Cannula with non-circular cross-section, system and method

Abstract

A cannula includes a tube having a central passage extending along a longitudinal axis of the tube between a proximal end and a distal end of the tube. A first cross-section of the passage at or adjacent the distal end of the tube and taken in a plane orthogonal to the longitudinal axis has a first cross-sectional shape that is non-circular. A second cross-section of the passage through a portion of the tube proximal of the distal end of the tube and taken in a plane orthogonal to the longitudinal axis has a second cross-sectional shape. The first cross-sectional shape is different than the second cross-sectional shape. Systems associated with the cannula and tools inserted through the cannula.

Description

[0001] Cross-references to related applications

[0002] This application claims priority to U.S. Provisional Application No. 62 / 775,432 (filed December 5, 2018), the entire contents of which are incorporated herein by reference. Technical Field

[0003] This disclosure relates to cannulas for tools (such as surgical instruments). Cannulas according to this disclosure are characterized by a non-circular cross-section and the ability to accommodate a flow of blown gas between the inner wall of the cannulas and the outer surface of the tool. Background Technology

[0004] During procedures such as surgical operations, cannulas can be used to guide, position, and / or support instruments such as surgical instruments. For example, during some procedures, a cannula is positioned within the body wall, and an instrument, such as a surgical instrument, is inserted through the cannula to reach a target site, such as a surgical site. Examples of such procedures can include minimally invasive surgery performed with remotely operated tools. During such procedures, air can be blown into the target site to facilitate the procedure by creating space for its execution. Inhalation can also be used to prevent infection by preventing foreign bodies from entering or otherwise invading the surgical site.

[0005] The blowing pressure is supplied through the space within the cannula between the cannula wall and the tool inserted through it. The flow rate of gas through the cannula to the target site may be limited by the cross-sectional area of ​​the space between the outer surface of the tool inserted through the cannula and the inner surface of the cannula. Increasing the cross-sectional size of the cannula relative to the tool can increase the cross-sectional area and thus increase the flow rate, but this increase in cannula size requires a corresponding increase in the kerf size to accommodate the larger cannula. Furthermore, increasing the cannula size relative to the tool size may provide less support for the tool tip when the tool protrudes from the cannula, and may therefore allow undesirable movement or vibration of the tool relative to the cannula.

[0006] There is a need for cannulas that can facilitate relatively large inlet gas flow rates without requiring a corresponding increase in slit size. There is also a need for cannulas that provide adequate support for the tool tip protruding from the cannulas. Summary of the Invention

[0007] The embodiments disclosed herein can solve one or more of the problems mentioned above and / or can demonstrate one or more of the desired features mentioned above. Other features and / or advantages will become apparent from the following description.

[0008] According to one aspect of this disclosure, a cannula includes a tube body having a central channel extending along a longitudinal axis between a proximal and distal end of the tube body. A first cross-section of the channel, taken at or near the distal end of the tube body in a plane orthogonal to the longitudinal axis, has a first cross-sectional shape that is non-circular. A second cross-section of the channel, taken proximally to a portion of the tube body passing through the distal portion of the axis and in a plane orthogonal to the longitudinal axis, has a second cross-sectional shape. The first cross-sectional shape differs from the second cross-sectional shape.

[0009] According to another aspect of this disclosure, a system includes a cannula with a body having a longitudinal axis extending between a proximal and a distal end of the cannula and a channel extending between the proximal and distal ends of the cannula. The distal portion of the cannula includes a portion of the channel with a first cross-sectional shape cut in a plane orthogonal to the longitudinal axis, and the proximal portion of the cannula includes a portion of the channel with a second cross-section cut in a plane orthogonal to the longitudinal axis. The system includes a tool containing an shaft inserted into the channel. A circle inscribed within the first cross-sectional shape has a first diameter that defines a first gap between the outer periphery of the channel and the shaft of the tool when the tool is inserted into the channel. When the tool is inserted into the channel, a second cross-sectional shape defines a second gap between the outer periphery of the channel and the shaft of the tool, the second gap being larger than the first gap. The first cross-sectional shape differs from the second cross-sectional shape.

[0010] According to another aspect of this disclosure, an apparatus includes a cannula body having a proximal end, a distal end, and a first channel defined between the proximal and distal ends. A blow-in source fitting is located at the proximal end of the cannula body. The blow-in source fitting includes a second channel, and the channel of the blow-in source fitting connects to the first channel of the cannula body. The cross-section of the cannula body is polygonal.

[0011] Additional objects, features, and / or advantages will be set forth in part in the description which follows, and will be apparent in part from that description, or may be learned by practice of this disclosure and / or the claims. At least some of these objects and advantages may be realized and obtained by means of the elements and combinations particularly pointed out in the appended claims.

[0012] It should be understood that the foregoing general description and the following detailed description are merely exemplary and explanatory and do not limit the claims; on the contrary, the claims should enjoy the full breadth of their scope, including equivalents. Attached Figure Description

[0013] This disclosure may be derived separately from the following detailed description or in conjunction with the appendix. Figure 1For the purpose of understanding, the accompanying drawings are included to provide a further understanding of this disclosure, and the drawings are incorporated in and constitute a part of this specification. The drawings illustrate one or more embodiments of the present teachings and, together with the specification, serve to explain certain principles and operations. In the drawings,

[0014] Figure 1 This is a schematic side view of an embodiment of a system including a cannula according to the present disclosure.

[0015] Figure 2 yes Figure 1 A cross-sectional view of the cannula.

[0016] Figure 3 yes Figure 1 Another cross-sectional view of the cannula.

[0017] Figure 4 This is a perspective view of another embodiment of the cannulation according to the present disclosure.

[0018] Figure 5 yes Figure 4 The distal view of the cannula.

[0019] Figure 6 This is a perspective view of another embodiment of the cannulation according to the present disclosure.

[0020] Figure 7 yes Figure 6 The distal view of the cannula.

[0021] Figure 8 This is a perspective view of another embodiment of the cannulation according to the present disclosure.

[0022] Figure 9 yes Figure 8 The distal view of the cannula.

[0023] Figure 10 This is a perspective view of another embodiment of the cannulation according to the present disclosure.

[0024] Figure 11 yes Figure 10 The distal view of the cannula.

[0025] Figure 12 This is a distal view of the cannula according to another embodiment of the present disclosure.

[0026] Figure 13 This is a distal view of the cannula according to another embodiment of the present disclosure.

[0027] Figure 14A and Figure 14B This is a distal view of the cannula in a partially formed state and a fully formed state according to another embodiment of the present disclosure.

[0028] Figure 15 This is a side view of another embodiment of the cannulation according to the embodiments of this disclosure.

[0029] Figure 16 This is a perspective view of an operating system according to an embodiment of the present disclosure.

[0030] Figure 17 This is a partial schematic view of an embodiment of a manipulator arm of a manipulator system according to the present disclosure, wherein two electrosurgical instruments are in the mounted position.

[0031] Figure 18 This is a schematic view showing the cross-sectional shape of the distal portion of an intubation tube according to another exemplary embodiment of the present disclosure.

[0032] Figure 19 This is a schematic view showing the cross-sectional shape of the distal portion of the cannula body according to yet another exemplary embodiment of the present disclosure. Detailed Implementation

[0033] This invention envisions various embodiments of cannulas configured to facilitate the flow rate of blown gas while maintaining positioning and support for the tool inserted through the cannulas. Embodiments of this disclosure may allow for increased blown gas flow rate to compensate for pressure losses caused, for example, by leakage through sealing elements in the system, sample retrieval from the target site, venting of the target site, or other conditions that permit pressure loss.

[0034] In various embodiments, the central channel of the cannula according to this disclosure has a non-circular cross-section at or near the distal portion of the cannula. The portion of the cannula with the non-circular channel cross-section maintains contact with a tool inserted through the central channel of the cannula while also providing a gap between the central channel of the cannula and the tool, and defining one or more flow paths around the tool within the central channel of the cannula. The portion of the central channel included in other portions of the cannula proximal to the distal portion may have a circular cross-section, or a cross-section with a different shape than the cross-section of the channel at or near the distal portion, and / or a cross-section with a larger shaped cross-section than the cross-section of the channel at or near the distal portion of the cannula, to provide a larger gap for inserting the tool within the central channel of the cannula. For example, in the portion of the cannula proximal to the distal portion, a larger gap between the tool and the central channel of the cannula allows the tool to be inserted without constricting it within the cannula. This gap is particularly useful for inserting tools within curved cannulas, such as… Figure 15 The cannula shown.

[0035] For example, in some embodiments of this disclosure, the non-circular cross-section of the central channel of the distal portion of the cannula defines at least one inscribed circle. That is, the diameter of the inscribed circle is defined by a circle at the radially innermost position passing through the inner wall of the distal portion of the cannula. The diameter of the inscribed circle is larger than the outer diameter of the tool inserted into the central channel of the cannula, and the difference between the diameter of the inscribed circle and the outer diameter of the tool is the gap between the tool and the inner cannula wall that defines the central channel of the distal portion of the cannula. A portion of the central channel of the cannula proximal to the distal portion may have a circular (or other shaped) cross-section as described above. This proximal portion of the central channel of the cannula has dimensions (such as the inner diameter or the size of the inscribed circle) in which the gap between the tool and the inner wall defining the central channel of the cannula is larger than the gap at the distal end. The increased gap in the central channel proximal to the distal portion of the cannula allows the tool to be inserted through the cannula without being constricted, while the smaller gap between the radially innermost positions of the non-circular cross-section at the distal portion of the cannula provides support for the tool to maintain its position. Figure 1 As shown, the distal end of the cannula is the end through which the tool or instrument exits the cannula and enters the target site.

[0036] In various embodiments, the non-circular cross-section of the central channel of the distal portion of the cannula may include an elliptical cross-section, an oval cross-section, or a polygonal cross-section. According to this disclosure, the polygonal cross-section may optionally include polygons with chamfered vertices (such as rounded vertices), polygons with pointed vertices, polygons with straight sides, polygons with curved sides (such as Reuleaux polygons), or other configurations and all combinations thereof. The chamfered configuration of these shapes can facilitate cannula insertion into the body wall and can facilitate cannula fabrication. Polygonal cross-sections according to embodiments of this disclosure may have three or more sides, and these cross-sections may include triangles, squares, pentagons, hexagons, heptagons, octagons, etc. Cross-sections according to other embodiments may include one or more multiple concave wall segments, convex wall segments, and / or flat (neither convex nor concave) wall segments around a perimeter, such as a lobular cross-section. In various exemplary embodiments, the multiple wall segments may alternate.

[0037] In various embodiments, the outer periphery of the distal portion of the cannula having a non-circular channel cross-section is equal in length to the outer periphery of the proximal portion of the cannula having a circular channel cross-section. Therefore, the size of the incision required to insert the cannula through the body wall into the target site is determined by the diameter of the proximal portion of the cannula with the circular channel cross-section, and the distal portion with the non-circular channel cross-section provides additional inhaled gas flow without requiring a larger incision. Thus, compared to a cannula in which the distal portion has a circular channel cross-section, embodiments of this disclosure provide a greater inhaled gas flow without requiring any corresponding increase in incision size.

[0038] Now for reference Figure 1 An embodiment of cannula 100 and tool 102 is shown. Cannula 100 includes a cannula body 104 having a proximal portion 106 and a distal portion 108. The proximal portion 106 of cannula body 104 includes a cup-shaped part 110, which may optionally be configured for coupling to a manipulation system, such as... Figure 16 The manipulation system 1600 shown and discussed below. The cannula body 104 has a central channel 103 through which the tool 102 can be inserted. Figure 1 In the illustrated mounting position of tool 102 within cannula 100, the distal end 112 of tool 102 protrudes beyond the cannula and includes one or more end effectors (not shown), such as, but not limited to, forceps, scissors, cauterization tools (such as cauterization hooks), anastomosing devices, clamp applicators, or other devices. The distal end 112 of tool 102 may optionally further include one or more articulated joints 114 to facilitate manipulation and positioning of the end effector of tool 102.

[0039] A pressurized blow-in gas supply is provided at the proximal portion 106 of the cannula body 104. As discussed further below, the blow-in gas flows through the cannula body 104 around the tool 102 and exits the distal end of the cannula body 104 around the tool 102. For example, the blow-in gas may be supplied by an actuation system (such as a combination...) Figure 16 The blow-in gas source associated with the manipulation system 1600 discussed is provided. Alternatively, any suitable blow-in gas source can be used, such as those found in a typical surgical operating room. Such a blow-in gas source can be connected to the cannula body 104 via fittings such as Luer interface fittings located near the proximal portion 106 of the cannula body 104, threaded connectors, or other connectors.

[0040] like Figure 1As shown, when the tool 102 is inserted into the cannula 100, the central channel 103 includes features at the distal portion 108 of the cannula body 104 configured to provide one or more flow paths around the tool 102 and out of the distal opening 116 of the cannula. As used herein, the term "distal portion" can include a portion of the cannula body that includes or is adjacent to the distal opening of the cannula. The distal portion 108 also provides support to hold the tool 102 in place within the distal portion 108 of the cannula 100. For example, in an embodiment of this disclosure, the central channel 103 at the distal portion 108 includes a longitudinal axis A orthogonal to the cannula body 104. L The plane (i.e., Figure 2 The non-circular cross-sectional shape in the plane. The non-circular cross-sectional shape of the central channel 103 defines one or more flow regions and one or more support regions, in which the inner wall of the distal portion 108 of the insertion tube 104 is perpendicular to the outer diameter D of the tool 102. T The inner wall of the distal portion 108 of the cannula 104, spaced apart in one or more support regions, is perpendicular to the outer diameter D of the tool 102. T Adjacent to or in contact with the flow area forms a flow path to guide the blow-in gas supplied to the cannula to the target site where tool 102 is used.

[0041] For example, now refer to Figure 2 , showing by Figure 1 Section line 2-2 in the figure shows a cross-sectional view of the distal portion 108 of the cannula body 104. Figure 2 In the view, the cannula body 104 ( Figure 1 The distal portion 108 of the central channel 103 has a non-circular cross-sectional shape 220. Figure 2 In this embodiment, the non-circular cross-sectional shape 220 of the central channel 203 is generally a square with rounded vertices 222 (i.e., chamfers). A circle 224 inscribed within the cross-sectional shape 220 has a diameter D. CI And tool 102 has an outer diameter D T The diameter D of the inscribed circle CI And the outer diameter D of tool 102 TThe difference between the two defines the gap C1 between the tool 102 and the distal portion 108 of the cannula 100. The gap C1 at the distal portion can be selected based on, for example, the desired accuracy of the position of the tool 102 relative to the cannula body 104, and other possible factors. It is envisioned that the gap at the distal portion is in the range, for example, from about 0.0005 inches (0.0127 mm) to about 0.031 inches (0.787 mm), while the gap proximal to the distal portion is in the range, for example, from about 0.0285 inches (0.724 mm) to about 0.055 inches (1.40 mm). These dimensional ranges are provided by way of example only, and gaps smaller or larger than the above ranges are considered within the scope of this disclosure.

[0042] like Figure 1 and Figure 2 As shown, when the tool 102 is located inside the cannula 100, the tool 102 only contacts or almost contacts some portions of the distal portion 108, which in Figure 2 The portion 226 through which the inscribed circle 224 passes in the distal end 108 of the cannula body 104. Figure 1 and Figure 2 In one embodiment, because there is a gap between the tool 102 and the inscribed circle, the tool 102 will not contact all parts 226 at the same time, and the tool 102 can move freely within the inscribed circle 224, depending on the amount of the gap.

[0043] Still referencing Figure 2 At the distal end of the cannula 104, a flow region 228 is defined between the tool 102 and the non-circular cross-sectional shape of the central channel 203. The flow region 228 provides a flow path through which fluids (such as blown gas) can flow to a target site, such as an operating site within a patient's body.

[0044] exist Figure 1 and Figure 2In this embodiment, the lateral and / or radial movement of the tool 102 is constrained by the size of the inscribed circle 224, while the flow region 228 is defined by a portion extending beyond the inscribed circle 224 in a non-circular cross-sectional shape 220. Compared to conventional arrangements (such as a circular cross-sectional shape at the distal end of the cannula's central channel), embodiments of this disclosure achieve a narrow gap between the tool 102 and the cannula body 104 to maintain the position of the tool 102 relative to the cannula, while also providing a relatively large flow region (such as flow region 228) to facilitate a correspondingly large gas flow rate. For example, some conventional tool and cannula designs feature a cannula with a circular distal cross-section, and the flow region in such an arrangement is defined by the difference in diameter between the openings in the tool and the cannula. Any increase in the cannula diameter at the distal end to provide additional flow region results in a larger gap between the tool and the cannula, and thus allows for greater movement between the tool and the cannula, thereby compromising the accuracy and precision of keeping the tool in place during the procedure. Embodiments of this disclosure decouple the relationship between the flow area and the gap, facilitating accurate and precise positioning of the tool, while also allowing for relatively high flow rates of the blown gas.

[0045] exist Figure 1 In the embodiment, the non-circular cross-sectional shape 220 of the central channel 103 of the cannula body 104 is... Figure 2 The non-circular cross-sectional shape 220 extends only along the distal portion 108 of the cannula body 104. The distance the non-circular cross-sectional shape 220 extends can be a portion of the total length of the cannula body 104. For example, in various embodiments, the non-circular cross-sectional shape 220 extends about one inch (25.4 mm) along the distal portion 108 of the cannula body 104. As a specific exemplary range, the distance the non-circular cross-sectional shape extends along the distal portion 108 of the cannula body ranges from about 0.75 inches (19.1 mm) to about 1.25 inches (31.6 mm). In other embodiments, the non-circular cross-sectional shape may optionally extend less than 0.75 inches or more than 1.25 inches along the distal portion 108 of the cannula body 104.

[0046] The central channel 103 of the cannula body 104 may optionally have a different cross-sectional shape along a portion of the cannula body 104 proximal to the distal portion 108. In some embodiments, particularly in embodiments including a curved cannula body (such as combined with...) Figure 15 As discussed, the gap between the cannula body 104 and the tool 102 may optionally be larger on the proximal side of the distal portion 108 to prevent the tool 102 from becoming trapped inside the cannula body 104 as it is inserted into the central channel 103 of the cannula body 104.

[0047] For example, now refer to Figure 3 , showing along Figure 1 The image shows a cross-sectional view taken from line 3-3. The central channel 103 of the cannula body 104 has a circular cross-sectional shape 330, which defines a gap C2 between the cannula body 104 and the tool 102. Figure 1-3 In the embodiment, the gap C2 is larger than the inscribed circle 224 of the tool 102 and the non-circular cross-sectional shape 220. Figure 2 The increased gap C1 between the tool 102 and the cannula 104 facilitates insertion and removal of the tool 102 within the cannula 104 without confining the tool 102 within the cannula 104, and without compromising the positioning of the tool 102 when it is positioned within the cannula 104, as the distal portion 108 of the cannula 104 provides accurate and precise positioning of the tool 102. Because the circular cross-sectional shape 330 of the central channel 103 of the cannula 104 proximal to the distal portion 108 has a relatively large gap C2 around the tool 102, the flow area through the portion of the central channel 103 of the cannula 104 proximal to the distal portion 108 is at least as large as the flow area defined by the flow area 228 defined at the distal portion 108 of the cannula 104. In this way, a relatively high and uniform flow rate is supported along the entire length of the cannula 104. For example, in tests conducted by the inventors, flow rates through the cannula were achieved that were 50% to 77% higher than conventional designs, depending on the diameter of the tool inserted into the cannula.

[0048] Although Figure 3 The shown with Figures 1-3 The cross-sectional shape 330 associated with the embodiment is circular, but any other cross-sectional shape (such as polygonal, elliptical, irregular, or other cross-sectional shapes) is within the scope of this disclosure. One factor to consider when selecting the cross-sectional shape of the central channel 103 of the proximal cannula 104 of the distal portion 108 is the provision of sufficient clearance to allow the tool 102 to be inserted into or withdrawn through the cannula 104 without becoming confined within it.

[0049] In various embodiments of this disclosure, the peripheral dimensions (e.g., length) of the outer surface of the cannula are consistent along the length of the cannula. For example, in Figures 1-3In one embodiment, the peripheral dimensions of the distal portion 108 of the non-circular cross-sectional shape 220 surrounding the central channel of the cannula body are approximately equal to (e.g., similarly or substantially the same) the peripheral dimensions of the cannula body 104 of the circular cross-sectional shape 330 surrounding the central channel. Because the peripheral dimensions of the portion of the central channel with the non-circular cross-sectional shape 220 and the portion of the central channel with the circular cross-sectional shape 330 are similar or the same, the distal portion 108 can be inserted into an incision, such as within a patient's body, without requiring the incision to be enlarged beyond the dimensions required based on the circular cross-sectional shape 330.

[0050] In various embodiments of this disclosure, the non-circular cross-sectional shape 220 of the central channel is formed by processes such as stamping, die forming, or other techniques. In one example embodiment, the cannula body 104 is formed from a tubular blank having a desired diameter and is made of a relatively malleable metal alloy, such as 304 stainless steel. The cannula body 104 is then cut to the desired length, and the non-circular cross-sectional shape 220 is stamped, die-formed, or otherwise imparted to the distal portion 108 of the cannula body 104. In other embodiments, the cannula may optionally be molded from a moldable polymer material or cast from a metal or polymer material.

[0051] In some embodiments of this disclosure, the forming process for imparting the non-circular cross-sectional shape 220 to the central channel at the distal portion 108 of the cannula body 104 does not significantly alter the peripheral dimensions of the cannula body 104, and therefore, the portion of the cannula body 104 with the non-circular cross-sectional shape 220 of the central channel exhibits a peripheral dimension (e.g., perimeter) substantially equal to that of the portion of the cannula body 104 with the circular cross-sectional shape 330 of the central channel. In other embodiments, one or more processes for forming the non-circular cross-sectional shape 220 of the central channel at the distal portion of the cannula body 104 may optionally have a stretching or shrinking effect on the material of the cannula body 104, resulting in a small difference between the periphery of the portion of the cannula body 104 with the non-circular cross-sectional shape 220 of the central channel and the periphery of the portion of the cannula body 104 with the circular cross-sectional shape 330 of the central channel.

[0052] Various cross-sectional shapes can be used at the distal end of the cannula. Figure 4-Figure 1 Figure 4 illustrates examples of other shapes that can be used according to various embodiments of this disclosure.

[0053] Now for reference Figure 4 and Figure 5This illustrates another embodiment of the cannula 400 according to the present disclosure. The cannula 400 includes a cannula body 404, a proximal portion 406 with a cup-shaped portion 410, and a distal portion 408. The proximal portion 406 includes an attachment portion 432 configured to engage with, for example, an actuation system (such as a coupling device). Figure 16 A portion of the control system 1600 under discussion is coupled. The distal portion 408 has a central channel 403 with a non-circular cross-sectional shape 434 and an oval shape. (Reference) Figure 5 A circle 424, tangent within an oval-shaped cross-section 434, defines a contact portion 426, at which the tool 102 can contact the cannula body 404. A flow region 428 defines one or more channel paths between the tool 102 and the cannula body 404, through which blown gas flows to the surgical site.

[0054] and Figures 1-3 Similar to the embodiments, the central channel 403 of the cannula body 404 is characterized by a circular cross-sectional shape proximal to the distal portion 408. The perimeter (i.e., circumference) of the cannula body portion having a central channel with a circular cross-sectional shape proximal to the distal portion 408 is substantially equal to the perimeter of the cannula body portion having a central channel with an oval cross-section 434.

[0055] Now for reference Figure 6 and Figure 7 This illustrates another embodiment of cannulation according to the present disclosure. Figure 6 and Figure 7 In the middle, the intubation 600 is similar to the combination in many ways. Figures 1-5 The described cannula, however, includes a distal portion 608 of the cannula body 604 with a central channel 603 having a generally triangular, non-circular cross-sectional shape 636. Therefore, a circle 624 tangent within the non-circular cross-sectional shape 636 defines three contact portions 626 at which the tool 102 can contact the cannula body 604 at the distal portion 608. That is, when the tool 102 is inserted into the cannula body 604, the contact portions 626 are configured to contact the tool 102. Three flow regions 628 are defined between the cannula body 604 and the tool 102 through which blown gas can flow to the surgical site. Figures 1-3 In one embodiment, the vertices of the triangular cross-sectional shape are rounded to provide a smooth outer surface for the cannula body 604.

[0056] Now for reference Figure 8 and Figure 9 This shows a similar combination. Figures 1-3The described embodiments of the cannula 800 include embodiments where both have a distal portion with a quadrilateral cross-sectional shape. The cannula body 804 includes a distal portion 808 with a central channel 803 having a generally square, non-circular cross-sectional shape 838 with rounded vertices. A circle 824 inscribed within the non-circular cross-sectional shape 838 defines four contact portions 826 through which the tool 102 can contact the cannula body 804 at the distal portion 808. Four flow regions 828 define areas between the cannula body 804 and the tool 102 through which blown gas can flow to the surgical site. Figure 8 and Figure 9 Other aspects of the embodiments are also similar to the combination Figures 1-3 The embodiments discussed.

[0057] refer to Figure 10 and Figure 11 Another embodiment of the cannula 1000 having a cannula body 1004 is shown. The cannula body 1004 includes a distal portion 1008 with a central channel 1003 having a generally hexagonal, non-circular cross-sectional shape 1040. Accordingly, a circle 1024 inscribed within the non-circular cross-sectional shape 1040 defines six contact portions 1026 through which the tool 102 can contact the distal portion 1008 of the cannula body 1004, and six flow regions 1028 define areas through which blown gas can flow through the cannula 1000 into the surgical site.

[0058] According to embodiments of the present disclosure, the non-circular cross-sectional shape that can be used at the distal end of the cannula is not limited to the combination of... Figure 1-11 The shapes discussed above. For example, now refer to... Figure 12 This illustrates yet another embodiment of the cross-sectional shape of the central channel in the distal portion of the cannula. Figure 12 In one embodiment, the non-circular cross-sectional shape 1242 is generally pentagonal, and the inscribed circle 1224 defines five contact portions 1226 and five flow regions 1228, at which the tool 102 can contact the cannula body, and the blown gas can flow through the five flow regions 1228 through the cannula to reach the surgical site.

[0059] Figure 13 An embodiment with a non-circular cross-sectional shape having eight sides (i.e., generally octagonal) is shown. Figure 13 In one embodiment, the inscribed circle 1324 defines eight contact portions 1326 and eight flow regions 1328. From Figure 13As can be seen, as the number of sides of a non-circular cross-sectional shape increases, the non-circular cross-sectional shape begins to approach a circle, and the area of ​​the flow region decreases. Without wishing to be limited to any particular theory or particular embodiment, the inventors have determined that a non-circular cross-sectional shape with five or six sides can provide a favorable trade-off between the flow region available for the blown gas and the overall cannula shape that can be acceptablely interfaced with other system components, such as an anchoring device coupled to the cannula by sliding above the distal end of the cannula.

[0060] In some embodiments, the non-circular cross-section of the central channel at the distal end of the cannula may optionally be formed by a material removal process rather than a material deformation process. For example, now refer to Figure 14A and Figure 14B This shows a cross-sectional view of the distal portion of the cannula 1404. Figure 14A In this embodiment, the cannula body 1404 has a circular outer surface 1444 and a non-circular inner surface 1446. In some embodiments, the non-circular inner surface 1446 may be formed from a material blank having a circular inner surface by thinning the inner surface in a selected region. For example, it can be formed by using a material blank having a circular inner surface 1444. Figure 14B The tube 1452, with the cross-section shown (i.e., the inner circular cross-section and the outer circular cross-section), is the starting point for manufacturing. Figure 14A The cannula body 1404 is shown. To achieve... Figure 14A The configuration shown reduces the thickness of some portions of the cannula body 1404 to form the flow region 1448, while the remaining portions of the cannula body 1404 retain a thickness close to or equal to the original thickness of the material blank of the cannula body 1452 to form the contact portion 1450, which is used for bonding. Figures 1-3 The implementation of the method of supporting tool 102 is discussed in more detail.

[0061] Refer again Figure 4-Figure 1 4. It can be seen that the non-circular cross-section at the distal portion of the cannula results in two or more contact lines between the outer surface of the tool extending through the distal portion and the inner surface of the non-circular cannula sidewall. For Figure 4 and Figure 5 The oval cross-section shown has two contact lines, for Figure 6 and Figure 7 The cross-section of the three sides shown has three contact lines, for Figure 8 and Figure 9The cross-sections shown for the four sides have four contact lines, and so on. With only two contact lines in the oval cross-section, the tool is stable on only one cross-sectional dimension inside the distal portion of the cannula. However, with three or more contact lines surrounding the tool, the tool is stable on two cross-sectional dimensions inside the distal portion of the cannula. Furthermore, since the outer surface of the tool contacts the inner surface of the cannula only along one or more contact lines, friction between the tool and the cannula sidewalls is minimized as the tool slides within the cannula.

[0062] Furthermore, it can be seen that, for a polygonal cross-section, the inner surface of the cannula sidewall of the contact tool's outer circular surface can optionally be straight or curved, provided that the curvature is shallow enough to establish a contact line rather than a contact area. As a geometric example, the circle representing the tool's cross-section can be inscribed within both equilateral and Luro triangles, where a contact line appears where the circle contacts each triangle's side. However, if the shape of the sidewall is altered to at least partially conform to the shape of the tool, the contact area between the sidewall and the tool is larger than the line, and the friction between the tool and the sidewall can be greater than that in the case of line contact. Of course, those skilled in the art will recognize the practical differences between this strict geometric example and real-life objects, but the description of the contrast between line contact and area contact still illustrates the principle of fully supporting the distal portion of the cannula of a tool extending through the distal portion, minimizing contact and friction between the tool and the distal portion of the cannula, and providing a sufficiently large cross-sectional area for fluid flow between the distal portion of the cannula and the tool.

[0063] This disclosure also envisions other cross-sectional shapes for the cannula. For example, the cannula may have a cross-sectional shape comprising alternating convex and concave wall sections around the circumference of the cannula. Such a cross-sectional shape may be referred to as a leaflet shape. Figure 18 An exemplary embodiment of a cannula body 1804 having a leaflet cross-sectional shape is shown, the leaflet cross-sectional shape having convex wall sections 1860 alternating with concave wall sections 1862, wherein the concavity / convexity is relative to the interior of the cannula body 1804. The concave sections 1862 extend radially inward and thus define a contact area 1864 against which an instrument shaft (not shown) is supported, while the convex sections 1860 define a flow area 1866 around the instrument shaft to facilitate the flow of blown gas or other fluids as described above. Although Figure 18The cross-sectional shape shown includes six convex portions 1860 that alternate between six concave portions 1862, but other numbers of convex and concave portions are also within the scope of this disclosure. Furthermore, other patterns may be used, such as irregularly alternating leaf patterns, or patterns including generally flat wall segments (neither convex nor concave) located between the convex and / or concave portions.

[0064] Figure 19 An embodiment of a cannula body 1904 having a Luró polygon cross-sectional shape is shown. As used herein, a Luró polygon is a polygon composed of curved segments. In this embodiment, the cannula body 1904 has a Luró pentagonal cross-sectional shape (i.e., a polygon with five sides, each side being a curved segment). Each curved side (curved segment) 1968 defines a contact region 1970 at or near the midpoint of the curved side 1968, which provides support for an instrument shaft (not shown) inserted into the cannula body 1904. A flow region 1972 is defined between the instrument shaft inserted into the cannula body 1904 and adjacent vertices 1974 and the inner wall portions of the cannula body 1904 adjacent to these vertices. Although in Figure 19 The example shown is a Lurau pentagon, but other Lurau cross-sectional shapes with more than five or less than five sides are within the scope of this disclosure.

[0065] Now for reference Figure 15 An embodiment of an intubation cannula 1500 having an intubation cannula body 1504, the intubation cannula body 1504 having an A along its longitudinal axis. L Extended curved segment 1554. Combined Figure 1-Figure 1 The various embodiments of the cannula body and associated cross-sectional shape described in 4 can be combined with straight cannulas (such as...) Figure 1 The cannula 100 in the middle) or the cannula including one or more bends (such as Figure 15 The cannula 1500 is used. Additionally or alternatively, in other embodiments of this disclosure, the cannula may optionally include multiple curves (i.e., complex curves). Embodiments of this disclosure facilitate the insertion and removal of tools (such as tool 102) within such a cannula without restriction, allow a relatively large flow rate of blown gas to pass through the distal portion of the cannula, and maintain the position of tool 102 at the distal portion of the cannula.

[0066] For example, the embodiments described herein can be used with remotely operated computer-assisted systems (e.g., remotely operated surgical systems), such as those described in U.S. Patent No. 9,358,074, entitled "Multi-Port Surgical Robotic System Architecture" (filed May 31, 2018), to Schena et al.; U.S. Patent No. 9,295,524, entitled "Redundant Axis and Degree of Freedom for Hardware-Constrained Remote Center Robotic Manipulator" (filed May 31, 2013), to Schena et al.; and U.S. Patent No. 8,852,208, entitled "Surgical System Instrument Mounting" (filed August 12, 2010), to Gomez et al., each of which is incorporated herein by reference in its entirety. Furthermore, the embodiments described herein can be used, for example, with the da Vinci (da Vinci) system. Surgical systems such as da Vinci were used together. Surgical System (model IS3000) or da Vinci Surgical systems, both with or without single-site surgical devices. Single-port surgical techniques, all of which are commercialized by Intuitive Surgical, Inc., Sunnyvale, California. While various embodiments of surgical instruments described herein are discussed with respect to the manipulation systems of remotely operated surgical systems, this disclosure is not limited to use with surgical instruments for remotely operated surgical systems. For example, the various embodiments described herein can optionally be used in conjunction with handheld, manual surgical instruments or other surgical and non-surgical tools.

[0067] As described above, according to various embodiments, the surgical instruments of this disclosure are configured for use in remotely operated computer-assisted surgical systems (sometimes referred to as robotic surgical systems). Reference is now made to... Figure 16This illustration shows an embodiment of a control system 1600 for a remotely operated computer-assisted surgical system, wherein surgical instruments are configured to be mounted on the control system 1600 for use. Such a surgical system may further include a user control system (such as a surgeon's console for receiving input from a user to control the instruments of the control system 1600) and auxiliary systems (such as a control / vision cart (not shown)), for example, as described in, above-incorporated U.S. Patent Nos. 9,358,074 and 9,295,524.

[0068] like Figure 16 As shown in the embodiment, the manipulation system 1600 includes a base 1620, a main column 1640, and a main arm 1660 connected to the main column 1640. The manipulation system 1600 also includes a plurality of arms 1610, 1611, 1612, and 1613, each connected to the main arm 1660. Each arm 1610, 1611, 1612, and 1613 includes an instrument loading portion 1622 to which an instrument 1630 can be loaded; the instrument loading portion 1622 is illustrated as being attached to the arm 1610. During a surgical procedure, portions of the arms 1610, 1611, 1612, and 1613 can be manipulated according to commands provided by the user at the surgeon's console. In an embodiment, one or more signals or inputs transmitted from the surgeon's console are transmitted to a control / vision cart, which can interpret one or more inputs and generate one or more commands or outputs to be transmitted to the manipulation system 1600 to induce control of the instrument 1630 (in...) at the manipulation system 1600. Figure 16 (Only one such device is added in the middle) and / or the operation of the part of the arm 1610 to which the device 1630 is coupled.

[0069] According to an embodiment, the instrument loading portion 1622 includes a drive assembly 1623 and a cannula loading member 1624, wherein the force transmission mechanism 1634 of the instrument 1630 is connected to the drive assembly 1623. The cannula loading member 1624 is configured to hold a cannula 1636 through which the axis 1632 of the instrument 1630 can be extended to the surgical site during a surgical procedure. As is known to those skilled in the art, the drive assembly 1623 includes various actuators and other mechanisms controlled to respond to input commands at a surgeon's console and to transmit force to the force transmission mechanism 1634 to actuate the instrument 1630.

[0070] Although the body is for easy observation, Figure 16The embodiment shown depicts an instrument 1630 attached only to arm 1610, but the instrument can be attached to any and each of arms 1610, 1611, 1612, and 1613. Instrument 1630 can be a surgical instrument with an end effector discussed herein. A surgical instrument with an end effector can be attached to and used with any of arms 1610, 1611, 1612, and 1613. The manipulation system 1600 can be operatively coupled to an inhaled gas source 1650, in... Figure 16 The diagram is schematically shown. The blown gas source 1650 may be, or include, for example, a pressurized cylinder, a pump, or other source. The embodiments described herein are not limited to those described herein. Figure 16 The embodiments described herein, and various other remotely operated computer-assisted surgical system configurations can be used in conjunction with the embodiments described herein.

[0071] Other configurations of surgical systems are also envisioned, such as surgical systems configured for single-port surgery. For example, now refer to Figure 17 This illustration shows a portion of an embodiment of a manipulator arm 2140 with a manipulator system comprising two instruments 2300, 2310 in a mounted position. A remotely operated robotic surgical system including a manipulator arm 2140 can be configured according to embodiments described in U.S. Patent Application Publication No. US2014 / 0128886A1 (filed November 1, 2013) entitled “FLUX DISAMBIGUATION FOR TELEOPERATE DSURGICAL SYSTEMS”, the disclosure of which is incorporated herein by reference. For simplicity, Figure 17 The schematic diagram depicts only two instruments, but as those skilled in the art will recognize, more than two instruments may be received in the mounting position at the control system. Each instrument 2300, 2310 includes instrument axes 2320, 2330, which have a movable end effector or endoscope, camera or other sensing device at a distal end, and may or may not include a wrist mechanism (not shown) for controlling the movement at the distal end.

[0072] exist Figure 17In this embodiment, the distal portions of instruments 2300 and 2310 are received via a single-port structure 2380 for introduction into the patient. As shown, the port structure includes a cannula and an instrument entry guide inserted into the cannula. Individual instruments are inserted into the entry guide to reach the surgical site. Several separate manipulator arms may be used in conjunction with other configurations of the manipulation system used in this disclosure. Additionally, individual manipulator arms may include a single instrument or multiple instruments. Further, the instrument may be a surgical instrument with an end effector, or it may be a camera instrument or other sensing instrument used during surgical procedures to provide information about the remote surgical site (e.g., visualization, electrophysiological activity, pressure, fluid flow, and / or other sensed data).

[0073] Force transmission mechanisms 2385, 2390 are disposed proximally to each shaft 2320, 2330 and connected to drive assemblies 2420, 2430 via sterile adapters 2400, 2410. Drive assemblies 2420, 2430 contain various internal mechanisms (not shown) controlled by a controller (e.g., at the control trolley of the surgical system) to transmit force to force transmission mechanisms 2385, 2390 to actuate instruments 2300, 2310 in response to input commands at the surgeon's side console of the surgical system. One or more diameters of the instrument shafts, wrist mechanisms, and end effectors are typically selected based on the size of the cannula to be used with the instrument and the surgical procedure to be performed. In various embodiments, the shafts and / or wrist mechanisms have diameters of, for example, about 4 mm, 5 mm, or 8 mm to match the sizes of some existing cannulation systems. According to an embodiment, one or more instruments 2300, 2310 may be inserted through a cannula that is in communication with a blow-in gas source 2440 (e.g., a pressurized cylinder, pump or other pressurized gas source) as described above.

[0074] These descriptions and illustrations of embodiments should not be considered limiting. Various mechanical, compositional, structural, and operational changes may be made without departing from the scope of this specification and the claimed invention (including equivalents). In some instances, well-known structures and techniques have not been shown or described in detail so as not to obscure this disclosure. Similar numerals in two or more figures represent the same or similar elements. Furthermore, where feasible, elements and their associated features described in detail with reference to one embodiment may be included in other embodiments where they are not specifically shown or described. For example, if an element is described in detail with reference to one embodiment but not with reference to a second embodiment, that element may still be claimed to be included in the second embodiment.

[0075] For the purposes of this specification and the appended claims, unless otherwise indicated, all figures expressing quantities, percentages or proportions, and other numerical values ​​used in the specification and claims shall be understood to be modified by the term "about" in all instances (unless they are not so modified). Accordingly, unless indicated to the contrary, the numerical parameters set forth in the specification and the appended claims are approximate values ​​that may vary depending on the desired implementation sought. At least, and without attempting to limit the application of the doctrine of equivalents to the scope of the claims, each numerical parameter shall be interpreted at least according to the number of significant figures reported and by applying ordinary rounding techniques.

[0076] Note that the singular forms “a,” “an,” and “the,” as used in this specification and the appended claims, and any singular use of any word, include plural indicators unless explicitly and unambiguously limited to one indicator. As used herein, the term “comprising,” and its grammatical variations, are intended to be non-limiting, such that the listing of items does not exclude other similar items that may be substituted for or added to the listed items.

[0077] Furthermore, the terminology used in this specification is not intended to limit the invention. For example, spatially relative terms such as “bneath,” “below,” “lower,” “above,” “upper,” “proximal,” “distal,” and similar terms may be used to describe the relationship of one element or feature to another element or feature illustrated in the figures. In addition to the positions and orientations shown in the figures, these spatially relative terms are also intended to cover different positions (i.e., locations) and orientations (i.e., rotational placements) of the device in use or operation. For example, if the device in the figures is flipped, an element described as “below” or “under” other elements or features will be “above” or “on” other elements or features. Thus, the exemplary term “below” can cover positions and orientations above and below. The device may be oriented in other ways (rotated 90 degrees or other orientations), and the spatially relative descriptive terms used herein will be interpreted accordingly.

[0078] In view of the disclosure herein, further modifications and alternative embodiments will be apparent to those skilled in the art. For example, for clarity of operation, apparatus and methods may include additional components or steps omitted from the drawings and description. Accordingly, these descriptions should be analyzed as illustrative only and are intended for the purpose of teaching those skilled in the art the general manner of implementing this teaching. It should be understood that the various embodiments shown and described herein are to be considered exemplary. After benefiting from this specification, it will be apparent to one of skill in the art that elements and materials, and the arrangement of such elements and materials, may replace those illustrated and described herein, parts and processes may be reversed, and certain features of this teaching may be utilized independently. Changes may be made to the elements described herein without departing from the spirit and scope of this teaching and the appended claims.

[0079] It should be understood that the specific examples and embodiments described herein are not limiting, and modifications can be made to the structure, dimensions, materials, and methods without departing from the scope of this teaching.

[0080] Other embodiments of the invention disclosed herein will be apparent to those skilled in the art from consideration of the specification and practice thereof. The specification and examples are intended to be exemplary only, wherein, under the law of the application, the appended claims enjoy their fullest breadth, including equivalents.

Claims

1. A cannula comprising: A tube body comprising a proximal end, a distal end, a longitudinal axis extending between the proximal end and the distal end of the tube body, and a channel extending between the proximal end and the distal end of the tube body along the longitudinal axis of the tube body. The tube, including a portion of its distal end, is configured to be inserted into a body cavity; The channel is configured to receive a medical device and allow the medical device to be inserted into the body cavity; The first cross-section of the channel, taken at or near the distal end of the tube and in a plane orthogonal to the longitudinal axis, has a first cross-sectional shape. The first cross-sectional shape includes one of a polygonal shape and a leaf shape; The second cross-section of the channel, which is located near the distal end of the tube and near the location where the first cross-section is cut, and is cut in a plane orthogonal to the longitudinal axis, has a second cross-sectional shape, and the second cross-sectional shape is different from the first cross-sectional shape. as well as The tube is formed with the first cross-sectional shape and the second cross-sectional shape having the channel.

2. The cannulation according to claim 1, wherein: The first cross-sectional shape has a first periphery; The second cross-sectional shape has a second periphery; and The first perimeter and the second perimeter have the same length.

3. The cannula according to claim 1 or claim 2, wherein the first cross-sectional shape comprises a polygon and is selected from triangles, squares, pentagons, hexagons, heptagons, and octagons.

4. The cannulation according to claim 3, wherein: The circle inscribed within the first cross-sectional shape has a first diameter; The second cross-sectional shape is a circle with a second diameter; and The first diameter is smaller than the second diameter.

5. The cannulation according to claim 4, wherein: The portion of the channel outside the circle that is inscribed within the first cross-sectional shape is the flow region within the first cross-sectional shape; and The portion of the channel adjacent to the circle tangent within the first cross-sectional shape is the contact portion of the first cross-sectional shape arranged to contact the tool inserted into the cannula.

6. The cannulation according to claim 1 or claim 2, wherein: The tube includes a portion of the length of the tube that is bent along the longitudinal axis.

7. The cannulation according to claim 1 or claim 2, wherein: The second cross-sectional shape is a circle.

8. The cannulation according to claim 1 or claim 2, wherein: The first cross-sectional shape is a Lurlo polygon.

9. The cannula according to claim 1 or claim 2, wherein the first cross-sectional shape comprises a leaflet shape having alternating convex and concave segments.

10. A system comprising: The cannula according to claim 1 and the medical device inserted through the channel of the cannula; The medical device includes a shaft, and the shaft is inserted into the channel; The channel includes an outer periphery, and a circle inscribed within the first cross-sectional shape has a first diameter, the first diameter defining a first gap between the outer periphery of the channel and the axis of the medical device; The second cross-sectional shape defines a second gap between the outer periphery of the channel and the axis of the medical device; and The second gap is larger than the first gap.

11. The system according to claim 10, wherein: The first cross-sectional shape comprises a polygon.

12. The system according to claim 11, wherein: The polygon contains chamfered vertices.

13. The system according to claim 11, wherein: The polygon is selected from one of a triangle, square, pentagon, hexagon, heptagon, and octagon.

14. The system according to any one of claims 10-13, wherein: The second cross-sectional shape is circular.

15. The system according to any one of claims 10-13, wherein: The system further includes a plurality of flow regions defined between the outer periphery of the shaft and the channel; and Each individual flow region in the plurality of flow regions forms a corresponding individual flow path through the channel to the outside of the tube body.

16. The system according to any one of claims 10-13, wherein: The system further includes a blow-in gas source; and The blow-in gas source is configured to supply pressurized blow-in gas to the channel of the tube.

17. The system according to any one of claims 10-13, wherein: The first cross-sectional shape has a periphery; The second cross-sectional shape has a periphery; and The perimeter of the first cross-sectional shape and the perimeter of the second cross-sectional shape have the same length.

18. An apparatus comprising: An intubation cannula includes a proximal end, a distal end, an inner wall between the proximal end and the distal end, and a first channel defined by the inner wall and extending along the longitudinal axis of the cannula between the proximal end and the distal end of the cannula; as well as A blow-in source fitting at the proximal end of the tube body, the blow-in source fitting including a second channel connected to the first channel of the tube body; The tube is formed such that the cross-section of the first channel transitions from a circular cross-section near the proximal end of the tube to a polygonal cross-section near the distal end of the tube, the cross-section being cut in a plane orthogonal to the longitudinal axis of the tube.

19. The apparatus according to claim 18, wherein: The device further includes an instrument shaft extending through the first channel; The instrument shaft includes an outer surface; and The outer surface of the instrument shaft contacts the inner wall of the tube body along a contact line at the polygonal cross-section of the tube body.

20. The apparatus according to claim 19, wherein: The outer surface of the instrument shaft contacts the inner wall of the tube body along the second contact line at the polygonal cross-section of the tube body.

21. The apparatus according to claim 19, wherein: The surface of the inner wall is straight at the contact line.

22. The device according to claim 19, wherein: The surface of the inner wall is curved at the contact line.

23. The device according to claim 19, wherein: The inner wall of the tube at the polygonal cross-section includes adjacent sidewall pairs connected at the vertices; The fluid passage is defined between the outer surface of the instrument shaft and the adjacent sidewall pair; and The second channel of the blow-in source accessory is connected to the fluid channel.

Images