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WO1994019052A1 - Manchon de trocart utile pour recevoir un instrument de chirurgie - Google Patents

Manchon de trocart utile pour recevoir un instrument de chirurgie Download PDF

Info

Publication number
WO1994019052A1
WO1994019052A1 PCT/EP1994/000409 EP9400409W WO9419052A1 WO 1994019052 A1 WO1994019052 A1 WO 1994019052A1 EP 9400409 W EP9400409 W EP 9400409W WO 9419052 A1 WO9419052 A1 WO 9419052A1
Authority
WO
WIPO (PCT)
Prior art keywords
trocar sleeve
flap
sleeve according
trocar
instrument
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/EP1994/000409
Other languages
German (de)
English (en)
Inventor
Volker DÖTZKIRCHNER
Roland Herzog
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.)
Aesculap AG
Original Assignee
Aesculap AG
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 Aesculap AG filed Critical Aesculap AG
Publication of WO1994019052A1 publication Critical patent/WO1994019052A1/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
    • A61B17/3498—Valves therefor, e.g. flapper valves, slide valves
    • 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
    • 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
    • A61M2039/0686—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof comprising more than one seal

Definitions

  • the invention relates to a trocar sleeve for receiving a surgical instrument with at least one flap which can be pivoted from the inserted surgical instrument into an open position and forms a valve body and which, when the instrument is removed, is pivoted against the direction of insertion of the instrument into a closed position in which the interior of the trocar sleeve is closed is.
  • Trocar sleeves of this type are known, for example, from German utility model 91 09 909.
  • the flaps used in these known trocar sleeves must be mounted in the trocar sleeves by means of a hinge, and there are also difficulties in sealing these rigid flap valves which can be pivoted out of the clear cross section.
  • a trocar sleeve of the type described in the introduction in that the flap consists of a flexible, elastomeric material, in which the trocar sleeve is held at one end in a plane running transversely to the longitudinal axis of the trocar and in the closed position on one Step of the interior of the trocar sleeve rests in such a way that the entire cross section of the trocar sleeve interior surrounded by the step is covered by the flap or the flaps.
  • this flap material nestles against the sealing step so that a perfect seal is achieved.
  • the flap can be opened very easily when an instrument is inserted into the trocar sleeve. is pushed because this instrument swings the flap away from the closed position.
  • the flap is preferably made of silicone, but other elastomeric plastics can also be used; materials which can be sterilized are preferably used for the flap.
  • a line-shaped weakening of the material forms a film hinge between the end serving to hold the flap and the flap.
  • a defined pivot line of the flap is thus obtained, so that a defined opening and closing movement of the flap is ensured.
  • the end serving to hold the flap forms a tab which is clamped between two parts of the trocar sleeve which can be clamped in the axial direction. These parts can preferably be screwed together.
  • the flap between the two parts is facilitated if at least one of the two parts of the trocar sleeve has a receiving space for the flap that is complementary to the flap. It is particularly advantageous if the flap carries projections which engage in complementary recesses in one part or in both parts of the trocar sleeve. When assembling the trocar sleeve, the flaps can therefore be inserted into one part, the projections dipping into the recesses, and the flap is firmly clamped by fitting the other part. In another embodiment, it can be provided that the end of the flap which is used for holding is clamped in a clamping piece which is fixed on the trocar sleeve.
  • the flap is integrally connected at its end serving as a holder to a ring surrounding the flap, which is fixed to the trocar sleeve.
  • This ring can, for example, be clamped between two parts of the trocar sleeve that can be clamped against one another in the axial direction.
  • the ring can be inserted into a circumferential groove on the inside of the trocar sleeve.
  • the ring is inserted into a circumferential groove on the inside of a sealing cap which can be releasably placed on the trocar sleeve.
  • a sealing cap which can be releasably placed on the trocar sleeve.
  • Such caps are normally placed on trocar sleeves to ensure a sealed insertion of the surgical instrument.
  • a flap made of flexible material is inserted into such a closure cap and closes an opening in the closure cap as soon as the surgical instrument is pulled out of the trocar sleeve.
  • closure cap has a sealing membrane with a push-through opening for the instrument and if the flap lies with the closed position on the underside of the sealing membrane.
  • closure cap it is also possible for the closure cap to be formed in one piece with the sealing membrane and the flexible flap which forms a flap valve.
  • a construction in which a single flap forms the flap valve is particularly advantageous.
  • a plurality of flaps to be arranged in the same plane of the trocar sleeve, each of which only partially closes the cross section of the trocar sleeve and which are offset in relation to one another in the circumferential direction in such a way that they are partially in their closed position Close the cross section of the trocar sleeve overlapping together.
  • two flaps can lie opposite each other, each closing slightly more than half of the cross section of the trocar sleeve.
  • the flaps carry an insert made of harder material in the central area. This prevents damage to the flaps, which are made of a soft, elastomeric material, by the tip of an inserted surgical instrument.
  • the insert is preferably made of metal, but it would also be possible to use a harder plastic material. It is advantageous if the insert protrudes like a button upwards from the top of the flap.
  • the insert can be “buttoned” into an opening of the flap; for this purpose the insert can have, for example, a circumferential groove for receiving the flap material.
  • the flap is flat, but an embodiment is also possible in which the flap is convex toward the insertion side of the trocar sleeve. As a result, the flap is centered when the interior of the trocar sleeve is closed and lines up with the step.
  • the flap can have the shape of a spherical cap.
  • Figure 1 a disassembled trocar sleeve with two embodiments of a flap valve
  • Figure 2 is a longitudinal sectional view of the trocar sleeve of Figure 1 in the assembled state
  • Figure 3 is a sectional view taken along line 3-3 in Figure 2;
  • FIG. 4 a perspective view of a special embodiment of a spherically shaped valve flap
  • FIG. 5 a partial longitudinal sectional view of a trocar sleeve with a valve flap according to FIG. 4;
  • FIG. 6 a side view of a partially longitudinally cut trocar sleeve with a flap valve with two flaps and
  • FIG. 7 shows a sectional view along the line 7-7 in FIG. 6.
  • the trocar sleeve 1 shown in FIGS. 1 to 3 comprises a shaft-shaped lower part 2 with a bevelled end 3 and an enlarged connecting part 4 at the upper end.
  • the connecting part has an external thread 5, onto which an upper part 7 of the trocar sleeve 1 is screwed with the interposition of an O-ring 6 made of an elastomer material.
  • the trocar sleeve 1 surrounds a continuous interior 8, the inside diameter of which is at the lower end of the upper part 7 during the transition into the connecting part 4 in the form of a step
  • the stage 9 forms the bottom of an annular recess
  • a flap 13 made of a flexible, elastomeric material is inserted into this recess, for example made of silicone, which is designed in the form of a sheet or plate and completely fills the recess 10 and the receiving space 11.
  • the end of the flap 13 entering the receiving space 11 forms an essentially rectangular tab 14 with two pin-shaped projections 15 which plunge into the recesses 12.
  • the part of the flap 13 filling the recess 10 has an essentially circular cross section and completely covers the interior 8.
  • the material is weakened in the transition area between the tab 14 and the circular part of the flap 13, so that a film hinge 16 is formed which runs essentially parallel to the longitudinal edge of the receiving space 11. Along this film hinge 16, the flap 13 can be pivoted downward into the enlarged part of the interior 8 in the connecting part 4.
  • the flap 13 In a central position arranged in the longitudinal axis of the interior 8, the flap 13 has an opening 17 into which an insert 18 made of a hard material, in particular metal, is “buttoned”.
  • the circular insert 18 has on its circumferential line a circumferential groove 19 into which the edge of the opening 17 of the flap 13 engages (FIG. 2).
  • the insert 18 protrudes convexly both over the top and over the bottom of the flat flap 13.
  • the receiving space 11 is at least partially covered by the upper end face of the connecting part 4, so that the tab 14 arranged in the receiving space 11 of the flap 13 is clamped between the upper part 7 and the lower part 2.
  • the flap 13 lies in the recess 10 and thus closes the clear cross section of the interior 8, as shown in FIG. 2.
  • a closure cap 20, which consists of a flexible plastic material and engages with a slightly inwardly projecting annular flange 21 in a circumferential groove 22 at the upper end of the upper part 7, is releasably placed on the upper end of the upper part 7.
  • This sealing cap 20 spans the interior 8 with a thin sealing membrane 23, in which a central opening 24 is arranged, the diameter of which is smaller than the inside diameter of the interior 8 in the upper part 7.
  • a circumferential groove 25 is inserted into which a retaining ring 26 made of a flexible, elastomeric material is inserted, preferably made of silicone.
  • a flap 28 is integrally formed on one side via a film hinge 27 in a manner similar to that of the flap 13, which flaps against the sealing membrane 23 from below in such a way that the opening 24 is completely covered, the surface of the flap 28 is therefore larger in the area of the opening 24 than the cross section of the opening 24.
  • the cross section of the flap 28 is, however, smaller than the area circumscribed by the holding ring 26; between the holding ring 26 and the flap 28 there is a crescent-shaped or circular-arc-shaped intermediate space 29.
  • the flap 28 does not have an insert comparable to the insert 18, but a corresponding insert could also easily be provided for this flap 28.
  • two flap valves are provided by the flaps 13 and 28, which normally close the interior of the trocar sleeve 1. If two such flap valves are used, there is a lock effect in the area between the upper and the lower end of the upper part 7, but it is readily possible to provide only one of these flap valves for trocar sleeves, i.e. either only the flap 13 or only the flap 28.
  • a surgical instrument is inserted into it, in the exemplary embodiment shown a spike-shaped obturator 30.
  • the sealing membrane lies against the obturator 30, and the tip of this pushes the flap 28 on, which is pivoted down under the influence of the movement of the obturator 30 about the film hinge 27 into the interior of the upper part 7.
  • the flap 13 is pivoted downward and exposes the clear cross section of the interior. The flap 13 is protected against damage by the tip of the obturator 30 in that this tip bumps into the insert 18 made of harder and more resistant material when inserted.
  • This material preferably also has a very low coefficient of friction, for example the insert can consist of polytetrafluoroethylene, so that the flap 13 pivoted downward by the obturator 30 opposes the insertion movement of the obturator 30 with practically no frictional resistance.
  • the trocar sleeve 1 is inserted together with the obturator 30 into a body cavity into which gas is filled under increased pressure in order to expand the volume of the body cavity.
  • the obturator 30 is pulled out of the trocar sleeve 1 again, the flaps 13 and 28 pivot into the closed position shown in FIG. 2 and are held in this by the increased gas pressure in the lower part 2 , which results from the increased gas pressure in the body cavity.
  • the flap 13 described with reference to FIGS. 1 to 3 has a flat construction
  • the flap shown in FIGS. 4 and 5, in which corresponding parts have the same reference numerals has a spherical cap-shaped configuration, so that the spherical cap-shaped part 31 is ver closed flap enters the interior 8 of the upper part 7 and the flap is centered.
  • FIGS. 6 and 7 corresponding parts are again designated with the same reference numerals as in the embodiment of FIGS. 1 to 3, since the structure of the trocar sleeve shown there is very similar.
  • the only difference is in the design of the flap 13, which is replaced by two diametrically opposed flaps 32 and 33 in the exemplary embodiment in FIGS. 6 and 7.
  • These two flaps 32 and 33 are made in the same way from a flexible, elastomeric material, for example from silicone, and can be held on the trocar sleeve in the same way as the flap 13.
  • a different version is shown for holding the flaps 32 and 33, namely the flaps 32 and 33 are held by cross-sectionally U-shaped clamping pieces 34 which surround the flaps 32 and 33 on both sides and which in FIG speaking recesses 35 are arranged in the separating region between the connecting part 4 and the upper part 7.
  • the opposing flaps 32 and 33 overlap in the central position in the closed position, in this area the two flaps 32 and 33 can be designed in stages as shown in FIG. 6, so that they have a particularly good seal in the overlapping area in the closed state achieve.
  • a pivoting of the two flaps 32 and 33 into the open position is also made possible here again, since the material of the flaps 32 and 33 is flexible.
  • a film hinge similar to the film hinges 16 and 27 could also be provided in this embodiment.

Landscapes

  • 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)

Abstract

Un manchon de trocart (1) utile pour recevoir un instrument de chirurgie comprend au moins un clapet (13) qui forme un corps de soupape. L'instrument de chirurgie inséré dans le manchon fait pivoter le clapet (13) jusqu'à une position ouverte et lorsque l'instrument est retiré du manchon, le clapet (13) pivote en sens contraire au sens d'introduction de l'instrument jusqu'à une position fermée dans laquelle l'espace intérieur du manchon de trocart est fermé. Afin d'améliorer la structure mécanique d'un tel manchon de trocart et d'obtenir une étanchéité améliorée, le clapet est constitué d'un matériau élastomère souple et est retenu à une extrémité du manchon de trocart dans un plan transversal à l'axe longitudinal du trocart. En position fermée, le clapet repose sur un gradin (9) de l'espace intérieur du manchon de trocart de sorte que toute la section transversale de l'espace intérieur du manchon de trocart entourée par le gradin est recouverte par le ou les clapets.
PCT/EP1994/000409 1993-02-27 1994-02-12 Manchon de trocart utile pour recevoir un instrument de chirurgie Ceased WO1994019052A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE19934306205 DE4306205C1 (de) 1993-02-27 1993-02-27 Trokarhülse zur Aufnahme eines chirurgischen Instruments
DEP4306205.9 1993-02-27

Publications (1)

Publication Number Publication Date
WO1994019052A1 true WO1994019052A1 (fr) 1994-09-01

Family

ID=6481564

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP1994/000409 Ceased WO1994019052A1 (fr) 1993-02-27 1994-02-12 Manchon de trocart utile pour recevoir un instrument de chirurgie

Country Status (2)

Country Link
DE (1) DE4306205C1 (fr)
WO (1) WO1994019052A1 (fr)

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1997047248A1 (fr) * 1996-06-11 1997-12-18 Origin Medsystems, Inc. Canule reutilisable avec ensemble d'etancheite jetable
US7056304B2 (en) 2001-07-24 2006-06-06 Karl Storz Gmbh & Co. Kg Medical instrument
US8968250B2 (en) 2005-10-14 2015-03-03 Applied Medical Resources Corporation Surgical access port
US9173680B2 (en) 2006-05-03 2015-11-03 Karl Storz Gmbh & Co. Kg Seal for a trocar sleeve and such trocar sleeve
US20210316128A1 (en) * 2018-12-24 2021-10-14 Hangzhou Endonom Medtech Co., Ltd. Hemostatic valve, sheath, and catheter sheath assembly

Families Citing this family (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE19619065C2 (de) * 1996-05-13 2000-12-28 Storz Karl Gmbh & Co Kg Trokarhülse mit einem Ventil
DE10358279A1 (de) 2003-12-11 2005-07-14 Karl Storz Gmbh & Co. Kg Medizinisches Instrument zum Schneiden von biologischen und insbesondere menschlichem Gewebe
DE102008035310A1 (de) * 2008-07-23 2010-01-28 Karl Storz Gmbh & Co. Kg Medizinisches Instrument mit einem flexiblen Dichtungssystem
DE102010016704A1 (de) 2010-04-29 2011-11-03 Trokamed Gmbh Trokar

Citations (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3295547A (en) * 1964-02-10 1967-01-03 Scaramucci Domer Foldable check valve
US3301443A (en) * 1965-02-01 1967-01-31 United States Steel Corp Feeding mechanism and valve used therein
FR1592547A (fr) * 1968-06-21 1970-05-19
US3628565A (en) * 1970-03-03 1971-12-21 Philco Ford Corp Flexible check valves
DE7430345U (de) * 1974-12-12 Richard Wolf Gmbh Trokarhülse für die Endoskopie von Körperhöhlen
GB2065479A (en) * 1979-12-17 1981-07-01 Technological Supply Devices for introducing a catheter or a probe into a blood vessel
US4430081A (en) * 1981-01-06 1984-02-07 Cook, Inc. Hemostasis sheath
EP0323018A2 (fr) * 1987-12-31 1989-07-05 United States Surgical Corporation Vanne pivotante, autocentrante pour dispositif d'insufflation par canule
DE9109909U1 (de) * 1991-08-10 1991-09-26 Klemm, Bernd, 7801 Umkirch Operationsinstrument
DE9112550U1 (de) * 1991-10-09 1991-11-28 Richard Wolf Gmbh, 7134 Knittlingen Trokarhülse zum Durchführen eines medizinischen Instrumentes
EP0521590A1 (fr) * 1991-07-02 1993-01-07 Ethicon Inc. Capsule de bouchage pour tubes conducteurs ou manchon de réduction pour l'introduction des instruments chirurgicaux

Family Cites Families (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5308336A (en) * 1982-09-28 1994-05-03 Applied Medical Resources Seal protection mechanism
US5122122A (en) * 1989-11-22 1992-06-16 Dexide, Incorporated Locking trocar sleeve

Patent Citations (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE7430345U (de) * 1974-12-12 Richard Wolf Gmbh Trokarhülse für die Endoskopie von Körperhöhlen
US3295547A (en) * 1964-02-10 1967-01-03 Scaramucci Domer Foldable check valve
US3301443A (en) * 1965-02-01 1967-01-31 United States Steel Corp Feeding mechanism and valve used therein
FR1592547A (fr) * 1968-06-21 1970-05-19
US3628565A (en) * 1970-03-03 1971-12-21 Philco Ford Corp Flexible check valves
GB2065479A (en) * 1979-12-17 1981-07-01 Technological Supply Devices for introducing a catheter or a probe into a blood vessel
US4430081A (en) * 1981-01-06 1984-02-07 Cook, Inc. Hemostasis sheath
EP0323018A2 (fr) * 1987-12-31 1989-07-05 United States Surgical Corporation Vanne pivotante, autocentrante pour dispositif d'insufflation par canule
EP0521590A1 (fr) * 1991-07-02 1993-01-07 Ethicon Inc. Capsule de bouchage pour tubes conducteurs ou manchon de réduction pour l'introduction des instruments chirurgicaux
DE9109909U1 (de) * 1991-08-10 1991-09-26 Klemm, Bernd, 7801 Umkirch Operationsinstrument
DE9112550U1 (de) * 1991-10-09 1991-11-28 Richard Wolf Gmbh, 7134 Knittlingen Trokarhülse zum Durchführen eines medizinischen Instrumentes

Cited By (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1997047248A1 (fr) * 1996-06-11 1997-12-18 Origin Medsystems, Inc. Canule reutilisable avec ensemble d'etancheite jetable
US5820606A (en) * 1996-06-11 1998-10-13 Origin Medsystems, Inc. Reusable cannula with disposable seal
US6159182A (en) * 1996-06-11 2000-12-12 Applied Medical Resources Corporation Reusable cannula with disposable seal
US7056304B2 (en) 2001-07-24 2006-06-06 Karl Storz Gmbh & Co. Kg Medical instrument
US8968250B2 (en) 2005-10-14 2015-03-03 Applied Medical Resources Corporation Surgical access port
US9833259B2 (en) 2005-10-14 2017-12-05 Applied Medical Resources Corporation Surgical access port
US10478219B2 (en) 2005-10-14 2019-11-19 Applied Medical Resources Corporation Surgical access port
US11504157B2 (en) 2005-10-14 2022-11-22 Applied Medical Resources Corporation Surgical access port
US9173680B2 (en) 2006-05-03 2015-11-03 Karl Storz Gmbh & Co. Kg Seal for a trocar sleeve and such trocar sleeve
US20210316128A1 (en) * 2018-12-24 2021-10-14 Hangzhou Endonom Medtech Co., Ltd. Hemostatic valve, sheath, and catheter sheath assembly

Also Published As

Publication number Publication date
DE4306205C1 (de) 1994-10-20

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