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WO2016068825A1 - Poche de morcellement laparoscopique fermée et son procédé d'utilisation - Google Patents

Poche de morcellement laparoscopique fermée et son procédé d'utilisation Download PDF

Info

Publication number
WO2016068825A1
WO2016068825A1 PCT/TR2015/050154 TR2015050154W WO2016068825A1 WO 2016068825 A1 WO2016068825 A1 WO 2016068825A1 TR 2015050154 W TR2015050154 W TR 2015050154W WO 2016068825 A1 WO2016068825 A1 WO 2016068825A1
Authority
WO
WIPO (PCT)
Prior art keywords
abdomen
bag
laparoscopic
morcellation
opening
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/TR2015/050154
Other languages
English (en)
Inventor
Ali AKDEMIR
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.)
TC EGE UNIVERSITESI
Original Assignee
TC EGE UNIVERSITESI
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 TC EGE UNIVERSITESI filed Critical TC EGE UNIVERSITESI
Publication of WO2016068825A1 publication Critical patent/WO2016068825A1/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
    • A61B17/00234—Surgical instruments, devices or methods for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/00234—Surgical instruments, devices or methods for minimally invasive surgery
    • A61B2017/00287—Bags for minimally invasive surgery

Definitions

  • the invention is related to an enclosed laparoscopic morcellation bag and usage method thereof; wherein said laparoscopic morcellation bag enables, to prevent complications that might occur due to scattering of the specimen that has been broken into pieces via the usage of morcellator devices when extracting solid materials out of the abdomen, and makes it easier to extract out the specimen (sample) located inside the abdomen (abdominal region) during laparoscopic operations.
  • Laparoscopic surgery which is a method that has been progressing rapidly and has been becoming more widespread in the field of surgery, is frequently chosen with each passing day in the gynaecologic surgery field as in all surgical fields.
  • Laparoscopic surgeries are operations carried out by means of a camera and metal tubes (trocar-port) that are as wide as a pen, wherein said camera and tubes are inserted from a few pre-determined points of the body.
  • the recovery of the patient is much faster and the patient can quickly return back to his/her daily life.
  • the bag After the bag whose mouth is positioned outside of the abdomen is inflated, the bag needs to be pierced with a different trocar inside the abdomen and the trocar needs to be inserted therein, and as the camera is located inside the bag during this process, said process is carried out in a half blind state and said piercing procedure creates a risk of intraabdominal injury inside the abdominal space,
  • the aim of the invention is to provide a laparoscopic enclosed morcellation bag which is small and inflatable, being produced from an elastic material, which enables to perform morcellation inside said bag after the specimen is received therein.
  • Another aim of the invention is to provide a laparoscopic enclosed morcellation bag having finger like protrusions extending out of the outer surface that can be easily taken out of the ports that are used laparoscopically and where laparoscopic instruments and morcellators can be inserted therein after the bag is easily extracted out by means of said finger like protrusions.
  • Another aim of the invention is to provide a laparoscopic enclosed morcellation bag which shortens the operation time.
  • Figure 1- Is the schematic view of the specimen that has been cut off from the tissue of the patient before laparoscopic morcellation
  • Figure 2- Is the schematic view of the laparoscopic morcellation bag subject to the invention where the bag is inserted inside the abdomen over the skin incision by means of twisting the apparatus used to open the mouth of the bag
  • Figure 3- Is the schematic view of the laparoscopic morcellation bag subject to the invention where the bag is inserted into the abdomen having an opening that is not enclosed.
  • Figure 4- Is the schematic view of the laparoscopic morcellation bag subject to the invention during the process where the specimen is being received inside the bag via a laparoscopic instrument while said process is being monitored with a camera.
  • Figure 5- Is the schematic view where the specimen is being received inside the laparoscopic morcellation bag.
  • Figure 6- Is the view of the process where the opening of the laparoscopic morcellation bag is pulled out of the abdomen by means of a laparoscopic instrument.
  • Figure 7- Is the schematic view of the morcellation process being monitored with a camera located inside the laparoscopic morcellation bag subject to the invention.
  • Figure 8- Is the schematic view of the laparoscopic morcellation bag subject to the invention at an extracted state, being extracted from the abdominal region, following the morcellation process.
  • Figure 9- Is the perspective view of the clamp design at an open position which is used to clamp the opening of the bag.
  • Figure 10- Is the perspective view of the clamp design at a closed position which is used to clamp the opening of the bag.
  • the laparoscopic enclosed morcellation bag (1) subject to the invention is a bag which makes it easier to extract the specimen (S) located inside the abdomen (A) (abdominal region) during laparoscopic surgical operations, and prevents the occurrence of complications due to the scattering of the specimen (S) into the abdomen (A) during the usage of morcellator (M) devices (M) when extracting solid materials out of the abdomen; wherein said bag comprises the following - At least a body (2) that is inflatable by gas produced from elastic material, forming an artificial volume wherein a morcellation process can be carried out therein, by means of being inflated by gas after said bag has been inserted into the abdomen (A) and wherein said body acts as an enclosed and impermeable chamber such that it prevents the specimen (S) received inside it to be scattered in the abdomen (A),
  • the mouth opening apparatus (4) according to a preferred embodiment of the invention is inserted into the mouth section (3) and clamps around the opening. According to another embodiment of the invention the mouth opening apparatus (4) is integrated with the opening (3).
  • protrusions (5) are provided in order to be able to use different laparoscopic instruments (L), whereby said protrusions are taken out of the abdomen by means of a clamp via different ports (P) and where said protrusions act as channels that extend into the body (2) after the closed ends of the protrusions are cut off.
  • At least a clamp (6) is provided; said clamp, clamps the walls of the mouth section (3) and or the protrusion (5) such that they are in contact with each other, and located on the protrusions (5) whose closed ends have been opened by cutting off said ends and/or the mouth (3), in order to prevent small tissue parts and fluid located inside the body (2) of the bag following the morcellation process to be scattered into the abdomen (A); and wherein it comprises a fixed section (6.1) positioned inside the walls and at least a mobile section (6.2) which clamps the walls at the fixed section (6.1) by being attached to the fixed section (6.1) at one end and by being rotated at said axis.
  • the mouth section (3) is closed by means of the surgeon pulling a draw string outside the abdomen (A) where said string has been inserted through the constriction channel located around the mouth.
  • Usage method of the laparoscopic enclosed morcellation bag (1) subject to the invention which enables the Specimen (S) that has been cut off from the tissue at the early stages of the operation during laparoscopic surgeries to be taken out of the abdomen; comprising the following steps:
  • the end of the protrusion (5) that has been cut off and opened is sealed off impermeably with a suture in order to prevent small tissue pieces and fluid located in the body (2) to be scatted inside the abdomen (A) following the morcellation process.
  • the organ or diseased tissue that is to be extracted out of the abdomen during laparoscopic surgeries is separated from the tissues they are bound to, during an operation by cutting and coagulation procedures. Following this stage, the organ or diseased tissue that is to be taken out of the abdomen shall remain inside the abdomen at a free state.
  • the specimen (S) that is no longer attached to an organ or tissue, is received into the laparoscopic enclosed morcellation bag (1) and the process to extract the bag out of the abdomen (A) is started.
  • At least three ports (P) having a diameter of 5mm is inserted at the abdominal region in order to carry out the laparoscopic surgical operation, and the diameter of the middle port is expanded up to 12- 15mm in order to first of all insert the laparoscopic enclosed morcellation bag (1) subject to the invention and then the camera (C) into the abdomen (A).
  • the bag is inserted into the abdomen (A) through the skin incision opened by means of an elastic metal apparatus and the opening (3) is opened.
  • the specimen (S) is inserted into the body (2) via the open mouth section (3).
  • the protrusions (5) that are provided to pass the morcellator (M) and other laparoscopic instruments into the body (2) are extended out from the abdomen (A) via the ports (P) using metal instruments and the closed ends that extend out of the abdomen (A) are cut off thereby providing channels that reach into the body (2).
  • C02 gas is fed inside the body and an artificial volume is created in which the morcellation process shall be carried out.
  • the lumen of the protrusion (5) through which the morcellator (M) is passed into the bag (1) shall be sealed off.
  • the bag (1) and the tissue parts, fluid and blood located inside the bag are extracted out of the abdomen (A) from the skin incision that corresponds to the belly button.
  • the laparoscopic enclosed morcellation bag (1) As the laparoscopic enclosed morcellation bag (1) is silicon based, it shall open on its own once it is inserted into the abdomen (A). Once the latex based inflatable bag (1) is opened, the tissue/mass that is desired to be received through the opening (3) shall be placed into the bag (1).
  • the laparoscopic enclosed morcellation bag (1) can be produced from a latex, nonoxynol-9, lambistic polyurethane, poliisopropylene material.
  • the laparoscopic enclosed morcellation bag (1) subject to the invention shall be inserted into the abdomen (A) through the trocar incision section.
  • the morcellation bag (1) that is received into the abdomen (A) easily through the trocar incision point, having a small size before being inserted into the abdomen (A) shall be inflated after the specimen (S) inside the abdomen (A) is received into the bag, by means of its flexible inflatable structure different to the traditional applications and by this means the sufficient volumetric area for the morcellation shall be obtained following inflation of the bag.
  • the size of the morcellation bag (1) shall shrink again after the gas inside the bag is discharged following the morcellation procedure and therefore the bag shall be able to be extracted easier out of the abdomen (A) in comparison to traditional applications.
  • the laparoscopic enclosed morcellation bag (1) subject to the invention comprises 3-4 protrusions (5) shaped like fingers that extend out of the outer surface of the bag, and show continuity with the content of the bag (1).
  • the protrusions (5) located on the morcellation bag (1) shall be grasped with laparoscopic instruments and shall be extracted out of the abdomen (A) from the skin incision points.
  • the opening (3) is also extracted out of the abdomen via laparoscopic grasping tools.
  • the opening (3) taken out of the abdomen (A) shall be opened and the camera (C) and the port (P) that is passed through shall be passed over said opening (3).
  • the bag (1) is inflated with air and the camera (C) is inserted into the bag by means of a port (P) that has been placed inside the bag (1) that has been inflated.
  • the top section of the protrusion (5) into which the morcellator (M) shall be inserted through is cut off, where the morcellator bag shall be taken out of the abdomen (A) using said protrusions (5) which resemble fingers and, the morcellator (M) is inserted into the body (2) of the morcellator bag (1) via the finger like protrusions (5).
  • one of the protrusions (5) resembling a finger shall be taken out of the abdomen (A) from the skin incision and a different laparoscopic instrument (L) can be inserted into the body (2) from the cut off end of the protrusion similar to the insertion process of the morcellator (M).
  • the specimen (S), camera (C) and the morcellator (M) is located inside the bag (1). Therefore a second artificial volume shall be formed inside the abdomen and the specimen (S) shall be morcellated under direct optical observation and shall be extracted out of the abdomen (A).
  • the bag shall be extracted out of the abdomen (A) following the morcellation procedure and the open end of the protrusion (5) into which the morcellator (M) had been inserted, shall be sealed with a suture.
  • spillage dissemination and/or fluid dissemination or the passage of tissue pieces into the abdomen (A) during the extraction of the morcellation bag (1) out of the abdomen (A) is prevented.
  • the air inside the body (2) is discharged over the camera (C) port (P) and the size of the morcellation bag (1) is then shrunk such that the bag can be easily re-extracted out of the trochar incision point.
  • the camera port (P) and the camera (C) is extracted out of the abdomen (A), and the morcellation bag (1) is pulled out of the abdomen (A) through the skin incisions by gripping the opening (3) of the bag.
  • the protrusions (5) of the morcellation bag (1) shall be extracted out of the abdomen (A). As the cut off ends of the protrusions (5) shall be sealed with a suture, it is prevented for fluids and/or small tissue parts to scatter or leak into the abdomen (A) from said ends that had been cut off.
  • the laparoscopic enclosed morcellation bag (1) subject to the invention makes it easier to extract the solid surgical specimen (S) located in the abdomen (A) during especially gynaecologic laparoscopic surgical operations out of said abdomen (A) and also makes the laparoscopic morcellation procedure carried out during the extraction process easier. Moreover the contact of the diseased section from which the specimen (S) is taken, with the abdomen (A) and the scattering of said disease into the abdomen (A) during the morcellation procedure is prevented.
  • the elimination of this problem which is one of the basic problems of traditional applications and one of the issues that is emphasized frequently by international health organizations create reliability following surgical operations.
  • the retracting of the solid specimen (S) out of the abdomen (A) during laparoscopic surgery is usually carried out especially during myomectomy and subtotal hysterectomy operations.
  • the laparoscopic enclosed morcellation bag (1) subject to the invention has two basic differences that distinguish the invention in comparison to traditional applications.
  • the first one of these differences is that the morcellation bag (1) is produced from an inflatable and expandable elastic material.
  • the bag is produced to have a small size, the bag can have a much larger volume after it is inflated inside the abdomen (A) during a laparoscopic surgery.
  • protrusions (5) shaped like a channel having closed ends that extend outwards from the body (2) of the morcellation bag are provided.
  • protrusions (5) are taken out of the abdomen (A) from the ports (P) after the morcellation bag (1) is inflated and the ends of the protrusions are cut off thereby acting as channels which allow the insertion of laparoscopic instruments (L) and morcellators (M) into the body (2) and in turn into the abdomen (A).
  • the breaking up of the specimen (S) that is received inside the body (2) by means of the morcellation bag (1) subject to the invention is carried out inside the body of the bag, and following morcellation, the morcellation bag can be extracted out of the abdomen (A) without the risk of dissemination of a tissue part or leakage of fluid into the abdominal (A) region. Therefore it is also prevented for any kind of diseased tissue to be dispersed or scattered into the abdomen.
  • the specimen (S) is morcellated in a closed medium by means of the laparoscopic enclosed morcellation bag (1) subject to the invention and the specimen is extracted out of the abdomen (A) by means of the bag and this procedure can be carried out in a shorter period of time without extending the duration of the operation in comparison to traditional similar applications.
  • laparoscopic morcellation can be performed easily and faster.
  • the procedure can be carried out inside an enclosed bag, the risk of scattering of a diseased specimen (S) into the abdomen is also prevented.

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

Abstract

L'invention concerne une poche de morcellement laparoscopique fermée (1) et son procédé d'utilisation, ladite poche de morcellement laparoscopique permettant de prévenir les complications qui peuvent surgir du fait de la diffusion de l'échantillon (S) qui a été brisé en morceaux par l'utilisation de dispositifs morcellateurs (M) lors de l'extraction de matériaux solides hors de l'abdomen (A) et facilitant l'extraction dudit spécimen (S) (échantillon) situé à l'intérieur de l'abdomen (A) (région abdominale) au cours d'opérations laparoscopiques.
PCT/TR2015/050154 2014-10-30 2015-10-28 Poche de morcellement laparoscopique fermée et son procédé d'utilisation Ceased WO2016068825A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
TR2014/12735A TR201412735A2 (tr) 2014-10-30 2014-10-30 Bir laparoskopik kapalı morselayon poşeti ve bunun kullanım metodu.
TR2014/12735 2014-10-30

Publications (1)

Publication Number Publication Date
WO2016068825A1 true WO2016068825A1 (fr) 2016-05-06

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Application Number Title Priority Date Filing Date
PCT/TR2015/050154 Ceased WO2016068825A1 (fr) 2014-10-30 2015-10-28 Poche de morcellement laparoscopique fermée et son procédé d'utilisation

Country Status (2)

Country Link
TR (1) TR201412735A2 (fr)
WO (1) WO2016068825A1 (fr)

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2017216803A1 (fr) * 2016-06-16 2017-12-21 Safesac Medical Ltd. Dispositif de confinement de tissu destiné à être utilisé dans des interventions chirurgicales
CN110123421A (zh) * 2019-04-18 2019-08-16 朱育春 单孔腹腔镜多功能通道
CN111991040A (zh) * 2020-08-27 2020-11-27 成都市妇女儿童中心医院 一种腹腔镜手术暴露装置
US11690604B2 (en) 2016-09-10 2023-07-04 Ark Surgical Ltd. Laparoscopic workspace device
US12285188B2 (en) 2016-09-10 2025-04-29 Ark Surgical Ltd. Laparoscopic workspace device

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US20130245636A1 (en) 2010-08-22 2013-09-19 Anton Jansen Device for Removing Tissue
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US20140236168A1 (en) * 2011-12-23 2014-08-21 Atrops Limited Pneumoperitoneum device
WO2015151117A2 (fr) * 2014-04-03 2015-10-08 Veol Medical Technologies Pvt. Ltd. Isolateur de tissu

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* Cited by examiner, † Cited by third party
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US5037379A (en) 1990-06-22 1991-08-06 Vance Products Incorporated Surgical tissue bag and method for percutaneously debulking tissue
US6361543B1 (en) 1991-05-29 2002-03-26 Sherwood Services Ag Inflatable devices for separating layers of tissue, and methods of using
US20040097792A1 (en) 1991-05-29 2004-05-20 Moll Frederic H. Endoscopic inflatable retraction device, method of using, and method of making
DE9109389U1 (de) 1991-07-30 1991-10-24 Martini-Eggert, Karin, 2000 Hamburg Endoscopisches Extraktionsinstrument
US5352184A (en) 1992-03-12 1994-10-04 Uresil Corporation Reservoir for enclosing and retrieving body specimens
EP0578997A1 (fr) 1992-06-25 1994-01-19 Udo Dr. Auweiler Poche de laparoscopie
WO1994013215A2 (fr) 1992-12-14 1994-06-23 Rainer Deckardt Sachet de reception et de recuperation utile en chirurgie a invasivite minimale, et dispositif de vidage du sachet
US5785677A (en) 1993-06-22 1998-07-28 Auweiler; Udo Laparoscopy bag
US5618296A (en) 1995-07-24 1997-04-08 Endomedix Corporation/Box 330 Tissue morcellator system and method
US5735289A (en) 1996-08-08 1998-04-07 Pfeffer; Herbert G. Method and apparatus for organic specimen retrieval
WO1998009569A1 (fr) * 1996-09-04 1998-03-12 University Of Massachusetts Sac de recuperation de tissus et procede permettant l'extraction de tissus cancereux
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US20090082634A1 (en) 2007-09-25 2009-03-26 Biten Kishore Kathrani Surgical method
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US20110190780A1 (en) 2010-02-03 2011-08-04 O'prey Cormac Surgical retrieval apparatus
US20110190779A1 (en) 2010-02-03 2011-08-04 Jennifer Rachel Gell Surgical retrieval apparatus
US20140135788A1 (en) 2010-03-08 2014-05-15 Ashford & St. Peter's Hospitals Medical device: laparoscopic bag
WO2011128622A1 (fr) 2010-04-13 2011-10-20 Central Manchester University Hospitals Nhs Foundation Trust Dispositif et procédés chirurgicaux
US20130245636A1 (en) 2010-08-22 2013-09-19 Anton Jansen Device for Removing Tissue
US20120089151A1 (en) 2010-10-01 2012-04-12 Taylor Scott V Laparoscopic tissue retrieval system
US20120083795A1 (en) 2010-10-04 2012-04-05 Alistair Ian Fleming Specimen retrieval device
GB2495522A (en) 2011-10-12 2013-04-17 Central Manchester University Hospitals Nhs Foundation Trust Device for creating a working space within a human or animal body
US20130184536A1 (en) 2011-12-23 2013-07-18 Atropos Limited Pneumoperitoneum device
US20140236168A1 (en) * 2011-12-23 2014-08-21 Atrops Limited Pneumoperitoneum device
WO2015151117A2 (fr) * 2014-04-03 2015-10-08 Veol Medical Technologies Pvt. Ltd. Isolateur de tissu

Cited By (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2017216803A1 (fr) * 2016-06-16 2017-12-21 Safesac Medical Ltd. Dispositif de confinement de tissu destiné à être utilisé dans des interventions chirurgicales
US11253239B2 (en) 2016-06-16 2022-02-22 Ark Surgical Ltd. Tissue containment device for use in surgical procedures
US12408905B2 (en) 2016-06-16 2025-09-09 Ark Surgical Ltd. Tissue containment device for use in surgical procedures
US11690604B2 (en) 2016-09-10 2023-07-04 Ark Surgical Ltd. Laparoscopic workspace device
US12285188B2 (en) 2016-09-10 2025-04-29 Ark Surgical Ltd. Laparoscopic workspace device
CN110123421A (zh) * 2019-04-18 2019-08-16 朱育春 单孔腹腔镜多功能通道
CN111991040A (zh) * 2020-08-27 2020-11-27 成都市妇女儿童中心医院 一种腹腔镜手术暴露装置
CN111991040B (zh) * 2020-08-27 2023-06-23 成都市妇女儿童中心医院 一种腹腔镜手术暴露装置

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