fluid remover for use in a surgical access device

专利摘要:
SURGICAL ACCESS DEVICES WITH sorbents The present invention generally provides methods and devices for removing fluid from a surgical instrument. Surgical access devices and sealing systems are generally provided with one or more valves or seal assemblies to create a closed system between the external environment and the environment in which the surgical access device is being inserted. The system devices may also include a fluid remover in the form of a sorbent element, a scraper element, a capital effect adsorption element, or any combination thereof that is configured to remove fluid from a channel and operational of the device or system and/or a surgical instrument inserted through it.
公开号:BR112012002041B1
申请号:R112012002041-2
申请日:2010-07-21
公开日:2021-05-04
发明作者:Cesar E. Moreno Jr.；Patrick J. Minnelli；Thomas A. Gilker；Daniel J. Mumaw；Rebecca J. Mollere；Randall Tanguay；Paul T. Franer
申请人:Ethicon Endo-Surgery, Inc.；
IPC主号:

专利说明:

CROSS REFERENCE TO RELATED ORDERS
[0001] The present application is a continuation-in-part of US patent application serial number 12/110,724, filed April 28, 2008 and entitled "Absorbing Fluids in a Surgical Access Device;" US Patent Application Serial Number 12/110,727, filed April 28, 2008 and entitled "Scraping Fluid Removal in a Surgical Access Device" (Summary Number 100873-242 (END6366USNP1)); US patent application serial number 12/110,742, filed April 28, 2008 and entitled "Wicking Fluid Management in a Surgical Access Device" (Summary Number 100873-243 (END6366USNP3)); and US patent application serial number 12/110,755, filed April 28, 2008 and entitled "Fluid Removal in a Surgical Access Device" (precedent number 100873-241 (END6366USNP3)), all of which are incorporated herein, the reference title in its shades. FIELD OF THE INVENTION
[0002] The present invention relates to methods and devices to perform surgical procedures and, in particular, to methods and devices to maintain visibility during surgical procedures. BACKGROUND OF THE INVENTION
[0003] During laparoscopic surgery, one or more small incisions are formed in the abdomen and a trocar is inserted through the incision to form a route that provides access to the abdominal cavity. The trocar is used to introduce various instruments and tools into the abdominal cavity, as well as to provide inflation to elevate the abdominal wall above the organs. During such procedures, a viewing device, such as an endoscope or laparoscope, is inserted through one of the trocars to allow a surgeon to view the operating field on an external monitor attached to the viewing device.
[0004] Visualization devices are commonly inserted and removed through a trocar multiple times during a single surgical procedure, and during each insertion and removal they may encounter fluid that can adhere to the lens of the devices and partially or totally impede visibility through of the lens. In addition, a device can pull fluid from the inside out of the patient's body and into the trocar, where fluid can be deposited until the device or other instrument is reinserted through the trocar. Upon reinsertion, fluid may adhere to the lens of the devices. The lens of devices therefore needs to be cleaned to restore visibility, commonly multiple times during a single surgical procedure. With limited access to only one device in the body, each lens cleaning may require removing the device from the body, cleaning fluid from the device lens, and reintroducing the device into the body. Such lens cleaning is a time-consuming procedure that also increases the chances of complications and contamination through repeated insertion and removal of the device.
[0005] Consequently, there is a need for methods and devices to maintain clear visibility through a lens of a viewing device during a surgical procedure. SUMMARY OF THE INVENTION
[0006] The present invention generally provides methods and devices to prevent fluid deposition in and/or to remove fluid from a surgical instrument. In one embodiment, an assembly for use in a surgical access device is provided and includes a seal that has an opening configured to receive a surgical instrument therethrough, and a sorbent associated with the seal and configured to sorb fluid away from the hair. minus one from the opening and a surgical instrument passed through the opening. The sorbent can be an adsorbent element or an absorbent element. The assembly may also include a scraper element positioned adjacent the seal and configured to remove fluid from a surgical instrument that extends through the opening in the seal. At least a portion of the scraper element can be hydrophilic. A capillary absorber element may be associated with the scraper and it may be configured to suck out fluid collected near the opening when a surgical instrument is passed through the opening. In another embodiment, a capillary absorber element may be associated with the seal and may be configured to suck out fluid collected near the opening when a surgical instrument is passed through the opening. In an exemplary embodiment, the seal is configured to remove fluid from a surgical instrument passed through the opening, and the sorbent is configured to sorb fluid removed from the surgical instrument through the seal. In other embodiments, the sorbent can be formed integrally with the seal. Various seals can be used. For example, the seal may be an instrument seal configured to form a seal when an instrument is inserted therethrough. The assembly may also include a second seal. In certain aspects, the sorbent can be positioned distal to the first and second seals.
[0007] A fluid remover for use in a surgical access device is also provided, and in one embodiment the fluid remover includes a sorbent member having opposite proximal and distal surfaces and opposite inner and outer side walls extending between the proximal and distal surfaces, so that the sorbent member has a polygonal cross-sectional shape, such as square or triangular. The proximal surface may be substantially planar, and the inner and outer side walls may have a radius of curvature. The inner sidewall may define a central opening extending through the sorbent element, and the sorbent element may include a gap formed therein so that the sorbent is C-shaped. The sorbent element may be formed from a plurality of fibers that are configured to sip fluid. The plurality of fibers can be oriented longitudinally with respect to a longitudinal axis of the central opening. In one embodiment, the inner sidewall may include a plurality of grooves formed therein and extending parallel to a longitudinal axis of the central opening; At least a portion of the sorbent element can be hydrophilic.
[0008] Methods for removing fluid from a seal opening are also provided, and in one embodiment the method includes passing a surgical instrument through an opening in a seal in an access device, with fluid in the instrument being absorbed by an element sorbent on the access device. The sorbent element can absorb fluids deposited on the seal by the instrument. The sorbent element can either adsorb or absorb fluid. Various seals can be used, and in one embodiment the seal can form a seal when no instrument is inserted through it. The method may also include scraping fluid from the instrument by a scraper, and the sorbent element sucking fluid out of the scraper.
[0009] In other aspects, a surgical access device is provided that has a compartment defining an operating channel sized and configured to receive a surgical instrument, a seal placed within the compartment, the seal having an opening positioned to receive a surgical instrument that passes through the operating channel, and a sorbent placed within the compartment and configured to sip fluid to prevent fluid from being redeposited on surgical instruments that have passed through the operating channel. The sorbent can be positioned to sip fluid away from the opening in the seal. The sorbent can be an adsorbent or an absorbent. The housing may have various configurations, and in one embodiment it may include a proximal portion that contains the seal and a distal cannula extending distally from the proximal portion and configured to be inserted into a body cavity. The seal may be a first seal, and the access device may include a second seal disposed within the housing. The sorbent can be positioned distal to the first and second seals. The device may also include a scraper disposed in the housing and configured to remove fluid from a surgical instrument passed through the operating channel. The sorbent can be configured to sorb fluid scraped off by the scraper. The device may also include a capillary absorber element disposed in the housing and configured to absorb fluid out of a surgical instrument that passes through the operative channel.
[00010] In another embodiment, a surgical access device is provided that has a proximal compartment, a distal cannula and an operating channel extending through the proximal compartment and the distal cannula that is sized and configured to receive a surgical instrument, a seal disposed within the proximal compartment configured to seal the operating channel when no surgical instrument is disposed therethrough, the seal having an opening extending therethrough and positioned to receive a surgical instrument passing through the operating channel, and a fluid remover. positioned distal to the seal, the fluid remover having an opening extending therethrough and positioned to receive a surgical instrument that passes through the operating channel, and the fluid remover being configured so that when an instrument occludes the opening in the remover of fluid, the fluid remover allows the insufflation gas to p bake from the distal cannula to a proximal side of the fluid stripper to thereby equalize a pressure on the proximal and distal sides of the fluid stripper. In one embodiment, the fluid remover is positioned so that it is configured to be in a path of an inflation gas flowing from an inflation port formed in the proximal compartment. The fluid remover can include a cutout formed in at least a portion thereof and configured to allow an inflation gas to pass from an inflation port through the cutout and into the distal cannula when the instrument occludes the opening. In an exemplary embodiment, the fluid remover can include a scraper configured to scrape fluid from a surgical instrument passed through the opening. The fluid remover may also include a sorbent positioned to sorb fluid removed by the scraper. The sorbent can be positioned distal to the inflation port, and in one embodiment it can be arranged around a substantially cylindrical element. The inflation port can have a lumen that extends therethrough and defines a longitudinal axis, and the scraper can be positioned distal to the longitudinal axis. At least a portion of the fluid remover can be positioned distal to the inflation port.
[00011] In other aspects, a device for removing fluid from medical instruments is provided and includes a scraper having a substantially flat configuration with a central opening extending therethrough, the central opening being configured to expand to engage and removing fluid from a surgical instrument inserted therein, the scraper having a distal surface with a plurality of channels formed therein and extending radially outwardly from the central opening so that fluid removed from an instrument inserted through the central opening can flow through the channels.
[00012] In yet another embodiment, a device for removing fluid from medical instruments is provided and includes a crown, a cap coupled to the crown and a scraper captured between the crown and the cap, the scraper having a central opening formed through the same and configured to expand to engage an instrument inserted therethrough and to scrape fluid from the instrument. A plurality of pins may extend between the crown and cap to engage the crown and cap, the plurality of pins extending through a plurality of openings formed in the scraper. BRIEF DESCRIPTION OF THE DRAWINGS
[00013] The invention will be understood more fully from the following detailed description, taken in conjunction with the attached drawings, in which:
[00014] Figure 1A is a perspective view of a modality of a trocar;
[00015] Figure 1B is an exploded view of the trocar of figure 1A;
[00016] Figure 1C is a cross-sectional view of a portion of the trocar of Figure 1A;
[00017] Figure 1D is a bottom perspective view of an instrument seal assembly for use with the trocar of figure 1A;
[00018] Figure 1E is an exploded view of the seal assembly of the instrument of figure 1D;
[00019] Figure 1F is a perspective view of a trough seal of the trocar of figure 1A;
[00020] Figure 1G is a bottom perspective view of one embodiment of a scraper fluid remover assembly for use with the trocar of figure 1A;
[00021] Figure 1H is a perspective view of an embodiment of a wick wick of a fluid remover assembly for use with the trocar of figure 1A;
[00022] Figure 1I is a perspective view of a sorbent element of a fluid remover assembly for use with the trocar of figure 1A;
[00023] Figure 1J is a perspective view of a structure for housing the sorbent element of figure 1I;
[00024] Figure 1K is a perspective view of a cap portion of a fluid remover assembly for use with the trocar of Figure 1A;
[00025] Figure 2A is a cross-sectional view of a proximal portion of another modality of a trocar;
[00026] Figure 2B is an exploded view of the trocar of Figure 2A;
[00027] Figure 3A is an exploded view of a portion of a trocar that has a drop in fluid removal assembly;
[00028] Figure 3B is an exploded view of the drop-in fluid remover assembly of Figure 3A;
[00029] Figure 3C is a cross-sectional view of the trocar of Figure 3A;
[00030] Figure 4A is an exploded view of one embodiment of a scraper assembly for scraping fluid;
[00031] Figure 4B is a bottom perspective view of the scraper assembly of Figure 4A;
[00032] Figure 4C is a top perspective view of the scraper assembly of figure 4A;
[00033] Figure 5A is a perspective view of another embodiment of fluid remover assembly that has a scraper nested within a sorbent element;
[00034] Figure 5B is a top view of the fluid remover assembly of Figure 5A;
[00035] Figure 5C is a cross-sectional view of the fluid remover assembly of Figure 5A disposed within a trocar housing;
[00036] Figure 6A is a cross-sectional view of a trocar having a scraper modality for scraping fluid from a surgical instrument passing therethrough;
[00037] Figure 6B is a cross-sectional view of a trocar having another embodiment of a scraper for scraping fluid from a surgical instrument passing therethrough;
[00038] Figure 6C is a cross-sectional view of a trocar having yet another embodiment of a scraper for scraping fluid from a surgical instrument passing therethrough;
[00039] Figure 7 is a cross-sectional view of another embodiment of a trocar housing having sorbent membrane ports positioned adjacent to a zero-closing seal;
[00040] Figure 8 is a cross-sectional view of yet another embodiment of a trocar compartment that has capillary absorption fingers coupled to a sorbent reservoir;
[00041] Figure 9 is a cross-sectional view of one embodiment of a trocar housing having a sorbent element disposed therein;
[00042] Figure 10A is a cross-sectional view of an embodiment of a zero-closing seal having extension members for capillary fluid absorption;
[00043] Figure 10B is a transparent perspective view of the seal of figure 10A;
[00044] Figure 11 is an exploded view of another modality of fluid remover assembly that has a sorbent element nested between the first and second zero closing seals;
[00045] Figure 12A is a cross-sectional view of yet another embodiment of a sorbent element having two sorbent bars disposed within a zero-closing seal;
[00046] Figure 12B is a transparent perspective view of the sorbent element and seal of Figure 12A;
[00047] Figure 13 is an exploded view of one embodiment of a trocar compartment having a scraper for scraping fluid from a surgical instrument passing therethrough;
[00048] Figure 14 is a cross-sectional view of an embodiment of a trocar cap having a scraper for scraping fluid from a surgical instrument passing therethrough;
[00049] Figure 15A is a top view of a trocar cap having another embodiment of a scraper for scraping fluid from a surgical instrument passing therethrough;
[00050] Figure 15B is a side perspective view of the trocar cap of Figure 15A;
[00051] Figure 16 is an exploded view of an embodiment of a multilayer seal having a sorbent element disposed between the layers;
[00052] Figure 17 is a perspective view from below of an embodiment of a trocar cap having a sorbent element disposed thereon;
[00053] Figure 18A is a bottom perspective view of an embodiment of a capillary absorber element formed in a portion of a seal protector to create between the seal protector and a seal;
[00054] Figure 18B is a top perspective view of the seal guard portion of Figure 18A;
[00055] Figure 19A is a top view of a multi-layer protective member having cam ribs;
[00056] Figure 19B is a top view of a layer of the protective member of Figure 19A;
[00057] Figure 20A is a side perspective view of a deep cone instrument seal having capillary absorption tabs formed on an outer surface;
[00058] Figure 20B is a top perspective view of another embodiment of a deep cone instrument seal that has capillary absorption tabs formed on an inner surface;
[00059] Figure 21 is a perspective view of a multi-layer protective element having holes formed therein to receive fluid;
[00060] Figure 22A is an exploded view of a multi-layer protective element;
[00061] Figure 22B is a cross-sectional view taken through line B-B of one of the protective elements of figure 22A;
[00062] Figure 23A is a side view of an embodiment of a seal having an hourglass configuration for scraping fluid from a surgical instrument;
[00063] Figure 23B is a side view of the seal of Figure 23A showing an instrument passed therethrough;
[00064] Figure 24A is a cross-sectional view of an embodiment of a trocar cannula having overlapping scrapers and a sorbent disposed thereon;
[00065] Figure 24B is an enlarged view of one of the scrapers and sorbents of Figure 24A;
[00066] Figure 25 is a perspective view of another embodiment of a scraper for scraping fluid from a surgical instrument shown passed through;
[00067] Figure 26 is a perspective view of another embodiment of a device for scraping fluid from a surgical instrument;
[00068] Figure 27A is an exploded view of a trocar and removable cap for scraping fluid from a surgical instrument;
[00069] Figure 27B is an assembled side view of a distal end of the trocar and the removable tip of Figure 27A;
[00070] Figure 27C is a perspective view of the removable tip and distal end of the trocar of Figure 26B;
[00071] Figure 28 is a partially transparent side view of an embodiment of the capillary absorber element having an hourglass shape;
[00072] Figure 29 is a perspective view of a trocar having a cannula with grooves formed therein for capillary absorption of fluid from the cannula;
[00073] Figure 30A is a perspective view of another embodiment of a trocar having a proximal compartment and a distal cannula;
[00074] Figure 30B is a cross-sectional side view of the trocar of Figure 30A;
[00075] Figure 30C is a perspective view of an instrument seal assembly, a channel seal, a fluid remover assembly, and a trocar inflation port of Figure 30A;
[00076] Figure 30D is a cross-sectional side view of the fluid remover and inflation port of figure 30C;
[00077] Figure 30E is a perspective view of the fluid remover of Figure 30C;
[00078] Figure 30F is an exploded view of the fluid remover of Figure 30E showing a cap, scraper, crown and sorbent;
[00079] Figure 30G is a bottom perspective view of a scraper of Figure 30F showing grooves formed therein;
[00080] Figure 30H is a cross-sectional view of one of the scraper channels of figure 30G;
[00081] Figure 30I is a top view of a cap of figure 30F;
[00082] Figure 30J is a bottom view of the cap of figure 33I; and
[00083] Figure 31 is a bottom view of another embodiment of a cap for use with a fluid remover assembly;
[00084] Figure 32A is a perspective view of another embodiment of a trocar;
[00085] Figure 32B is a side perspective view of an instrument seal, a channel seal, a fluid remover and a trocar inflation port of figure 32A;
[00086] Figure 32C is a side view of the fluid remover and inflation port of Figure 32B; and
[00087] Figure 32D is a side perspective view of the fluid remover of figure 32C. DETAILED DESCRIPTION
[00088] Certain exemplary embodiments will now be described to provide a general understanding of the principles of structure, function, fabrication and use of the devices and methods described herein. One or more examples of three modalities are illustrated in the accompanying drawings. Those skilled in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary embodiments, and that the scope of the present invention is defined solely by the claims. Aspects illustrated or described in connection with one exemplary embodiment may be combined with aspects of other embodiments. These modifications and variations are intended to be included within the scope of the present invention.
[00089] The present invention in general provides methods and devices for maintaining clear visibility through a viewing device during surgical procedures, and in particular, methods and devices are provided for removing fluid from an access device and/or surgical instrument passed, for example, inserted and/or withdrawn, through an access device, and/or to prevent fluid from being transferred into a display device that passes through an access device. In certain exemplary embodiments, the methods and devices are effective to remove fluid from an access device and/or surgical instrument as the instrument is being withdrawn from the access device, thereby preventing fluid from being deposited on an instrument being inserted through the device. of access. However, methods and devices can be configured to remove fluid prior to and/or during insertion and/or removal.
[00090] A person skilled in the art will understand that the term fluid, for use in the present invention, is intended to include any substance that, when in a surgical instrument, may negatively affect the operation of the instrument or a surgeon's ability to use it. Fluids include any type of bodily fluid, such as blood, and any type of fluid introduced during a surgical procedure, such as saline. Fluids also include fluid/solid mixtures or fluids with particles (such as pieces of tissue) suspended or located therein, as well as viscous materials and gases. A person skilled in the art will also appreciate that the various concepts presented in the present invention can be used with various surgical instruments during various procedures, but in certain exemplary embodiments the present invention is particularly useful during laparoscopic procedures, and more particularly during procedures where a A viewing device, such as a laparoscope or endoscope, passes through a surgical access device, such as a trocar, that provides a route from a skin incision to a body cavity. As explained above, during such procedures repeated insertion and removal of the display device may deposit fluid into the access device, thereby causing fluid to be transferred back to the display's distal display end on reinsertion through the same. Various exemplary methods and devices are provided here to prevent such an occurrence.
[00091] In certain exemplary embodiments, the methods and devices presented herein utilize a fluid remover that is effective to remove fluid from an access device and/or surgical instrument passed therethrough. While the fluid remover can have various configurations and can function in various ways to remove fluid, exemplary fluid removers include scrapers for scraping fluid, sorbents for absorbing fluid, and capillary absorption elements for redirection or capillary absorption of fluids. , for example, by capillary action. Any combination of fluid removers can be provided, and the fluid removers can be arranged at various locations on an access device to remove fluid from portions of the access device and/or surgical instruments, such as visualization devices, passed through the access device. The particular location of the fluid removers may depend on the particular configuration of the access device and/or surgical instrument.
[00092] In certain exemplary embodiments, the fluid scavenger may include one or more sorbents. The sorbent can be any insoluble (or at least partially insoluble) material or mixture of materials that are capable of sorbing fluids or trapping fluids through a process of one or both of absorption and adsorption. An sorbent material or element may thus include any one or a combination of absorbent materials and/or adsorbent elements and materials and/or elements. In certain exemplary embodiments, the sorbent is formed from a hydrophilic material and/or includes a hydrophilic material to facilitate fluid uptake. For example, the sorbent can be coated using known coating techniques during manufacturing to make one or more portions of the sorbent hydrophilic. In one embodiment, the sorbent can be formed by any extrusion process in which, for example, the fibers can all extend longitudinally in a direction generally parallel to a longitudinal axis of the cylindrical tube, as shown in Figure 30F. The fibers will thus form a generally cylindrical hollow tubular member which can be subsequently cut to form a plurality of sorbents. A gap or cutout in the side wall can also be made to form a C-shaped sorbent, or the sorbent can be formed to have a C-shaped configuration without the need to make any additional cuts. Exemplary formats and configurations for the sorbent will be discussed in more detail below. A hydrophilic surfactant can be applied to the sorbent either before or after the sorbent is cut. One of skill in the art will appreciate that a variety of techniques can be used to coat the sorbent or portions thereof with a hydrophilic material and/or to form the sorbent or portions thereof from a hydrophilic material. The particular hydrophilic material used may also vary, and exemplary materials will be discussed in more detail below in relation to the scraper. The same hydrophilic materials used with the scraper can also or alternatively be used with the sorbent.
[00093] In general, sorbents that are absorbents remove fluid through an absorption process, similar to a sponge, in which a liquid diffuses into the absorbent volume and/or structure and becomes a part of that volume and/or structure. For example, the sorbent can capture and retain a liquid distributed through its molecular structure, causing the sorbent to swell. Liquid can cause the solid structure to swell by 50% or more. Typical absorbents are at least 70% insoluble in excess fluid. Absorbents can be any shape, size and shape known in the art as needed to stand alone and/or fit within, around or across any component of a fluid remover and/or trocar. Certain exemplary embodiments of absorbents include, but are not limited to, ground wood pulp fluff, cellulose fibers, polymeric gelling agents, hydrophilic nonwovens, cellulose, sodium polyacrylate, cotton, polyethylene terephthalate, polyethylene, polypropylene, chloride polyvinyl, ABS, polyamide, polystyrene, polyvinyl alcohol, polycarbonate, ethylene-methacrylate copolymer and polyacetal.
[00094] Sorvents that are adsorbents, on the other hand, remove fluid through an adsorption process by retaining a liquid on their surfaces, including pores and capillaries. Liquid accumulates on the surface of an adsorbent by forming a film of molecules or atoms that are trapped in it as a consequence of surface energy. In some embodiments, an adsorbent material can include one or more insoluble (or at least partially insoluble) materials that can be coated by a liquid on their surfaces. For example, the adsorbent can be a structure formed from insoluble fibers. The structure can be porous, as voids or spaces can be situated between the individual fibers. In this way, liquid can accumulate on the surface of the fibers, thereby filling the voids between the fibers. Typical adsorbents will absorb fluid without swelling more than 50% excess fluid. Adsorbents can be of any shape, size and shape known in the art as needed to act independently and/or fit within, around or across any component of a fluid scavenger and/or trocar. In an exemplary embodiment, the adsorbent is shaped to have a predetermined shape and size. Certain exemplary adsorbent materials include, but are not limited to, compounds containing carbon-based compounds and/or polymer-based compounds, among others. For example, adsorbent materials can include silica gel, alumina, zeolites, activated carbon, graphite, cellulose, porous polymer matrices, perlite, metal hydroxides, butyrate and nitrate and metal oxysellulose acetate, polyamide, polysulfone, vinyl polymers, polyesters, polyolefins and PTFE, as well as porous glass or glass ceramics, graphite oxide, polyelectrolyte complexes, alginate gel, etc.
[00095] Although the fluid removers disclosed in the present invention can be used with various surgical access devices known in the art, in certain exemplary embodiments a trocar is provided that has one or more fluid removers disposed therein to remove fluid from portions of the trocar and/or an instrument, such as a viewing device, passed through it. A person skilled in the art will appreciate that a trocar is shown for illustrative purposes only, and that virtually any type of access device, including cannulas, ports, etc., can be used. Figures 1A to 1C illustrate an exemplary embodiment of a trocar 2. As shown, the trocar 2 is generally in the form of a compartment 6 that has a proximal portion (also called a proximal compartment in the present invention) that can accommodate one or more. further sealing elements and a distal cannula 8 extending distally from the proximal compartment 6. The trocar 2 defines an operative channel 4 extending therethrough to introduce various instruments into a body cavity. Numerous configurations are available for the proximal compartment 6. In the illustrated embodiment, the proximal compartment 6 is generally cylindrical in shape with a removable cap portion 5 and an inner sidewall 3. An opening 7 may be formed within the proximal end of the compartment. 6, so that opening 7 extends through removable cap 5 and through the remainder of housing 6 and is coaxial with operative channel 4 extending through cannula 8. Cannula 8 may also have various configurations, and may include various features known in the art. In the illustrated embodiment, the cannula 8 is generally elongated cylindrical in shape and includes a series of annular ridges 9 formed on an outer surface 10 thereof. The opening 7 extending through the proximal compartment 6 and the cannula 8 define the operative channel 4 which is sized and configured to receive a surgical instrument. One skilled in the art will appreciate that compartment 6 and cannula 8 can be formed as a unitary structure or as two separate components that are paired with each other. Compartment 6 may also include other features, such as a stop-cock type regulating valve 13 to allow and prevent the passage of an inflation fluid, eg carbon dioxide, through trocar 2 and into a body cavity.
[00096] In use, the distal cannula 8 can be inserted through an incision in the skin and through tissue to position a more distal end within a body cavity. The proximal compartment 6 can remain external to the body cavity, and various instruments can be inserted through the operative channel 4 and into the body cavity. Typically, during surgical procedures in a body cavity such as the abdomen, inflation is provided through the trocar 2 to expand the body cavity to facilitate the surgical procedure. Thus, in order to maintain inflation within the body cavity, most trocars include at least one seal arranged therein to prevent the escape of air. Various sealing configurations are known in the art, but typically the trocar 2 includes an instrument seal that forms a seal around an instrument disposed therethrough but does not otherwise form a seal when no instrument is disposed through the same; a channel seal (also referred to herein as a zero-closing seal) which seals the operative channel 4 when no instrument is placed therethrough; or a combination instrument seal and channel seal which is effective both to form a seal around an instrument disposed therethrough and to form a seal in the operating channel 4 when no instrument is disposed therethrough. In the embodiment shown in Figures 1A to 1C, the trocar 2 includes an instrument seal 14 and a separate channel or zero closure seal 24. However, one of skill in the art will appreciate that various other seals known in the art can be used including , eg membrane valves, gel seals, diaphragm seals, etc.
[00097] In an exemplary embodiment, as shown in figures 1C to 1E, the instrument seal 14 is generally in the form of a multi-layer conical seal 16 and a multi-layer protective member 18 disposed on a proximal surface 15 of the seal 16. As is best shown in Figure 1E, the multi-layer tapered seal 16 may include a series of overlapping seal segments 20 which are mounted in an interlocking arrangement to provide a complete seal body. The seal segments 20 can be stacked on top of one another or interlaced together in an overlapping fashion to form the multi-layer seal 16 which has a central opening 17 therein. The seal segments 20 can be produced from any number of materials known to those skilled in the art, but in an exemplary embodiment, the seal segments 20 are formed from an elastomeric material. The seal segments 20 can also be shaped so that they have a variable thickness along the seal profile 16. Varying the thickness along the seal profile 16 can be effective to minimize leakage and reduce drag forces on the instrument . The multi-layer protective member 18 may similarly be formed from a series of overlapping segments 22 which are placed proximate the overlapping seal segments 20 and which are configured to protect the seal segments 20 from damage caused by surgical instruments passing through the opening 17 in seal 16. Protective member 18 may also be formed from various materials, but in certain exemplary embodiments, protective member 18 is formed of a molded thermoplastic polyurethane elastomer, such as Pellethane™. The segments 20 and 22 that form the seal 16 and the protective member 18 can be joined using various techniques known in the art. As shown in Figures 1D and 1E, segments 20 and 22 are held together by a number of ring members that mate to engage segments 20 and 22 with each other. In particular, the protective member 18 is meshed between a ring 26 and a trim ring 28, and the seal 16 is meshed between the trim ring 28 and a retainer ring 30. Pins 32 are used to pair the ring members 26 and 28 and to extend through and engage the segments of seal 16 and protective member 18.
[00098] When fully assembled, the instrument seal 14 can be disposed at various locations within the trocar 2. In the illustrated embodiment, the instrument seal 14 is disposed on the cap 5 of the trocar 2 at a location just distal to the proximal opening 7 and proximal end of a gutter seal, as discussed in more detail below. In use, an instrument may pass through the center of the seal assembly and the seal segments 20, 22 may engage and form a seal around an outer surface of the instrument to thereby prevent fluid from passing through the seal 14. When no instrument is disposed therethrough, the opening will not form a seal in the operating channel 4, however, other configurations where a seal is formed when no instrument is placed therethrough are also conceivable. Exemplary instrument seal configurations are described in more detail in US publication No. 2004/0230161 entitled "Change Seal Assembly," filed March 31, 2004, and in US order serial no. 10/687,502, entitled "Conical Trocar Seal," filed October 15, 2003, which are incorporated herein by reference in their entirety.
[00099] The zero closing seal in the illustrated embodiment is shown in more detail in Figure 1F, and as shown the illustrated zero closing seal is in the form of a duckbill seal 24. The seal 24 is configured to form a seal in the operating channel 4 when no instrument is placed therethrough to thereby prevent the leakage of insufflation gases distributed through the trocar 2 into the body cavity. As shown, the duckbill seal 24 has a generally circular flange 34 with a sidewall 36 extending distally therefrom. The shape of the sidewall 36 may vary, but in the illustrated embodiment, the sidewall 36 includes opposing tabs 35 that extend at an angle toward each other in a distal direction and that join at a distal end to form a face. seal 38. Opposite flaps 35 are movable relative to one another to allow sealing face 38 to move between a closed position, in which no instrument is disposed therethrough, and sealing face 38 seals operating channel 4 of trocar 2, and an open position where an instrument is disposed across it. The seal may include various other features, as described in detail in US Application No. 11/771,263 entitled "Duckbill Seal with Fluid Drainage Feature," filed June 29, 2007, which is incorporated herein in its entirety by reference. .
[000100] According to the present disclosure the general structure of the seals, as well as the trocar generally does not form part of the present invention. As such, a person skilled in the art will certainly understand that various sealing configurations as well as various trocars can be used without departing from the spirit of the invention presented in the present invention.
[000101] As noted above, a fluid remover can be placed within the trocar 2 to remove fluid from a seal and/or a surgical instrument that extends through the seal. As best shown in Figures 1B and 1C, the illustrated trocar 2 includes a fluid removal assembly 40 that is disposed within the proximal compartment 6 of the trocar 2 at a distal location of the duckbill seal 24. The fluid removal assembly 40 includes a scraper for scraping fluid from a surgical instrument that passes through the operative channel 4 in the trocar 2, and a sorbent for sucking up the removed fluid. The scraper may also include a capillary absorption feature to absorb fluid by capillary effect from the opening in the scraper, and/or the sorbent may include a capillary absorption feature to absorb fluid by capillary effect from the scraper.
[000102] The components of the fluid remover assembly 40 are shown in more detail in figures 1G to 1K, and as shown the assembly generally includes a cap 42 (figure 1K), a scraper 44 (figure 1G), a wicking wick 46 ( figure 1H), sorbent cartridges 48 (figure 1I), and a housing or frame 50 (figure 1J). When fully assembled, the fluid remover assembly 40 is configured to scrape fluid from surgical instruments passing through the operating channel 4 of the trocar 2, to capillary the scraped fluids and to sip them up, thus preventing the fluids from being redeposited in the instrument through reinsertion through the operational channel.
[000103] Referring first to Fig. 1G, the scraper 44 may have a variety of configurations, but in an exemplary embodiment, as shown, the scraper has a generally flat configuration with a circular shape. A central opening 52 is formed through a central portion thereof and is sized and configured to receive a surgical instrument therethrough. In use, the central opening 52 may be coaxial with the openings in the instrument and in the channel seals. The scraper 44 can be formed from a variety of materials, but in an exemplary embodiment, the scraper is formed from polyisoprene to allow the scraper 44 to engage and scrape fluid from any instrument passed therethrough. As further shown in Fig. 1G, a distal face surface 54 of scraper 44 may include a plurality of channels 56 formed therein and extending radially outward from central opening 52, or from a location just radially outward but adjacent to the opening. central 52. The channels 56 may be configured so that fluid scraped from an instrument through the central opening 52 will flow into the channels 56 and thus be capillaryly removed from the opening 52.
[000104] As indicated above, the fluid remover assembly 40 may also include a sorbent wick 46. As shown in Figure 1H, in an exemplary embodiment the sorbent wick 46 has a generally flat circular portion 62 with a central opening 58 formed therethrough. . The central opening 58 may have a diameter slightly larger than a diameter of the central opening 52 in the scraper 44, and it can be configured to be positioned coaxially with the opening 52 in the scraper 44. As further shown in Figure 1H, the wick wick 46 may also include one or more sidewalls 60 extending from circular planar portion 62. The illustrated sidewalls 60 extend proximally, however they may extend distally depending on the particular configuration of wick 46. Sidewalls 60 may be configured to accommodate within the inner side wall 3 of the trocar housing 6. In use, the sorbent wick 46 can capillary and sorb fluid from the central opening 52 within the scraper 44, and it can deliver the fluid to the sorbent cartridges. 48, as discussed in more detail below. The sorbent wick 46, as well as various other sorbent members disclosed in the present invention, can be formed from a variety of sorbent materials as described above.
[000105] The sorbent cartridges 48 are shown in more detail in Figure 1I, and as shown each of the cartridges 48 has a generally semicircular shape with a width as measured from an inner surface 64 to an outer surface 66, which decreases in a proximal to distal direction to form wedge-shaped members 68. Together, the cartridges 48 may have an annular configuration. In use, cartridges 48 can sorb fluid from sorbent wick 46, thus storing the fluid in a location remote from any instrument that passes through operative channel 4. Cartridges 48 can be contained within trocar 2 by a housing or structure 50, as shown in figure 1J. Structure 50 may have a generally cylindrical configuration with an opening 68 extending therethrough, and a plurality of ridges 70 projecting radially outwardly and extending axially along an outer surface 72 thereof. Each sorbent cartridge 48 can be mounted between two ridges. In use, structure 50 can be particularly advantageous as it can protect the sorbent from coming into contact by instruments passing through the operating channel.
[000106] When fully together, the scraper 44 can be seated within the sorbent wick 46, which can rest on top of the structure 50 that holds the sorbent cartridges 48. The cap 42, shown in Figure 1K, can be seated on top of the scraper 44 and into wick 46, and cap 42 may lock onto frame 50, thus holding fluid remover assembly 40 together. Referring to Figure 1C, the whole assembly 40 may rest within the proximal compartment 6 of the trocar 2 just distal to the duckbill seal 24. As a result, when an instrument, such as a display device, passes through the operating channel 4 of the trocar 2, any fluid in the instrument will be removed from the instrument side walls by the scraper 44. The fluid will flow through the channels 56 and/or be removed by capillary action from the opening 52 by the sorbent wick 46, which distributes the fluid to the cartridges sorbents 48. As a result, when the instrument is removed, for example, fluid will be prevented from being deposited on the instrument seal 14, thus preventing fluid from being transferred from the instrument seal 14 back into the instrument upon reinsertion.
[000107] Figures 2A and 2B illustrate yet another modality of a fluid remover assembly 80 that is similar to the modality shown in Fig. 1A. In this embodiment, the proximal compartment 79 of the trocar has a frame 82 that is molded into the inner side wall 81 of the compartment 79 for the direct seating of a sorbent, a scraper and a cap, thus eliminating the need for the frame 50 of Figure 1J. . A single sorbent element 86 is also provided, instead of a sorbent wick and separate sorbent cartridges. In particular, the sorbent element 86 in this embodiment has a generally cylindrical configuration with a distal portion 88 that tapers inwardly on an outer surface 87 thereof to mate with the inner surface 81 of the proximal compartment 79 of the trocar. A recess 90 may be formed around an inner surface 92 of a proximal end 93 of the sorbent element 86 to seat a scraper 94, which may have a configuration that is the same or similar to scraper 44 described above with respect to Figure 1G. Recess 90 may engage an outer perimeter 96 of scraper 94 so that channels 56 in scraper 94 can distribute fluid away from opening 52 within scraper 94 to sorbent element 86 surrounding scraper 94. A cap 98 may seat on the the top of the scraper 94 and may include a flange 99 that extends around the proximal end 93 of the sorbent element 86. The cap 98 may engage the inner side wall 81 of the proximal compartment 79 of the trocar to retain the scraper 94 and the sorbent element 86 therein at a location just distal to the duckbill seal 24. In use, instruments passing through the operating channel 4 of the trocar will be engaged by the scraper 94, which scrapes fluid from the outer surface of the instrument. Fluid is capillaryly removed from opening 52 within scraper 94 by channels 56, which deliver fluid to sorbent element 86 surrounding scraper 94. Thus, similarly to the embodiment of Fig. 1A, when the instrument is withdrawn, for example, fluid will be prevented from being deposited on the seals and, in particular, the instrument seal 14, thus preventing fluid from being transferred from the instrument seal 14 back into the instrument upon reinsertion.
[000108] One of skill in the art will appreciate that fluid remover assemblies 40 and 80 can have a variety of other configurations. Figures 3A and 10B illustrate additional exemplary embodiments of fluid scavengers, e.g., scrapers, sorbents and capillary absorber elements, or combinations thereof. In these modalities, the fluid removers are all located distally from the gutter seal, for example, duckbill seal or other zero-closing seal, and distal from the instrument seal 14. However, a person skilled in the art will realize that the The particular location of the fluid remover can vary and the fluid removers can be positioned anywhere within the trocar.
[000109] Figures 3A to 3C illustrate one embodiment of a fluid remover assembly 100 having a scraper and a sorbent. In particular, as best shown in Figure 3B, the fluid removal assembly 100 may include a stabilizing cup 106 coupled to a flange 108. The stabilizing cup 106 may be formed of an absorbent material and the flange 108 may seat the cup. 106 within the proximal compartment 6 of the trocar 2 as shown in Figure 3C. A scraper element in the form of a scraper disk 102 may be positioned between the flange 108 and the stabilizing cup 106, and a sorbent ring 104 may be coupled to a distal surface 103 of the scraper disk 102. The scraper disk 102 may have a central opening 105 extending therethrough and configured to scrape fluid from surgical instruments passing through operating channel 4 of trocar 2. As an instrument passes through operating channel 4, fluid can be scraped off by scraper disk 102 and sorbed by the ring. sorbent, as well as by the stabilization cup. As can be seen in Figure 3B, each of the flange 108, scraper disk 102 and the sorbent ring 104 can optionally include cutouts 110 to fit around the stop-cock regulator 13 associated with the trocar 2. In use, the assembly Fluid remover 100 can be formed as a drop-in unit that fits within the proximal compartment 6 of the trocar 2. As shown in Figure 3C, the assembly 100 can be accommodated in a distal portion of the proximal compartment 6 at a locations just distal to the duckbill seal 24. The fluid remover assembly 100 will thus remove fluid from instruments that have passed through the operating channel 4 of the trocar, thus preventing fluid from being deposited on the seals, and in particular , in the instrument seal 14, and/or redeposited in instruments passed through the operational channel 4.
[000110] Figures 4A to 4C illustrate another embodiment of a fluid removal assembly 114 that is similar to the assembly shown in Figures 3A to 3C, however in this embodiment the assembly 114 does not include a stabilization cup. As shown, the fluid remover assembly includes a substantially planar circular scraper disk 116 that has a central opening 115 for receiving a surgical instrument. Scraper disk 116 can be accommodated within a retainer flange or ring 118 configured to be positioned within the proximal compartment of a trocar. A sorbent ring 120 may be positioned adjacent a distal surface 117 of the scraper disk 116 and it can act to sip any fluid that is scraped from the instruments passing through the scraper disk 116. When disposed within a trocar, the flange 118 can act. as a support structure for securing the scraper disk 116 and sorbent ring 120 in a fixed position within the proximal compartment. Although the position may be distal to the duckbill seal, as indicated above, the assembly may be situated in various other portions within the trocar, including between the duckbill seal and the instrument seal, proximal to the instrument seal or inside any portion of the cannula.
[000111] In another embodiment, shown in Figures 5A to 5C, a fluid scavenging assembly 122 is provided and may have a generally conical configuration with a scraper 124 having a generally proximal planar flange 125 and a conical body 126 extending distally therefrom. and defining a central opening 128. The tapered body 126 may have a plurality of slots 127 extending proximally from a distal end thereof and designed to reduce insertion and withdrawal forces in a surgical instrument passing therethrough. The conical body 126 can be surrounded by a conical sorbent element 130 so that the conical body 126 is nested within the conical sorbent element 130. When mounted and disposed within a trocar, as shown in Figure 5C, the flange 125 can be placed inside the proximal compartment 6 just below the duckbill seal 24 and it may mate with or engage the inner side wall of the compartment 6 to retain the fluid remover assembly therein. In use, as an instrument passes through the operative channel, the scraper 124 can engage and remove fluid from the instrument and the sorbent element 130 can absorb the fluid. A person skilled in the art will realize that any number of geometries can be used in a similar way. Also, a size or diameter of a flange can be adjusted as needed, or the flange can be removed, to seat the fluid remover assembly at other locations within the trocar.
[000112] Figures 6A to 6C illustrate additional embodiments of tapered scrapers 132a, 132b and 132c that are similar to scraper 124 described above and shown in figures 5A to 5C. As with the prior embodiment, the scrapers 132a, 132b and 132c in Figures 6A to 6C are positioned distally to the duckbill seal 24. Such a configuration can prevent fluid in the instruments from being inserted and/or withdrawn from being deposited on the beak seal of duck, as well as the more proximally located instrument seal 14. In an exemplary embodiment, each scraper 132a, 132b and 132c may be made of a flexible material and may include at least one slit formed therein and configured to allow scrapers 132a, 132b and 132c expand radially. Slots are available in a variety of configurations. In the embodiment shown in Figure 6A, a single slot 134 extends diagonally around the scraper 132a so that the slot 134 follows the shape of the cone. In another embodiment shown in Figure 6B, the multiple slits 137 extend proximally from the distal end of the cone and terminate at a location 139 just distal to the proximal end. Such a configuration can provide a scraper that has multiple scraper segments 138. As further shown in Figure 6B, each scraper segment 138 may also include a notch or cutout 140 formed in an outer surface at the distal end thereof to allow segment 138. expand and contact as the instruments are passed through it. Figure 6C illustrates another exemplary embodiment of a cone-shaped scraper 132c. Similar to the scraper 132b shown in Figure 6B, the scraper 132c includes a number of slots 142 that extend proximally from its distal end. In this embodiment, however, the slots 142 increase in width in a distal to proximal direction so that each scraper element 143 has a distal end 144 with a width that is greater than a width of a proximal end 145 thereof. As indicated above, in use the slits 134, 137 and 142 formed in the scrapers 132a, 132b and 132c allow the scrapers to expand radially as a surgical instrument is passed therethrough, thus accommodating instruments of various sizes, while still being effective to scrape fluid from instruments.
[000113] Figure 7 illustrates another embodiment of a fluid remover positioned just distal to a channel seal, for example, duckbill seal 150, in a proximal compartment of a trocar. In this embodiment, the fluid remover is in the form of sorbent membrane ports 152. The membrane ports 152 can be of various shapes and sizes, and they can be formed from any number of components. For example, the membrane doors 152 can be in the form of two side walls 153 that are movable with each other. The side walls 153 may have a profile that is similar to the profile of the duckbill fence 150. In other embodiments, the membrane ports 152 may have a shape that matches the shape of the duckbill fence 150. A person skilled in the art technique will notice that several configurations are possible. The membrane ports 152 can be placed within the proximal compartment 6 and secured to the compartment 6 by any fastening means known in the art, including mechanical means, adhesives, etc. The membrane ports 152 may define an opening 154 therebetween to receive a surgical instrument, and the opening 154 may be positioned just distal to the sealing face 151. In use, the membrane ports 152 may move from a closed or closed position. substantially closed to an open position as an instrument is passed through the duckbill seal 150 and the membrane port 152. Ports 152 can contact and engage the surgical instrument as it is passed therethrough to sip fluids from the instrument. . The membrane ports 152 can also absorb any excess fluid that is scraped off the instrument by the duckbill seal 150 and that is distal to the duckbill seal 150.
[000114] In a similar embodiment, shown in figure 8, the fluid remover can be in the form of a capillary absorber element rather than a sorbent. In the illustrated embodiment, the capillary absorber element is in the form of first and second capillary absorber fingers 160a and 160b which are coupled to opposite outer edges 162 of sealing face 161 on duckbill seal 163. Capillary absorption fingers 160a and 160b may be in the form of elongated elements which follow the natural shape of the inner side wall 165 of the proximal compartment 6 of the trocar 2 so that fluid will naturally flow through the fingers 160a and 160b. Capillary absorber fingers 160a and 160b may also include a sorbent reservoir 164 disposed over a distal end thereof. In the illustrated embodiment, the sorbent reservoir 164 on each finger 160a and 160b is in the form of a ring placed within the proximal compartment 6 and effective to sorb fluids absorbed by capillary effect from the duckbill seal 163 by the capillary absorption fingers 160a and 160b. The sorbent reservoir 164 can, however, have various other configurations, such as ring segments. In use, as fluids are deposited on the duckbill seal 163 by instruments that pass therethrough, the fluid will naturally flow to the outer corners or edges of the seal face 161. The surface difference between the absorbing effect fingers capillary 160a and 160b and duckbill seal 24 will cause fluid to flow from seal 163 to fingers 160a and 160b and fingers 160a and 160b into sorbent reservoir 164. As will be appreciated by those skilled in the art , capillary absorbent fingers 160a and 160b may be formed integrally with duckbill seal 163 or may simply be in intimate contact with sealing face 161 of duckbill seal 163.
[000115] Figure 9 illustrates another embodiment of a fluid remover that is positioned distal to a zero closing seal. Similar to the embodiment shown in Figure 7, the fluid remover is in the form of a sorbent. However, in this embodiment the sorbent is a sorbent grommet 172. The grommet 172 may have a generally circular or conical configuration with an opening 173 formed therethrough, as shown, but it may have any number of other geometries to facilitate passage. of an instrument through it. The grommet 172 may also include multiple slits 174 formed therethrough and extending radially outward from the opening 173 to reduce insertion and withdrawal forces on an instrument being passed therethrough. In use, grommet 172 can be placed within a distal portion of proximal compartment 6 of the trocar, just distal to duckbill seal 166, and opening 173 can be positioned coaxially with operating channel 4. As a surgical instrument passes through it, the grommet 172 will contact the instrument and suck up any fluid in the instrument. The grommet 172 can also suck up any fluid that drips from the duckbill seal 166 as the seal 166 scrapes the instrument.
[000116] In other embodiments, the zero closing seal itself can be modified to include a fluid remover. For example, Figures 10A and 10B illustrate another embodiment of a duckbill seal 176 in which the seal face 168 extends distally and is expanded in width to bring the outer ends of the seal face 168 into contact with the inner side wall 169 of the proximal compartment 6 of the trocar, thus forming an absorption element by capillary effect. In use, when an instrument passes through the duckbill seal 176, the seal face 168 will remove fluid from the instrument by scraping. The fluid will naturally move outward towards the outermost edges of the sealing face 168. Since the outer edges are in contact with the inner sidewall 169 of the proximal compartment 6, the fluid will be removed by capillary absorption of the sealing face 168 and inner side wall 169 of housing 6. Although not shown, housing 6 may optionally include a sorbent disposed therein to sorb fluid removed by capillary absorption of the seal.
[000117] Figure 11 illustrates another embodiment of a modified zero-closure seal 186. In this embodiment, a sorbent element 180 is nested within the duckbill seal 177, and a second duckbill seal 178 is nested within the element sorbent 180. Nested sorbent 180 and nested duckbill seal 178 may have two sealing walls, 182 and 184 similar to duckbill seal 177, that meet on a sealing face that is configured to form a seal when no instruments are disposed therein and they are set to open when a surgical instrument passes through it. Nested sorbent body 180 and nested duckbill 178 may each have a similar or identical profile to duckbill seal 177, except smaller in size to all fit into a nested configuration. Components 177, 178 and 180 may merely be sealed within one another, or they may be secured together using various fastening mechanisms known in the art, including an adjustment of the press, glue, etc. In use, the seal face of all three components will contact a surgical instrument as it passes through the seal assembly. The sorbent 180 will thus sorb any fluid in the instrument, as well as fluid scraped from the instrument by the duckbill seal 177 and the nested duckbill seal 178.
[000118] Figures 12A and 12B illustrate another embodiment of a modified zero closing seal 190. In this embodiment, the duckbill seal 191 includes two sorbent bars 192 disposed therein and extending therethrough. The sorbent bars 192 may be positioned to extend substantially parallel to the sealing face 193, or to extend substantially perpendicularly as shown. Seal 190 may also include a sorbent ring 194 positioned around an inner sidewall 193 of the duckbill seal 191 and in contact with sorbent bars 192. The sorbent ring 194 may provide a reservoir for the fluid collected by the sorbent bars 192. In use, the sorbent bars 192 will contact and engage a surgical instrument as it passes through the duckbill seal 191, and will thereby remove fluid by sorption from the surgical instrument.
[000119] As indicated above, the various fluid removal modalities presented in the present invention may be located anywhere within a trocar or other access device, including distal to a channel seal, between a channel seal and a channel seal. instrument, or proximal to an instrument seal. A fluid remover position can also vary from an inflation port, as will be discussed in more detail below. Fluid removers can also be formed integrally with the seal(s) and/or compartment portions, and any combination of fluid removers can be used. Figures 13 through 22B illustrate various exemplary embodiments of fluid removers that are integrally formed or incorporated into an instrument seal, or located adjacent to an instrument seal and thus proximal to a channel seal.
[000120] Turning first to Figure 13, in this embodiment the fluid remover 200 is in the form of a combination scraper and sorbent. In particular, the fluid remover 200 includes a generally flat circular scraper disk 202 having an opening 204 formed therethrough and configuration to be positioned coaxially with the operative channel 4 in the trocar 2. The opening 204 may be sized and configured to form a seal around an instrument passed through it. Fluid remover 200 may also include a sorbent disk 206 disposed concentrically around opening 204 in the scraper 202. In use, the scraper 202 will scrape fluid from instruments passing therethrough, and the sorbent disk 206 will sorb the scraped fluid. . The fluid remover 200 can be disposed within the proximal compartment 6 of the trocar 2 using various techniques, but as shown in Figure 13, the fluid remover 200 is configured to be engaged between the removable cap 5 and the distal portion of the proximal compartment 6 of trocar 2. As a result, scraper 202 and sorbent 206 will be positioned in alignment with operating channel 4 extending through compartment 6, and will also be positioned between the proximal instrument seal and the distal channel seal.
[000121] Figure 14 illustrates another modality of a fluid remover 210 that has a combination of scraper and sorbent, however, in this modality the fluid remover 210 is fully disposed within the removable cover 5 containing the instrument seal. As shown, a scraper 212 can be cone-shaped and can be positioned perfectly distal to the instrument seal. In other embodiments, scraper 212 may be flat. The scraper 212 may also replace or function as the instrument seal. A sorbent ring 214 may be positioned concentrically around and in contact with an opening 216 at the distal end of the tapered scraper 212. As a result, the sorbent ring 214 will sorb any scraping fluid from a surgical instrument extending through the scraper 212.
[000122] In yet another embodiment, shown in figures 15A and 15B, the fluid remover may be in the form of a scraper that is part of the instrument 218 seal. As shown, the instrument 218 seal is a multilayer seal that has the shield disposed on a proximal surface thereof, as previously described in relation to figure 1E. The scraper may be in the form of a second shield 222 which is disposed distal to the segments of the multilayer seal. The second shield 222 may have the same configuration as the shield of Figure 1E, however, the second shield 222 may define an opening 224 that is configured to contact and engage a surgical instrument that passes through the seal 218. In use, the second shield 222 can engage and scrape fluid from instruments that pass through the seal 218.
[000123] In another embodiment, shown in Figure 16, the fluid remover may be in the form of a multi-layer sorbent that is positioned between multiple layers 20 of seal 16, as shown, or that is positioned between multiple layers 22 of seal protector 18. The sorbent may be in the form of multiple sorbent sheets 232 which are layered between the layers of seal 16 (or seal protector 18). Thus, in use, when an instrument passes through the instrument seal, the sheets 232 will absorb any fluids removed by scraping the instrument through the seal 14, thus preventing fluid from accumulating around the seal opening 14 and being reapplied to a surgical instrument as it is reinserted through it. The sorbent sheets 232 can be effective in sorbing fluid as well as interrupting surface tension and/or capillary action between the seal and the shield. Thus, there must be no fluid in or near the seal opening and/or shield opening that will be able to touch or collect on an instrument being passed through it.
[000124] Figure 17 illustrates another modality of a sorbent fluid remover. In this embodiment, the sorbent is in the form of an grommet 242 which is similar in configuration to the grommet 172 previously described in relation to Fig. 9. However, in this embodiment, the grommet 242 is positioned adjacent a distal surface 244 of the seal. of the instrument 14, rather than the zero closing seal 24. In particular, as shown in Figure 17, the grommet 242 can be placed concentrically around a distal opening 246 formed in the removable cap 5, so that the instrument passing through The instrument seal 14 will contact the grommet 242 which will sorb fluid from the instrument. The grommet 242 can also suck up any fluid that is scraped off or drips from the instrument seal 14.
[000125] In another embodiment shown in figures 18A and 18B, an absorbing element by capillary effect is formed integrally with the multilayer sealing protector 18 previously described with respect to figure 1E. As previously explained, the multi-layer seal 16 may have a natural shape that is slightly tapered and it may include an opening sized to receive an instrument therethrough. Shield 18 similarly has an opening, however, in the embodiment shown in Figures 18A and 18B, the length of a shield 240 decreases to thereby increase the diameter of the opening defined by the shield 18. As a result, the shield 240 will have an opening that is larger than the opening in seal 16 to create a flattened profile against the conical shape of seal 16, thus creating a gap between shield 240 and seal 16. As surgical instruments are removed from the trocar, the gap will prevent fluid from collecting between layers 20 of seal 16 and will allow shield 240 to absorb fluids by capillary effect from opening of seal 16. Thus, if fluid is deposited on seal 16, there will be no capillary action to retain the fluid between the seal 16 and the shield 240, thus allowing the fluids to drain. In addition, when an instrument is passed through shield 240 and seal 16, the gap created between seal 16 and shield 18 will prevent fluid from being squirted from between seal 16 and shield 240 and into an instrument.
[000126] In another embodiment shown in figures 19A and 19B, the multilayer sealing protector 248 has a capillary effect absorption element in the form of cam ribs 250 arranged on a surface of each individual protective layer 249 so that the ribs 250 create pockets between layers to remove by capillary absorption and retain fluid removed by scraping instruments through the instrument seal. In the illustrated embodiment, the ribs 250 are offset by 90 degrees, although other geometries are possible as will be appreciated by those skilled in the art. In one embodiment, ribs 250 may be disposed on a top or proximal surface of the shield. In this way, as a surgical instrument is passed through the instrument seal 14, the instrument will come into contact with the ribs 250 to thereby cam open the shield 248 and seal, preventing the surgical instrument from coming into contact with the surface of the protector 248 and/or the seal. In another embodiment, the ribs 250 may be disposed over a bottom or distal surface of the shield, thereby creating a gap between the shield 248 and the seal to prevent capillary action and fluid capture between the seal and the shield 248.
[000127] Figures 20A and 20B illustrate another embodiment of an instrument seal 254 that has ribs to absorb fluid by capillary effect away from an opening in the seal 254. In this embodiment, the instrument seal 254 is in the form of a seal of deep cone that has a flange 260 with a conical sidewall 262 extending distally therefrom. A distal portion 264 of tapered sidewall 262 tapers inwardly to define an opening 258 in distal end 264 of seal 254. In the embodiment shown in Figure 20A, sidewall 262 may include one or more ribs 266 formed in an outer surface 261 therefrom and extending between the proximal and distal ends of sidewall 262, ending at opening 258. Outer ribs 266 may be effective to capillary fluid away from opening 258 in seal 254. In the embodiment shown in Figure 20B, the ribs 266 are formed on the inner surface 268 of the sidewall 262 and extend between the proximal and distal ends of the sidewall 262, terminating at the opening 258. The ribs 266 will thus have a cam effect, causing any instrument inserted through seal 254 contact ribs 266 to cam open seal 254, rather than contacting an inner surface 26 8 of seal 254.
[000128] In another embodiment, shown in Figure 21, the multi-layer sealing shield 269 may include a plurality of holes 270 formed in the individual layers 271 of the shield 269 to form a capillary absorption element to absorb fluid by capillary effect of the seal. . As fluid is trapped between the shield 269 and the seal when an instrument is passed through the instrument seal, the holes 270 act to capillary absorb fluid from the seal and the opening in the seal. Fluid may be retained within orifices 270 by surface tension so that an instrument passed through the seal will not contact fluid retained in orifices 270.
[000129] Various other modifications can also be made to the multi-layer seal protector previously described in figure 1E to remove fluid from the seal or instruments passed through the seal. In another embodiment, shown in Figures 22A and 22B, the protective segments 272 may include surface features, such as a crimped surface 276, formed on the distal surface thereof. As shown in Figure 22B, when the shield segments 272 are positioned against the seal segments 20, the crimped surface 276 will create a gap that separates the shield 273 from the seal, thereby providing a path for the fluid to be removed by capillary absorption. of the opening in the seal and between the guard 273 and the seal.
[000130] Figures 23A and 23B illustrate another embodiment of a seal 280 that is configured to remove fluid. In this embodiment, seal 280 has an hourglass configuration such that seal 280 is a combination of trocar and instrument seal. In other words, seal 280 is effective both to form a seal within the operating channel of the trocar when no instrument is disposed therethrough and to form a seal around an instrument disposed therethrough. The hourglass shape of the seal 280 allows a central portion 282 of the seal 280, which in a natural state is in a closed configuration as shown in Figure 23A, to open and engage an instrument passed through it, as shown in Figure 23B, and thus scrape off any fluid from the instrument. Due to the curvature in the inner side walls 284 of the seal 280, the removed fluid will flow away from the center portion, thereby preventing the fluid from being redeposited in an instrument reinserted therethrough. The 280 seal's hourglass configuration is also advantageous in that it will accommodate instruments of various sizes. The central portion 282 may also move or float relative to the central axis of the operating channel in the trocar, thereby accommodating off-axis instruments.
[000131] Figures 24A to 29 illustrate several other exemplary embodiments of fluid removers. Although certain modalities are described as being disposed or formed in the cannula, a person skilled in the art will appreciate that, as with the previous modalities, the modalities of Figures 24A to 29 can similarly be disposed at various locations within a trocar. and that various combinations of fluid removers can be used.
[000132] In the embodiment shown in Figures 24A and 24B, the fluid remover is in the form of a plurality of scraper elements that extend at least partially through the operative channel 4 of the cannula 8. The scraper elements can be relatively thin and can assume the shape and shape of cloths 292, as best shown in figure 24B, which will scrape or dry fluid from a surgical instrument passed through the cannula 8. The cloths 292 may be fixedly or articulately attached to an inner sidewall 294 of the cannula 8, and they can be flexible to accommodate instruments of various sizes, and to allow both insertion and withdrawal of instruments. The cannula 8 may also include any number of cloths 292, and the cloths 292 may be spaced apart from one another, or they may be in a stacked configuration. The cloths 292 may have a conical configuration so that each cloth 292 extends around the entire inner diameter of the cannula 8. Alternatively, the cloths 292 can be formed into individual segments that are positioned at a distance from each other, for example , approximately 90 degrees apart within the inner surface 294 of the cannula 8. The segments may be layered within the cannula 8 so that different parts of the surgical instrument come into contact with the cloths 292 at different heights as the instrument is being passed through. from that. The rags 292 may also be in contact with a sorbent element 296, or include a sorbent portion, so that the collected fluid drips into or is capillaryly absorbed into the sorbent material and away from possible contact with a reinserted instrument. As shown in Figures 24A and 24B, the sorbent element 296 is located adjacent the inner side wall 294, and thus radially outwardly of the squeegee body 292. The sorbent elements 296 may be formed within a wall of the cannula 8 so that the cannula 8 is partially formed from the sorbent elements 296. The sorbent elements 296 can also be formed within the grooves in the cannula wall and/or can be directly adhered to the cannula wall by any fastening mechanism known in the art, by example, a clamping ring 297. In use, as an instrument is passed through the cannula 8, the instrument will be scraped on all sides simultaneously by the plurality of rags 292. The fluid will flow out where it will be sorbed by the sorbent element 296 .
[000133] Figure 25 illustrates another exemplary embodiment of a scraper 300. In this embodiment, the scraper 300 is substantially conical in shape increasing in diameter in a distal direction. A proximal end 302 of scraper 300 includes an opening 304 formed therethrough, and a fluid collecting member is formed in a distal end 306 thereof and extends inwardly. The fluid collecting member can have a variety of configurations and can generally be configured to collect fluid scraped off by the scraper 300. In an exemplary embodiment, as shown, the fluid collecting member can be in the form of a substantially shaped rim. C 308 extending inwardly from distal end 306 of scraper 300. At least a portion of the fluid collecting member may also optionally be sorbent, thus allowing the fluid collecting member to both collect and sip fluid scraped by the scraper. Scraper 300 can be formed from a flexible material so that it can radially expand to engage a surgical instrument extending therethrough. In use, the narrow proximal end of scraper 300 can engage a surgical instrument passed therethrough to thereby scrape fluid from the instrument. Fluid scraped from the instrument will travel to an inner surface 310 of scraper 300 and be collected and/or absorbed by the fluid collecting member disposed at distal end 306 of scraper 300. Although scraper 300 is generally indicated as being disposed. in the cannula 8, the scraper 300 can similarly be disposed anywhere within the trocar 2, including in the proximal compartment 6.
[000134] Figure 26 illustrates another exemplary embodiment of a scraper 312. In this embodiment, the scraper 312 includes first and second swivel members 314a and 314b that are configured to rotate and engage a surgical instrument as the instrument is passed through. The first and second swivel members 314a and 314b can have a variety of shapes and sizes. In the illustrated embodiment, the first and second swivel members 314a and 314b are spool-shaped. The spools can be configured so that the geometry of the second member 314b complements that of the first member 314a. As shown, first member 314a includes a substantially spherical shaped central portion 316 that corresponds with a concave cut 318 in second member 314b. Spool geometry can be of various shapes including, but not limited to, straight-sided cylindrical, C-shaped, and serrated cylindrical. The first and second swivel members 314a and 314b can be positioned at a variety of locations on the cannula, or within the proximal compartment of a trocar, and they can be formed from a variety of materials including, but not limited to, rigid, flexible and sorbent materials. In use, swivel members 314a and 314b can pivot and engage a surgical instrument that passes therethrough to thereby scrape and optionally remove fluid from the instrument.
[000135] Figures 27A to 27C illustrate another embodiment of a fluid remover in the form of a removable tip or sleeve 322 that can be removable coupled to a distal end 324 of the cannula 8. As shown, the sleeve 322 is in the form of a generally cylindrical housing with a tapered distal end 326, similar to the distal end 324 of the cannula 8. A proximal end 328 of the sleeve 322 can be sized to fit over and engage the distal end of the cannula 8, e.g. by interference, and the distal end of the housing may include an opening 330 formed therein and sized to receive a surgical instrument therethrough. The sleeve 322, or at least a portion of the sleeve 322 surrounding the opening 330 at the distal end 326, may be formed from a pliable or expandable material to allow the opening in the sleeve 322 to radially expand as an instrument is passed through the same. Exemplary malleable materials include, but are not limited to, polyisoprene, pelatan, and silicone. In use, as a surgical instrument is passed through opening 330 in sleeve 322, opening 330 will scrape fluid from the instrument, thus preventing fluid from being drawn into the trocar and deposited in the seals.
[000136] In another embodiment shown in figure 28, an hourglass-shaped seal 340, similar to the seal 280 described with reference to figures 23A and 23B is provided, however, the seal 340 includes a capillary absorption element under the shape of one or more cuts or slits 342 formed in the central reduced diameter portion 344. Similar to the seal 280 previously described with respect to Figures 23A and 23B, the hourglass shape will allow the central portion 344 to scrape or drain fluid from a surgical instrument passed through it. Cutouts or slits 342 will allow scraped fluid to be capillaryly absorbed through slits 342 to an outer surface 346 of seal 340.
[000137] In another embodiment shown in Figure 29, the capillary absorption element may take the form of a plurality of slits 350 formed in the operative channel 4 of a cannula 352. The slits 350 may have any size and shape sufficient for the fluid transfer disposed on an inner surface of cannula 352 to an outer surface 354 of cannula 352. Thus, as an instrument is passed through cannula 352, any fluid that drips to the inner surface of cannula 352 will be transferred to surface 354 of the cannula 352 through the slits 350.
[000138] Figures 30A to 30J illustrate another embodiment of a trocar 400 that has a fluid remover 430 disposed therein. As shown, trocar 400 has a proximal compartment 402 and a distal cannula 404 with an operating channel 408 formed through and extending between the proximal and distal ends 400a, 400b thereof. Housing 402 may include one or more seals that are effective to seal operative channel 408, i.e., to prevent inflation leakage, when no instrument is disposed therethrough and/or when an instrument is disposed therethrough. As shown in Figures 30B and 30C, housing 402 includes a proximal instrument seal in the form of a multi-layer seal 412, which is effective to form a seal around an instrument inserted therethrough, and a distal channel seal, such as a 410 duckbill seal, which is effective in sealing the operating channel when no instrument is inserted through it. An exemplary embodiment of a duckbill seal 410 that can be used with the present invention is disclosed in US Patent Application Serial No. 11/771,263 filed June 29, 2007 and entitled "Duckbill Seal With Fluid Drainage Feature, " by Paul T. Franer and Thomas A. Gilker. Such a duckbill is particularly useful as it has a low profile and fluid drain characteristics that can help further prevent fluid redeposition on instruments inserted through the seals. A person skilled in the art will appreciate that any number, type and configuration of channel and/or instrument seals can be positioned within housing 402 at various locations. The compartment may also include an inflation port 406 that is formed in the compartment 402 to supply an inflation gas to the operating channel 408.
[000139] As noted above, housing 402 may include a fluid remover 430 positioned therein and configured to remove fluid from a surgical instrument inserted therethrough. Fluid remover 430 may have an opening 470 formed through a central portion thereof, in axial alignment with operative channel 408, to receive a surgical instrument. The opening 470 can be effective to remove fluid from a surgical instrument upon insertion and/or withdrawal therethrough. In an exemplary embodiment, fluid remover 430 is preferably positioned distal to seals 412 and 410 so that fluid collected in the instrument when disposed in a body cavity can be removed from the surgical instrument before being withdrawn through seals 412 and 410, thereby preventing fluid from being deposited at the seals and, consequently, deposited in an instrument inserted into the trocar. In order to position fluid remover 430 distally to seals 412 and 410, fluid remover 430 will be positioned near, distal to or in the path of the inflation port. When the fluid remover 430 is positioned in the path of or distal to the inflation port, it is preferably configured so that it does not block the path of an inflation gas from the port through the distal cannula 404. During many surgical procedures with the use of In a trocar, the insufflation is used to expand the body cavity into which the trocar extends. Trocars may thus have an inflation port, such as port 406 shown in Figures 30A to 30C, which is positioned distal to seals 412 and 410 so that the seals are effective to prevent gas from flowing out of the proximal compartment 402. In this way, a constant flow of gas is maintained through the distal cannula 404 and into the body cavity. Since port 406 is positioned distally to seals 412 and 410, in an exemplary embodiment, in order to maintain a low profile compartment and the position of fluid remover 430 distal to the seals, fluid remover 430 may be positioned adjacent to or distal to port 406. As such, fluid stripper 430 is preferably configured to allow air to pass through and/or around it so that it does not block the flow of insufflation gas. from port 406 to cannula 404 when an instrument is inserted through opening 470 in fluid stripper 430. In other words, fluid stripper 430 may have a configuration that permits the passage of insufflation gas from port 406 to the distal cannula 404 even when an instrument is disposed through the fluid stripper 430. Figures 30A to 30J illustrate one such embodiment of the fluid stripper 430 which is in the gas flow path from port 406 to cannula 404. In one embodiment, a cut or route is provided in a portion of the fluid remover 430 to permit the passage of gas therethrough from port 406 to cannula 404, as will be discussed in more detail below. Fluid remover 430 may also include other features to facilitate the passage of gas therethrough, as will be discussed in more detail below.
[000140] The fluid remover 430 can have various configurations and it can include any one or more of a capillary absorber element, a sorbent and a scraper. Figures 30C to 30F illustrate an embodiment of fluid remover 430 that is positioned distal to seals 412 and 410 and near inflation port 406. Fluid remover 430 generally includes a sorbent 414 disposed within the housing and disposed thereon. around a crown 420, a scraper 422 positioned on a proximal surface of the crown 420 and a cap 418 positioned against a proximal surface of the scraper 422.
[000141] As shown in more detail in figures 30F and 30G, the scraper 422 of the fluid remover 430 can have many shapes and configurations, but in the illustrated embodiment the scraper 422 is in disk shape and has an opening 424 formed through a central portion of it. Scraper 422 can be configured to remove fluid from a surgical instrument by passing through opening 424 by contacting the surgical instrument and scraping and/or wiping its circumference. In an exemplary embodiment, scraper 422 is formed from a flexible and resilient material to allow opening 424 of scraper 422 to expand around and engage an outer wall of an instrument passed therethrough.
[000142] The scraper 422 may also include features to direct the flow of fluids. For example, as shown in Fig. 30G, the scraper may include one or more channels 422c formed in a distal surface thereof and extending radially outward from opening 424, so that fluid removed by scraping an instrument is withdrawn through the opening 424 will flow through the channels and radially away from opening 424. As further shown in Figures 30F and 30G, scraper 422 may also include one or more holes 422h formed therethrough to receive pins formed in ring 420, as will be discussed in more detail below. Holes 422h allow the scraper 422 to rest on a proximal surface of the crown 420 and be captured between the crown 420 and the cap 418. The holes 422h may also be of a size that allows air to pass through it when the crown pins 420 are arranged in it. Such a configuration can help prevent the fluid remover 430 from functioning as a seal, as will be discussed in more detail below. In some embodiments, however, the scraper 422 may also be formed as an instrument seal and/or as a scraper for smaller diameter surgical instruments and a seal for larger diameter surgical instruments.
[000143] In certain exemplary embodiments, in order for the scraper 422 to effectively absorb fluid by capillary action radially out of the opening and toward the sorbent, all or portions of the scraper may be formed of or may include a hydrophilic material. For example, the scraper can be formed from a hydrophilic material, such as nylon, and/or the scraper can be spray coated, dip coated, plasma etched, or otherwise coated using various coating techniques. known, with a surfactant coating which makes the scraper or portions thereof hydrophilic. In an exemplary embodiment, where the scraper is formed from a hydrophobic material such as polyisoprene, a hydrophilic coating is applied to the scraper to make the scraper hydrophilic. The coating can be applied to any one or more of the scraper surfaces, and it can be applied at any stage during manufacturing. In one embodiment, the scraper can be soaked in a bath of surfactant during manufacture to make the entire scraper hydrophilic. Exemplary coating materials include, by way of non-limiting example, sodium dodecyl benzene sulfonate (SDBS) and sodium dodecyl sulfate (SDS). The coating is preferably one that remains stable during sterilization, such as gamma and thermal radiation sterilization.
[000144] A person versed in the technique will realize that several factors can be changed to facilitate the absorption action by capillary effect of the scraper. For example, the contact angle of a fluid drop on a hydrophilic scraper surface can be optimized so that fluid will spread out in contact with the surface. In certain exemplary embodiments, the hydrophilic material can have a low contact angle, such as 90 degrees or less. Other factors that can affect the scraper's ability to absorb fluid by capillary action away from the opening include the smoothness of the surface, the geometry of the capillary absorption channels, and the surface tension of the fluid being applied. For example, the channel geometry can be designed to provide the capillary forces necessary to direct fluid to a minimum capillary height so that the fluid will expand just past the outer wall of crown 420 to reach sorbent 414. of the channel can be changed to obtain the desired capillary height. Figure 30H illustrates an exemplary embodiment of a gutter geometry that is optimized to facilitate the capillary action of the gutter. As shown, the gutter has a generally U-shaped cross-sectional shape, with the inner corners located at the base of the gutter being rounded and having a radius of curvature r1, and the outer corners, located at the gutter opening, being rounded and having a radius of curvature r2. The gutter may also have a width w at the base, as measured between the opposing side walls of the gutter, which differs from the width w1 at the opening, as measured between the outer rounded corners, and which also differs from a maximum width w2 as measured from the outer ends of the channel in the opening. The difference between width w and width w1 is indicated by the reference x. The gutter may additionally have a maximum height h, as measured from the base to the outermost ends of the gutter in the opening, which differs from a height h1 as measured from the base to the outer rounded corners. The particular dimensions of the channel may vary. For example, the radius of curvature r1 at the base of the trough may be smaller than the radius of curvature r2 at the opening of the trough, and the width w at the base of the trough is less than the width w1 at the opening, which in turn is smaller than the maximum width w2 so that the channel width gradually increases from the base towards the opening. In an exemplary embodiment, however, the width w at the base of the channel is preferably equal to or greater than the width w1 at the opening. The dimensions and cross-sectional shape of the gutter may also vary along the entire length of the gutter. For example, the gutter may have a height and/or width that increases or decreases radially outward, so that the height and/or width of the gutter near the central opening in the scraper is either less than or greater than the height and width of the gutter. proximal channel of the outer perimeter of the scraper. Each trough may also reach a maximum height and/or width at a certain distance from the central opening, and the height and/or width may then remain constant across the remainder of the trough extending radially outward from that location. A person skilled in the art will appreciate that the trough can be modified to obtain a desired capillary height so as to direct fluid from the scraper opening, past the crown and into the sorbent.
[000145] As indicated above, other modifications can be made to obtain an optimal capillary absorption effect. In another embodiment, the scraper and the sorbent can both be configured to have a surface energy gradient so that the surface energy increases as the fluid moves from the opening inside the scraper, along the channels and into of the sorbent.
[000146] Fluid remover 430 may also include a scraper crown 420, shown more clearly in Figure 30F, which can extend distally from a distal surface of scraper 422 and which can help assemble scraper 422 and sorbent 414 inside the compartment. The scraper crown 420 can have various configurations, but in the illustrated embodiment it has a ring-shaped body 434 with multiple pins 436 extending closely therefrom. Pins 436 may extend through corresponding holes 422h formed in scraper 422 and into holes 418h formed in cap 418, as shown in Figure 30J. Crown 420 and cap 418 can be paired with each other using various techniques, such as a squeeze fit or interference fit, adhesive or welding, etc. By interconnecting scraper 422 between cap 418 and crown 420, scraper 422 may have an outer diameter that is less than an inner diameter of housing 402, so that a gap G is provided between scraper 422 and housing 402. as shown in figure 30D. Span G will allow air to flow proximally past scraper 422.
[000147] As further shown in Figure F, the scraper crown 420 may also include a cutout 426 formed in a side wall thereof. One or more flange members 440 may extend radially outwardly from a side wall of the scraper crown 420 on either side of the cut 426 formed through the crown 420 to define a route. Flange members 440 may be positioned to align axially with the cut formed in sorbent 414 and a cut formed in cap 418, as will be discussed in greater detail below, to form a complete route that allows for the flow of insufflation gas from the port. of insufflation 406 through the cutouts, and into the operating channel 408 into the distal cannula 404. This allows the insufflation to be delivered through the cannula while an instrument is passed through the fluid remover 430 and occludes the operating channel. Flange portions 440 may be positioned on either side of an opening 442 of inflation port 406 through which the inflation gas flows. As a result, a pressure on each side of the fluid remover will be equalized.
[000148] The molded scraper cap 418 is shown in more detail in Figures 30I and 30J, and it may have a generally circular or ring-shaped configuration that is proximal to the scraper. In use, cap 418 can serve to protect proximal surface 432 of scraper 422 from insertion of acute surgical instruments by acting as a guide or funnel for the surgical instrument within opening 424 of scraper 422. As noted above, the scraper cap 418 may include one or more holes 418h formed in a distal surface thereof to receive pins 436 formed in crown 420. Scraper cap 418 may also include an opening 418o through which a surgical instrument may extend that is in axial alignment with aperture 424 formed in scraper 422, and a cutout 448 formed in a side wall or perimeter of scraper cap 418 that lines up with cutout 446 formed in scraper crown 420 and sorbent 414.
[000149] As shown in Figure 30J, in one embodiment the scraper cap 418 may further include a circular microsphere or compaction crest 450 projecting distally beyond a more distal surface thereof, so that the crest extends. extends toward and presses against the proximal surface of the scraper 422 to secure the scraper 422 in controlled compression between the compaction crest 450 in the cap 20 and the proximal surface of the crown 420. The compaction crest 450 may also function to seal and remove prevent fluid from flowing back towards the scraper opening 422.
[000150] Although there may be many configurations for the fluid remover 430, in the embodiment shown in figures 30B to 30E, the fluid remover 430 also includes a sorbent 414 positioned circumferentially around the scraper crown 420 and configured to sip up scraped fluid by scraper 422. As shown in Fig. 30F, sorbent 414 can be configured to be positioned around scraper ring 420, and thus may have a cut 444 formed therein that lines up with cut 426 formed on rim 420. terminal ends of sorbent 414 will thus be in abutting position with flange 440 on ring 420. As a result, sorbent 414 will be substantially C-shaped. Cutting 444 in sorbent 414 will also allow air to flow throughout. part around the outside of the scraper 422, due to the gap G between the outer perimeter of the scraper 422 and the housing. The cut in sorbent 414 will thus continue to allow air to pass through and around scraper 422 in the event that sorbent 414 becomes clogged. This is particularly advantageous since air forced to flow through the sorbent 414 could potentially push fluid out of the sorbent 414. The sorbent 414 can be secured around the scraper crown 420 using any method known in the art including, by example, an adhesive, or simply by an interference fit between an inner wall of housing 402 and scraper crown 420. As will be understood by those skilled in the art, sorbent 414 can have a solid ring shape, or any other shape, and it it can be made up of multiple individual portions as needed.
[000151] Although sorbent 414 preferably has a shape that matches the shape of crown 420, sorbent 414 can be configured to be compressed between crown 420, scraper 422 and housing 402. it may have an initial cross-sectional shape that is more square and it may deform into a shape that is more triangular. The sorbent 414 can be formed from various materials that allow it to be compressed while still allowing the sorbent 414 to sorb fluid. The sorbent 414 can also be permeable so that air can flow therethrough.
[000152] The particular size of the sorbent 414 may also vary, but in an exemplary embodiment the sorbent 414 has an internal diameter that is greater than a diameter of the opening 424 in the scraper, so that the sorbent 414 will only contact the scraper 422 at a location radially outward from the opening 424. This will allow fluid to flow from the opening, through the channels 422c, and then be sorbed by the sorbent. In an exemplary embodiment, the sorbent is positioned radially out of the holes 422h formed in the scraper as it allows the sorbent 414 to be positioned around the crown 420.
[000153] As noted above, when the fluid remover 430 is fully assembled, it can rest within a distal portion of the proximal compartment 402. The sorbent 414 can be positioned in contact with an inner surface of the compartment 402, the crown 420 can be disposed within the sorbent 414, the scraper 422 can be on the crown 420 and be positioned in contact with the sorbent, and the cap can be positioned on the scraper 422 and be paired with the crown 420. The cap 418 can optionally be welded on by ultrasound or otherwise being fixedly paired with housing 402 to secure fluid remover 430 therein. As shown in Figure 30F, sorbent 414 may include surface features such as longitudinally extending grooves 415 formed in an inner surface thereof and configured to align with and receive pins 436 in wiper crown 420.
[000154] When disposed within the compartment 402, the fluid remover 430 will be positioned in the inflation path. In particular, referring again to Figures 30C and 30D, the inflation port 406 has a lumen 460 extending therethrough. Lumen 460 defines a longitudinal axis LA and has a cylindrical inner surface with a more proximal inner surface 462 and a more distal inner surface 464. Fluid scavenger 430 is generally positioned within the path of lumen 460 and more particularly it is positioned so that the innermost surface 462 of the lumen 460 is positioned distal to the scraper 422 and the longitudinal axis LA extends through a medial portion of the sorbent 414. In other words, the sorbent 414 is positioned in the path of the flow of gas from the inflation port 406 to the distal cannula. A person skilled in the art will appreciate that the various components of the fluid trap 430 can be positioned at various locations relative to the inflation port 406. Since the portions of the fluid trap 430 in the illustrated embodiment are positioned in the flow path of air from the inflation port 406 to the distal cannula, cuts 426 and 444 in crown 420 and sorbent 414 will allow airflow to pass therethrough and into the distal cannula.
[000155] In use, a surgical instrument may be inserted through seals 412 and 410 and through opening 470 into fluid remover 430 as needed in a particular procedure. With the use of inflation port 406, inflation gas can be introduced into operating channel 408 of trocar 400 so that inflation is achieved distal to seals 412 and 410 and fluid remover 430. displace along the route defined by flange portions 440, through cutouts 426 and 444 in crown 420 and sorbent 414, respectively, and into operating channel 408 of distal cannula 404. In this way, fluid remover 430 can be distal to the seals 412 and 410 to remove fluid from instruments being withdrawn, while allowing insufflation gas to flow within the distal cannula. As a surgical instrument is withdrawn from operating channel 408, fluid scraped from the surgical instrument by scraper 422 flows radially outwardly and is sorbed by sorbent 414, thereby keeping the fluid away from any instrument that may be reinserted into operating channel 408. Fluid remover 430 thus permits the removal of fluid from a surgical instrument in a position distal to seals 412 and 410, while also allowing the introduction of inflation gas distal to both seals 412, 410. The technique will notice the possible variations for the placement of seals and fluid removers to allow for inflation distal to both.
[000156] Figure 31 illustrates another embodiment of a cap 418' for use with a fluid remover. In this embodiment, rather than including a cutout 448 formed in a side wall of cap 418 to allow air to pass through cap 418 in a proximal direction toward the seals, cap 418' includes a plurality of holes or openings 448' formed in the and positioned radially around a perimeter of the cap 418'. The cap 418' can include any number of holes at any location and having any size. The holes 448' are merely configured to prevent the fluid remover from forming a seal if not necessary, as it may be desirable to maintain a zero pressure differential across the fluid remover to prevent air from forcing the fluid out of the sorbent.
[000157] Figures 32A to 32D illustrate yet another embodiment of a trocar 500 having a fluid remover 530 disposed therein. As shown, trocar 500 has a proximal compartment 502 and a distal cannula 504 with an operating channel 508 formed through and extending between the proximal and distal ends thereof. As shown in Figure 32B, housing 502 may include an instrument seal, such as a deep cone seal 512 (only a proximal flap is shown), positioned within a channel seal, such as a duckbill seal 510. The person skilled in the art will appreciate that any number, type and configuration of channel and/or instrument seals can be positioned within compartment 502. The compartment may also include an insufflation port 506 that is formed in compartment 502 to supply a gas from supply to the operational channel 508.
[000158] In this embodiment, the fluid remover 530 differs from the fluid remover 430 described above in that it is positioned more distal to the inflation port. In general, the fluid remover 530 has an opening 570 formed through a central portion thereof, in axial alignment with the operative channel 508, to receive a surgical instrument. The opening 570 can be effective to remove fluid from a surgical instrument upon insertion and/or withdrawal therethrough. Fluid remover 530 is positioned distal to seals 512 and 510 so that fluid can be removed from the surgical instrument before it is withdrawn through seals 512 and 510 to prevent fluid deposition at the seals. As with the fluid remover 430, the fluid remover 530 may have a configuration that permits the passage of insufflation gas from the port 506 to the distal cannula 504 even when an instrument is disposed through the fluid remover 530. In one embodiment the fluid remover 530 is generally positioned in the path of the lumen 560 of the inflation port 506 and, more particularly, it is positioned so that the longitudinal axis LA of the lumen 560 extends through a substantially central portion of the scraper cap. 518. The most proximal interior surface 562 of the port is thus generally aligned with a top wall 556 of the scraper cap 518. As shown in Figure 32B, the scraper 522 is thus positioned distal to the longitudinal axis LA of the 560 lumen and can generally be positioned in alignment with the most distal inner surface 564 of the 560 lumen. In other embodiments, the scraper 522 can be positioned fully distal or proximal. al to the most distal inner surface 564 of the 460 lumen. One of skill in the art will appreciate that the fluid remover 530 can be positioned in any number of ways with respect to the 560 lumen.
[000159] Since the cap portion 518 and the scraper 522 are positioned in the inflation path, the cap 518 and the scraper 522 in this mode can each have a cut 548 and 546 that is positioned within the gas path of insufflation to allow gas to flow into operating channel 508 as shown in Figure 32D. Cuts 548 and 546 may align with corresponding cuts 526 and 544 in crown 520 and sorbent 514, respectively, similar to crown 420 and sorbent 414 discussed above. As further shown in Figure 32D, scraper cap 518 may also include a tab or flange 550 extending around a proximal portion thereof and located proximal to cut 548 formed in the sidewall of scraper cap 518. , notch 546 is not a complete cut, but is defined on three sides by two opposing notch side walls 552a and 552b and a top wall 556, and thus top wall 556 may optionally serve as a sealed proximal contour. for the insufflation gas route that will be described next. In an exemplary embodiment, top wall 556 may be positioned in alignment with the most proximal interior surface 562 of lumen 560 within the inflation port.
[000160] In another embodiment, all of the fluid removal embodiments described above can be formed into a single "input" unit, as required. The input unit may include sorbent elements, scraper elements, capillary absorption elements and/or combinations thereof. These elements can be combined as needed into an externally configured unit that can be placed into an existing trocar system as needed. In this way, the inlet unit will fit in and around any seals and components disposed within the proximal compartment, including the removable cap, and/or inside the cannula. For example, the inlet unit can be configured to fit below or distal to one or more sealing elements and/or it can be configured to fit above or proximal to one or more sealing elements. Alternatively or in addition, the inlet unit can be configured to have components that fit above, below or between the sealing elements. The inlet unit may also include seals in it so that the entire unit can be placed within an empty compartment of a trocar. The input unit may also be removable as needed, and the unit, or portions thereof, may be reusable.
[000161] Methods for removing fluid from a surgical instrument are also provided. In an exemplary embodiment, a surgical instrument can be passed through an access device and a fluid remover in the access device can remove any fluid in the instrument, or fluid deposited in a seal within the access device by the instrument. In an exemplary embodiment, a fluid remover can engage a surgical instrument that has passed through an access device, such as a trocar, by removing the instrument to thereby remove fluid from the instrument, thereby preventing fluid from accumulating in the ) sealing/sealing and/or being redeposited in instruments passing through it. As indicated above, the fluid remover can be formed from any combination of one or more sorbent, scraper and capillary absorber elements. A person skilled in the art will realize that virtually any combination of wicking, scraping, and capillary absorbing elements can form the fluid remover resulting in a variety of methods for removing fluid that can include any combination of sipping, scraping, and absorbing fluid. by capillary effect away from a surgical instrument and/or a seal or other portion of a trocar or other access device.
[000162] Those skilled in the art will additionally appreciate that the present invention has applications in conventional open surgery and endoscopic instrumentation as well as applications in robotic-assisted surgery.
[000163] The devices described herein may be designed to be disposed of after a single use, or they may be designed to be used multiple times. In either case, however, the device can be refurbished for reuse after at least one use. Reconditioning can include any combination of steps of disassembling the device, followed by cleaning or replacing particular parts, and subsequent reassembly. In particular, the device can be disassembled, and any number of particular parts or parts of the device can be selectively replaced or removed, in any combination. By way of non-limiting example, the scraper and/or sorbent can be removed, cleaned, re-coated with a hydrophilic material, sterilized and reused. When cleaning and/or replacing particular parts, the device can be reassembled for subsequent use in a reconditioning facility or by a surgical team immediately prior to a surgical procedure. Those skilled in the art will appreciate that reconditioning a device can utilize a variety of techniques for disassembly, cleaning/replacement, and reassembly. The use of such techniques, and the resulting refurbished device, are all within the scope of this patent application.
[000164] Preferably, the devices described here will be processed prior to surgery. First, a new or used instrument is obtained and if necessary cleaned. The instrument can then be sterilized. In a sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and its contents are then placed in a field of radiation that can penetrate the container, such as gamma radiation, X-rays, or high energy electrons. Radiation kills bacteria in the instrument and in the container. The sterilized instrument can then be stored in a sterile container. The sterile container keeps the instrument sterile until it is opened at the medical facility.
[000165] It is preferred that the device be sterilized. This can be accomplished in any number of ways known to those skilled in the art including beta or gamma radiation, ethylene oxide or steam.
[000166] The person skilled in the art will appreciate other aspects and advantages of the invention based on the modalities described above. Accordingly, the invention is not to be limited by what has been particularly shown and described, except as indicated by the appended claims. All publications and references cited herein are expressly incorporated herein by reference in their entirety.

权利要求:
Claims (14)
[0001]
1. Fluid remover (430) for use in a surgical access device (400) characterized in that it comprises: a sorbent element (48,414) having opposing proximal and distal surfaces and opposing inner and outer side walls extending between the proximal and distal surfaces such that the sorbent element (48,414) has a polygonal shape in cross section, the proximal surface being planar and the inner and outer side walls having a radius of curvature, the inner side wall defining an extending central opening through the sorbent element (48.414), and the sorbent element (48.414) includes a gap (444) formed therein so that the sorbent (48.414) has a C shape, wherein the sorbent element (48.414) is formed from a plurality of fibers that are configured to sip fluid.
[0002]
2. Fluid remover (430) according to claim 1, characterized in that the inner side wall includes a plurality of grooves (415) formed therein and extending parallel to a longitudinal axis of the central opening.
[0003]
3. Fluid remover (430) according to claim 1, characterized in that a plurality of fibers is oriented longitudinally with respect to a longitudinal axis of the central opening.
[0004]
4. Fluid remover (430), according to claim 1, characterized in that the polygonal cross-sectional shape of the sorbent element comprises a square.
[0005]
5. Fluid remover (430), according to claim 1, characterized in that the polygonal cross-sectional shape of the sorbent element comprises a triangle.
[0006]
6. Fluid remover (430) according to claim 1, characterized in that at least a portion of the sorbent element is hydrophilic.
[0007]
7. Fluid remover (430) according to claim 1, characterized in that the terminal ends are flat.
[0008]
8. Fluid remover (430) according to claim 1, characterized in that the outer side wall of the sorbent member is narrowed between the proximal surface and the distal surface.
[0009]
9. Fluid remover (430) according to claim 8, characterized in that at the outer side wall defines a radius extending from a central point of the sorbent member and wherein the radius of the adjacent outer side wall the proximal surface is greater than the radius of the outer sidewall adjacent to the distal surface.
[0010]
10. Fluid remover (430), according to claim 1, characterized in that the polygonal cross-sectional shape of the sorbent element is triangular.
[0011]
11. Fluid remover (430) according to claim 1, characterized in that the length of the arc of the sorbent element comprises a larger arc.
[0012]
12. Fluid remover (430) according to claim 11, characterized in that the gap between the terminal ends of the sorbent member is formed between the terminal ends of the larger arc.
[0013]
13. Fluid remover (430) according to claim 12, characterized in that the sorbent element comprises first and second flat terminal ends having the gap between them.
[0014]
14. Fluid remover (430) according to claim 13, characterized in that the first and second terminal end surfaces face each other.

类似技术:

---

公开号 | 公开日 | 专利标题

---

BR112012002041B1|2021-05-04|fluid remover for use in a surgical access device

---

EP2627269B1|2018-02-28|Surgical access device

---

JP5478933B2|2014-04-23|Absorption of fluids in surgical access devices

---

JP5653590B2|2015-01-14|Fluid removal in surgical access devices

---

JP5484780B2|2014-05-07|Fluid scrubbing in surgical access devices

---

JP5468293B2|2014-04-09|Management of fluid transfer in surgical access devices.

---

US11235111B2|2022-02-01|Surgical access device

同族专利:

---

公开号 | 公开日

---

CA2769469C|2017-11-28|

---

US20100022958A1|2010-01-28|

---

EP2459084A1|2012-06-06|

---

AU2010276622B2|2014-02-27|

---

MX2012001422A|2012-06-12|

---

JP2013500766A|2013-01-10|

---

WO2011014394A1|2011-02-03|

---

EP3459475A1|2019-03-27|

---

RU2012107541A|2013-09-10|

---

CN102573676A|2012-07-11|

---

BR112012002041A2|2020-08-18|

---

RU2577447C2|2016-03-20|

---

US8568362B2|2013-10-29|

---

EP2459084B1|2018-08-22|

---

CN102573676B|2016-04-27|

---

KR20120060830A|2012-06-12|

---

JP5661767B2|2015-01-28|

---

IN2012DN00882A|2015-07-10|

---

PL2459084T3|2019-01-31|

---

CA2769469A1|2011-02-03|

---

AU2010276622A1|2012-02-16|

---

KR101787959B1|2017-10-19|

引用文献:

---

公开号 | 申请日 | 公开日 | 申请人 | 专利标题

---

---

US2628404A|1951-11-30|1953-02-17|John M Myers|Trocar|

---

US3229691A|1963-07-10|1966-01-18|Johnson & Johnson|Flexible absorbent sheet|

---

US3566871A|1968-06-11|1971-03-02|American Cyanamid Co|Hydrophilic medical sponge and method of using same|

---

US3903877A|1973-06-13|1975-09-09|Olympus Optical Co|Endoscope|

---

DE2424749B2|1973-05-23|1976-10-21|Olympus Optical Co. Ltd., Tokio|ENDOSCOPE WITH A CHANNEL FOR INSERTING A FORCEPS AND SUCTIONING A LIQUID SUBSTANCE|

---

US3900022A|1973-12-10|1975-08-19|Jerrold Widran|Endoscope with uninterrupted flow purging system|

---

US3981276A|1974-06-06|1976-09-21|Ford Motor Company|Induction-exhaust system for a rotary engine|

---

JPS5444473Y2|1974-07-23|1979-12-20|

---

JPS5826641Y2|1978-06-19|1983-06-09|

---

US4281646A|1978-06-30|1981-08-04|Olympus Optical Co., Ltd.|Cleaning device for an observation window of an endoscope|

---

US4204563A|1978-10-02|1980-05-27|Chevron Research Company|Discharge spout tip for a liquid fuel-dispensing nozzle|

---

US4335721A|1981-02-17|1982-06-22|Kimberly-Clark Corporation|Tampon containing fusible portions|

---

US5308336A|1982-09-28|1994-05-03|Applied Medical Resources|Seal protection mechanism|

---

US4687033A|1984-03-15|1987-08-18|Gilbarco, Inc.|Venturi liquid evacuator system for maintaining clear vapor path in vapor recovery hose|

---

CH661275A5|1984-08-22|1987-07-15|Ciba Geigy Ag|METHINE AZO CONNECTIONS.|

---

US4929235A|1985-07-31|1990-05-29|Universal Medical Instrument Corp.|Self-sealing percutaneous tube introducer|

---

US4651517A|1985-08-15|1987-03-24|Oroamerica, Inc.|Jewelry rope chain|

---

US4690140A|1986-04-01|1987-09-01|John Mecca|Arterial regenerator|

---

US4722000A|1986-10-01|1988-01-26|Medical Concepts Incorporated|Adapter for endoscopic camera|

---

JPS63164931A|1986-12-27|1988-07-08|Toshiba Corp|Constant pressure apparatus of endoscope|

---

JP2602823B2|1987-03-11|1997-04-23|株式会社東芝|Liquid feeding device for endoscope|

---

US4919305A|1987-11-06|1990-04-24|Emco Wheaton, Inc.|Fuel dispensing nozzle with built-in flow regulator|

---

US4943280A|1987-12-31|1990-07-24|United States Surgical Corporaiton|Self-seating flapper valve for an insufflation cannula assembly|

---

US4960412A|1988-04-15|1990-10-02|Universal Medical Instrument Corp.|Catheter introducing system|

---

US4942867A|1988-07-13|1990-07-24|Asahi Kogaku Kogyo K.K.|Distal end part of endoscope|

---

US4877016A|1988-07-29|1989-10-31|Kantor Edward A|Video endoscopic microscope|

---

US4958970A|1988-08-17|1990-09-25|The United States Of America As Represented By The Secretary Of The Navy|Graduated-load spring washer system for screws and threaded fasteners|

---

IL88356A|1988-11-10|1990-11-05|Rozenwasser David|Fine jewelry rope chain|

---

US5000745A|1988-11-18|1991-03-19|Edward Weck Incorporated|Hemostatis valve|

---

US5084057A|1989-07-18|1992-01-28|United States Surgical Corporation|Apparatus and method for applying surgical clips in laparoscopic or endoscopic procedures|

---

US5104383A|1989-10-17|1992-04-14|United States Surgical Corporation|Trocar adapter seal and method of use|

---

JPH03151790A|1989-11-08|1991-06-27|Hitachi Ltd|Contour correction circuit for color signal|

---

US5312397A|1989-12-11|1994-05-17|Ioan Cosmescu|Lens exchanger for a surgical laser system and method therefor|

---

US5514153A|1990-03-02|1996-05-07|General Surgical Innovations, Inc.|Method of dissecting tissue layers|

---

US5127909A|1990-04-05|1992-07-07|United States Surgical Corporation|Flapper valve for an insufflation cannula assembly|

---

US5191878A|1990-04-12|1993-03-09|Olympus Optical Co., Ltd.|Endoscope device|

---

US5395342A|1990-07-26|1995-03-07|Yoon; Inbae|Endoscopic portal|

---

US5167220A|1990-08-09|1992-12-01|Brown Cathy K|Systems and methods for maintaining a clear visual field during endoscopic procedures|

---

US5112308A|1990-10-03|1992-05-12|Cook Incorporated|Medical device for and a method of endoscopic surgery|

---

US5207213A|1991-02-01|1993-05-04|Circon Corporation|Laparoscope having means for removing image impeding material from a distal lens|

---

CA2060930A1|1991-04-05|1992-10-06|Fred A. Allgood|Endoscopic surgical instrument cleaning and fog abatement composition and method|

---

US5400767A|1991-05-14|1995-03-28|Murdoch; Mervyn J.|Laparoscopic telescope lens cleaner and protector|

---

US5180373A|1991-06-07|1993-01-19|United States Surgical Corporation|Valve system for introducing objects into anatomical body portions|

---

US5386817A|1991-06-10|1995-02-07|Endomedical Technologies, Inc.|Endoscope sheath and valve system|

---

WO1992022385A1|1991-06-14|1992-12-23|Halcro Nominees Pty. Ltd.|Ultrasonic vibration generation and use|

---

US5237984A|1991-06-24|1993-08-24|Xomed-Treace Inc.|Sheath for endoscope|

---

RU2014032C1|1991-06-28|1994-06-15|Шевц Рафаил Лазаревич|Needle locking device|

---

CA2054029C|1991-07-17|1998-05-19|Louise Cynthia Ellis Coe|Absorbent article exhibiting improved fluid management|

---

DE4220701C2|1991-08-02|2001-02-08|Olympus Optical Co|Endoscope cleaning device|

---

US5289963A|1991-10-18|1994-03-01|United States Surgical Corporation|Apparatus and method for applying surgical staples to attach an object to body tissue|

---

US5545142A|1991-10-18|1996-08-13|Ethicon, Inc.|Seal members for surgical trocars|

---

US6981966B2|1991-10-18|2006-01-03|United States Surgical|Valve assembly for introducing instruments into body cavities|

---

US6569120B1|1991-10-18|2003-05-27|United States Surgical Corporation|Seal assembly|

---

US5551448A|1991-10-18|1996-09-03|United States Surgical Corporation|Endoscopic surgical instrument for aspiration and irrigation|

---

US5326013A|1991-10-18|1994-07-05|United States Surgical Corporation|Self contained gas powered surgical apparatus|

---

US20050096605A1|1992-04-24|2005-05-05|Green David T.|Valve assembly for introducing instruments into body cavities|

---

US5197955A|1991-10-18|1993-03-30|Ethicon, Inc.|Universal seal for trocar assembly|

---

US5535759A|1994-11-02|1996-07-16|Wilk; Peter J.|Endoscopic method of cleaning and operating on a site within a patient|

---

US5320610A|1991-12-16|1994-06-14|Inbae Yoon|Automatic retractable trocar with safety shield and method of use|

---

US5334164A|1992-01-03|1994-08-02|United States Surgical Corporation|Variable interior dimension cannula assembly|

---

US5514157A|1992-02-12|1996-05-07|United States Surgical Corporation|Articulating endoscopic surgical apparatus|

---

US5256149A|1992-02-14|1993-10-26|Ethicon, Inc.|Trocar having transparent cannula and method of using|

---

US5419309A|1992-02-18|1995-05-30|Biehl; Albert G.|Tip cleaning accessory for rigid endoscopic instrument|

---

US5201714A|1992-03-05|1993-04-13|Conmed Corporation|Laparoscopic cannula|

---

US5441513A|1992-03-12|1995-08-15|United States Surgical Corporation|Retracting tip trocar assembly|

---

US5274874A|1992-03-13|1994-01-04|Merocel Corporation|Endoscope cleaning and defogging apparatus|

---

DE4211547C2|1992-04-06|1994-08-11|Henke Sass Wolf Gmbh|Protective cover for the distal end of endoscopes|

---

US5226891A|1992-04-07|1993-07-13|Applied Medical Resources|Seal protection apparatus|

---

CA2093748C|1992-04-24|1996-11-12|Roy D. Gravener|Valve assembly for introducing instruments into body cavities|

---

CA2093754C|1992-04-24|1996-08-13|David T. Green|Valve assembly for introducing instruments into body cavities|

---

US5347988A|1992-05-13|1994-09-20|Linvatec Corporation|Endoscope coupler with liquid interface|

---

US5540711A|1992-06-02|1996-07-30|General Surgical Innovations, Inc.|Apparatus and method for developing an anatomic space for laparoscopic procedures with laparoscopic visualization|

---

US6312442B1|1992-06-02|2001-11-06|General Surgical Innovations, Inc.|Method for developing an anatomic space for laparoscopic hernia repair|

---

US5337730A|1992-06-18|1994-08-16|The United States Of America As Represented By The Secretary Of The Air Force|Endoscope cleansing catheter and method of use|

---

CA2098896C|1992-06-30|2005-03-29|H. Jonathan Tovey|Specimen retrieval pouch and method for use|

---

US5496280A|1992-07-02|1996-03-05|Applied Medical Resources Corporation|Trocar valve assembly|

---

US5443452A|1992-07-02|1995-08-22|Applied Medical Resources|Seal assembly for access device|

---

US5279542A|1992-07-23|1994-01-18|Wilk Peter J|Colon irrigation method|

---

US5339800A|1992-09-10|1994-08-23|Devmed Group Inc.|Lens cleaning means for invasive viewing medical instruments with anti-contamination means|

---

US5313934A|1992-09-10|1994-05-24|Deumed Group Inc.|Lens cleaning means for invasive viewing medical instruments|

---

CA2133687C|1992-10-09|2007-03-27|David T. Green|Surgical clip applier|

---

US5575756A|1993-08-16|1996-11-19|Olympus Optical Co., Ltd.|Endoscope apparatus|

---

US5354302A|1992-11-06|1994-10-11|Ko Sung Tao|Medical device and method for facilitating intra-tissue visual observation and manipulation of distensible tissues|

---

US5476475A|1992-11-23|1995-12-19|Applied Medical Resources|Trocar with universal seal protector|

---

US5369525A|1992-12-02|1994-11-29|United States Surgical Corporation|Ring lens assembly for an optical viewing device|

---

US5743884A|1992-12-17|1998-04-28|Hasson; Harrith M.|Sealing structure for medical instrument|

---

US5312351A|1993-01-29|1994-05-17|Gerrone Carmen J|Combined pneumo-needle and trocar apparatus|

---

US5458640A|1993-01-29|1995-10-17|Gerrone; Carmen J.|Cannula valve and seal system|

---

US5320608A|1993-01-29|1994-06-14|Gerrone Carmen J|Combined pneumo-needle and trocar apparatus|

---

US5419311A|1993-02-18|1995-05-30|Olympus Optical Co., Ltd.|Endoscope apparatus of a type having cover for covering the endoscope|

---

US5387197A|1993-02-25|1995-02-07|Ethicon, Inc.|Trocar safety shield locking mechanism|

---

US5370656A|1993-02-26|1994-12-06|Merocel Corporation|Throat pack|

---

US5431676A|1993-03-05|1995-07-11|Innerdyne Medical, Inc.|Trocar system having expandable port|

---

US5551945A|1993-03-16|1996-09-03|Olympus Optical Co., Ltd.|Endoscope system including endoscope and protection cover|

---

US5342315A|1993-04-12|1994-08-30|Ethicon, Inc.|Trocar seal/protector assemblies|

---

US5449370A|1993-05-12|1995-09-12|Ethicon, Inc.|Blunt tipped ultrasonic trocar|

---

US5389081A|1993-05-18|1995-02-14|United States Surgical Corporation|Stabilizer for a valve assembly for introducing instruments into body cavities|

---

AU7047694A|1993-06-03|1995-01-03|Xomed, Inc|Disposable endoscope sheath|

---

US5486154A|1993-06-08|1996-01-23|Kelleher; Brian S.|Endoscope|

---

US5492304A|1993-06-16|1996-02-20|United States Surgical Corporation|Seal assembly for accommodating introduction of surgical instruments|

---

US5312363A|1993-07-13|1994-05-17|Symbiosis Corporation|Low friction slit valve|

---

CA2126150C|1993-07-14|2005-02-22|David T. Green|Seal assembly for accommodating introduction of surgical instruments|

---

US5496142A|1993-07-20|1996-03-05|Applied Materials, Inc.|Slotted conical spring washer|

---

AU7365294A|1993-07-22|1995-02-20|Xomed, Inc|Disposable endoscope sheath|

---

WO1995005112A1|1993-08-18|1995-02-23|Vista Medical Technologies|Optical surgical device|

---

US5391154A|1993-08-30|1995-02-21|United States Surgical Corporation|Trocar seal system|

---

EP0648637A1|1993-09-15|1995-04-19|General Motors Corporation|Vapour recovery system|

---

US5392766A|1993-10-06|1995-02-28|Innerdyne Medical, Inc.|System and method for cleaning viewing scope lenses|

---

US5330437A|1993-11-12|1994-07-19|Ethicon Endo-Surgery|Self sealing flexible elastomeric valve and trocar assembly for incorporating same|

---

US5746695A|1993-11-18|1998-05-05|Asahi Kogaku Kogyo Kabushiki Kaisha|Front end structure of endoscope|

---

WO1995017218A1|1993-12-22|1995-06-29|Baxter International Inc.|Self-priming drip chamber with enhanced visibility|

---

US5448990A|1994-02-15|1995-09-12|Very Inventive Physicians, Inc.|Endoscope viewing cannula and surgical techniques|

---

US5533496A|1994-02-15|1996-07-09|Very Inventive Physicians, Inc.|Endoscopic technique particularly suited for exploratory surgery|

---

US5620458A|1994-03-16|1997-04-15|United States Surgical Corporation|Surgical instruments useful for endoscopic spinal procedures|

---

US5685823A|1994-03-30|1997-11-11|Asahi Kogaku Kogyo Kabushiki Kaisha|End structure of endoscope|

---

US5464008A|1994-04-14|1995-11-07|Kim; John H.|Laparoscope defogging|

---

US5458633A|1994-05-24|1995-10-17|Bailey; Robert W.|Irrigating laparoscopic cannula or trocar|

---

US5782751A|1994-05-26|1998-07-21|Asahi Kogaku Kogyo Kabushiki Kaisha|Side view endoscope|

---

US5569183A|1994-06-01|1996-10-29|Archimedes Surgical, Inc.|Method for performing surgery around a viewing space in the interior of the body|

---

US5518502A|1994-06-08|1996-05-21|The United States Surgical Corporation|Compositions, methods and apparatus for inhibiting fogging of endoscope lenses|

---

US5569205A|1994-07-14|1996-10-29|Hart; Charles C.|Multiport trocar|

---

US5514084A|1994-07-26|1996-05-07|Fisher; Yale|Retractable wipe for cleaning endoscopic surgical devices|

---

US5603702A|1994-08-08|1997-02-18|United States Surgical Corporation|Valve system for cannula assembly|

---

US5590697A|1994-08-24|1997-01-07|G. T. Products, Inc.|Onboard vapor recovery system with two-stage shutoff valve|

---

US5522833A|1994-08-29|1996-06-04|Ethicon Endo-Surgery, Inc.|Retractable obturator for a trocar|

---

US5752938A|1994-09-12|1998-05-19|Richard-Allan Medical Industries, Inc.|Seal for surgical instruments|

---

US5647840A|1994-09-14|1997-07-15|Circon Corporation|Endoscope having a distally heated distal lens|

---

US5554151A|1994-09-27|1996-09-10|United States Surgical Corporation|Specimen retrieval container|

---

US5518026A|1994-09-30|1996-05-21|G. T. Products, Inc.|Filler neck butterfly check valve|

---

US5568828A|1994-11-30|1996-10-29|Stant Manufacturing Inc.|Fuel-delivery control system|

---

US5630813A|1994-12-08|1997-05-20|Kieturakis; Maciej J.|Electro-cauterizing dissector and method for facilitating breast implant procedure|

---

US5643227A|1995-01-19|1997-07-01|Stevens; Robert C.|Hemostasis cannula valve apparatus and method of using same|

---

US5591192A|1995-02-01|1997-01-07|Ethicon Endo-Surgery, Inc.|Surgical penetration instrument including an imaging element|

---

GB2298906A|1995-03-15|1996-09-18|Microsurgical Equipment Ltd|Modular seal system for trocars|

---

US6017333A|1995-04-13|2000-01-25|Bailey; Robert W.|Irrigating laparoscopic cannula|

---

JPH08285001A|1995-04-18|1996-11-01|Mitsui Toatsu Chem Inc|Cushion seal ring for shock absorber|

---

US5662614A|1995-05-09|1997-09-02|Edoga; John K.|Balloon expandable universal access sheath|

---

US5964781A|1995-05-19|1999-10-12|General Surgical Innovations, Inc.|Skin seal with inflatable membrane|

---

US5634911A|1995-05-19|1997-06-03|General Surgical Innovations, Inc.|Screw-type skin seal with inflatable membrane|

---

US5605175A|1995-05-24|1997-02-25|Bergsma; Rudolph|Fluid responsive vent control valve with peel-away opening action|

---

US5584850A|1995-05-25|1996-12-17|Applied Medical Resources Corporation|Trocar having an anti-inversion seal|

---

US5549543A|1995-06-01|1996-08-27|Kim; Il G.|Laparoscopic defogging apparatus|

---

DE19520277C1|1995-06-02|1996-11-21|Winter & Ibe Olympus|Endoscopic instrument with flushing passage|

---

US5643301A|1995-06-07|1997-07-01|General Surgical Innovations, Inc.|Cannula assembly with squeeze operated valve|

---

US5658273A|1995-07-21|1997-08-19|Laser Centers Of America|Apparatus and method for supporting and cleaning an elongate laparoscopic surgical tool used via a cannula|

---

US5545179A|1995-07-21|1996-08-13|Ethicon Endo-Surgery, Inc.|Endoscopic access assembly|

---

US5957888A|1995-10-10|1999-09-28|United States Surgical Corporation|Surgical cannula having a variable length|

---

US5709671A|1995-10-16|1998-01-20|Ethicon Endo-Surgery, Inc.|Trocar having an improved tip configuration|

---

US5807338A|1995-10-20|1998-09-15|United States Surgical Corporation|Modular trocar system and methods of assembly|

---

US5871440A|1995-12-15|1999-02-16|Olympus Optical Co., Ltd.|Endoscope|

---

US5628732A|1996-01-19|1997-05-13|Ethicon Endo-Surgery, Inc.|Trocar with improved universal seal|

---

US5651757A|1996-02-15|1997-07-29|Meckstroth; Clyde S.|Endoscope warmer|

---

US5725478A|1996-03-14|1998-03-10|Saad; Saad A.|Methods and apparatus for providing suction and/or irrigation in a rigid endoscope while maintaining visual contact with a target area through the endoscope|

---

US5814026A|1996-03-19|1998-09-29|Yoon; Inbae|Endoscopic portal having a universal seal and methods for introducing instruments therethrough|

---

US6679833B2|1996-03-22|2004-01-20|Sdgi Holdings, Inc.|Devices and methods for percutaneous surgery|

---

AU2324697A|1996-03-22|1997-10-10|Sdgi Holdings, Inc.|Devices and methods for percutaneous surgery|

---

US7198598B2|1996-03-22|2007-04-03|Warsaw Orthopedic, Inc.|Devices and methods for percutaneous surgery|

---

US5792044A|1996-03-22|1998-08-11|Danek Medical, Inc.|Devices and methods for percutaneous surgery|

---

TW375522B|1996-10-24|1999-12-01|Danek Medical Inc|Devices for percutaneous surgery under direct visualization and through an elongated cannula|

---

US5788676A|1996-03-25|1998-08-04|Yoon; Inbae|Endoscopic portal having multiple universal seals and method of introducing instruments therethrough|

---

RU2117493C1|1996-04-02|1998-08-20|Сысолятин Павел Гаврилович|Method of administration of drugs into articular cavity|

---

US5902264A|1996-04-26|1999-05-11|United States Surgical Corporation|Endoscopic surgical instrument for aspiration and irrigation|

---

DE19619065C2|1996-05-13|2000-12-28|Storz Karl Gmbh & Co Kg|Trocar sleeve with a valve|

---

US5820600A|1996-05-14|1998-10-13|Innerdyne, Inc.|Adjustable introducer valve|

---

US5882345A|1996-05-22|1999-03-16|Yoon; Inbae|Expandable endoscopic portal|

---

US5842971A|1996-05-22|1998-12-01|Yoon; Inbae|Optical endoscopic portals and methods of using the same to establish passages through cavity walls|

---

US5820606A|1996-06-11|1998-10-13|Origin Medsystems, Inc.|Reusable cannula with disposable seal|

---

WO1998009673A1|1996-09-05|1998-03-12|Applied Medical Resources Corporation|Modular trocar|

---

US6036667A|1996-10-04|2000-03-14|United States Surgical Corporation|Ultrasonic dissection and coagulation system|

---

USD399316S|1996-10-29|1998-10-06|Incutech, Inc.|Syringe needle cushion with cover|

---

US5944654A|1996-11-14|1999-08-31|Vista Medical Technologies, Inc.|Endoscope with replaceable irrigation tube|

---

US5792113A|1996-12-12|1998-08-11|Ethicon Endo-Surgerym Inc.|Universal seal for a trocar|

---

SE508772C2|1997-01-31|1998-11-02|Sven A Swallert|Device with an aperture covered by a glass plate or lens|

---

US5848992A|1997-03-07|1998-12-15|Hart; Charles C.|Superfascial surgical access device|

---

US5906595A|1997-04-25|1999-05-25|Ethicon Endo-Surgery, Inc.|Trocar having protector with flexible end and improved seal assembly|

---

US5906577A|1997-04-30|1999-05-25|University Of Massachusetts|Device, surgical access port, and method of retracting an incision into an opening and providing a channel through the incision|

---

ES2287857T3|1997-05-02|2007-12-16|United States Surgical Corporation|CANULA ASSEMBLY|

---

US5817061A|1997-05-16|1998-10-06|Ethicon Endo-Surgery, Inc.|Trocar assembly|

---

EP1745810B1|1997-05-28|2009-07-08|United States Surgical Corporation|Trocar seal system|

---

US6004326A|1997-09-10|1999-12-21|United States Surgical|Method and instrumentation for implant insertion|

---

US6013227A|1997-12-17|2000-01-11|Johnson & Johnson Medical, Inc.|Lumen device reprocessor without occlusion|

---

WO1999042028A1|1998-02-19|1999-08-26|California Institute Of Technology|Apparatus and method for providing spherical viewing during endoscopic procedures|

---

US5989224A|1998-02-23|1999-11-23|Dexide Corporation|Universal seal for use with endoscopic cannula|

---

US6093176A|1998-03-10|2000-07-25|Core Dynamics, Inc.|Trocar with disposable valve and reusable cannula|

---

US6497714B1|1998-07-16|2002-12-24|Olympus Optical Co., Ltd.|Ultrasonic trocar|

---

US6976957B1|1998-06-22|2005-12-20|Origin Medsystems, Inc.|Cannula-based surgical instrument and method|

---

US6176825B1|1998-06-22|2001-01-23|Origin Medsystems, Inc.|Cannula-based irrigation system and method|

---

US6126592A|1998-09-12|2000-10-03|Smith & Nephew, Inc.|Endoscope cleaning and irrigation sheath|

---

US6873409B1|1998-11-17|2005-03-29|Kaiser Optical Systems|Optical probe with sampling window cleaning configuration|

---

US6534002B1|1998-12-30|2003-03-18|Ethicon, Inc.|Flow of fluid through a lumen device from smaller-caliber end to larger-caliber end|

---

USD425619S|1999-01-06|2000-05-23|Venetec International, Inc.|Catheter anchor|

---

DE19910295C2|1999-03-09|2002-06-20|Storz Karl Gmbh & Co Kg|Medical or technical endoscopic instrument|

---

US6258065B1|1999-03-26|2001-07-10|Core Dynamics, Inc.|Surgical instrument seal assembly|

---

US6860869B2|1999-03-26|2005-03-01|William G. Dennis|Surgical instrument seal assembly|

---

JP2000279370A|1999-03-31|2000-10-10|Fuji Photo Optical Co Ltd|Washing device for observation window of endoscope|

---

US6216661B1|1999-04-01|2001-04-17|Randy Pickens|Filtered carburetor cover|

---

ES2272285T3|1999-05-14|2007-05-01|Gen-Probe Incorporated|PERFORABLE PLUG WITH INTERNAL VERTICE.|

---

US6716396B1|1999-05-14|2004-04-06|Gen-Probe Incorporated|Penetrable cap|

---

US6860892B1|1999-05-28|2005-03-01|General Surgical Innovations, Inc.|Specially shaped balloon device for use in surgery and method of use|

---

US6253802B1|1999-05-28|2001-07-03|Borgwarner Inc.|Electromechanically controlled refueling valve|

---

US6167920B1|1999-05-28|2001-01-02|Borgwarner Inc.|Electromechanical refueling control system|

---

US20020161387A1|2000-06-22|2002-10-31|Blanco Ernesto E.|Safety trocar with progressive cutting tip guards and gas jet tissue deflector|

---

EP1196214B1|1999-06-22|2008-08-20|Ernesto E. Blanco|Safety trocar with progressive cutting tip guards and gas jet tissue deflector|

---

IE990795A1|1999-07-30|2001-03-07|Gaya Ltd|Hand Access Port Device|

---

JP3565099B2|1999-08-02|2004-09-15|富士写真光機株式会社|Endoscope fluid supply device|

---

US6447446B1|1999-11-02|2002-09-10|Medtronic Xomed, Inc.|Method and apparatus for cleaning an endoscope lens|

---

US6354992B1|1999-11-08|2002-03-12|Daniel T. Kato|Automated laparoscopic lens cleaner|

---

US6287313B1|1999-11-23|2001-09-11|Sdgi Holdings, Inc.|Screw delivery system and method|

---

AU3837701A|2000-02-18|2001-08-27|Univ Massachussets|Devices and methods for warming and cleaning lenses of optical surgical instruments|

---

IL134630D0|2000-02-20|2001-04-30|Spintech Technologies Ltd|Lens protection mechanism|

---

US6595946B1|2000-02-25|2003-07-22|United States Surgical Corporation|Valve assembly|

---

US6319266B1|2000-03-16|2001-11-20|United States Surgical Corporation|Trocar system and method of use|

---

US6648906B2|2000-04-06|2003-11-18|Innercool Therapies, Inc.|Method and apparatus for regulating patient temperature by irrigating the bladder with a fluid|

---

US6663598B1|2000-05-17|2003-12-16|Scimed Life Systems, Inc.|Fluid seal for endoscope|

---

GB0012461D0|2000-05-24|2000-07-12|Surgical Innovations Ltd|Surgical seal|

---

US7056321B2|2000-08-01|2006-06-06|Endius, Incorporated|Method of securing vertebrae|

---

JP3945133B2|2000-08-02|2007-07-18|フジノン株式会社|Endoscope observation window cleaning device|

---

JP3785908B2|2000-08-17|2006-06-14|フジノン株式会社|Endoscope observation window cleaning device|

---

US6685665B2|2000-09-08|2004-02-03|Pall Corporation|Cannula assembly|

---

US6679834B2|2000-09-22|2004-01-20|Pilling Weck Incorporated|Endoscopic suction-irrigation instrument for surgery|

---

US20060020281A1|2000-10-13|2006-01-26|Smith Robert C|Valve assembly including diameter reduction structure for trocar|

---

US7025747B2|2000-10-13|2006-04-11|Tyco Healthcare Group Lp|Valve assembly including diameter reduction structure for trocar|

---

US6942671B1|2000-11-06|2005-09-13|Tyco Healthcare Group Lp|Surgical sealing apparatus|

---

JP3845296B2|2000-11-29|2006-11-15|オリンパス株式会社|Endoscope dirt remover|

---

US6820614B2|2000-12-02|2004-11-23|The Bonutti 2003 Trust -A|Tracheal intubination|

---

US20020103420A1|2001-01-26|2002-08-01|George Coleman|Endoscope with alterable viewing angle|

---

JP3890900B2|2001-02-21|2007-03-07|フジノン株式会社|Ultrasound endoscope|

---

JP2002282274A|2001-03-23|2002-10-02|Fuji Photo Optical Co Ltd|Cleaner for endoscope|

---

US6712757B2|2001-05-16|2004-03-30|Stephen Becker|Endoscope sleeve and irrigation device|

---

US6679837B2|2001-06-01|2004-01-20|Intlas Ltd.|Laser light irradiation apparatus|

---

IL143682D0|2001-06-11|2002-04-21|Shalman Michael|Endoscope with cleaning optics|

---

US20030004529A1|2001-06-28|2003-01-02|Mark Tsonton|Trocar having an improved seal design|

---

JP2003010102A|2001-06-29|2003-01-14|Terumo Corp|Medical energy irradiator|

---

US6916286B2|2001-08-09|2005-07-12|Smith & Nephew, Inc.|Endoscope with imaging probe|

---

JP4324471B2|2001-08-14|2009-09-02|アプライドメディカルリソーシーズコーポレイション|Access path sealing device|

---

US6989003B2|2001-08-31|2006-01-24|Conmed Corporation|Obturator and cannula for a trocar adapted for ease of insertion and removal|

---

US7344519B2|2001-08-31|2008-03-18|Conmed Corporation|Trocar system|

---

US20040260244A1|2001-08-31|2004-12-23|Piechowicz Michael E.|Seals for trocars|

---

EP2984998B1|2004-06-29|2017-03-15|Applied Medical Resources Corporation|Insufflating optical surgical instrument|

---

US6605098B2|2001-09-28|2003-08-12|Ethicon, Inc.|Surgical device for creating an anastomosis between first and second hollow organs|

---

US7052454B2|2001-10-20|2006-05-30|Applied Medical Resources Corporation|Sealed surgical access device|

---

US7438702B2|2001-11-13|2008-10-21|Applied Medical Resources Corporation|Multi-seal trocar system|

---

EP1323382B1|2001-12-27|2009-02-25|Olympus Corporation|Sheath with devices for endoscopic blood vessel harvesting|

---

DE60235793D1|2001-12-28|2010-05-12|Terumo Corp|Apparatus for obtaining living tissue|

---

JP3671002B2|2001-12-28|2005-07-13|オリンパス株式会社|Endoscope sheath|

---

US6668418B2|2002-01-22|2003-12-30|Daniel Bastien|Squeegee implement|

---

US7235062B2|2002-01-24|2007-06-26|Applied Medical Resources Corporation|Surgical access device with floating gel seal|

---

US7060025B2|2002-03-15|2006-06-13|Ethicon Endo-Surgery, Inc.|Method for controlling position of medical instruments|

---

JP4034584B2|2002-03-28|2008-01-16|フジノン株式会社|Endoscope imaging device|

---

US20030187397A1|2002-03-29|2003-10-02|Dario Vitali|Trocar with a reinforced seal|

---

US7632250B2|2002-05-10|2009-12-15|Tyco Healthcare Group Lp|Introducer seal assembly|

---

EP2363105B1|2002-06-05|2014-01-08|Applied Medical Resources Corporation|Wound retractor|

---

JP4130940B2|2002-06-17|2008-08-13|Ｈｏｙａ株式会社|End of the endoscope|

---

US20040034339A1|2002-08-16|2004-02-19|The Regents Of The University Of California|Device for improved visualization of operative sites during surgery|

---

US7083626B2|2002-10-04|2006-08-01|Applied Medical Resources Corporation|Surgical access device with pendent valve|

---

US7105009B2|2002-10-16|2006-09-12|Applied Medical Resources Corporation|Access device maintenance apparatus and method|

---

DE60325879D1|2002-11-08|2009-03-05|Tyco Healthcare|SELF-CLOSING CANNULA|

---

US7390317B2|2002-12-02|2008-06-24|Applied Medical Resources Corporation|Universal access seal|

---

US8147457B2|2003-03-21|2012-04-03|Ethicon Endo-Surgery, Inc.|Conical trocar seal|

---

US9486241B2|2003-03-21|2016-11-08|Ethicon Endo-Surgery, Llc|Trocar seal assembly|

---

US7854724B2|2003-04-08|2010-12-21|Surgiquest, Inc.|Trocar assembly with pneumatic sealing|

---

CA2522617C|2003-04-25|2012-04-17|Tyco Healthcare Group Lp|Surgical access apparatus|

---

JP3938760B2|2003-05-12|2007-06-27|オリンパス株式会社|Fluid control input means|

---

US7165568B2|2003-05-29|2007-01-23|Axial Technologies Limited|Rotating valve assembly|

---

DE10330518B4|2003-07-05|2006-11-30|Carl Zeiss Ag|Surgical microscope with fluid flow curtain|

---

US20070142709A1|2003-08-04|2007-06-21|Vision-Sciences, Inc.|Sheath with channel for endoscope|

---

GB0318740D0|2003-08-09|2003-09-10|Orr Paul|Flexible fibreoptic endoscope|

---

US7771384B2|2003-08-20|2010-08-10|Biagio Ravo|Trocar with integral irrigation and suction tube|

---

US7163510B2|2003-09-17|2007-01-16|Applied Medical Resources Corporation|Surgical instrument access device|

---

EP1663344A4|2003-09-24|2007-11-14|Applied Med Resources|Anti-inversion trocar seal|

---

US7785294B2|2003-09-30|2010-08-31|Ethicon Endo-Surgery, Inc.|Woven protector for trocar seal assembly|

---

US20050070947A1|2003-09-30|2005-03-31|Franer Paul T.|Rotational latching system for a trocar|

---

US20050070850A1|2003-09-30|2005-03-31|Albrecht Thomas E.|Low-profile, recessed stop-cock valve for trocar assembly|

---

US8034032B2|2003-09-30|2011-10-11|Ethicon Endo-Surgery, Inc.|Multi-angled duckbill seal assembly|

---

US8029475B2|2003-09-30|2011-10-04|Ethicon Endo-Surgery, Inc.|Reinforced seal assembly|

---

RU2254811C1|2003-10-24|2005-06-27|Сухонос Юрий Анатольевич|Method and device for diagnosing articulation diseases|

---

US8951275B2|2003-11-20|2015-02-10|Children's Medical Center Corporation|Trocar for use during endoscopy|

---

JP4329510B2|2003-11-26|2009-09-09|株式会社デンソー|Ignition coil|

---

CA2547848A1|2003-12-12|2005-07-07|Applied Medical Resources Corporation|Shielded septum trocar seal|

---

US8652089B2|2004-01-19|2014-02-18|Arthrex, Inc.|System for distending body tissue cavities by continuous flow irrigation|

---

JP4448348B2|2004-03-10|2010-04-07|Ｈｏｙａ株式会社|Endoscope water channel|

---

US20050203543A1|2004-03-15|2005-09-15|Nabil Hilal|Surgical guide valve|

---

US8292853B2|2004-03-24|2012-10-23|Applied Medical Resources Corporation|Self-sealing cannula having integrated seals|

---

JP4868602B2|2004-04-05|2012-02-01|タイコ・ヘルスケア・グループ・リミテッド・パートナーシップ|Surgical hand access device|

---

EP1732623B1|2004-04-05|2014-07-16|Covidien LP|Surgical hand access apparatus|

---

JP4546143B2|2004-05-10|2010-09-15|オリンパス株式会社|Endoscope anti-fogging device|

---

US7811228B2|2004-07-26|2010-10-12|Medtronic Xomed, Inc.|Disposable endoscope sheath having adjustable length|

---

US7444801B2|2004-08-05|2008-11-04|Avraham Rozenvasser|Method of weaving links and resulting product|

---

US7207347B2|2004-08-23|2007-04-24|Raval A.S.C. Ltd.|Dual function valve for fuel tank|

---

US8241251B2|2004-08-25|2012-08-14|Tyco Healthcare Group Lp|Gel seal for a surgical trocar apparatus|

---

US8591464B2|2004-08-27|2013-11-26|Atul Kumar|Low turbulence fluid management system for endoscopic procedures|

---

WO2006021880A2|2004-08-27|2006-03-02|Atul Kumar|A tissue cavity distending system with low turbulence|

---

US8388570B2|2004-08-27|2013-03-05|Atul Kumar|Controlled tissue cavity distending system with minimal turbulence|

---

WO2006024929A2|2004-09-03|2006-03-09|Atul Kumar|An electromagnetically controlled tissue cavity distending system|

---

US7479106B2|2004-09-30|2009-01-20|Boston Scientific Scimed, Inc.|Automated control of irrigation and aspiration in a single-use endoscope|

---

US20060069312A1|2004-09-30|2006-03-30|Scimed Life Systems, Inc.|System for retaining optical clarity in a medical imaging system|

---

US20060068360A1|2004-09-30|2006-03-30|Scimed Life Systems, Inc.|Single use fluid reservoir for an endoscope|

---

JP2006130073A|2004-11-05|2006-05-25|Olympus Corp|Ultrasonic trocar|

---

US7811253B2|2004-12-09|2010-10-12|Applied Medical Resources Corporation|Insufflation gas warmer and humidifier|

---

US7163525B2|2004-12-17|2007-01-16|Ethicon Endo-Surgery, Inc.|Duckbill seal protector|

---

US7371227B2|2004-12-17|2008-05-13|Ethicon Endo-Surgery, Inc.|Trocar seal assembly|

---

US7481795B2|2004-12-17|2009-01-27|Ethicon Endo-Surgery, Inc.|Circumferential trocar seal assembly|

---

US20060149137A1|2005-01-05|2006-07-06|Applied Medical Resources Corporation|Easily placeable and removable wound retractor|

---

US7608082B2|2005-01-06|2009-10-27|Tyco Healthcare Group Lp|Surgical seal for use in a surgical access apparatus|

---

JP4451316B2|2005-01-07|2010-04-14|オリンパスメディカルシステムズ株式会社|Endoscope insertion part and endoscope|

---

WO2006073187A1|2005-01-07|2006-07-13|Olympus Medical Systems Corp.|Endoscope-use insertion unit|

---

USD541417S1|2005-02-08|2007-04-24|Ethicon Endo-Surgery, Inc.|Trocar|

---

US8328768B2|2005-02-11|2012-12-11|Angiodynamics, Inc|Pressure activated safety valve with improved flow characteristics and durability|

---

JP4472549B2|2005-02-14|2010-06-02|オリンパスメディカルシステムズ株式会社|Endoscope device|

---

WO2006087771A1|2005-02-15|2006-08-24|Fujitsu Limited|Spring pressing unit and fitting washer|

---

USD555788S1|2005-02-28|2007-11-20|Unomedical Limited|Device for fixating a tube relative to a skin surface part of a patient or person|

---

US7582071B2|2005-03-28|2009-09-01|Tyco Healthcare Group Lp|Introducer seal assembly|

---

US7931624B2|2005-04-05|2011-04-26|Tyco Healthcare Group Lp|Introducer seal assembly with low profile gimbal seal|

---

US7591802B2|2005-04-29|2009-09-22|Applied Medical Resources Corporation|Seal housing having anti-inversion features|

---

WO2006125054A1|2005-05-17|2006-11-23|Wilson-Cook Medical Inc.|Hemostasis flushing device|

---

US8932208B2|2005-05-26|2015-01-13|Maquet Cardiovascular Llc|Apparatus and methods for performing minimally-invasive surgical procedures|

---

US7875019B2|2005-06-20|2011-01-25|C. R. Bard, Inc.|Connection system for multi-lumen catheter|

---

US20060293559A1|2005-06-24|2006-12-28|Grice George D Iii|Disposable scope cleaner and method of using same|

---

US20070005087A1|2005-06-30|2007-01-04|Smith Robert C|Thin bladed obturator with curved surfaces|

---

EP1933733A2|2005-10-14|2008-06-25|Applied Medical Resources Corporation|Surgical access port|

---

JP2007117289A|2005-10-26|2007-05-17|Olympus Medical Systems Corp|Sheath for endoscope, endoscope apparatus|

---

US20080249475A1|2006-02-22|2008-10-09|Applied Medical Resources Corporation|Trocar seal|

---

JP5009541B2|2006-03-06|2012-08-22|富士フイルム株式会社|Endoscope flow path merging structure|

---

US20070225556A1|2006-03-23|2007-09-27|Ethicon Endo-Surgery, Inc.|Disposable endoscope devices|

---

JP2007252673A|2006-03-24|2007-10-04|Fujinon Corp|Endoscope observation window washing system|

---

JP4981344B2|2006-04-13|2012-07-18|富士フイルム株式会社|Endoscope balloon unit|

---

US7507210B2|2006-05-01|2009-03-24|Ethicon Endo-Surgery, Inc.|Biopsy cannula adjustable depth stop|

---

USD567372S1|2006-11-30|2008-04-22|Medical Components, Inc.|Catheter information clip|

---

USD565729S1|2006-11-30|2008-04-01|Medical Components, Inc.|Catheter information clip|

---

EP2101662B1|2006-12-18|2018-07-11|SurgiQuest, Incorporated|System for surgical insufflation and gas recirculation|

---

US20100063364A1|2007-02-01|2010-03-11|Frank Bonadio|Instrument insertion device|

---

US8491568B2|2007-05-16|2013-07-23|Coloplast A/S|Coupling arrangement for a telescopic device|

---

CA2631607A1|2007-05-22|2008-11-22|Tyco Healthcare Group Lp|Surgical portable apparatus with variable adjustment|

---

EP1994894A1|2007-05-22|2008-11-26|Tyco Healthcare Group LP|Access assembly with ribbed seal|

---

US8100929B2|2007-06-29|2012-01-24|Ethicon Endo-Surgery, Inc.|Duckbill seal with fluid drainage feature|

---

US20090093682A1|2007-10-05|2009-04-09|Tyco Healthcare Group Lp|Surgical portal with foam and fabric composite seal assembly|

---

US20090105635A1|2007-10-17|2009-04-23|Tyco Healthcare Group Lp|Access assembly with seal lubricant mechanism|

---

EP2231233B1|2008-01-25|2016-03-30|Applied Medical Resources Corporation|Insufflating access system|

---

EP2247335B1|2008-03-03|2014-09-03|Applied Medical Resources Corporation|Balloon trocar advanced fixation|

---

ES2637790T3|2008-03-14|2017-10-17|Applied Medical Resources Corporation|Instrument seal|

---

WO2009117694A2|2008-03-20|2009-09-24|Applied Medical Resources Corporation|Instrument seal with inverting shroud|

---

USD589617S1|2008-04-21|2009-03-31|Tyco Healthcare Group Lp|Cannula assembly|

---

US8550988B2|2008-04-21|2013-10-08|Covidien Lp|Endoscopic cleaner|

---

US8870747B2|2008-04-28|2014-10-28|Ethicon Endo-Surgery, Inc.|Scraping fluid removal in a surgical access device|

---

US8636686B2|2008-04-28|2014-01-28|Ethicon Endo-Surgery, Inc.|Surgical access device|

---

US8579807B2|2008-04-28|2013-11-12|Ethicon Endo-Surgery, Inc.|Absorbing fluids in a surgical access device|

---

US8273060B2|2008-04-28|2012-09-25|Ethicon Endo-Surgery, Inc.|Fluid removal in a surgical access device|

---

US8568362B2|2008-04-28|2013-10-29|Ethicon Endo-Surgery, Inc.|Surgical access device with sorbents|

---

US9358041B2|2008-04-28|2016-06-07|Ethicon Endo-Surgery, Llc|Wicking fluid management in a surgical access device|

---

US7981092B2|2008-05-08|2011-07-19|Ethicon Endo-Surgery, Inc.|Vibratory trocar|

---

US8075528B2|2008-10-30|2011-12-13|Ethicon Endo-Surgery, Inc.|Surgical access port with flexible sealing cannula|

---

JP3151790U|2009-02-09|2009-07-09|正 西|Water pull wrist ring|

---

US8206357B2|2009-03-26|2012-06-26|Tyco Healthcare Group Lp|Articulating surgical portal apparatus with spring|

---

CN102109153B|2010-12-01|2012-11-21|鸿富锦精密工业（深圳）有限公司|Routing positioning device of hollow rod|

---

USD652509S1|2011-07-14|2012-01-17|Zefon International, Inc.|Slotted catheter securement device|US8690831B2|2008-04-25|2014-04-08|Ethicon Endo-Surgery, Inc.|Gas jet fluid removal in a trocar|

---

US8870747B2|2008-04-28|2014-10-28|Ethicon Endo-Surgery, Inc.|Scraping fluid removal in a surgical access device|

---

US11235111B2|2008-04-28|2022-02-01|Ethicon Llc|Surgical access device|

---

US8568362B2|2008-04-28|2013-10-29|Ethicon Endo-Surgery, Inc.|Surgical access device with sorbents|

---

US8579807B2|2008-04-28|2013-11-12|Ethicon Endo-Surgery, Inc.|Absorbing fluids in a surgical access device|

---

US9358041B2|2008-04-28|2016-06-07|Ethicon Endo-Surgery, Llc|Wicking fluid management in a surgical access device|

---

USD700326S1|2008-04-28|2014-02-25|Ethicon Endo-Surgery, Inc.|Trocar housing|

---

US8273060B2|2008-04-28|2012-09-25|Ethicon Endo-Surgery, Inc.|Fluid removal in a surgical access device|

---

US8636686B2|2008-04-28|2014-01-28|Ethicon Endo-Surgery, Inc.|Surgical access device|

---

US7981092B2|2008-05-08|2011-07-19|Ethicon Endo-Surgery, Inc.|Vibratory trocar|

---

US8915842B2|2008-07-14|2014-12-23|Ethicon Endo-Surgery, Inc.|Methods and devices for maintaining visibility and providing irrigation and/or suction during surgical procedures|

---

US8702596B2|2010-09-17|2014-04-22|United States Endoscopy Group, Inc.|Biopsy inlet valve improvements|

---

US8690764B2|2010-10-20|2014-04-08|Covidien Lp|Endoscope cleaner|

---

US9033872B2|2011-02-16|2015-05-19|Reza Mohajer-Shojaee|Laparoscopic cannula with suturing capability|

---

US10420585B2|2011-02-16|2019-09-24|Reza Mohajer-Shojaee|Laparoscopic cannula with suturing passage cutoff|

---

JP5409742B2|2011-09-30|2014-02-05|富士フイルム株式会社|Plug|

---

US8708889B2|2011-10-24|2014-04-29|Trocare, LLC|Jawed trocar assembly|

---

EA026616B1|2011-10-24|2017-04-28|ТроКэа ЭлЭлСи|Jawed trocar tip assembly|

---

JP6076469B2|2012-05-09|2017-02-08|イーオン サージカル リミテッド|Laparoscopic port|

---

CN110338910A|2012-11-20|2019-10-18|瑟吉奎斯特公司|For carrying out the system and method for smoke evacuator during laprascopic surgical procedure|

---

KR102206435B1|2013-03-15|2021-01-22|어플라이드 메디컬 리소시스 코포레이션|Trocar cannula assembly with low profile insertion configuration and method of manufacture|

---

US20160311294A1|2015-04-27|2016-10-27|Carrier Corporation|Regulated output power from a transport refrigeration unit|

---

CA2985626A1|2015-05-15|2016-11-24|Covidien Lp|Surgical access device|

---

US10413322B2|2015-10-27|2019-09-17|Intai Technology Corp.|Assembling surgical access device|

---

US20170216015A1|2016-02-01|2017-08-03|DePuy Synthes Products, Inc.|Tissue augmentation scaffolds for use with soft tissue fixation repair systems and methods|

---

US10299785B2|2016-04-01|2019-05-28|Ethicon Llc|Surgical access devices with integrated wound closure features|

---

CN106214191B|2016-08-24|2018-10-16|魏云海|A kind of puncture outfit of air pressure balance|

---

CN106725756A|2016-12-02|2017-05-31|青岛华仁医疗用品有限公司|A kind of antifouling mirror abdominal operation puncture outfit|

---

US10758719B2|2016-12-15|2020-09-01|Surmodics, Inc.|Low-friction sealing devices|

---

CN109124733B|2017-06-28|2020-11-10|江苏风和医疗器材股份有限公司|Puncture outfit and cannula assembly thereof|

---

US10869690B2|2017-06-29|2020-12-22|Ethicon Llc|Trocar obturator with transverse needle ports|

---

US10675018B2|2017-06-29|2020-06-09|Ethicon Llc|Needle guide instrument with transverse suture capture feature|

---

US10568619B2|2017-06-29|2020-02-25|Ethicon Llc|Surgical port with wound closure channels|

---

US10485580B2|2017-06-29|2019-11-26|Ethicon Llc|Trocar with oblique needle insertion port and coplanar stopcock|

---

US10709473B2|2017-06-29|2020-07-14|Ethicon Llc|Trocar obturator with detachable rotary tissue fastener|

---

US10939937B2|2017-06-29|2021-03-09|Ethicon Llc|Trocar with oblique needle insertion port and perpendicular seal latch|

---

US10639068B2|2017-06-29|2020-05-05|Ethicon Llc|Trocar with oblique needle insertion port and perpendicular seal latch|

---

US10709440B2|2017-06-29|2020-07-14|Ethicon Llc|Suture passing instrument with puncture site identification feature|

---

US10639029B2|2017-06-29|2020-05-05|Ethicon Llc|Suture grasping instrument|

---

US20210338283A1|2020-05-01|2021-11-04|Ethicon Llc|Tilting tang cannula depth limiter|

---

US20210338274A1|2020-05-01|2021-11-04|Ethicon Llc|Threaded cannula depth limiter|

---

US20210338276A1|2020-05-01|2021-11-04|Ethicon Llc|Balancing feature for reusable trocar|

---

US20210338275A1|2020-05-01|2021-11-04|Ethicon Llc|Two-piece separable obturator|

---

US20210338273A1|2020-05-01|2021-11-04|Ethicon Llc|Pinch-to-clamp cannula depth limiter|

---

US20210338281A1|2020-05-01|2021-11-04|Ethicon Llc|Multi-diameter cannula depth limiter|

---

US20210338282A1|2020-05-01|2021-11-04|Ethicon Llc|Universal size multi-walled elastomer cannula depth limiter|

---

US20210338371A1|2020-05-01|2021-11-04|Ethicon Llc|Stabilizer for surgical shafts or cannulas|

---

US20210338278A1|2020-05-01|2021-11-04|Ethicon Llc|Airflow channels and patterns in lumen for cannula|

---

US20210338272A1|2020-05-01|2021-11-04|Ethicon Llc|Pinch to release cannula depth limiter|

---

US20210338269A1|2020-05-01|2021-11-04|Ethicon Llc|Latchless obturator with interference fit feature|

法律状态:
2020-09-01| B06F| Objections, documents and/or translations needed after an examination request according [chapter 6.6 patent gazette]|

---

2020-09-08| B06U| Preliminary requirement: requests with searches performed by other patent offices: procedure suspended [chapter 6.21 patent gazette]|

---

2021-01-05| B15K| Others concerning applications: alteration of classification|Free format text: AS CLASSIFICACOES ANTERIORES ERAM: A61B 17/34 , A61B 19/00 Ipc: A61B 17/34 (2006.01) |

---

2021-02-09| B09A| Decision: intention to grant [chapter 9.1 patent gazette]|

---

2021-05-04| B16A| Patent or certificate of addition of invention granted [chapter 16.1 patent gazette]|Free format text: PRAZO DE VALIDADE: 20 (VINTE) ANOS CONTADOS A PARTIR DE 21/07/2010, OBSERVADAS AS CONDICOES LEGAIS. PATENTE CONCEDIDA CONFORME MEDIDA CAUTELAR DE 07/04/2021 - ADI 5.529/DF |

优先权:

---

申请号 | 申请日 | 专利标题

---

US12/533,590|2009-07-31|

---

US12/533,590|US8568362B2|2008-04-28|2009-07-31|Surgical access device with sorbents|

---

PCT/US2010/042765|WO2011014394A1|2009-07-31|2010-07-21|Surgical access devices with sorbents|

---