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WO1992010141A1 - Systeme de trocart pour laparoscopie - Google Patents

Systeme de trocart pour laparoscopie Download PDF

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Publication number
WO1992010141A1
WO1992010141A1 PCT/US1991/008805 US9108805W WO9210141A1 WO 1992010141 A1 WO1992010141 A1 WO 1992010141A1 US 9108805 W US9108805 W US 9108805W WO 9210141 A1 WO9210141 A1 WO 9210141A1
Authority
WO
WIPO (PCT)
Prior art keywords
sheath
cannula
distal end
rod
proximate
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/US1991/008805
Other languages
English (en)
Inventor
Edwin L. Adair
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Publication of WO1992010141A1 publication Critical patent/WO1992010141A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3494—Trocars; Puncturing needles with safety means for protection against accidental cutting or pricking, e.g. limiting insertion depth, pressure sensors
    • A61B17/3496—Protecting sleeves or inner probes; Retractable tips
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3474—Insufflating needles, e.g. Veress needles

Definitions

  • This invention relates to a trochar system or insufflation needle for laparoscopy and more particularly to one which is inexpensive to manufacture and which is constructed, in one form of the invention, to minimize accidental dislodge ent after placement in the patient.
  • the Veress Needle was originally designed for insertion into the chest to collapse a lung in treatment of tuberculosis. Later, when laparoscopy was first introduced to allow surgeons to look into the peritoneal cavity, the needle found new usage in filling the abdominal cavity with carbon dioxide.
  • the Veress Needle comprises an outer cannula which has a needle point for easy penetration of the skin and underlying structures in the abdominal wall.
  • the outer cannula expands into a relatively long needle hub which is used to house a spring mechanism for retraction of an inner cannula.
  • This inner cannula includes a hollow tube having an enclosed end which is rounded to help avoid injury of the intra-abdominal structures.
  • the inner cannula is fully retracted within the inner cannula to allow easy penetration all the way through the abdominal wall.
  • the inner, rounded tip snaps forwardly into the space of the abdominal cavity and pushes underlying movable structures out of the way, such as large or small bowel or intestine, omentum or liver.
  • the gas is then delivered to the abdominal cavity via a gas delivery system which is connected to the upper hub or valve section of the
  • Veress Needle by a long plastic delivery tube This gas creates a space or work area within the abdomen whereby good visualization is provided through a separate laparoscope. Any definitive surgical procedures, such as tubal ligations must generally be done through a separate opening, unless an operative laparoscope is utilized.
  • the Veress Needle has been a very useful instrument for about fifty years, it has certain drawbacks. It is a complex design and therefore expensive to manufacture. Because of its construction and small parts, the parts can be lost during cleaning and it is virtually impossible to clean the side hole adjacent the blunt tip of the inner cannula, resulting in small pieces of tissue and tissue fluid being transferred from one patient to the next. Also, after repeated use, the point becomes dull. Furthermore, the needle can be dislodged if left in place during an entire operative procedure and must be reinserted. Also, because of the rigid construction, the sharp end may be driven into the abdomen and cause damage to intra-abdo inal contents such as the bowel, liver or major blood vessels if accidentally bumped by the surgeon. Furthermore, the Veress Needle can only be used for gas delivery and is not usable for a port hole for introduction of a laparoscope, operating instruments, cautery devices, laser fiber or other devices. If these devices are used they must be
  • SUBSTITUTESHEET introduced through an additional trochar which creates an additional incision in the patient.
  • a disposable trochar which has a removable rod and needle portion within an outer sheath.
  • the rod has a blunt end and is retractable during insertion so that the needle edge cuts through the abdominal wall. Once passing through the wall the rod extends so as to protect the bowel from the sharp needle.
  • a gas port is provided for introducing gas through the rod and out a side passageway near the blunt end. After the abdomen is extended, the rod and needle can be removed as a unit from the sheath and thrown away and a suitable instrument introduced through an instrument port having a separate diaphragm.
  • U.S. Patent No. 1,527,291 to Zorraquin shows a surgical needle which has a spring urged blunt rod within it to permit exploration of internal body cavities without perforating the wall of the cavity being explored.
  • U.S. Patent No. 2,630,803 to Baren shows a pneumothoracic needle with spring-loaded inner blunt needle and an outer sharp cannula.
  • UTESHEET needle is hollow and is removable without extracting the cannula from the chest wall.
  • U.S. Patent No. 3,840,008 to Noiles discloses a hypodermic needle for safely injecting fluid into nerve and vessel crowded areas of a patient.
  • the needle has a pointed hollow piercing member slidably mounted about a fluid delivery tube.
  • the delivery tube has a blunt nose with at least one fluid opening near its blunt end, the other end being connected to a conventional syringe.
  • the hollow piercing member is connected to the delivery tube by a finger-operated collapsible bar.
  • the bar is provided with a centrally located groove to facilitate collapse at the moment the operator removes the force of his finger, the blunt nose delivery tube is then free to penetrate the tissue of the patient without endangering nerve or vessel.
  • U.S. Patent No. 3,982,533 to Wiest discloses a device for introducing limited quantities of carbon dioxide into the human body for operational purposes, particularly laparoscopy. It includes a control device for delivering the carbon dioxide, a connecting nipple on the control device for connecting a flexible tubing to a Veress Needle introduceable into the body and a pressure gage for indicating the pressure present in the body cavity. A second connection nipple is provided on the control device and connected by a nipple to the pressure gage.
  • the second connection nipple is connected by a further flexible tubing either to a dual Veress Needle or to a second single Veress Needle, so that the pressure gage is directly connected with the body cavity rather than through the operative Veress Needle.
  • U.S. Patent No. 4,096,860 to McLaughlin discloses an encatheter incorporating a plastic insertion conduit placed into a blood vessel with a needle.
  • the structure includes an elastomeric sealing flapper or one-way valve that allows insertion of a syringe needle.
  • U.S. Patent No. 4,535,773 to Yoon shows a safety puncturing instrument and method using a shielding mechanism that is biased to protrude from the distal end of the instrument to shield its sharp, penetrating point after the point has penetrated.
  • U.S. Patent No. 4,769,018 to Wilson discloses a surgical cannula assembly for receiving and guiding a surgical instrument which has an instrument portion insertable through the cannula assembly and includes two selectively interconnectable and separate cannula sub-assemblies.
  • U.S. Patent No. 4,808,168 to Waring discloses a single-use Veress-type pneumoneedle that has a flanged handle and a fixed valve sub-assembly that permits the pneumoneedle to be gripped like a syringe when it is being inserted.
  • the stylet body is either a solid rod or a hollow tube. Insufflating gas is carried into the abdominal cavity through the lumen of the needle when the stylet is a solid rod or through the stylet lumen when the stylet is a hollow tube.
  • French Patent No. 2,308,346 to Storz discloses a probe for insertion of surgical instruments or insufflation tubes in the cavities of a body. It has a probe sleeve in which the instrument or tube is
  • SUBSTITUTESHEET guided axially and which is enclosed by a tubular casing so as to orm an air passage around it with air entry ports at the end.
  • a generally disposable trochar for use as a gas insufflation needle for insertion through the abdominal wall of a patient and into a body cavity. It has an outer sheath with a tubular body, a distal open end and a proximate open end.
  • the distal end optionally may have means which is expandable after the trochar has been inserted into the body cavity to minimize dislocation of the outer sheath during use.
  • This optional feature generally will be used in larger diameter devices and omitted in smaller diameter devices.
  • a cannula is removably received within the sheath which has a sharp distal end extendable beyond the distal end of the sheath and an enlarged head at the proximate end of the cannula.
  • the head has a flat land which is engageable with the proximate end of the sheath to limit the extension of the distal end of the cannula beyond the distal end of the sheath.
  • a rod is mounted within the cannula for longitudinal movement between a retracted position and an extended position.
  • a blunt member is provided at the distal end of the rod extending beyond the sharp distal end of the cannula when in extended position.
  • Resilient means is attached to the rod urging it toward the extended position.
  • the head can be provided with a cannula which has a coil spring therein as the resilient means, the coil spring being connected to and formed integrally with the proximate end of the
  • the rod can be made up of a pair of wires, the first wire constituting an integral extension of the rod which is bent back upon itself and has an end attached to the side of the rod to form a first loop which moves with the rod between the retracted and extended position. In the smaller diameter devices, this single loop will be sufficient. In larger diameter devices, a second wire is bent into a second loop and positioned transversely of the first loop and has opposite ends attached to the side of the rod adjacent the first wire end.
  • the single loop hairpin configuration or the double loop eggbeater type configuration each serve to minimize the chance of the sharp distal end of the cannula coming in contact with the bowel or other body surfaces which are to be protected. If desired, the wire can be formed in a flat configuration at the loops to provide a larger contact surface with the bowel.
  • the extendable means comprises an inflatable bladder adjacent the distal end of the outer sheath and an inflation tube which is in fluid communication with the bladder and runs longitudinally of the sheath.
  • the inflation tube has a proximate end outside of the proximate end of the sheath.
  • a check valve is connected to the proximate end of the tube for controlling flow of fluid to the bladder.
  • an inlet port is provided in the side of the sheath adjacent the proximate end of the sheath for supplying CO- gas to the body cavity.
  • a spring biased pivotal closure is mounted within the sheath adjacent the proximate end thereof which is normally urged to a closed position to seal the proximate open end and minimize the escape of CO- gas. It is movable to an open position upon insertion of the cannula or other surgical instrument through the proximate end of the sheath.
  • a novel method is provided with the above apparatus which includes the steps of pressing the sharpened end of the cannula against the skin of the abdomen to cause the rod to be retracted.
  • the sharpened end of the cannula is then thrust through the abdominal wall into the space between the peritoneum and the bowel to position the distal end of the sheath through the opening formed by the cannula.
  • the rod then is extended beyond the sharpened end into the space between the peritoneum and the bowel.
  • the annulus is inflated to hold the sheath in place within the opening. Gas is then introduced into the sheath to inflate the abdomen.
  • the cannula and rod are then removed from the sheath.
  • the spring closure is closed upon removal of the cannula and rod and then reopened upon introducing an instrument through the sheath into the abdomen space. Additional gas can be introduced through the sheath while an instrument is in place.
  • the instrument can be removed from the sheath and the annulus deflated and the sheath removed from the opening to complete the operative process.
  • the devices just described are of simple construction, with few parts, thereby substantially reducing cost of parts and assembly.
  • the device can be disposable, thereby eliminating any possibility of transferring contamination from one patient to another. Additional advantages of this invention will become apparent from the description which follows, taken in conjunction with the accompanying drawings. Brief Description of the Drawings
  • FIG. 1 is an exploded view of a trochar system constructed in accordance with this invention
  • Figure 2 is an enlarged vertical section, taken along line 2-2 of Figure 1, showing details of the insufflation needle;
  • Figure 3 is a bottom plan view, taken along line 3- 3 of Figure 2;
  • Figure 4 is an enlarged vertical section, taken along line 4-4 of Figure 1, showing details of the outer sheath;
  • Figure 5 is a horizontal section, taken along line 5-5, showing details of the inflatable annulus
  • Figure 6 is a side elevation, with parts broken away, of the trochar system in assembled position
  • Figure 7 is a diagrammatical view of a portion of the abdomen showing the positioning of the insufflation needle prior to insertion;
  • Figure 8 is a view, similar to Figure 7, but showing the beginning of the penetration of the needle through the abdominal wall;
  • Figure 9 shows the insufflation needle in place within the abdominal cavity
  • Figure 10 shows the annulus of the outer sheath inflated to minimize unwanted displacement of the sheath
  • Figure 11 is a horizontal section, taken along line 11-11 of Figure 10, showing the dispersion of air into the annulus.
  • a needle or trochar T which includes a cannula 10 having a head 12 at the proximate end and a sharp distal edge 14 for cutting through the abdominal wall of a patient.
  • a vertically slidable rod 16 Within cannula 10 is a vertically slidable rod 16, as best seen in Figure 2.
  • Head 12 has a recess or cavity 18 whose diameter is greater than that of cannula 10.
  • a coil spring 20 is provided in cavity 18 within head 12 and has a lower end integrally formed or attached to rod 16.
  • Coil spring 20 also has a diameter which is greater than that of cannula 10 and may rest on flange 22 at the proximate end of cannula 10.
  • the lower end of wire 16 is bent back upon itself to form a loop 24 and has an end 26 which is connected to the side of rod 16, as by soldering. In the smaller diameter devices this single loop will be sufficient. In larger diameter devices a second wire is formed into a loop 28 having its ends also soldered to the side of rod 16 adjacent end 26. This eggbeater type construction forms a blunt end 29. This blunt end or that formed by single loop 24 minimized the chance that the sharp edge 14 of the cannula 10 will come in contact with and perforate the bowel or other body surface.
  • the wire can be formed in a flat rectangular configuration to provide a flat bearing surface.
  • the trochar T may be received within a sheath S having an elongated body 30 with a connector 32 at the proximate end thereof.
  • the connector has a Leur lock 34 at the upper end thereof for attachment to a suitable medical instrument.
  • the connector also includes an inlet port 36 in one side thereof through which a gas, such as C0 2 may be introduced to inflate the abdomen of the patient after the device is inserted through the abdominal wall, as will be described below.
  • the connector 32 also has a door 38 which normally closes off passageway 40 to
  • SUBSTITUTESHEET prevent escape of the C0 2 gas.
  • the door 38 is urged toward closed position by coil spring 42 and seals against a gasket 44.
  • the door 38 will be pushed downwardly to the position shown in dotted lines.
  • land 45 of head 12 engages Leur lock 34 to limit the projection of blunt end 29 beyond the distal end of sheath 30.
  • the lower end of body 30 optionally has an annular inflated bladder 46 which is in fluid communication by means of passageway 48 to an inlet 50 located near the proximate end of body 30.
  • This inlet is connected by means of a hose 52 to a supply valve 54 in turn connected to a supply hose 56.
  • annular bladder 46 could be replaced with any expandable or extendable device which is operable by air pressure.
  • a low voltage electrical circuit could be used in place of the pneumatic device shown to activate an expandable member to minimize the displacement of sheath S once it is inserted into a body cavity.
  • the body 30 is illustrated as having an inner sleeve 58 with a flange 60 at its upper end which is received within the lower portion of connector 32.
  • Body 30 also has an outer sleeve 62 whose distal end grips the edges of bladder 46.
  • the distal end of bladder 46 is received in a recess 64 in rib 66 at the distal end of inner sleeve 58.
  • the bladder 46 may be omitted, but is particularly desirable with large diameter devices.
  • an insert 68 can be provided to reduce the effective size of passageway 40 so as to
  • SUBSTITUTESHEET accommodate a smaller instrument. Inserts can be provided of different sizes and they can be color coded, if desired, so that the size of the insert will be readily apparent to the user.
  • the use of the insufflation needle of this invention is best illustrated in Figures 7-11.
  • the blunt end 29, formed by a single loop 24 or double loops 24 and 28 is pressed against the surface of skin 70 and the needle is thrust downwardly against the skin. This motion causes the rod 16 to be retracted into cannula or needle 10 against the force of spring 20 which is compressed within recess 18.
  • the exposed sharp edge 14 of cannula 10 pierces the skin 70 and fat 72 as shown in Figure 8.
  • a gas such as carbon dioxide, can be introduced through inlet 36 and pass through inner sleeve 58 and the space between inner sleeve 58 and cannula 10 into the air space.
  • the gas may be introduced at sufficient pressure to distend the abdominal cavity to a considerable extent.
  • a gas such as compressed air, may be introduced through inlet hose 52 and inlet 50 which is transmitted through passageway 48 to bladder 46 causing the bladder to be extended, as best shown in Figure 10.
  • This pressure may be maintained as long as the sheath is to be positioned in the body cavity.
  • the trochar T can be withdrawn which will allow door 38 to close under the influence of spring 42 against gasket 44 to prevent escape of the C0 2 gas being introduced through inlet 36.
  • An instrument can be inserted through the passageway which was previously occupied by the trochar.
  • suitable inserts such as insert 68, can be first inserted in passageway 40 to reduce the size of the passageway to one appropriate for the particular instrument being introduced which will not only more positively fix the position of the instrument but will minimize the escape the gas around the instrument when door 38 is opened upon insertion of the instrument.
  • the instrument can be withdrawn, the pressure can be relieved to bladder 46 so that it collapses and the sheath can be removed.
  • a disposable insufflation needle has been provided which can be used to introduce gas into an abdominal cavity to extend the same while at the same time introducing a suitable instrument, all of this being accomplished through a single incision made by a trochar.
  • the insufflation needle is of simple construction which includes a rod having an integral spring at one end and an eggbeater shaped integral distal end within a needle which is removable from an outer sheath after the device is inserted in the abdomen. During insertion, the rod is retracted and needle inserted through the skin whereupon the rod extends under the
  • SUBSTITUTESHEET influence of the spring bias so that the distal end protects the bowel or other organs from the sharp edge of the needle.
  • the loops at the distal end can be formed from rectangular wire to provide a larger bearing surface against the bowel or other organs.
  • the rod and needle can be removed together and a bladder or other expandable device can be extended to minimize the possibility of the sheath being inadvertently dislodged from the opening through the skin.
  • Other instrumentation can be introduced through the sheath for running appropriate procedures and/or operations on the patient.
  • gas can be introduced through the sheath around the instrument to distend the abdomen to a sufficient extent to allow the procedures to be conducted.

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Pathology (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)
  • Endoscopes (AREA)

Abstract

Trocart jetable (T) utilisé comme aiguille d'insufflation de gaz et destiné à être inséré dans la paroi abdominale d'un patient et dans une cavité du corps. Ledit trocart a une gaine extérieure (S) et un corps tubulaire, une extrémité ouverte distale et une extrémité ouverte proximale. L'extrémité distale peut être pourvue d'un moyen (46) qui peut s'agrandir une fois que le trocart a été inséré dans la cavité du corps afin de minimiser le déplacement de la gaine extérieure pendant l'utilisation. Une canule (10) peut venir se loger de façon amovible à l'intérieur de la gaine. Cette canule a une extrémité distale pointue (14) qui peut dépasser à l'extrémité distale de la gaine, et une tête (12) élargie, à son extrémité proximale. Ladite tête a une partie plate (45) qui peut peut venir en contact avec l'extrémité proximale de la gaine pour limiter le dépassement de l'extrémité distale de la canule au-delà de l'extrémité distale de la gaine. Une tige (16) est montée à l'intérieur de la canule et s'y déplace longitudinalement entre une position rétractée et une position sortie. Un élément (29) à bout rond situé à l'extrémité distale de la tige dépasse de l'extrémité distale pointue de la canule lorsqu'il est dans sa position sortie. Un ressort (20) se trouvant dans une cavité de la tête est fixé à l'extrémité proximale de la tige et pousse celle-ci dans sa direction de sortie. L'invention concerne également un procédé d'utilisation de ce trocart.
PCT/US1991/008805 1990-12-11 1991-11-22 Systeme de trocart pour laparoscopie Ceased WO1992010141A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US62541390A 1990-12-11 1990-12-11
US625,413 1990-12-11

Publications (1)

Publication Number Publication Date
WO1992010141A1 true WO1992010141A1 (fr) 1992-06-25

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PCT/US1991/008805 Ceased WO1992010141A1 (fr) 1990-12-11 1991-11-22 Systeme de trocart pour laparoscopie

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CA (1) CA2056543A1 (fr)
WO (1) WO1992010141A1 (fr)

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1994004082A1 (fr) * 1992-08-13 1994-03-03 Advanced Surgical Ltd Trocart
FR2697150A1 (fr) * 1992-10-28 1994-04-29 Melin Cyriac Trocard à protection de pointe.
US5336172A (en) * 1992-10-09 1994-08-09 Symbiosis Corporation Endoscopic suction-irrigation instrument having insertible probes with lateral ports
US5549565A (en) * 1993-07-13 1996-08-27 Symbiosis Corporation Reusable surgical trocar with disposable valve assembly
EP1438029A4 (fr) * 2001-10-23 2009-01-14 Medtronic Minimed Inc Procede et systeme d'implantation d'une sonde non vasculaire
EP2200689A4 (fr) * 2007-10-02 2011-03-09 Minos Medical Accès péritonéal transluminal et cathéter
DE102011084918B3 (de) * 2011-10-20 2013-03-07 Digital Endoscopy OEM GmbH Einwegeinführspitze, endoskopiesystem und kühlsystem

Families Citing this family (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8932249B2 (en) 2009-10-08 2015-01-13 Ethicon Endo-Surgery, Inc. Trocar assembly
US8491533B2 (en) 2009-10-08 2013-07-23 Ethicon Endo-Surgery, Inc. Trocar assembly

Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3039468A (en) * 1959-01-07 1962-06-19 Joseph L Price Trocar and method of treating bloat
FR2284303A1 (fr) * 1974-09-10 1976-04-09 Wolf Gmbh Richard Douille de trocart pour l'endoscopie de cavites corporelles
US4535773A (en) * 1982-03-26 1985-08-20 Inbae Yoon Safety puncturing instrument and method
US4608965A (en) * 1985-03-27 1986-09-02 Anspach Jr William E Endoscope retainer and tissue retracting device
US4861334A (en) * 1988-06-24 1989-08-29 Nawaz Arain Self-retaining gastrostomy tube
EP0339945A2 (fr) * 1988-04-25 1989-11-02 Edwin L. Adair Aiguille d'insufflation de gaz avec orifice d'introduction d'un instrument
US5002557A (en) * 1989-04-06 1991-03-26 Hasson Harrith M Laparoscopic cannula
EP0323018B1 (fr) * 1987-12-31 1993-06-16 United States Surgical Corporation Vanne pivotante, autocentrante pour dispositif d'insufflation par canule

Patent Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3039468A (en) * 1959-01-07 1962-06-19 Joseph L Price Trocar and method of treating bloat
FR2284303A1 (fr) * 1974-09-10 1976-04-09 Wolf Gmbh Richard Douille de trocart pour l'endoscopie de cavites corporelles
US4535773A (en) * 1982-03-26 1985-08-20 Inbae Yoon Safety puncturing instrument and method
US4608965A (en) * 1985-03-27 1986-09-02 Anspach Jr William E Endoscope retainer and tissue retracting device
EP0323018B1 (fr) * 1987-12-31 1993-06-16 United States Surgical Corporation Vanne pivotante, autocentrante pour dispositif d'insufflation par canule
EP0339945A2 (fr) * 1988-04-25 1989-11-02 Edwin L. Adair Aiguille d'insufflation de gaz avec orifice d'introduction d'un instrument
US4861334A (en) * 1988-06-24 1989-08-29 Nawaz Arain Self-retaining gastrostomy tube
US5002557A (en) * 1989-04-06 1991-03-26 Hasson Harrith M Laparoscopic cannula

Cited By (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1994004082A1 (fr) * 1992-08-13 1994-03-03 Advanced Surgical Ltd Trocart
US5336172A (en) * 1992-10-09 1994-08-09 Symbiosis Corporation Endoscopic suction-irrigation instrument having insertible probes with lateral ports
FR2697150A1 (fr) * 1992-10-28 1994-04-29 Melin Cyriac Trocard à protection de pointe.
WO1994009712A1 (fr) * 1992-10-28 1994-05-11 Cyriac Melin Trocart a protection de pointe
US5549565A (en) * 1993-07-13 1996-08-27 Symbiosis Corporation Reusable surgical trocar with disposable valve assembly
US6099505A (en) * 1993-07-13 2000-08-08 Symbiosis Corporation Valve assembly with automatic valve
EP1438029A4 (fr) * 2001-10-23 2009-01-14 Medtronic Minimed Inc Procede et systeme d'implantation d'une sonde non vasculaire
EP2200689A4 (fr) * 2007-10-02 2011-03-09 Minos Medical Accès péritonéal transluminal et cathéter
DE102011084918B3 (de) * 2011-10-20 2013-03-07 Digital Endoscopy OEM GmbH Einwegeinführspitze, endoskopiesystem und kühlsystem
WO2013057204A1 (fr) 2011-10-20 2013-04-25 Digital Endoscopy Gmbh Pointe d'introduction à usage unique, système d'endoscopie et système de refroidissement

Also Published As

Publication number Publication date
CA2056543A1 (fr) 1992-06-12

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