Device

Abstract

An apparatus includes one or more instrument ports configured to respectively retain one or more laparoscopic instruments during surgery, a top opening of each instrument port including a downward recess configured to receive and retain a handle of a laparoscopic hand instrument placed in the port such that the handle faces a surgeon in use.

Description

Related Applications

[0001] This patent application is related to Australian Provisional Patent Application No. 2021901689, the specification of which was originally filed is hereby incorporated herein by reference. Technical Field

[0002] The present disclosure is directed to a device (including an "instrument holder" or "instrument sleeve") for holding laparoscopic instruments during surgery. Background Art

[0003] Laparoscopic instruments include laparoscopic hand instruments and laparoscopic energy instruments or suction / irrigation devices, which are used by surgeons during surgery. Laparoscopic instruments may also be referred to as "tools". Laparoscopic hand instruments may be referred to as "hand instruments" or "laparoscopic instruments". Each hand instrument includes 3 to 5 hand instrument parts, which are usually assembled after sterilization and before surgery. The hand instrument parts generally include: a tip with a grasper or separator in the form of a jaw, located at the distal end of the instrument, configured to operate in the patient's body; an outer shaft that penetrates the body cavity; an inner shaft connected to the jaws and can move longitudinally; a handle at the proximal end of the instrument for the surgeon to hold the instrument and open / close the grasper or separator; and a rotating wheel located at the connection between the handle and the outer shaft (the rotating wheel is part of the outer shaft, and when rotated, usually by the surgeon's index finger, it rotates the inner shaft and the jaws); there is usually also an electrode (or "post") extending from the outer shaft to connect the current supply when the operation requires it. The handle (also called the "gripping mechanism") is similar to that of a pair of scissors, although the axis of the instrument is angled 120 degrees to the longitudinal axis of the handle. Laparoscopic energy instruments, which may be referred to as "energy instruments" or "energy devices," are used to cut and seal tissue and have handles that are about four times larger than those of hand instruments and typically include a large housing and a power cord / cable connected to an external power source. Laparoscopic surgery may require the provision of a suction / irrigation device for aspiration, for example, an irrigation device that looks like a tube with a tube / hose hanging from the top and extending from the rear to an air / water supply. The power cord / cable or tube / hose extends from the handle of the instrument / device when in use.

[0004] During laparoscopic surgery, instruments are used within the sterile field. The sterile field is the area around the surgical site that is considered sterile. The sterile field usually extends from below the surgeon's waist to the shoulders, and the height of the operating table is adjusted accordingly. Everyone (surgeon, patient, and nurses) wears sterile gloves and gowns, masks, and / or surgical drapes, and anything is covered with a drape or sterilized (such as hand instruments).

[0005] During surgery, surgeons use many different long, thin instruments and change instruments during surgery to perform different functions (this is called "instrument exchange," when the surgeon needs to stop, remove and put down the tool he is using, and pick up the tool he needs to insert). During surgery, a tray or laparoscopic sleeve can be provided to hold the instruments (hand instruments and energy instruments or suction / irrigation devices) in a sterile manner, which the surgeon can pick up and put down.

[0006] However, for certain surgical procedures, when more than one or two instruments are required, and / or when there are more instrument exchanges (when the surgeon needs to stop the procedure, remove and put down the instrument being used, and pick up the now needed instrument for insertion), known instrument holders may make it difficult for the surgeon to quickly and / or intuitively retrieve the required instrument.

[0007] It would be desirable to address or mitigate one or more disadvantages or limitations associated with the prior art, or at least provide a useful alternative. Summary of the invention

[0008] Disclosed herein is a device ("laparoscopic instrument holder") comprising: one or more instrument ports configured to respectively hold one or more laparoscopic instruments during surgery (i.e., one port holds one instrument), The top opening of each instrument port includes a downward groove (also called a "slot" or "notch") configured to receive and hold the handle of a laparoscopic hand instrument placed in the port (due to gravity, which pushes the handle into the groove and prevents the handle from moving out) so that the handle is facing the surgeon (or at least not away from the surgeon) when in use (because the direction of the handle is determined by the position of the groove around the top opening).

[0009] One or more instrument ports may include multiple ports, and the grooves of adjacent ports are oriented about their respective top openings so that handles of adjacent hand instruments are guided to avoid overlapping each other when in adjacent ports (so that the handles are aligned with each other by the grooves and separated by dividing walls in adjacent ports).

[0010] The groove may include two edges (or faces) having opposite slopes and intersecting at a low point or line of the groove, such that, in use, the handle is urged by gravity toward the low point / line, thereby orienting the handle toward the surgeon. The groove may be a V-shaped groove, formed by two straight edges, or a U-shaped groove, formed by curved edges. At least one instrument port may include two downward grooves configured to receive and hold a handle of a laparoscopic hand instrument placed in the port, the two downward grooves comprising a downward groove on the front wall of the port and a further downward groove on the side wall.

[0011] Disclosed herein is a device ("laparoscopic instrument holder") comprising: a. One or more instrument ports configured to respectively hold one or more laparoscopic instruments during surgery (ie, one port holds one instrument); and b. When in use, the leg bend extends from the top opening of the port in a direction away from the surgeon (second direction) and around / over / toward the patient's legs. (The leg bend can keep the support stable because the support is partially against the patient, rather than just hanging from the sterile surgical drape on the patient's upper legs.)

[0012] The leg flex includes a plurality of fixation points configured to be attached to a patient, typically to a sterile surgical drape secured to the patient. The fixation points include holes through the leg flex configured to receive clips (e.g., towel clips or surgical clips) to secure the leg flex to the sterile surgical drape.

[0013] The leg curvature includes a curvature that substantially matches the curvature of an adult thigh, such as the curvature of an average adult thigh or a tall adult thigh, such as for bariatric or gynecological surgery patients.

[0014] The leg bends are rigid, including being formed from a hard plastic.

[0015] The leg bend may extend from the top opening and / or from the substantially straight rear wall of the port around at least a quarter circle, at least an eighth circle, or at least a sixteenth circle. The average radius of the leg bend may be between 4 cm and 20 cm, including between 8 cm and 9 cm.

[0016] One or more instrument ports may include a D-shaped port ("D-port") configured to hold a laparoscopic energy instrument or suction / irrigation device with power cords / cables and / or tubing / hoses during surgery.

[0017] The top opening of a D-port includes: a substantially straight edge and a substantially curved edge that cooperates with the straight edge to form a "D" shape. Unlike an instrument port, a D-port has a substantially flat top opening to support the handle of a laparoscopic energy instrument or suction / irrigation device, while allowing the handle of the laparoscopic energy instrument and / or suction / irrigation device to rotate about the curved edge, such as when moving power cords / cables and / or tubing / hoses during surgery (i.e., there is no V-shaped groove so that the energy instrument and / or suction / irrigation device can move freely). In other words, the D-port tube has a flat side facing the end port (and other ports), and an opposing curved side that forms a D-shaped horizontal cross-section.

[0018] The end (terminal) of one of the D-port and the instrument port can be configured to be connected at least at its top opening to prevent the surgeon from manually inserting laparoscopic instruments between the D-port and the end when in use (i.e., the D-port can be fixed to the hand instrument port). The end port can have an end wall formed to receive the mating wall of the D-port to align the D-port adjacent to the end port. The end wall can be substantially flat, and the mating wall is correspondingly substantially flat. The D-port and the end wall can include a mating fixing element to fix the D-port to the end port. The mating fixing element can include a groove in the end wall to receive the mating protrusion (stud) of the D-port. The mating fixing element can include a groove in the D-port to receive the mating protrusion (stud) of the end wall. The groove can include respective wide upper holes and narrow lower holes, and the mating protrusion can include a rod passing through the narrow lower hole and a head passing through the wide upper hole but not through the narrow lower hole.

[0019] Disclosed herein is a device ("laparoscopic instrument holder") comprising: one or more instrument ports configured to respectively hold one or more laparoscopic instruments during surgery (i.e., one port holds one instrument), The top opening of each instrument port includes at least one inclined guide rail, which is used to guide the distal end of the instrument to the throat of the port when the instrument is inserted into the port during use.

[0020] At least one angled guide provides an inwardly angled opening to the port, making it easier for a surgeon to manually insert instruments into the port.

[0021] The at least one inclined rail may include: a. a shelf extending from the top opening toward the surgeon (first direction); and / or b. When in use, the legs extending from the top opening away from the surgeon (the second direction) are bent around / over / toward the patient's legs.

[0022] Disclosed herein is a device (including a "laparoscopic instrument holder") comprising: two or more instrument ports configured to respectively hold two or more laparoscopic instruments during surgery (i.e., one port holds one instrument), The adjacent ports are connected at least at their top openings to prevent the surgeon from manually inserting a laparoscopic instrument between the adjacent ports during use.

[0023] The adjacent ports form one or more adjacent port pairs. Each pair of adjacent ports is separated by a partition wall (partition wall), which is a wall provided for two adjacent ports.

[0024] Disclosed herein is a device ("laparoscopic instrument holder") comprising: one or more instrument ports configured to respectively hold one or more laparoscopic instruments during surgery (i.e., one port holds one instrument), Each instrument port includes a window formed of a transparent, waterproof material configured to display to the surgeon the distal end of an instrument (including the tip of the instrument) in the port (to allow the surgeon to see the tip of the instrument while the instrument is residing in the port).

[0025] The window may be provided by a transparent, waterproof wall of the port.

[0026] A window may extend from the bottom of the port to the same side as the platform, allowing the surgeon to see the tip of the instrument when in use.

[0027] The shelf includes a recess.

[0028] Each port includes a wall including a lower wall formed of a waterproof material and a rigid material (e.g., a hard plastic). Each port includes a lower portion enclosed by the lower wall to aseptically retain the distal end of the instrument, including the tip. The lower portion includes a sealed bottom. Each port has a length, from its top opening to its sealed bottom, selected based on the expected length of the instrument, configured to retain hand instruments having a length of approximately 250 mm, 330 mm, and / or 430 mm.

[0029] Each port has a throat that accommodates the rotating wheel of the hand instrument so that the rotating wheel falls below the top opening when inserted into the port. The throat is slightly larger in cross section than the rotating wheel (e.g., 10% to 20% larger) so that the rotating wheel is laterally retained (constrained) by the upper wall of the port when in the bracket, such as a wheel with a radius of approximately 40 to 50 mm.

[0030] Each port has a rectangular cross-section such that, in use, it is directed further away from the patient than parallel to the longitudinal axis of the patient.

[0031] The walls are substantially vertical when in use, including an inward slope from the top opening to the bottom.

[0032] One or more instrument ports may include a disposable material, such as polypropylene (PP) or polycarbonate.

[0033] One or more instrument ports may comprise injection molded plastic, such as polypropylene (PP) or polycarbonate.

[0034] The one or more instrument ports may include 2, 3, 4, or 5 hand instrument ports. BRIEF DESCRIPTION OF THE DRAWINGS

[0035] Certain embodiments of the present invention are described below by way of non-limiting examples, including reference to the accompanying drawings, in which some exemplary dimensions are provided in millimeters (mm):

[0036] Figure 1 is a superior anterior right perspective view of a device ("laparoscopic instrument holder") configured to hold one or more hand instruments;

[0037] Figure 2 is the main view of the bracket;

[0038] Figure 2A is an enlarged front view of the circled portion marked “A” in the bracket;

[0039] Figure 3 It is the right side view of the bracket;

[0040] Figure 4 is a superior anterior left perspective view of a stent including a D-port configured to hold an energy instrument or a suction / irrigation device;

[0041] Figure 5 is an enlarged right view of the circled portion marked “B” in the bracket;

[0042] Figure 6 yes Figure 2 A right side view of the cross section marked "C"-"C" in FIG.

[0043] Figure 7 It is the left side view of the bracket;

[0044] Figure 8 is a top view of the bracket;

[0045] Fig. 9 is a top view of the D-port; and

[0046] Fig.10 is a perspective view of a deformation of a D-port with legs bent. DETAILED DESCRIPTION

[0047] The device described herein ("laparoscopic instrument holder") facilitates storage of readily available laparoscopic surgical instruments during surgery ("surgery"), i.e., in a location that is convenient and easily accessible to the surgeon and scrub nurse. The holder includes an ergonomic design that facilitates display and delivery of instruments to the surgeon during surgery.

[0048] The stent 100 includes one or two or more instrument ports 102, such as Figure 1 Three instrument ports 102 are shown. The support 100 may include 2, 3, 4, or 5 hand instrument ports. During surgical preparation, the surgeon typically selects 2, 3, 4, or 5 hand instruments, and an energy instrument or suction / irrigation device, depending on the surgical procedure and the surgeon.

[0049] Each port 102 is configured to hold a laparoscopic hand instrument, allowing for convenient manual insertion and removal of the instrument into and from the port 102 during surgery. In use, at most one hand instrument may be accommodated in each port 102 of the bracket 100.

[0050] Adjacent ports 102 (e.g., adjacent ports 102A and 102B, or adjacent ports 102B and 102C, such as Figure 1 The top openings are connected at least at their top openings to prevent the surgeon from manually (and incorrectly, i.e., mistakenly) inserting laparoscopic instruments between adjacent ports (e.g., between 102A and 102B, or between 102A and 102B). The top openings are connected by a connection, such as a common edge between adjacent top openings. Adjacent ports 102 having such connections may be more convenient and reliable than completely separate ports, such as a set of unconnected single instrument holders.

[0051] Adjacent ports 102 form one or more adjacent port pairs. Adjacent ports 102 in each pair are separated by a partition wall (or "partition wall") 104, which provides a common edge and side wall for two adjacent ports: for example, Figure 1 As shown, ports 102A and 102B share a partition wall 104A and are separated by the partition wall 104A. Similarly, ports 102B and 102C share a partition wall 104B and are separated by the partition wall 104B. The partition wall 104 acts as a separator to separate the hand instruments in the bracket 100 to prevent the instruments from being entangled with each other. Figure 8 As shown, the thickness of the partition wall 104 may be between 1 and 3 mm, for example, substantially 2 mm.

[0052] The top opening of each port 102 includes a downwardly directed recess 106 (or "groove" or "notch") configured to receive and retain the handle of a laparoscopic hand instrument in the corresponding port 102: e.g. Figure 1 As shown, port 102A includes groove 106A, port 102B includes groove 106B, and port 102C includes groove 106C. When a hand instrument is in port 102, it is held there by gravity because bracket 102 is mounted / positioned / oriented substantially vertically (e.g., Figure 1 As shown), the groove 106 at the top opening faces upward and the bottom 108 faces downward: gravity pushes the handle downward into the groove 106 and prevents the handle from moving outward because the groove 106 includes a center line and walls that slope upward on both sides of the center line.

[0053] The groove 106 is configured and oriented so that the handle, when in use, is forced by gravity toward the centerline (i.e., where the surgeon normally stands, beside the support 100, on the side of the support 100 opposite the patient) toward the surgeon, or at least not away from the surgeon. The direction of the groove 106, and thus the direction of the handle, is determined by the position of the centerline of the groove 106 around the top opening: Figure 1 As shown, during use, the groove 106 is oriented in the position where the surgeon typically stands ("toward the surgeon"). The groove 106 can improve the bracket 100 compared to the bracket 100 with a straight-sided top opening (without a groove) because (i) the handle will be naturally oriented and aligned when dropped into the groove 106, even if the handle is lowered / placed by the surgeon at another angle within the width of the groove 106; and (ii) some hand instruments include electrode posts that extend upward when the handle extends downward, which may align with the corner of the rectangular port (the angle provided by the connection of the adjacent side walls), thus tending to orient the handle at about 45 degrees to the rectangular slot, i.e., along the diagonal of the slot, and therefore offset by about 45 degrees from the direction toward the surgeon, so as to be in an overlapping position with the adjacent handle, especially if the adjacent handle is oriented toward the first handle, such as 45 degrees in the opposite direction.

[0054] The grooves 106 of adjacent ports 102 (when there are multiple ports) are oriented around their respective top openings so that the handles of adjacent hand instruments are directed away from each other when in adjacent ports 102 to avoid overlapping each other, so that the handles are aligned and spaced apart from each other when in adjacent ports 102. Figure 1 As shown, the grooves 106A, 106B and 106C face in the same direction, ie, are substantially parallel, and are separated by the lateral width of the port, as the grooves 106A, 106B and 106C are substantially centered within the lateral width of each respective port 102A, 102B, 102C.

[0055] The groove 106 includes upwardly sloping walls, each providing two edges or faces that intersect at a center line, which provides a low point or line of the groove 106, so that when in use, the handle is urged by gravity toward the low point / line, thereby orienting the handle toward the surgeon. The groove can be a V-shaped groove, formed by two substantially straight edges, or a U-shaped groove, formed by curved edges. Figure 2 and 2AAs shown, the grooves 106A, 106B and 106C can be V-shaped grooves, located at the center of the lateral width of each port 102A, 102B, 102C, each groove having two straight edges to form a symmetrical groove, the groove depth is between 6 and 24 mm (or between 10 and 14 mm), and the groove width is between 20 and 80 mm (or between 40 and 44 mm), so that each straight edge forms an angle of substantially between 100 degrees and 130 degrees (or between 113 degrees and 119 degrees) from the horizontal direction when in use.

[0056] Each port 102 includes a wall including a lower wall formed of a waterproof material and a rigid material (e.g., a hard plastic, such as polypropylene or polycarbonate suitable for injection molding). Each port 102 includes a lower portion closed by the lower wall to hold the distal end of the instrument including the tip in a sterile manner. The lower portion includes a sealed bottom 108.

[0057] Each port 102 has a length, from its top opening to its sealed bottom, selected based on the expected length of the instrument, so that the port 102 is deep enough to allow a handle to rest against the top opening (i.e., so that the instrument is supported by the handle on the top opening, rather than the top reaching the bottom 108). The length of the port 102, i.e., the length in the substantially vertical direction when in use, can be between 45 cm and 50 cm, such as Figure 6 The length of the support (i.e., the height when in use) includes the height of the frame 110 and the leg bend 112, as shown in FIG. Figure 7 As shown: the height of the support 100 including the leg bend 112 can be between 27 and 60 cm (or between 55 and 57 cm), and the height of the support 100 including the frame 110 can be between 45 and 50 cm (or between 46 and 48 cm), as shown in FIG. Figure 7 The height of the support 100 including the leg flexure 112 may be less than 60 cm or 70 cm for an adult patient.

[0058] The instrument length is measured by the outer shaft length, including 250mm, 330mm (most common) and 430mm for tall obese patients. The bracket 100 is configured to receive not only the shaft length, but also the rotating wheel and jaws. The jaw length ranges from 30mm to 55mm, plus the rotating wheel is about 60mm long, so the port 102 is at least 445mm from the deepest part of the groove 106 in the frame 110 to the bottom "floor" 108 to accommodate instruments with a shaft length of 330mm.

[0059] Each port 102 has a throat that accommodates a rotating wheel of a hand instrument so that the rotating wheel falls below the top opening when inserted into the port 102. The throat is slightly larger in cross-section than the rotating wheel (e.g., 10% to 20% larger) so that the rotating wheel is laterally retained (restricted) by the upper wall ("throat wall") of the port 102 when in the bracket 100, for example, as Figure 6 and 7 As shown, the throat may have an anterior-posterior width of between 7.5 cm and 4 cm. Figure 2A As shown, the lateral width is between 3.5cm and 5cm (or between 40mm and 43mm). The throat is configured to hold a rotating wheel with a radius of about 40 to 50mm. The length of the rotating wheel can vary according to the manufacturer's design, with a length of 40mm to 60mm (measured parallel to the axis), and the radius of the wheel itself is about 40mm to 50mm. Each port 102 has a substantially rectangular cross-section at least in the upper portion, so that it is farther away from the patient (front and back) than the direction parallel to the patient's longitudinal axis (side to side) when in use. However, near the bottom 108 of the port 102, the cross-section can be substantially square or rectangular, with a side length between 3.5cm and 5cm, or between 40mm and 43mm, or between 10mm and 15mm (within 10mm of the bottom 108).

[0060] like Figure 1 and Figure 8 As shown, the bracket includes side walls 116B, 104A, 104B, 116A forming the left and right sides of the port 102, and these side walls 116B, 104A, 104B, 116A are substantially vertical when in use. Figure 8 As shown, the thickness of the side walls 116A, B may be between 1 and 3 mm, for example, substantially 2 mm or 1.5 mm. The side wall 116B may be referred to as a left end wall.

[0061] In some embodiments, the left end wall 116B and / or the right end wall 116A may have a straight top edge, such as Figure 1As shown. In other embodiments, at least one instrument port may include two downward grooves configured to receive and hold a handle of a laparoscopic hand instrument placed in the port, including a downward groove on the front wall and a further downward groove on the side wall. In these embodiments, the top edge of the left end wall 116B and / or the right end wall 116A may include a further downward groove ("depression" or "groove" or "notch") configured to receive and hold a handle of a laparoscopic hand instrument in the corresponding port 102. Therefore, the end ports 102A, 102C can each include two grooves: the groove 106 in the front, and the groove on the side of the corresponding side wall 116A, B. The grooves on the side walls 116A, B can be substantially 65 mm wide and 20 mm deep, and can have a V-shape or U-shape, with a centerline and a pair of walls that slope upward on both sides of the centerline. The grooves in the left end wall 116B and / or the right end wall 116A serve as additional grooves for holding instrument handles and allow larger instrument handles to be hung on either side of the bracket without encroaching on adjacent instruments placed in one or more central instrument ports 102B. The grooves on the left end wall 116B can orient the handles toward the surgeon's left hand when in use. The grooves on the right end wall 116A can orient the handles toward the surgeon's right hand when in use.

[0062] like Figure 1 and Figure 3 As shown, the bracket includes a front wall 120A and a rear wall 120B forming the front and rear sides of the port 102. Figure 3 and Figure 7 As shown, the rear wall 120B is substantially vertical when in use, and the front wall 120A partially deviates from the vertical, with an angle between 0 and 12 degrees (e.g., as Figure 7 , between 85 and 86 degrees) such that the port 102 slopes inwardly from its top opening to its bottom 108.

[0063] The top opening of each instrument port 102 includes at least one angled guide for guiding the distal end (i.e., the end with the tip) of the instrument into the throat of the port 102 when the instrument is inserted into the port 102 (during use). The at least one angled guide provides an inwardly angled opening for each port 102, making it easier for a surgeon to manually insert an instrument into the port 102, which may improve the handling of the holder 100 when in use when the surgeon is unable to carefully and accurately guide an instrument directly into the port 102, and / or allow the port 102 to have a smaller throat while still having an easily accessible opening.

[0064] The at least one inclined rail may include: a. When in use, a shelf 110 (or "platform" or "workbench") extending from the top opening toward the surgeon (first direction); and / or b. When in use, the leg bend 112 extends from the top opening away from the surgeon (a second direction, opposite to the first direction), and the leg bend 112 extends around / over / toward the patient's leg.

[0065] like Figure 1 As shown, each port 102A, 102B, and 102C has a corresponding shelf 110A, 110B, and 110C, each shelf being inclined downwardly toward the corresponding port 102A, 102B, and 102C. In some embodiments, the inclined rail includes the shelf 110 and the leg bend 112, while in other embodiments, the only inclined rail is the shelf 110, i.e., the leg bend 112 is not always required.

[0066] like Figure 7 As shown, the shelf 110 substantially extends the front-to-back width of the opening, effectively enlarging the top opening by at least 50%, 60% (e.g., from Figure 6 The approximately 75 mm shown is enlarged to Figure 7 120 mm as shown), 70%, 80%, 100% (i.e. doubling the width of the opening), 150% or 200% (e.g., from about 40 mm (which would keep the rotating wheel in the throat) to Figure 7 The opening width is approximately 120 mm as shown, i.e. the opening width is tripled).

[0067] The shelf 110 may include a substantially straight inclined or slide-in top opening. Alternatively, as Figure 3 As shown, the shelf 110 may include a shelf curve that curves toward the top opening with an increasing slope, for example, substantially following a radius: the shelf radius may be between 3 cm and 5 cm, and the shelf curve may extend about a quarter circle around the shelf radius. The shelf 110 may extend at least partially toward the surgeon from the top opening, at an angle of about 120 degrees to the longitudinal direction of the port 102, thereby extending along the instrument handle when the instrument shaft is in the port 102 (when the instrument shaft is in a hand instrument at 120 degrees to the longitudinal axis of the handle).

[0068] like Figure 1 As shown, the shelf 110 includes a groove 106 that not only pushes the handle into the center direction of the port 102, but also pushes / guides the instrument into the port 102 during the insertion process.

[0069] like Figure 1 As shown, the leg bend 112 is on the other side of the port 102 opposite the shelf 110 and cooperates with the shelf 110 to provide an inclined guide.

[0070] The leg bend 112 also keeps the support 100 stable because the leg bend 112 at least partially rests on the patient (particularly on the patient's legs), so the support 100 at least partially rests on or at least against the patient's legs (particularly the upper legs or thighs), rather than just hanging on the sterile surgical drape covering the upper legs of the patient, which may improve the stability of the support 100 when in use.

[0071] like Figure 1 As shown, the leg flexure 112 includes a plurality of fixing points (which may be in the form of holes 114) configured to be attached to the patient through a sterile surgical drape (which itself is fixed to the patient). The plurality of fixing points prevent rotation of the support 100 (including left-right rotation at least when in a fixed position) and prevent displacement. The fixing points include holes 114 passing through the leg flexure 112, configured to receive a clip (e.g., a towel clip or a surgical clip) to fix the leg flexure 112 to the sterile surgical drape.

[0072] like Figure 8 As shown, the hole 114 includes two holes 114A and 114B, arranged near the left edge 122A and the right edge 122B of the leg bend 112, for example, about 1 to 2 cm from the edge 122A, 122B respectively. The average diameter of the hole 114 can be between 1 cm and 2 cm (or 15 mm or 17 mm).

[0073] like Figure 3 As shown, the leg curve 112 includes a curvature that substantially matches the curvature of an adult thigh, for example, the curvature of an average adult thigh or a tall adult thigh, for example, suitable for patients undergoing bariatric surgery or gynecological surgery. The curvature may include a radius between 4 cm and 20 cm, including between 8 cm and 9 cm. The leg curve 112 may extend from the top opening and / or from the substantially straight rear wall 120B of the port, such as Figure 3 As shown, around at least a quarter circle, at least an eighth circle, or at least a sixteenth circle. Having a larger leg bend 112 can increase the stability and support of the stent 100 during surgical use, while having a smaller leg bend 112 can make it easier to stack and store during transportation and storage prior to surgical use.

[0074] The leg bend 112 is rigid, including being formed of hard plastic and / or other rigid material, and having a thickness of 1 mm to 5 mm, or 2 mm to 4 mm.

[0075] The wall thickness of the stent 100 may be between 1 mm and 3 mm. The stent 100, including one or more instrument ports and leg bends, may be formed from disposable materials. The stent 100, including one or more instrument ports and leg bends, may be formed from one or more injection molded polymers to form an integral injection molded stent.

[0076] The support 100 may include a removable D-shaped port ("D-port") 400 configured to hold a laparoscopic energy instrument or suction / irrigation device with power cords / cables and / or tubing / hoses during surgery.

[0077] The D-port 402 and one end (terminal end) of the instrument port (102C) are configured to be connected at least at their top openings to prevent the surgeon from manually inserting laparoscopic instruments between the D-port and the end when in use (i.e., the D-port 402 can be secured to the hand instrument ports 102A, 102B, 102C via connection to the end port 102C).

[0078] The end port 102C has a right side end (terminal) wall 116A, such as Figure 1 As shown, the shape of the end wall 116A can selectively receive the mating wall 404 of the D-port 402 to align the D-port 402 adjacent the end port 102C. Figure 1 and 4 As shown, the end wall 116A can be substantially flat and the mating wall 404 can be substantially flat accordingly. The D-port 402 and the end port 102C can optionally include mating fixing elements to fix the D-port 402 to the end port 102C. The mating fixing element (also referred to as a "D-component attachment") can include a groove 118 in the end wall, such as Figure 1 As shown, it is configured (i.e., sized and positioned, e.g., two vertical rows of three slots per row) to receive the mating protrusions 406 (studs) of the D-port 402. Alternatively and / or additionally, as Figure 4 As shown, the mating fixing element may include a slot 118 formed in the D-port 402 to receive a mating post 406 formed in the end wall 116A (in Figure 1 The position of the middle groove 118). Figure 5 As shown, the slot 118 may include respective wide upper holes 502 and narrow lower holes 504, and the mating protrusion may include a rod that passes through the narrow lower hole 504 and a head that passes through the wide upper hole 502 but not through the narrow lower hole 504, so that when the walls 116A and 404 are manually aligned and brought together, the mating protrusion can easily slide into the slot and then downward (because the D-port 402 is suspended from the end port 102C by gravity, and the end port 102C itself is supported by the leg bend 112 or other means) so that the head is secured by the narrow lower hole 504, thereby maintaining the D-port 402 on the end port 102C during the use procedure (but allowing the D-port 402 to be manually removed after use, for example, for cleaning and / or disposal, if desired). As shown Figure 5As shown, the average radius of the wide upper hole 502 may be about 3mm to 4mm, the average radius of the narrow lower hole 504 may be about 2mm to 3mm, and the centers of each pair of wide upper hole 502 and narrow lower hole 504 may be spaced about 3mm to 4mm apart. The column head may have a diameter of about 6mm.

[0079] like Figure 4 As shown, the top opening of the D-port 402 includes: a substantially straight edge 408; and a substantially curved edge 410 that cooperates with the straight edge 408 to form a "D" shape. Unlike the hand instrument port 102, the D-port 402 has a substantially flat top opening to support the handle of a laparoscopic energy instrument or suction / irrigation device, while allowing the handle of the laparoscopic energy instrument or suction / irrigation device to rotate about the curved edge 410, such as when moving power cords / cables and / or tubes / hoses during surgery (i.e., the curved edge 410 has no grooves so that the energy instrument or suction / irrigation device can move freely). In other words, the D-port 402 has a flat side 404 that faces and connects to the end port 102C (and other interconnected ports 102), and an opposing curved side 412 that forms a D-shaped horizontal cross-section of the D-port 402. As shown Fig. 9 As shown, the average radius of the curved edge may be between 3 cm and 5 cm, or about 4 cm. Fig. 9 As shown, the wall thickness of the flat side 404 can be between 1 mm and 3 mm, or about 2 mm. The wall thickness of the curved side 412 can also be between 1 mm and 3 mm, or about 2 mm. Fig. 9 As shown, the D bottom 414 of the D port 402 can have a D-shaped bottom plane that mirrors the D shape of the top opening, although smaller (e.g., an average radius between 1 cm and 3 cm, or approximately 2 cm, such as half the radius of the top opening), and is aligned to connect to the bottom 108 of the hand instrument port 102 (particularly the bottom 108C of the end port 102C) so that the flat side 404 rests on the end wall 116A of the hand instrument port 102 as previously described.

[0080] Energy instruments held in D-port 402 may include elongated electrocautery instruments, which are commonly used in laparoscopic surgery, have extremely high temperatures, and need to be stored in a location that prevents contact with the patient and / or flammable materials (e.g., surgical drapes). These instruments have cords that need to be kept away from other surgical instruments to prevent entanglement.

[0081] like Fig.10 As shown, in some embodiments, the D-port 402 may include a leg-bend D-port portion 112A (or "D-port leg bend") having substantially the same length, thickness, and radius as the leg bend 112 (i.e., substantially the same dimensions, except that the left-right width may be smaller, depending on the size of the "D" shape). Fig.10 As shown, the D-port portion 112A includes a plurality of fixing points for fixing to a surgical drape - these fixing points may include holes 114C and 114D, which are substantially the same size as holes 114A and 114B. The D-port 402 may include a D-port leg bend 112A on its wall 404, rather than including a mating fixing element, such as Fig.10 As shown, the D-port 402 can be suspended from a surgical drape using a clip through holes 114C and 114D, adjacent to the end port 102C. The device 100 can therefore include a D-port 402 configured to hold a laparoscopic instrument during surgery; and a leg bend 112A extending from the top opening of the D-port, away from the surgeon and around / over / toward the patient's legs, partially resting on the patient's thigh, when in use.

[0082] like Figure 4 As shown, a substantially straight edge 408 may be configured and used to abut terminal port 102C. Fig.10 As shown, substantially straight edge 408 may connect to and form a portion of leg bend 112A.

[0083] Each hand instrument port 102 may include a window formed of a transparent, waterproof material configured to display the distal end of the instrument in the port (including the tip of the instrument) to the surgeon (to allow the surgeon to see the tip of the instrument while the instrument is residing in the port). Since typical hand instruments have interchangeable handles and tips, it is difficult to distinguish the tip type based on the handle: therefore, the hand instruments all look the same when stored, despite having different tips that perform different functions. The window allows the instrument tip in the holder 100 to be identified.

[0084] The window may comprise a transparent, watertight wall of the port 102. The window portion may comprise a transparent plastic material.

[0085] The window may extend from the bottom 108 of the port 102, on the same side of the platform / shelf 110, so that the surgeon can see the tip of the instrument when in use. The window may extend through all ports 102 and be at least 50 mm to 100 mm high from the bottom 108. Alternatively, at least the front of each port 102 may be transparent to provide a window. The window may include a transparent polymer, such as polypropylene (PP) or polycarbonate.

[0086] The stent 100 may include two ports and may be configured to be assembled with another stent 100 using the same configuration of slots 118 and posts 406 as described above. Example

[0087] The holders described herein can alleviate problems in cylindrical instrument holders ("laparoscopic instrument sleeves") where instruments are stored in random orientations, making instrument access and exchange difficult and causing handles and / or cables / hoses of energy instruments or suction / irrigation devices to become entangled within the cylindrical holder.

[0088] The holders described herein can alleviate the problem of opaque instrument holders, for example, made of opaque plastic. The opacity of such holders prevents visualization of individual instrument tips. Since the gripping mechanisms all look the same, it is difficult for the surgeon / nurse to identify the required instrument.

[0089] The brackets described herein can alleviate the problems of cylindrical or substantially rigid, straight brackets that are secured to a sterile surgical drape at only one point. Such rigid cylindrical brackets do not rest easily against the patient's thighs, which are typically bent, so displacement is common, causing instruments to fall onto the operating room floor. explain

[0090] Many modifications will be apparent to those skilled in the art without departing from the scope of the invention.

[0091] Unless otherwise indicated, " / " appearing in the figures or text herein should be understood as "and / or". The statement of a specific numerical value or numerical range herein should be understood to include or state an approximate numerical value or numerical range, for example, within ±20%, ±15%, ±10%, ±5%, ±2.5%, ±2%, ±1%, ±0.5% or ±0%. The term "substantially" can mean a percentage greater than or equal to 80% or 90%, for example, 92.5%, 95%, 97.5%, 99% or 100%.

[0092] Reference in this specification to any previous publication (or information derived therefrom) or known matter is not to be taken as an acknowledgement or recognition or any form of suggestion that the previous publication (or information derived therefrom) or known matter forms part of the common general knowledge in the field to which this specification relates.

[0093] In this specification and the claims that follow, unless the context requires otherwise, the word "comprise" and variations such as "comprising" and "comprises", will be understood to imply the inclusion of a stated integer or step or group of integers or steps but not the exclusion of any other integer or step or group of integers or steps.

Claims

1. A device comprising: one or more instrument ports configured to respectively hold one or more laparoscopic instruments during surgery, Characterized in that the top opening of each instrument port includes a downward groove configured to receive and retain the handle of a laparoscopic hand instrument placed in the port so that the handle faces the surgeon during use.

2. The device according to claim 1, characterized in that The one or more instrument ports include a plurality of ports, and the grooves of adjacent ports are oriented about their respective top openings such that handles of adjacent hand instruments are guided away from overlapping each other when in the adjacent ports.

3. The device according to claim 1 or 2, characterized in that The groove comprises at least two edges having opposite slopes and meeting at a low point or line of the groove, such that, in use, the handle is urged by gravity towards the low point / line, thereby orienting the handle towards the surgeon.

4. The device according to claim 3, characterized in that The groove is a V-shaped groove formed by two straight edges, or a U-shaped groove formed by curved edges; and / or at least one of the instrument ports includes two downward grooves configured to receive and hold the handles of laparoscopic hand instruments, the two downward grooves including a downward groove on the front wall of the port and a further downward groove on the side wall.

5. The device according to any one of claims 1 to 4, characterized in that Each port includes walls comprising a lower wall formed of a waterproof material and a rigid material (e.g., a hard plastic), wherein each port includes a lower portion enclosed by the lower wall to aseptically hold the distal end of the instrument including the tip, wherein the lower portion includes a sealed bottom, and / or wherein each port has a length, from its top opening to its sealed bottom, configured to hold a hand-held instrument having a length of approximately 250 mm, 330 mm, and / or 430 mm.

6. The device according to any one of claims 1 to 5, characterized in that Each port has a throat that accommodates a rotating wheel of a hand instrument so that the rotating wheel falls below the top opening when inserted into the port, and / or wherein the throat is slightly larger in cross-section than the rotating wheel so that the rotating wheel is laterally retained by the upper wall of the port when in the holder, including a wheel having a radius of approximately 40 to 50 mm.

7. The device according to any one of claims 1 to 6, characterized in that Each port has a rectangular cross-section such that, in use, it is further away from the patient than parallel to the longitudinal axis of the patient, and / or wherein the walls are substantially vertical in use including an inward slope from a top opening to a bottom.

8. The device according to any one of claims 1 to 7, characterized in that The port comprises a disposable material, the port comprises injection molded plastic, and / or the one or more instrument ports comprises 2, 3, 4, or 5 hand instrument ports.

9. The device according to any one of claims 1 to 8, characterized in that The top opening of each instrument port includes at least one inclined guide for guiding the distal end of an instrument to the throat of the port during use when the instrument is inserted into the port.

10. The device according to claim 9, characterized in that The at least one angled guide provides an inwardly angled opening to the port, making it easier for a surgeon to manually insert instruments into the port.

11. The device according to claim 9 or 10, characterized in that The at least one inclined guide rail comprises: When in use, a shelf extends from the top opening in a first direction toward a surgeon; and / or In use, the legs extending from the top opening in a second direction away from the surgeon are bent, and the legs are bent around / over / toward the patient's legs.

12. The device according to claim 11, characterized in that The shelf includes a recess for each port.

13. The device according to any one of claims 1 to 10, comprising: In use, the legs extending from the top opening of the port away from the surgeon and around / over / toward the patient's legs are bent to rest partially against the patient's thigh.

14. An apparatus comprising: one or more instrument ports configured to respectively hold one or more laparoscopic instruments during surgery; and In use, the legs extending from the top opening of the port away from the surgeon are bent around / over / toward the patient's legs to rest partially against the patient's thighs.

15. The device according to claim 14, characterized in that The leg flexure includes a plurality of attachment points configured to be attached to a patient, including to a sterile surgical drape secured to the patient.

16. The device according to claim 15, characterized in that The securing point includes a hole through the leg curve configured to receive a clip to secure the leg curve to the sterile surgical drape.

17. The device according to any one of claims 14 to 16, characterized in that The leg curvature includes a curvature that substantially matches the curvature of an adult thigh.

18. The device according to any one of claims 14 to 17, characterized in that The leg bends are rigid, including being formed from a hard plastic.

19. The device according to any one of claims 14 to 18, characterized in that The legs curve out from the top opening and / or from the substantially straight rear wall of the port, around at least a quarter of a circle, at least an eighth of a circle, or at least a sixteenth of a circle.

20. The device according to any one of claims 14 to 19, characterized in that The average radius of the leg bend is between 4 cm and 20 cm, including between 8 cm and 9 cm.

21. The device according to any one of claims 14 to 20, characterized in that The top opening of each instrument port includes at least one inclined guide for guiding the distal end of an instrument to the throat of the port during use when the instrument is inserted into the port.

22. The device according to claim 21, characterized in that The at least one angled guide provides an inwardly angled opening to the port, making it easier for a surgeon to manually insert instruments into the port.

23. The device according to claim 21 or 22, characterized in that The at least one inclined guide rail comprises: A shelf extending from the top opening toward a surgeon in a first direction when in use; and In a second orientation, the legs extending from the top opening away from the surgeon are bent around / over / toward the patient's legs during use.

24. The device according to any one of claims 1 to 23, characterized in that The one or more instrument ports include a D-shaped port (D-port) configured to hold a laparoscopic energy instrument or suction / irrigation device with a power cord / cable and / or tubing / hose during surgery, wherein the top opening of the D-port includes: a substantially straight edge and a substantially curved edge that cooperates with the straight edge to form a "D" shape.

25. The device according to claim 24, characterized in that The top opening of the D-port is substantially flat to support the handle of a laparoscopic energy instrument or suction / irrigation device while allowing the handle of the laparoscopic energy instrument and / or suction / irrigation device to rotate about the curved edge, such as when moving power cords / cables and / or tubes / hoses during surgery.

26. The device according to claim 24 or 25, characterized in that The end of one of the D-port and the instrument port is configured to be connected at least at its top opening to prevent the surgeon from manually inserting laparoscopic instruments between the D-port and the end when in use, wherein the end port has an end wall formed to receive a mating wall of the D-port to align the D-port of an adjacent end port, optionally wherein the end wall is substantially flat and the mating wall is correspondingly substantially flat, optionally wherein the D-port and the end wall include mating fixing elements to fix the D-port to the end port, optionally wherein the mating fixing element includes a groove in the end wall to receive a mating protrusion (stud) of the D-port; or the mating fixing element includes a groove in the D-port to receive a mating protrusion (stud) of the end wall, optionally wherein the groove includes respective wide upper holes and narrow lower holes, and the mating protrusion includes a rod passing through the narrow lower hole and a head passing through the wide upper hole but not through the narrow lower hole.

27. The device according to any one of claims 1 to 26, characterized in that The one or more instrument ports include a plurality of ports, and adjacent ports are connected at least at their top openings to prevent the surgeon from manually inserting laparoscopic instruments between adjacent ports when in use.

28. The device according to claim 27, characterized in that The adjacent ports form one or more adjacent port pairs, and each pair of adjacent ports is separated by a partition wall (partition wall) which is a wall provided for two adjacent ports.

29. The device according to any one of claims 1 to 28, characterized in that Each instrument port includes a window formed of a transparent, waterproof material configured to display to the surgeon the distal end of an instrument in the port including the tip of the instrument to allow the surgeon to see the tip of the instrument while the instrument is residing in the port.

30. The device according to claim 29, characterized in that The window is provided by the transparent, watertight wall of the port.

31. The device according to claim 29 or 30, characterized in that The window extends from the bottom of the port to the same side as the platform so that the surgeon can see the tip of the instrument when in use.

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