred to as a flow channel for the substance. The distal end or tip 2.2 of the delivery tube or instrument may be introduced into the body cavity, for example, manually by an assistant, for example, via a trocar port. To facilitate handling and insertion of the delivery tube (which may be flexible), the device advantageously includes an insertion guide, such as a rigid sheath 3 configured for inserting the delivery tube into a trocar (not shown). The rigid sheath may, for example, be in the form of a rigid tubular sheath that may be positioned around a portion of the delivery tube, such as attached to a portion of the delivery tube or formed as a coating around a portion of the outer delivery tube, as shown in FIG. The insertion guide 3 may include a handle 3a so that a user can hold the handle and guide the insertion guide 3 and possibly also guide the delivery tube 2 inside the insertion guide, for example through a trocar. Since the insertion guide is rigid, the user can easily push the insertion guide and the delivery tube inside the insertion guide to a position close to the robot arm. The insertion guide can then be withdrawn so that the flexible delivery tube can be easily held and manipulated by an external robotic arm and moved to the surgical site.

The proximal end 2.1 of the device 1 comprises a reservoir 4 for holding a larger amount of substance per length unit than the delivery tube 2 .

FIG. 2 shows a syringe 11 with a syringe tip 13 , wherein the reservoir proximal end 4 . 1 of the reservoir 4 is configured to accommodate and be connected to the syringe tip 13 in a liquid-tight and/or paste-tight manner, so that a substance such as a paste can be delivered to the device 1 without any substance leaking out.

When the device 1 is to be used to deliver the paste to the surgical site, a first syringe 11 containing the paste is usually connected to the reservoir 4 of the device 1 and the delivery tube 2 and the reservoir 4 are filled with the paste. Preferably, the volume of the syringe is equal to the combined volume of the delivery tube 2 and the reservoir 4 so that the paste is not wasted. The volume of the syringe may be slightly smaller than the combined volume of the delivery tube 2 and the reservoir 4 so that the hemostatic agent is not pressed out of the tip 2.2 of the delivery tube and contaminate the trocar before the device is inserted into the trocar.

The device 1 can be used in combination with a hemostatic substance, a medicine or a paste. The steps of use can be, for example, as follows:

The device is pre-filled with a hemostatic agent or paste by connecting a first syringe 11 containing the hemostatic agent to the device, wherein the first syringe may have a male connection such as, for example, a male Luer-Lock, and the device may have a female connection such as, for example, a female Luer-Lock, wherein the male connection or male Luer-Lock and the female connection or female Luer-Lock, respectively, may be releasably connected to each other. The user may push the piston rod manually or by means of a motor, a power grip configuration or a syringe pistol with a transmission mechanism, etc., pushing the piston rod until the hemostatic agent has filled the inner cavity of the reservoir and the delivery tube. The empty first syringe with the hemostatic agent is detached from the device and the second syringe is filled with saline. The second syringe is connected to the device and the device is inserted into the patient via a trocar. In order to correctly position the instrument relative to the surgical site so that the hemostat is delivered where it is needed, the tip of the instrument can be moved and positioned by a robotic arm (not shown). When the surgeon holds the tip of the instrument with the robotic arm, the insertion guide 3 can be retracted to expose the flexible delivery tube. The instrument can then be freely moved around by the robotic arm. By injecting saline from a second syringe into the instrument, the hemostat is pushed out of the instrument onto the surgical site.

Fig. 3 shows an exploded view of a specific example of a reservoir 4 , a non-return valve 15 in the form of a duckbill valve and a connector 17. The reservoir distal end 4.2 of the reservoir is configured to receive the delivery pipe 2 in a liquid-tight connection.

According to the present disclosure, the reservoir 4 may have a larger cross-section than the transport tube 2 , so that the reservoir can accommodate a larger amount of material per unit length than the transport tube 2 , as shown in FIG. 3 .

The connector 17 is configured to connect the reservoir 4 and the one-way valve 15 at one end to the syringe 11 at the other end. In a specific example, the reservoir 4 , the one-way valve 15 and the connector 17 are connected in a non-detachable manner, such as by gluing. Preferably, the connector 17 and the syringe 11 are detachably connected to each other in a liquid-tight manner so that the syringe can be easily replaced with another syringe.

The non-return valve 15 will only allow flow from the proximal end 2.1 of the device 1 to the distal end 2.2 of the device.

FIG4 shows a cross section of the reservoir 4 , duckbill valve 15 and connector 17 of FIG3 in an assembled view. In the example shown in FIG4, the device has been filled with substance 19 and saline 21 has been pressed into the device and half of the substance has been pushed out of the reservoir. The duckbill valve can be easily sterilized due to its uniform surface and the lack of recesses inside the duckbill valve.

A small pressure from the proximal end (from the right in FIG. 4 ) will open the duckbill valve so that flow can occur through the duckbill valve 15 in a direction toward the distal end (left in FIG. 4 ).

Due to the viscosity of the substance, prefilling the instrument with the substance from the syringe will generate a small overpressure which will cause the substance to leak out of the reservoir when the syringe is removed. By means of a non-return valve located at the proximal end 2.1 of the instrument, the substance will not leak out of the prefilled instrument when the syringe is removed and contamination can be avoided.

In a specific example, the inner cross-section of the delivery tube can be less than 30 mm ² , such as less than 20 mm ² , such as less than 14 mm ² or such as less than 11 mm ² . If the inner cross-section of the delivery tube is less than 14 mm ² , then the delivery tube without an insertion guide can be inserted into a 5 mm trocar. If the inner cross-section of the delivery tube is less than 11 mm ² , then the delivery tube with an insertion guide can be inserted into a 5 mm trocar.

In a specific example, the delivery tube cross section may be greater than 5 mm ² , such as greater than 9 mm ² . If the delivery tube cross section is greater than 9 mm ² , the device may be pre-filled with a hemostatic agent by a syringe that is manually operated without any additional aids such as a motor or pistol grip.

In a specific example, the cross section of the reservoir may be greater than 30 mm ² , such as greater than 50 mm ² . If the cross section of the reservoir is greater than 30 mm ² , the length of the reservoir will be of a length suitable for providing a good grip for attaching and detaching the syringe to the device.

In a specific example, the cross-section of the storage device may be less than 200 mm ² , preferably less than 100 mm ² , preferably less than 80 mm ² , and preferably less than 70 mm ² .

To reduce waste of material, it is advantageous that the material and saline do not mix and that the material closer to the peripheral wall of the reservoir is pushed by the saline together with the material in the center of the reservoir and at the same speed. This preferred flow is called plug flow, in which the velocity of the material is constant over the cross section of the conveying pipe perpendicular to the axis of the conveying pipe.

In one specific example, the internal cross-section of the reservoir may preferably be less than 70 ^mm2 to maintain plug flow.

FIG. 5 shows another embodiment in which the reservoir 4 is connected to the delivery tube 2 and the non-return valve is a ball valve 23 in which a spring 25 presses a ball 27 against a base 29 to close the ball valve. In this embodiment, the ball valve 23 includes a connector 17' configured to receive a syringe (not shown). In another embodiment, the ball valve 23 and the connector 17' may be two different units. The pressure pressing against the spring and away from the base 29 on the ball 27 will open the ball valve so that the device can be pre-filled with a substance, such as a hemostatic agent or a paste. Subsequently, saline under pressure from the syringe will open the ball valve and press the substance out of the device. The ball may have any other form which together with the corresponding seat will prevent the substance from leaking out of the reservoir. There are other types of non-return valves, such as for example a lifting check valve, a swing check valve or a cross-slit valve, or a butterfly check valve which can also be used as a non-return valve.

According to the present disclosure, the reservoir distal end 4.2 of the reservoir 4 may have a transition zone 22 from the reservoir to the delivery tube 2 , wherein the transition zone has a conical shape as shown in Figures 4 and 5. In other specific examples, the transition zone may have a curved conical shape as shown in Figure 6 or have another smooth transition zone or smooth shape between different cross-sections of the reservoir and the delivery tube. The smooth transition zone will maintain plug flow so that saline does not mix with the hemostat in the contact area between saline and the hemostat during dispensing of the hemostat, and so that a minimum amount of hemostat remains in the reservoir after use.

Fig. 6 shows another specific example of a transition zone 22' from the reservoir 4 to the delivery pipe 2 , wherein the transition zone has a curved cone shape. The curved cone shape will also provide plug flow similar to the cone shape shown in Figs. 4 and 5. The cone shape or the curved cone shape can be combined with any type of non-return valve.

FIG. 7 shows the duckbill valve 15 , wherein the clamp 31 is pressed on the duckbill valve 15 in the slender direction of the slender structure of the duckbill valve 15 .

FIG8 shows a cross-slit valve 41 with two slits 43 forming a cross. Similar to a duckbill valve, a cross-slit valve will only allow paste to pass through the cross-slit valve in one direction, which is from the right to the left in FIG8. A small pressure from the right in FIG8 will open the cross-slit valve so that there can be flow through the cross-slit valve 41 in a direction toward the left in FIG8. The cross-slit valve is also easy to sterilize. As in FIG7 , a pliers acting on a duckbill valve to open the duckbill valve, a cross-slit valve can be opened by pliers acting on opposite ends of either of the two slits or by any mechanism such as a button or mechanical button that pushes opposite ends of either of the two slits together. In any of the specific examples presented above and below, a cross-slit valve can replace a duckbill valve or any other non-return valve.

In a specific example, the pressure required to open the non-return valve may be very small, so that a device filled with normal saline is held vertically, with the reservoir at the top and the distal end 2.2 of the device 1 at the bottom, due to the drag force of the water column, air will be sucked through the non-return valve and into the reservoir and the delivery tube, so that the normal saline can be emptied from the distal end 2.2 of the device and enter, for example, a drain.

In another specific example, the one-way valve may be designed so that the pressure required to open the one-way valve may be 100 cm of water, 50 cm of water, or 10 cm of water. If the instrument has been emptied of material and filled with saline, and the instrument has been removed from the trocar and surgical site, the instrument may be easily emptied of saline by removing the syringe from the instrument and raising the reservoir 100 cm, or 50 cm, or 10 cm above the distal end 2.2 of the instrument 1 , respectively, because the height difference between the reservoir and the distal end 2.2 of the instrument 1 will provide the pressure required to open the one-way valve and allow air to enter and saline to exit the instrument. Of course, the check valve can be designed to open at any pressure less than 100 cm of water, less than 50 cm of water, or less than 10 cm of water.

In one specific example, the device may include a button that will act on the non-return valve, so that by pressing the button, the non-return valve will open. In that case, the saline in the device can be easily discharged after use by pressing the button, and the non-return valve can be designed so that a higher pressure is required to open the non-return valve, and the risk of the device accidentally discharging saline is reduced. The duck-bill valve has an elongated structure that has a shape similar to a duck's bill. The button can act on the duck-bill valve by pressing the duck's bill in the elongated direction as shown in Figure 7, forcing the duck's bill to open. Two opposing buttons acting on the duck's bill in opposite directions in the elongated direction will force the duck's bill to open. The button can act on the ball by moving it away from the seat. The button can be kept in place in a groove in the wall surrounding the non-return valve without penetrating the wall. In that way there is no risk of contamination through the opening where the button is located. The wall surrounding the groove should preferably be of a deformable material so that the button can be moved and act on the non-return valve.

Alternatively, the wall of the reservoir surrounding the non-return valve may be made of a deformable material so that by pressing the wall of the reservoir surrounding the non-return valve, the non-return valve, such as a duckbill valve or a ball valve, will open. A button is not necessary.

In a specific example, the volume of the reservoir may be between 0.5 ml and 3 ml, preferably between 0.7 ml and 2 ml, such as 1 ml. If the total volume of the device is 8 mL, the delivery tube will only need to contain 5 to 7.5 mL, 6 to 7.3 mL or 7 mL, so that the delivery tube will not be too short or too long.

In one specific example, the first connection of the reservoir to the proximal end of the delivery tube may be opposite to the second connection of the reservoir to the non-return valve. In the case of a reservoir having an elongated shape, the first connection and the second connection may be located at opposite short sides of the elongated reservoir. The elongated reservoir may have a portion of a toroidal shape, such as, for example, a quarter of a toroid, wherein the two end cross-sections are oriented perpendicular to each other, but will still be opposite to each other due to the toroidal shape of the reservoir. However, two surfaces of a cube oriented perpendicular to each other are not considered to be opposite to each other.

By having the first connection and the second connection facing each other, plug flow can be maintained with less waste of material.

In a specific example, the first connection and the second connection may be positioned on a symmetry axis passing through the reservoir, so that in the case of a reservoir having an elongated shape, the first connection and the second connection are positioned in the center of their respective short sides and the distance from, for example, the surrounding cylindrical wall is equal in all directions. Such a position of the first connection and the second connection would be ideal for maintaining plug flow.

1: Instrument 2: Delivery tube 2.1: Proximal end 2.2: Tip 3: Rigid sheath/insertion guide 3a: Handle 4: Reservoir 4.1: Proximal end 4.2: Distal end 11: First syringe 13: Syringe tip 15: Check valve 17: Connector 17': Connector 19: Substance 21: Saline 22: Transition zone 22': Transition zone 23: Ball valve 25: Spring 27: Ball 29: Base 31: Clamp 41: Cross slit valve 43: Slit

The present invention will be described in more detail below with reference to the accompanying drawings. [FIG. 1] shows a perspective view of a specific example of an apparatus according to the present disclosure. [FIG. 2] shows a syringe for providing a paste, powder, liquid or fluid to the apparatus. [FIG. 3] shows a perspective view and an exploded view of a specific example of a reservoir. [FIG. 4] shows a cross-section of a specific example of a reservoir connected to a check valve in the form of a duckbill valve. [FIG. 5] shows a cross-section of a specific example of a reservoir connected to a check valve in the form of a ball valve. [FIG. 6] shows a cross-section of a specific example of a reservoir connected to a check valve in the form of a duckbill valve. [Figure 7] shows a duckbill valve having a slender structure, wherein a tweezer acts on the duckbill valve in the slender direction of the slender structure. [Figure 8] shows a cross slit valve having two slits forming a cross.

2:Transmission pipe

4: Storage

4.1: Proximal end

4.2: Distal end

15: Check valve

17: Connector

19:Matter

21: Physiological saline solution

22: Transition Zone

Claims (14)

A laparoscopic instrument for dispensing a substance, such as a substance containing a hemostatic agent, at a selected site with the aid of a surgical robot arm, the laparoscopic instrument comprising: a delivery tube; an instrument tip connected to the distal end of the delivery tube, the instrument tip being configured to be controllably manipulated by the robot arm via a grip portion in an axial extension of the delivery tube, the grip portion having a periphery transverse to the axis, the grip portion including an apex-shaped portion such that the grip portion is configured to be gripped and spatially manipulated by the robot arm, a reservoir connected to the proximal end of the delivery tube, the reservoir having a fixed volume, and A check valve connected to the proximal end of the reservoir, wherein the check valve is configured to prevent the substance from flowing from the reservoir through the check valve. An apparatus as claimed in any of the preceding claims, wherein the non-return valve is a duckbill valve or a cross-slit valve. An apparatus as claimed in any preceding claim, wherein the volume of the reservoir is between 0.5 ml and 3 ml, preferably between 0.7 ml and 2 ml, such as 1 ml. An apparatus as in any of the preceding claims, wherein the reservoir has a reservoir cross-section that is larger than a transport tube cross-section of the transport tube. The apparatus of claim 4, wherein the cross-section of the delivery pipe is less than 30 mm ² , less than 20 mm ² , less than 14 mm ² , less than 11 mm ² , and/or wherein the cross-section of the delivery pipe is greater than 5 mm ² , preferably greater than 9 mm ² , and/or wherein the cross-section of the storage container is greater than 30 mm ² , preferably greater than 50 mm ² , and/or wherein the cross-section of the storage container is less than 200 mm ² , preferably less than 100 mm ² , preferably less than 80 mm ² , preferably less than 70 mm ² . An apparatus as claimed in any of the preceding claims, wherein the delivery tube includes a deformable portion or a portion of the delivery tube is configured to be tension-free and flexible. An apparatus as claimed in claim 6, wherein the apparatus further comprises an expandable wire or rod configured so that the deformable portion of the delivery tube can be bent into a desired shape, which shape is substantially maintained when the delivery tube is released. An apparatus as claimed in claim 6 or 7, wherein the handle portion includes the deformable portion. An apparatus as claimed in any of the preceding claims, wherein the delivery tube comprises or consists of a vibration energy dissipating material selected from the group consisting of silicone elastomer, butyl rubber, polyurethane, thermoplastic elastomer, polyvinyl chloride, polypropylene and combinations thereof. An apparatus as claimed in any of the preceding claims, further comprising an insertion guide for supporting the delivery tube, wherein the insertion guide is optionally configured to slide along the axial direction of the delivery tube. An apparatus as claimed in any of the preceding claims, wherein the apparatus has a conical shape or a bent conical shape connecting the reservoir and the delivery tube. An apparatus as claimed in any of the preceding claims, wherein a first connection of the reservoir to the proximal end of the delivery tube is opposite a second connection of the reservoir to the non-return valve. An apparatus as claimed in claim 12, wherein the first connection and the second connection are positioned on an axis of symmetry passing through the memory. A method for dispensing a substance using an apparatus as claimed in any of the preceding claims, wherein the method comprises the following steps: providing a first syringe containing the substance and a second syringe containing water or an aqueous solution such as, for example, saline, connecting the first syringe to the one-way valve, transferring the substance to the apparatus through the one-way valve, into the reservoir and the delivery tube, disconnecting the first syringe from the one-way valve, connecting the second syringe to the one-way valve, transferring the water or the aqueous solution to the apparatus through the one-way valve, into the reservoir and the delivery tube to dispense the substance outside the apparatus.