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    • 专利摘要:
    valve assembly configured and adapted to selectively control a flow of pressurized fluid from a source to the trocars; and appliance. a valve assembly and method are provided to selectively control a flow of pressurized fluid from a fluid source to the trocars. the valve assembly includes a first connector configured and adapted to mate with a primary trocar for directing pressurized fluid thereto, a second connector configured and adapted to mate with a secondary trocar for directing pressurized fluid thereto, a third connector configured and adapted to mate with a source of pressurized fluid to direct pressurized fluid from the source to the first and second connectors; and at least one valve member adapted and configured to be operable in at least a first and second operating position, wherein (i) the first operating position directs pressurized fluid from the source to a coupled primary trocar while preventing the pressurized fluid from the source moves to the at least one coupled secondary trocar, and (ii) the second operating position directs pressurized fluid from the source to the coupled primary trocar and to the at least one coupled secondary trocar.
    公开号:BR112015004890B1
    申请号:R112015004890-0
    申请日:2013-09-05
    公开日:2021-07-27
    发明作者:Dominick Mastri；Raymond Yue-Sing Tang；Ralph Stearns；Kenneth Blier
    申请人:Surgiquest, Inc.；
    IPC主号:
    专利说明:

    CROSS REFERENCE TO RELATED ORDERS
    [001]This patent application claims priority from US Patent Application 13/606,824, filed September 7, 2012, the contents of which are incorporated herein in their entirety by reference. HISTORY OF THE INVENTION FIELD OF THE INVENTION
    [002] The present invention relates to systems and methods for surgical access, and more particularly, to systems and methods for delivering pressurized fluid to surgical devices. DESCRIPTION OF RELATED TECHNIQUE
    [003] Laparoscopic, or “minimally invasive” surgical techniques are becoming increasingly common. Benefits of such procedures include reduced trauma to the patient, reduced opportunity for infection, and decreased recovery time. Such procedures within the abdominal cavity are typically performed through a device known as a trocar or cannula, which facilitates the introduction of laparoscopic instruments into a patient's abdominal cavity.
    [004] Additionally, such procedures commonly involve filling or “inflating” the abdominal (peritoneal) cavity with a pressurized fluid, such as carbon dioxide, to create what is referred to as a pneumoperitoneum. Insufflation can be performed by a trocar equipped to deliver filling fluid, or by means of an inflation device, such as an inflation needle. The introduction of surgical instruments into the pneumoperitoneum without substantial loss of fill gas is desirable in order to maintain the pneumoperitoneum.
    [005] During typical laparoscopic procedures, a surgeon makes three to four small incisions that are usually not larger than about twelve millimeters each, and typically made with the trocar devices themselves using a separate inserter or obturator placed therein. After insertion, the inserter is removed, and the exchanger allows instruments to be inserted through it into the abdominal cavity. Typical trocars often provide a means to inflate the abdominal cavity so that the surgeon has an open interior space in which to work.
    [006] Once inserted, the trocar must provide a means to maintain pressure within the cavity, which requires providing a seal between the trocar and the surgical instruments being used while allowing at least some freedom of movement of the surgical instruments. Such instruments can include, for example, scissors, grasping instruments, occlusion instruments, cautery units, cameras, light sources, and other surgical instruments. Sealing elements and mechanisms are typically provided on the trocars to prevent the escape of filling gas. The sealing elements and mechanisms typically include a duckbill type valve made of a relatively collapsible material, and are configured to seal around an external surface of the surgical instruments traversing the trocar. However, sealing performed in this manner cannot seal between multiple instruments, and inhibits free movement of the surgical instruments and/or tissue removal through the trocar. Such seals are also vulnerable to damage during the surgical procedure. Alternatively, a spring loaded hinge valve or safety port can be used. However, these types of mechanical valves suffer from similar disadvantages.
    [007] Most valves, and particularly duckbill type valves that include resilient valve members that directly contact surgical instruments, not only interfere with the movement of the surgical instruments, but also reduce a surgeon's ability to accurately sense the anatomy of the patient on which the surgeon is operating. While minimally invasive surgical procedures are performed with a visualization aid such as a camera, the surgeon's depth perception is inhibited during the procedure. In addition, when the endoscope passes through the mechanical seals, the camera lens can become dirty, typically with visible smudges, resulting in greater difficulty in vision. In the absence of such mechanical seals, specimens can be extracted without undue interference. Additionally, the surgeon's ability to physically sense the resistance of structures and tissues through the movement of surgical instruments plays an important role in the success and safety of the surgical procedure. The frictional forces exerted on the surgical instruments through the contact of the mechanical valves mentioned above can mask the sensory signals, i.e., haptic perception, which the surgeon might otherwise use to accurately determine what is happening at the opposite end of the surgical instruments being used.
    [008] A type of seal used more recently during surgical procedures is a fluid or pneumatic seal provided in a trocar coupled to a pressurized fluid source. The trocar is inserted into a cavity (eg, the abdominal cavity) of a patient, and defines a lumen that provides access to the cavity. Pressurized fluid is directed into the trocar lumen to provide a pneumatic seal within the lumen. In this way, surgical instruments can be traversed through the lumen and pneumatic seal and maneuvered into the body cavity. The pressurized fluid moves around the surgical instruments inserted into it, maintaining the pneumatic seal in the trocar and a differential pressure between the patient's body cavity and the external environment while causing minimal frictional forces on the surgical instruments as they are maneuvered through the trocar at the operation site.
    [009] While conventional methods and systems for sealing technologies have generally been found satisfactory for their purpose, there is still a need in the art for improved systems and methods that are easy to make and use to provide free access to a body cavity, and for operating surgical access devices while maintaining the pneumoperitoneum created during inflation. SUMMARY OF THE INVENTION
    [010] The invention is directed to a new and useful valve assembly and method for selectively providing pressurized fluid to a plurality of trocars. The valve assembly includes a first connector configured and adapted to mate with a primary trocar for directing pressurized fluid thereto; a second connector configured and adapted to mate with a secondary trocar to direct pressurized fluid thereto; a third connector configured and adapted to mate with a source of pressurized fluid to direct pressurized fluid from the source to the first and second connectors; and at least one valve member adapted and configured to be operable in at least the first and second operating positions. In the preferred embodiment, the first operating position of the valve assembly directs pressurized fluid from the source to a coupled primary trocar while preventing pressurized fluid from the source from traveling to the at least one coupled secondary trocar, and the second position The valve assembly's operating mechanism directs pressurized fluid from the source to the coupled primary trocar and to the at least one coupled secondary trocar.
    [011] In certain embodiments of the valve assembly, the first connector defines three passageways, the second connector defines two passageways, and the third connector defines three passageways. The valve assembly couples to a first elongated tube that preferably defines three passageways configured to couple the primary trocar with the three passageways of the first connector. The valve assembly also couples to a second elongated tube that preferably defines two passageways configured to couple the secondary trocar to two passageways of the second connector, and a third elongated tube that preferably defines three passageways, a first of which it is configured to couple the pressurized fluid source with a first of the three passageways of the third connector.
    [012] In certain embodiments, the at least one valve member of the valve assembly includes an elongated axis swivelable about a longitudinal axis to switch the valve assembly between the first and second operating positions. The elongated shaft preferably defines first and second openings configured to be fluidly isolated from the second valve assembly connector in the first operating position, and fluidly coupled to the second valve assembly connector in the second operating position. The at least one valve member may alternatively be configured as a shuttle valve.
    [013] According to one aspect of the invention, the at least one valve member includes a first cable, the elongated shaft has a top end and a bottom end, and the first cable is coupled to one of the top ends and bottom of the elongated shaft.
    [014] These and other aspects of the systems and methods of the invention will be more readily apparent to those skilled in the art from the following detailed description of the preferred embodiments in conjunction with the drawings. BRIEF DESCRIPTION OF THE DRAWINGS
    [015] In order for those skilled in the art to which the invention belongs to readily understand how to make and use the devices and methods of the invention without undue experimentation, the preferred embodiments thereof will be described in detail here below with reference to certain figures, in which:
    [016] Fig. 1 is a partially exploded perspective view of an exemplary embodiment of a valve assembly constructed in accordance with an illustrated embodiment of the invention;
    [017] Fig. 2 is an enlarged exploded view of the primary trocar coupler of the valve assembly of Fig. 1;
    [018] Fig. 3 is an enlarged exploded view of the secondary trocar coupler of the valve assembly of Fig. 1;
    [019] Fig. 4 is an enlarged view of the fluid source coupler of the valve assembly of Fig. 1;
    [020] Fig. 5 is a cross-sectional view of the fluid source coupler of Fig. 4;
    [021] Fig. 6 is an enlarged view of the first, second and third connectors and the valve of the valve assembly of Fig. 1;
    [022] Fig. 7 is a cross-sectional view of the third connector of Fig. 6;
    [023] Fig. 7a is a first cross-sectional view of the first, second and third connectors and the valve of Fig. 6 along line 7a.
    [024] Fig. 7b is a second cross-sectional view of the first, second and third connectors and the valve of Fig. 6 along line 7b.
    [025] Fig. 8 is an enlarged exploded view of the valve of Fig. 6;
    [026] Fig. 9 is a sectional view of the valve of Fig. 6;
    [027] Fig. 10 is a sectional view of the valve of Fig. 6;
    [028] Fig. 11 is an exploded view of a veress needle;
    [029] Fig. 11a is a cross-sectional view of the veress needle connector of Fig. 11.
    [030] Figs. 12 and 13 are perspective views of the system of the present invention being used during a surgical procedure. DETAILED DESCRIPTION OF PREFERRED ACHIEVEMENTS
    [031] The present invention is now more fully described with reference to the accompanying drawings, in which an illustrated embodiment of the present invention is shown. The present invention is in no way limited to the illustrated embodiment, just as the illustrated embodiment described below is merely exemplary of the invention, which may be incorporated in various ways, as understood by the person skilled in the art. Therefore, it is to be understood that any structural and functional details disclosed herein are not to be construed as limiting, but merely as a basis for the claims and as a representation to teach one skilled in the art to variously utilize the present invention. Furthermore, the terms and expressions used herein are not intended to be limiting, but rather to provide an understandable description of the invention.
    [032] Unless defined otherwise, all technical and scientific terms herein have the same meaning as commonly understood by a person skilled in the art to which this invention belongs. Although any methods and materials similar or equivalent to those described herein may also be used in the practice or testing of the present invention, exemplary methods and materials are now described. All publications mentioned are hereby incorporated by reference to disclose and describe the methods and/or materials in connection with which the publications are cited. It should be noted that as used here and in the appended claims, the singular form of “a”, “an”, and “the”, “a” include plural references unless the context clearly dictates otherwise.
    [033] The publications discussed herein are provided only for your disclosure prior to the filing date of this patent application. Nothing in this specification should be construed as an admission that the present invention is not entitled to anticipate such publication by virtue of the foregoing invention. Also, the publication dates provided may differ from the actual publication dates which may need to be independently confirmed.
    [034] Beginning with Fig. 1, there is shown a partial view of an exemplary embodiment of a system in accordance with the invention, generally designated as the reference character 10. The system 10 generally includes a valve assembly 14 coupled to a source 12 of pressurized fluid, valve assembly 14 configured to selectively supply pressurized fluid from source 12 to a primary trocar 16 and secondary trocar 18, as described below.
    [035]Examples of systems and apparatus that include a pressurized fluid source used in conjunction with trocars adapted and configured to perforate the abdominal cavity and provide fluid seals are set forth in the following patent and patent applications, all of which are incorporated herein as reference in its entirety: PCT/US09/005537, filed October 9, 2009, US Provisional Patent Application No. 61/104,448, filed October 10, 2008, US Patent Application No. 11 /960,701, filed December 20, 2007, PCT/US07/88017, filed December 18, 2007, US Provisional Patent Application No. 60/923,917, filed April 17, 2007, Patent Application US Provisional No. 60/959,826, filed July 16, 2007, US Patent Application No. 11/786,832, filed April 13, 2007, US Provisional Patent Application No. 60/875,436 , filed on December 18th 2006, US Patent Application No. 11/544,856, filed October 6, 2006, US Patent Application No. 11/517,929, filed September 8, 2006 (now US Patent No. 7,854,724), US Patent Application No. 10/776,923, filed February 11, 2004 (now US Patent No. 7,338,473), US Patent Application No. 10/739,872, filed December 18 of 2003 (now U.S. Patent No. 7,285,112), U.S. Patent Application No. 10/441,149, filed May 17, 2003 (now U.S. Patent No. 7,182,752), and US Provisional Patent Application. US No. 60/461,149, filed April 8, 2003. The various devices, systems and methodologies disclosed in the references listed above must be used with system 10.
    [036] The system 10 of the present invention is used in accordance with the exemplary methodologies of the invention to inflate the abdominal cavity of a patient, to selectively provide fluidic pneumatic seals within the primary and secondary trocars 16, 18 using pressurized fluid from from a single access of fluid source 12, and to recirculate such pressurized fluid from the primary and secondary trocars 16, 18 back to the single access of fluid source 12. The useful new valve assembly 14 of system 10 facilitates such operation and functionality, and is discussed below with respect to Figs. 1-11. The operation of system 10 in accordance with preferred methodologies of the invention is discussed below with reference to Figures 12-13.
    [037] Continuing now with Fig. 1, the valve assembly 14 includes a first connector 20 configured to be coupled to a first elongated tube 22, a trocar connector 24, a second connector 26 configured to be coupled to a second elongated tube 28, a secondary trocar connector 30, a third connector 32 configured to be coupled to a third elongated tube 34, a fluid source connector 36, and a valve member 38.
    [038] The first, second and third connectors 20, 26, 32 and the valve member 38 of the valve assembly 14 together form a manifold 6 which is best shown in Figs. 6-7b. The first connector 20 includes a housing 21 defining three passageways 21a, 21b, 21c, the second connector 26 includes a housing 27 defining two passageways 27a, 27b and the third connector 32 includes a housing 33 defining three passageways passage 33a, 33b, 33c (Figs. 7, 7a, 7b). The passageway 33a of the third connector 32 is fluidly coupled to both the passageway 21a of the first connector 20 and the passageway 27a of the second connector 26. The passageway 33b of the third connector 32 is fluidly coupled to both the passageways. The passageway 21b of the first connector 20 and the passageway 27b of the second connector 26. The passageway 33c of the third connector is fluidly coupled to the passageway 21c of the first connector 20, but not to any of the passageways 27a, 27b of the second connector 26. The compartments 21, 27, 33 of the manifold 6 are preferably integrally formed with each other as a single integral unit, but may alternatively be detachably coupled to each other by filament fitting, interference fitting, or whatever. another suitable medium known in the art.
    [039] In continuation with reference to Figs. 1 and 6-7b, the first elongated tube 22 is preferably a trifurcated tube defining three separate tubes 22a, 22b, 22c sized and configured to fluidly mate with the three passageways 21a, 21b, 21c of the first connector 20 within the delivery tube 6, and trocar connector 24 at an end 23 opposite delivery tube 6. The second elongated tube 28 (Fig. 1) is preferably a bifurcated tube defining two separate tubes 28a, 28b sized and configured to mate fluidly with the two passageways 27a, 27b of the second connector 26 within the delivery tube 6, and to the secondary trocar coupler 30 at an end 29 opposite the delivery tube 6. The third elongated tube 34 is preferably a tube. trifurcate defining three separate tubes 34a, 34b, 34c sized and configured to fluidly mate with the three passageways 33a, 33b, 33c of the third connector 32 within the manifold 6, and the fluid source coupler 36 at an end 37 opposite delivery tube 6. Primary trocar coupler 24, secondary trocar coupler 30, and fluid source coupler 36 detachably couple, respectively, to the trocar primary 16, secondary trocar 18, and fluid source 12.
    [040] Referring now to Fig. 2, the primary trocar coupler 24 includes a connecting body 40, three cylindrical passages 42a, 42b, 42c defined by annular walls 43a, 43b, 43c extending and projecting from of the connecting body 40 on opposite sides thereof, a connecting ring 44, and a receiving edge 46 mounted on the primary trocar 16. The receiving edge 46 defines three passageways 48a, 48b, 48c sized and configured to receive the walls annulars 43a, 43b, 43c and leading to respective chambers within primary trocar 16 in which pressurized fluid is provided and recovered. Connecting ring 44 threadably couples connecting body 40 to receiving edge 46 with passages 42a, 42b, 42c fluidly coupled to passageways 48a, 48b, 48c. Tubes 22a, 22b, 22c of first elongated tube 22 are detachably and fluidly coupled to passages 42a, 42b, 42c on the side of connecting body 40 opposite ring 44. This configuration fluidly couples first elongated trifurcated tube 22 to primary trocar 16 .
    [041] Referring to Fig. 3, the secondary trocar coupler 30 includes a connecting body 50, two cylindrical passages 52a, 52b defined by annular walls 53a, 53b extending and projecting from the connecting body 50 on opposite sides thereof, a connecting ring 54, and a receiving edge 56 mounted on the secondary trocar 18. The receiving edge 56 defines two passageways 58a, 58b sized and configured to receive the annular walls 53a, 53b and leading to the respective chambers within the secondary trocar 18 in which pressurized fluid is provided and recovered. Connecting ring 54 threadably couples connecting body 50 to receiving edge 56 with passages 52a, 52b fluidly coupled to passageways 58a, 58b. Tubes 28a, 28b of second elongated tube 28 are detachably and fluidly coupled to passages 52a, 52b on the side of connector body 50 opposite ring 54. This configuration fluidly couples second elongated bifurcated tube 28 with secondary trocar 18.
    [042] Referring to Figs. 4 & 5, fluid source coupler 36 includes a connecting body 60 defining three channels 62a, 62b, 62c coupled and received by fluid source 12, and configured to fluidly couple to first, second and third tubes 34a , 34b, 34c of the third elongated tube 34 at the end 37 thereof. This configuration fluidly couples the third elongated trifurcated tube 34 with the fluid source 12.
    [043] Referring now to Fig. 8, valve 38 of valve assembly 14 includes an elongated shaft 64 swivelable about a longitudinal axis 66. Elongated shaft 64 defines upper and lower openings 68, 70 extending through. from this, upper concavities 72, 74 on opposite sides thereof, lower concavities 76, 78 on opposite sides thereof, and annular walls 71, 73, 75, 77 projecting from concavities 72, 74, 76, 78. The concavities 72 , 74, 76, 78 are configured to receive respective O-rings 80, 82, 84, 86 which are press-fitted into recesses 72, 74, 76, 78 through annular walls 71, 73, 75, 77. The valve 38 also includes an upper cable 88 which mates to an upper end 64a of the elongate shaft 64, and a lower cable 90 which mates to a lower end 64b of the elongate shaft 64. The upper and lower ends 64a, 64b are of diameter reduced with respect to axis 64, and may be integrally formed with axis 64 or detachably coupled to these. Coupling of the cables 88, 90 to the upper and lower ends 64a, 64b can be achieved by suitable means, such as, for example, thread engagement, press fit, sticky adhesives, and the like. Shaft 64 is also provided with three additional rings 81, 83, 85 oriented concentrically with respect to longitudinal axis 66 of shaft 64 about the outer surface of shaft 64. Rings 81, 83, 85 preferably fit in circumferential grooves defined by the surface of shaft 64. Rings 80, 81, 82, 83, 84, 85, 86 function to provide rotational resistance to shaft 64 and fluid sealing as discussed below. Both the upper and lower handles 88, 90 can be manipulated by a user to rotate the elongated shaft 64 of the valve 38 between the first and second operating positions shown in Figs. 9 and 10.
    [044] Referring to Fig. 9, the valve 38 is shown operatively associated and coupled to the second elongated tube 28 in the first operating position. In the first operating position, the upper and lower openings 68, 70 are fluidly isolated from the two tubes 28a, 28b of the bifurcated tube 28. The O-rings 80, 81, 82, 83, 84, 85, 86 of the valve 38 do interface with the respective edges of the tubes 28a, 28b, to provide rotational resistance to the elongated shaft 64 of the valve 38 through interference that can be overcome by manual manipulation of one of the cables 88, 90. In this way, the rings 80, 81 , 82, 83, 84, 85, 86 help maintain the rotational position of valve 38 in the first operating position of Fig. 9.
    [045] Referring to Fig. 10, the valve 38 is shown operatively associated and coupled to the second elongated tube 28 in the second operating position. In the second operating position, the upper and lower openings 68, 70 are fluidly coupled to the two tubes 28a, 28b of the bifurcated tube 28. O-rings 81, 83, 85, and O-rings 80, 82, 84, 86 (hidden in the view of Fig. 10) of valve 38 interface with respective edges of tubes 28a, 28b on opposite sides thereof to help maintain the rotational position of elongated shaft 64 of valve 38 in the second operating position of Fig. 10 through interference. Such interference can be overcome by manual manipulation of one of the cables 88, 90. It will be appreciated that the O-rings 80, 82, 84, 86 also provide the respective seals between the upper and lower openings 68, 70 and the tubes 28a, 28b when valve 38 is disposed in the second operating position. Valve 38 can be manually manipulated to move valve assembly 14 between the first and second operating positions as discussed below in connection with Figs. 12-13.
    [046] Referring now to Figs. 11 and 11a, system 10 is also preferably used in conjunction with a version needle 92 which includes a connector body 94, rim 96, coupling 97, tube 98, and needle 99. Connector body 94 includes three annular walls 91a, 91b , 91c extending through it and projecting from it on opposite sides of it. The annular walls 91a, 91b, 91c define passageways 93a, 93b, 93c configured to fluidly mate with the three tubes 22a, 22b, 22c of the first trifurcated tubular member 22. The edge 96 filament couples the connector body 94 to the connector 97, which is fluidly coupled to tube 98 through lumen 95c. Plugs 95a, 95b protruding from connector 47 connect ports 93a, 93b. The fitting of connector body 94, edge 96 and connector 97 fluidly couple passage 93c with tube 98 through lumen 95c and fluidly isolate passages 93a, 93b from tube 98 through plugs 93a, 93b. As discussed further below, this configuration allows the filling fluid to be translated from passage 93c of the first trifurcated tubular member 22 to tube 98 and the lumen of needle 99 for inflation of the abdominal cavity. Connector body 94, edge 96 and connector 97 are preferably provided pre-assembled so that the surgeon need only connect needle 99 to tube 98.
    [047] With the structure of the present inventive system 10 being described above, its operation will now be described. Referring to Fig. 12, the valve assembly 14 of Fig. 1 is initially used to inflate a patient's abdominal cavity. Initially, verss needle 92 is coupled to end 23 of first elongated trifurcated tube 22 through connector body 94 and edge 96 with tube 22c fluidly coupled to tube 98 and the lumen (not shown) of needle 99 and tubes 22a , 22b fluidly isolated from tube 98 and needle lumen 99. First, second and third tubes 22, 28, 34 are coupled to first, second and third connectors 20, 26, 32 of valve assembly 14, and end 37 of the third elongated tube 34 is coupled to the fluid source 12. The fluid source 12 preferably includes a tank containing pressurized fluid (e.g., carbon dioxide gas), and is preferably mounted within and operatively coupled to a control unit 13 and a pressure regulator for controlled operation thereof to controllably supply pressurized fluid through a single port 15.
    [048] With no pressurized fluid traveling through access 15, the patient's abdominal wall 102 is pierced using needle 99 of veress needle 92, placing tube 92 in fluid communication with the lumen of needle 99. control 13 is then operated to supply fill gas (eg CO2) from fluid source 12 via tube 34c (inflation line) through port 15. Fill gas flows through tube 34c, a passageway 33c of third connector 32 of valve assembly 14, tube 22c of first elongated trifurcated tube 22, passageway 93c (Fig. 11) of connector body 94, tube 98, and finally, through the lumen of 99 needle in the patient's abdominal cavity for inflation. The passageway 33c of the third connector 32 is fluidly coupled to the passageway 21c of the first connector 20, but not to any of the passageways of the second connectors 26. The valve 38 remains in the first operating position of Fig. 9.
    [049] The controller 13 preferably includes a pressure sensor that monitors the pressure in at least pipe 34c, and automatically shuts off or reduces the supply gas supply when a predetermined pressure limit is reached. Controller 13 can also be manually operated to turn on, off or reduce the supply of fill gas to the abdominal cavity during or after inflation, although it is recommended that controller 13 be inoperable to supply the inflation fluid once the maximum predetermined pressure is reached.
    [050] Once the predetermined pressure limit within the abdominal cavity is reached, the connector body 94, the edge 96, the connector 97 and the tube 98 are detached from the needle 99 and the first elongated trifurcated tube 22. The needle is removed from the patient, and the small left incision through the needle is sealed to prevent deflation through the abdominal wall 102. Alternatively, if the needle is provided with a valve, then this can be left in the abdominal wall 102 with the valve in position. 'off'to prevent deflation of the abdominal cavity.
    [051] Referring to Fig. 13, the abdominal wall 102 is then pierced at a first location 103 using the primary trocar 16, which preferably includes a cannula and obturator. The obturator is slidably inserted and translated through an opening 19 at a proximal end 16a of the primary trocar into and through the abdominal wall 12 at the first location 103. The distal end 16b of the primary trocar 16 is then inserted through the incision in the abdominal wall 102 made by the shutter. A friction fit/seal between the obturator outer diameter and an inner diameter of the cannula prevents deflation through the primary trocar 16.
    [052] The end 23 of the first elongated tube 22 is then connected to the primary trocar 16 using the primary trocar coupler 24, thereby fluidly coupling each of the tubes 22a, 22b, 22c of the first elongated tube 22 with various chambers of the trocar cannula. primary 16. For example, tubes 22a, 22b corresponding to the supply/pressure line and the return/vacuum line are placed in fluid communication with a cannula chamber to respectively create a pneumatic/fluidic seal within of the chamber and return/circulation of gas that would otherwise exit through the opening 19 of the primary trocar 16, and the insufflation/detection line 22c is placed in fluid communication with a separate chamber defined by the cannula leading to the patient's abdominal cavity to in order to detect abdominal pressure within the abdominal cavity. The valve member 38 is initially held in the first operating position of Fig. 9, shown in Fig. 13 by the dotted position 39 of the upper handle 88.
    [053] Control unit 13 is operated to supply pressurized gas from fluid source 12 through tube 34a (pressure line) of trifurcated tube 34 through port 15. The primary trocar obturator 16 is then removed, and the pressurized fluid (e.g., CO2) travels through the tube 34a, through the passageway 33a of the third connector 32 of the valve assembly 14, the passageway 21a of the first connector 20 of the valve assembly 14, the tube 22a of the first elongated trifurcated tube 22, the passageway 42a (Fig. 2) of the connecting body 40 of the primary trocar coupler 24, and the passageway 48a of the receiving edge 46 in a proximal chamber of the primary trocar assembly 16. While pressurized gas is supplied to primary trocar chamber 16, gas is simultaneously recovered from it through tube 22b. In particular, the recovered gas flows from the primary trocar chamber 16, through the passageways 48b and 42b of the receiving edge 46 and the connecting body 40 of the primary trocar coupler 24, the tube 22b, the passageway 21b of first connector 20 of valve assembly 14, passageway 33b of third connector 32, tube 34b of third elongated trifurcated tube 34, and back through port 15 of fluid source 12. to the primary trocar 16 flows through one or more nozzles, preferably formed at a proximal end and in fluid communication with the primary trocar chamber 16, and is directed downward to form a fluidic/pneumatic seal therein and an effective barrier to the proximal gas outlet from the patient's abdominal cavity and maintains the pneumoperitoneum formed therein as described in the patent and patent applications cited above and incorporated herein by reference. Gas recovered from primary trocar 16 recirculates gas that would otherwise exit through opening 19 of primary trocar 16.
    [054] Essentially, while pressurized fluid from the passageway 33a of the third connector 32 of the valve assembly 14 flows to both the passageway 21a of the first connector 20 and the passageway 27a of the second connector 26, the valve 38 is held in the first operating position 39, thus keeping the passageway 27a of the second connector 26 fluidly isolated from the tube 28a. Thus, no pressurized fluid flows into the second elongated bifurcated tube 28 with valve 38 disposed in the first operating position.
    [055]Surgical instruments and/or recording devices, such as a camera, are optionally translated through the primary trocar cannula 16 through the opening 19 in the patient's abdomen as needed. Pressurized fluid continues to flow through the supply/pressure line 22a and vacuum return line 22b through the fluid path described above in amounts and at pressure levels dictated by controller 13 to maintain fluid sealing in primary trocar 16 and the abdominal pressure in the abdominal cavity. Controller 13 continuously monitors, and if necessary, adjusts pressure in the abdominal cavity through inflation/sensing tube 34c (which, as discussed above, is fluidly coupled to tube 23c), as well as pressure in pressure line 34a, which it is fluidly coupled to tube 22a to maintain the fluidic/pneumatic seal.
    [056] The abdominal wall 102 is then pierced at a second location 105 using the secondary trocar 18, which preferably also includes a cannula and obturator. The obturator is slidably inserted and translated through an opening 25 at a proximal end 18a of the secondary trocar 18 into and through the abdominal wall 12 at the second location 105. The distal end 18b of the secondary trocar 18 is then inserted through the incision in the abdominal wall. 102 made by the shutter. A friction fit/seal between the obturator outer diameter and an inner diameter of the cannula prevents deflation through the secondary trocar 18.
    [057] The end 29 of the second elongated tube 28 is then connected to the secondary trocar 18 using the secondary trocar coupler 30, thereby fluidly coupling each of the tubes 28a, 28b of the second elongated tube 28 with a secondary trocar cannula chamber 18 (for example, tubes 28a, 28b, corresponding respectively to the feed/pressure line and the return/vacuum line), are placed in fluid communication with the secondary trocar cannula chamber 18, respectively, to create a seal. fluidic/pneumatics within the chamber and return/recirculation of gas that would otherwise exit through opening 25 of secondary trocar 18.
    [058] The valve 38 is then manipulated into the second position of Fig. 10 by rotating one of the upper and lower cables 88, 90, thus fluidly coupling the tubes 28a, 28b with the passageways 27a, 27b of second connector 26, which are fluidly coupled to passageways 33a, 33b of third connector 32, where pressurized fluid from fluid source 12 routed through tube 34a is directed to both primary trocar 16 and secondary trocar 18 In particular, pressurized fluid (e.g. CO2) continues to flow to primary trocar 16 through the same fluid pathway described above, but is no longer blocked in second connector 26 via valve 38, and so also flows through passageway 27a of tube 28a, passageway 52a of connecting body 50 of secondary trocar 30, passageway 58a of receiving edge 56, and, once the secondary trocar obturator 18 is removed in the secondary trocar chamber 18.
    [059]Pressurized gas is simultaneously recovered from the secondary trocar chamber 18 through tube 28b. In particular, the recovered pressurized gas flows from the secondary trocar chamber 18, through the passageways 58b and 52b of the receiving edge 56 and the connecting body 50 of the secondary trocar coupler 30, the tube 28b, the passageway 27b from the second connector 26, the passageway 33b from the third connector 32, and the tube 34b from the third elongated trifurcated tube 34 to the fluid source 12. The pressurized gas supply flows through one or more nozzles, preferably formed at one end. proximal and in fluid communication with the secondary trocar chamber 18, and is directed downward to form a fluidic/pneumatic seal therein and an effective barrier to the proximal exit of gas from the patient's abdominal cavity and maintains the pneumoperitoneum formed therein. Surgical instruments and/or recording devices, such as a camera, are then optionally translated through the secondary trocar cannula 18 through the opening 25 in the patient's abdomen as needed. Pressurized fluid continues to travel through the feed/pressure line 28a and vacuum return line 28b to maintain the fluidic seal therein. Controller 13 continuously monitors, and if necessary, adjusts pressure in the abdominal cavity through inflation/detection tube 34c (which, as discussed above, is fluidly coupled to tube 23c), as well as pressure in the pressure and vacuum lines 34a , 34b which are fluidly coupled to tubes 22a, 22b to maintain the pneumatic fluidic seal.
    [060] Essentially, with valve 38 disposed in the second operating position of Fig. 10 (designated by handle position 41 of Fig. 13), pressurized fluid supplied from fluid source 12 through port 15 diverges within the dispensing tube 6 to the first and second trocars 16, 18, and pressurized fluid recovered from the first and second trocars 16, 18 converges within the dispensing tube 6 and is routed back through port 15. In this way, it should be perceived in accordance with the illustrated embodiments of the invention, pressurized fluid can be selectively routed and retrieved from multiple trocars using a single port 15 without requiring continuous flow through more than one trocar. In addition, the use of multiple trocars with the valve assembly of the present invention allows for better sealing, greater flexibility in terms of the number of surgical instruments that can be used simultaneously, and greater efficiency in terms of setup and operating time.
    [061] It will be appreciated that additional trocars (e.g., third, fourth, fifth, etc.) can be added to system 10 using additional valves and further dividing the pressure/supply and return/vacuum lines of valve assembly 14. No However, it is preferred that detection of the abdominal cavity be done with a single trocar (eg primary trocar 16).
    [062] It should also be appreciated that the pressure and return lines 28a, 28b of the bifurcated tube 28 could be configured to mechanically and fluidly couple to a standard trocar known in the art through a set of luer locks. In this way, a standard trocar could be used in conjunction with the present system 10.
    [063] It is also anticipated that the valve assembly could be configurable to a third operating position that prevents pressurized fluid from moving to the primary and secondary trocars, as well as any additional trocars coupled to valve assembly 14. For example It is anticipated that a secondary valve, similar to or different from valve 38, could be coupled to third connector 32 and configurable to block pressurized fluid flowing through tube 34c from reaching both the first and second elongated tubes 20, 28.
    [064] The above descriptive report presents a description of a best contemplated mode for carrying out the present invention, and the manner and process of making and using the present invention, in such complete, clear, concise and exact terms in order to allow the technical in the subject to which it pertains to the manufacture and use of these devices and methods. The present invention, however, is susceptible to modifications and method steps alternative to those discussed above that are fully equivalent. Accordingly, the present invention is not limited to the particular embodiments disclosed. In contrast, the present invention encompasses all modifications and alternative constructions and methods that are within the spirit and scope of this invention.
    [065] The above descriptions and accompanying drawings are to be interpreted in an illustrative rather than a limited sense. While the invention has been disclosed in connection with the preferred embodiment or embodiments thereof, it is to be understood that there may be other embodiments which are within the scope of the invention as defined by the following claims. Where a claim, if any, is expressed as a means or step for performing a specified function, it is intended that such claim be constructed to cover the corresponding structure, material or actions described in the specification and equivalents thereof, including both structural equivalents and equivalent structures, equivalents based on material and equivalent materials, and equivalents based on equivalent actions and actions.
    权利要求:
    Claims (10)
    [0001]
    1. VALVE ASSEMBLY (14) CONFIGURED AND ADAPTED TO SELECTIVELY CONTROL A PRESSURIZED FLUID FLOW FROM A SOURCE TO THE TROCARTS, the valve assembly comprising: (a) a first connector (20) configured and adapted to mate to a primary trocar (16) for directing pressurized fluid thereto (b) a second connector (26) configured and adapted to mate with a second trocar (18) for directing pressurized fluid thereto (c) a third connector (32) configured and adapted to couple with a source (12) of pressurized fluid to direct pressurized fluid from the source (12) to the first and second connectors (20, 26); and (d) at least one valve member (38) adapted and configured to be operable in at least a first and second operating position, characterized in that: (1) the first operating position directs pressurized fluid from the source ( 12) to the coupled primary trocar (16) while preventing pressurized fluid from the source from traveling to at least one coupled secondary trocar (18), and (ii) the second operating position directs pressurized fluid from the source (12 ) for the coupled primary trocar (16) and for at least one coupled secondary trocar (18); wherein: the first coupling (20) defines three passages (21a, 21b, 21c), the second coupling (26) defines two passages (27a, 27b), the third coupling (32) defines three passages (33a, 33b, 33c ), and the valve assembly further comprises a first elongated tube (22) defining three passageways (22a, 22b, 22c), wherein the three passageways of the first elongated tube (22) are configured to engage the primary trocar. (16) with the three passageways (21a, 21b, 21c) of the first connector (20).
    [0002]
    A VALVE ASSEMBLY according to claim 1, further comprising a second elongated tube (22) defining two passageways (28a, 28b), wherein the two passageways of the second elongated tube are configured to couple the secondary trocar (18) with the two passageways (27a, 27b) of the second connector (26).
    [0003]
    VALVE ASSEMBLY according to claim 2, characterized in that it comprises a third elongated tube (34) defining three passageways (34a, 34b, 34c), wherein a first (34a) of the three passageways of the third Elongated tube (34) is configured to couple the source (12) of pressurized fluid with a first (33a) of the three passageways (33a, 33b, 33c) of the third connector (32).
    [0004]
    Apparatus as defined in claim 1, characterized in that at least one valve member (38) is rotatable between the first and second operating positions.
    [0005]
    APPARATUS as defined in claim 1, characterized in that at least one valve member (38) includes an elongated axis (64) rotational about a longitudinal axis (66).
    [0006]
    Apparatus according to claim 5, characterized in that the elongated axis (64) defines the first and second openings (68, 70).
    [0007]
    APPARATUS according to claim 6, characterized in that the first and second openings (68, 70) of the elongated shaft (64) are configured to be fluidly isolated from the second connector (26) in the first operating position, and fluidly coupled to the second connector (26) in the second operating position.
    [0008]
    APPARATUS according to claim 5, characterized in that at least one valve member (38) includes a first handle (88).
    [0009]
    The apparatus of claim 8, characterized in that the elongated shaft (64) has a top end (64a) and a bottom end (64b), and the first cable (88) is coupled to one of the top ends. and bottom (64a, 64b) of the elongated shaft.
    [0010]
    The apparatus of claim 9, wherein the at least one valve member (38) is characterized in that it includes a second cable (90), and the second cable is coupled to another of the top and bottom ends (64a , 64b) of the elongated shaft (64).
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    CN104780957B|2017-07-21|
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    EP2892589B1|2019-02-20|
    ES2727494T3|2019-10-16|
    EP2892589A4|2016-05-25|
    BR112015004890A2|2017-07-04|
    WO2014039633A1|2014-03-13|
    CN104780957A|2015-07-15|
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    法律状态:
    2017-07-18| B08F| Application fees: application dismissed [chapter 8.6 patent gazette]|
    2017-09-26| B08G| Application fees: restoration [chapter 8.7 patent gazette]|
    2018-11-21| B06F| Objections, documents and/or translations needed after an examination request according [chapter 6.6 patent gazette]|
    2019-12-03| B06U| Preliminary requirement: requests with searches performed by other patent offices: procedure suspended [chapter 6.21 patent gazette]|
    2021-06-08| B09A| Decision: intention to grant [chapter 9.1 patent gazette]|
    2021-07-27| B16A| Patent or certificate of addition of invention granted|Free format text: PRAZO DE VALIDADE: 20 (VINTE) ANOS CONTADOS A PARTIR DE 05/09/2013, OBSERVADAS AS CONDICOES LEGAIS. |
    优先权:
    申请号 | 申请日 | 专利标题
    US13/606,824|2012-09-07|
    US13/606,824|US9017281B2|2012-09-07|2012-09-07|System having multiple pneumatically sealed trocars|
    PCT/US2013/058192|WO2014039633A1|2012-09-07|2013-09-05|System having multiple pneumatically sealed trocars|
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