Device

Abstract

An apparatus comprising one or more instrument ports configured to hold one or more laparoscopic instruments respectively during a surgical operation, wherein an upper opening of each instrument port includes a downward groove configured to receive and hold a handle of a laparoscopic hand-held instrument within the port such that the handle faces the surgeon during use.

Description

Technical Field

[0001] Related Applications This patent application is related to Australian Provisional Patent Application No. 2021901689, the specification of which, as first filed, is incorporated herein by reference.

[0002] The present disclosure relates to devices for holding laparoscopic instruments (including "instrument holders" or "quivers") during surgery.

Background Art

[0003] Laparoscopic instruments include laparoscopic hand-held instruments and laparoscopic energy instruments or suction / irrigation devices that are used by a surgeon during a surgical operation. Laparoscopic instruments may also be referred to as "tools". Laparoscopic hand-held instruments may also be referred to as "hand-held instruments" or "lap (laparoscopic) instruments". Each hand-held instrument typically includes three to five hand-held instrument components that are assembled prior to the surgical operation after sterilization. The hand-held instrument components generally include a tip at the distal end of the instrument that includes a jaw in the form of a grasper or dissector configured to operate within the patient's body, an outer shaft that penetrates the body, an inner shaft that moves longitudinally and is connected to the jaw, a surgeon's handle at the proximal end of the instrument for holding the instrument and opening / closing the grasper or dissector, a rotating wheel (which is part of the outer shaft and typically rotated by the surgeon's index finger to rotate the inner shaft and the jaw) disposed where the handle and the outer shaft intersect, and often, an electrode (or "post") protruding from the outer shaft to enable connection to a power supply if required during the surgical operation. The handle (also referred to as a "grasping mechanism") resembles pliers, but the shaft of the instrument is at 120 degrees to the longitudinal axis of the handle. Laparoscopic energy instruments may also be referred to as "energy instruments" or "energy devices", are used for tissue cutting and sealing, have a handle that is approximately four times larger than the hand-held instrument handle, and may often include a large housing and a power cord / cable connected to an external power supply. Laparoscopic surgery may require suction performed by a suction / irrigation device, which is, for example, a cleaning device having a pipe / hose that is tubular in appearance and hangs outside the rear from above and is connected to an air / water supply source. The cord / cable or pipe / hose extends away from the handle of the instrument / device when in use.

[0004] During laparoscopic surgery (the "surgical procedure"), the instruments are used within the sterile field. The sterile field is the area around the surgical site that is considered sterile. The sterile field generally extends from the surgeon's lower torso to the shoulders, and the height of the operating table is adjusted accordingly. All personnel (surgeon, patient, and nurse) wear sterile gloves and gowns, face masks, and / or drapes, and any items (such as hand-held instruments) are covered by a surgical drape or sterilized within a sterilization device.

[0005] During the surgical procedure, the surgeon uses many different elongated instruments and may exchange one instrument for another to perform different functions during the surgery (this is also referred to as "instrument exchange," i.e., when the surgeon has to stop the surgery, remove the tool being used, place it, and then select and insert the necessary tool). During the surgical procedure, a tray or laparoscopic cannula is provided to hold the instruments (hand-held instruments and energy instruments or suction / irrigation devices) in a sterile manner, where the surgeon can select the instruments and place them there.

[0006] However, depending on the surgical procedure, if more than one or two instruments are required and / or there are more instrument exchanges (when the surgeon has to stop the surgery, remove the instrument being used, place it, and then select and insert the necessary instrument), it can be difficult for the surgeon to quickly and / or intuitively pick up the desired instrument with known instrument holders. Summary of the Invention Problems to be Solved by the Invention

[0007] It is desirable to address or improve one or more drawbacks or limitations associated with the prior art or at least provide a useful alternative. Means for Solving the Problems

[0008] Disclosed herein is a device (the "laparoscopic instrument holder") that One or more instrument ports configured to hold one or more laparoscopic instruments, respectively (i.e., one by one), during a surgical procedure comprising a downward groove (also referred to as a "garter" or "notch") in each instrument port, the upper opening of each instrument port being configured to receive and hold the handle of a laparoscopic hand-held instrument within the port such that (since the orientation of the handle is determined by the position of the groove around the upper opening) the handle faces the surgeon (or at least does not move away from the surgeon) during use, i.e., by gravity (i.e., gravity prevents the handle from being pushed out of the groove by pushing the handle into the groove). The device is

[0009] The one or more instrument ports may include a plurality of ports, and the grooves of adjacent ports are oriented around their respective upper openings such that the handles of adjacent hand-held instruments are guided to avoid overlapping each other when in adjacent ports (thus, the handles are aligned with each other by the grooves and separated by a partition wall when in adjacent ports).

[0010] The groove may include two edges (or surfaces) having opposing slopes that intersect at the low point or low line of the groove such that, during use, the handle is moved by gravity towards the low point / low line and thereby faces the surgeon. The groove may be a V-groove formed from two straight edges or a U-groove formed from curved edges. At least one of the instrument ports may include two downward grooves configured to receive and hold the handle of a laparoscopic hand-held instrument within the port, a downward groove in the front wall of the port and a further downward groove in the side wall.

[0011] Disclosed herein is a device (a "laparoscopic instrument holder") comprising a. one or more instrument ports configured to hold one or more laparoscopic instruments, respectively (i.e., one by one), during a surgical procedure; b. When in use, from the upper opening of the port, (in the second direction) protruding around / above / over the patient's leg away from the surgeon, the leg curvature part (the leg curvature part is not simply hung on a sterile drape (also called "surgical drape") placed on the patient's upper leg but is partially placed on the patient, so the holder can be kept in a stable state) is a device including

[0012] The leg curvature part includes a plurality of fixing points configured to be attached to the patient, which are typically attachments to a sterile drape fixed to the patient. The fixing points include holes passing through the leg curvature part configured to receive clips (such as towel clips or surgical clips) for fixing the leg curvature part to the sterile drape.

[0013] The leg curvature part includes a curvature that substantially matches the curvature of an adult's thigh, such as the curvature of an average adult's thigh, or, for example, in the case of patients typically having obesity or gynecological surgeries, the curvature of a large adult's thigh.

[0014] The leg curvature part is a rigid body, including formation from rigid plastic.

[0015] The leg curvature part may protrude from the upper opening of the port and / or from a substantially straight rear wall over at least a quarter circle, or at least an eighth circle, or at least a sixteenth circle. The leg curvature part may include an average radius between 4 cm and 20 cm, including between 8 cm and 9 cm.

[0016] One or more instrument ports may include D-shaped ports ("D-ports") configured to hold laparoscopic energy instruments or suction / irrigation devices including power cords / cables and / or pipes / hoses during surgery.

[0017] The upper opening of the D-port includes a substantially straight edge and a substantially curved edge that cooperates with the straight edge so as to form a "D" shape. Unlike the instrument port, the D-port supports the handle of a laparoscopic energy instrument or a suction / irrigation device while allowing the handle of the laparoscopic energy instrument and / or the suction / irrigation device to rotate around the curved edge when, for example, the power cord / cable and / or the pipe / hose move during a surgical procedure. It has a substantially flat upper opening (i.e., there is no V-groove, and thus the energy instrument and / or the suction / irrigation device can move freely). In other words, the D-port tube has a flat surface facing the end port (and other ports) that forms a D-shaped horizontal cross-section and an opposite curved surface.

[0018] The end (terminal) ports of the D-port and the instrument port may be configured to be connected at least at their upper openings so as to prevent a surgeon from manually inserting a laparoscopic instrument between the D-port and the end during use (i.e., the D-port is fixable to the handheld instrument port). The end port may have an end (terminal) wall shaped to receive the cooperating wall of the D-port so as to align the D-port adjacent to the end port. The end wall may be substantially flat, and the cooperating wall may be substantially flat accordingly. The D-port and the end wall may include cooperating fixing elements that fix the D-port to the end port. The cooperating fixing elements may include slots in the end wall for receiving the cooperating protrusions ("studs") of the D-port. The cooperating fixing elements may include slots in the D-port for receiving the cooperating protrusions ("studs") of the end wall. The slots may each include a wide upper hole and a narrow lower hole, and the cooperating protrusions may include a stem that fits through the narrow lower hole and a head that fits through the wide upper hole rather than the narrow lower hole.

[0019] Disclosed herein is an apparatus ("laparoscopic instrument holder") comprising one or more instrument ports configured to hold one or more laparoscopic instruments, respectively (i.e., one by one) during a surgical procedure comprising, each instrument port having an upper opening that includes at least one angled guide that guides the distal end of the instrument into the throat of the port when the instrument is inserted into the port during use. A device.

[0020] The at least one angled guide provides an inwardly tapered opening in the port, thereby making it easier for a surgeon to manually insert the instrument into the port.

[0021] The at least one angled guide a. a shelf that projects from the upper opening towards the surgeon (in a first direction) during use, and / or b. a leg curvature that projects from the upper opening away from the surgeon around / over / above the patient's leg (in a second direction) during use may include.

[0022] Disclosed herein is a device (including a "laparoscopic instrument holder") comprising two or more instrument ports configured to hold two or more laparoscopic instruments, respectively (i.e., one by one), during a surgical procedure comprising, adjacent ones of the ports being connected at least at their upper openings so as to prevent a surgeon from manually inserting a laparoscopic instrument between adjacent ports during use. A device.

[0023] Adjacent ones of the ports form one or more pairs of adjacent ports. Adjacent ports in each pair are separated by a separating wall (a "dividing wall") that provides a wall for both of the adjacent ports.

[0024] Disclosed herein is a device (a "laparoscopic instrument holder") comprising one or more instrument ports configured to hold one or more laparoscopic instruments, respectively (i.e., one by one), during a surgical procedure comprising, Each instrument port includes a window of transparent waterproof material configured to show the surgeon the distal end of the instrument within the port (including the tip of the instrument) such that the surgeon can see the tip of the instrument when the instrument is within the port. It is a device.

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

[0026] The window may extend from the bottom of the port on the same side as the deck so that the surgeon can see the tip of the instrument during use.

[0027] The shelf includes a groove.

[0028] Each port includes a wall including a lower wall formed from a waterproof material and a rigid material such as rigid plastic. Each port includes a lower portion surrounded by the lower wall to sterilely hold the distal end of the instrument including the tip. The lower portion includes a sealed bottom. Each port has a length extending from its upper opening to its sealed bottom that is selected based on the expected length of the instrument and is configured to hold a hand-held instrument generally 250 mm, 330 mm, and / or 430 mm in length.

[0029] Each port has a throat that accommodates the rotating wheel of the hand-held instrument such that the rotating wheel drops below the upper opening when inserted into the port. The throat has a cross-section that is slightly larger (e.g., 10% to 20% larger) than the rotating wheel such that the rotating wheel is laterally held (constrained) by the upper wall of the port when within the holder, for example, for a wheel with a radius generally from 40 to 50 mm.

[0030] Each port has a rectangular cross-section that spreads further from the patient than parallel to the longitudinal axis of the patient during use.

[0031] The wall is substantially vertical during use, including an inner taper from the upper 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 include injection molded plastic, such as polypropylene (PP) or polycarbonate.

[0034] One or more instrument ports may include two, three, four or five hand-held instrument ports.

[0035] Some embodiments of the present invention are described below in this specification by way of non-limiting examples only, including reference to the accompanying drawings. In the drawings, some exemplary dimensions are provided in millimeters (mm).

Brief Description of the Drawings

[0036]

Figure 1

[0037]

Figure 2

[0038]

Figure 2A

[0039]

Figure 3

[0040]

Figure 4

[0041]

Figure 5

[0042]

Figure 6

[0043]

Figure 7

[0044]

Figure 8

[0045]

Figure 9

[0046]

Figure 10

DETAILED DESCRIPTION OF THE INVENTION

[0047] The device (the "laparoscopic instrument holder") described in this specification facilitates storing laparoscopic surgical instruments in a convenient location ready for use in surgery (the "surgical operation"), i.e., a convenient location easily accessible to both the surgeon and the operating room nurse. The holder includes an ergonomic design that assists in providing and delivering instruments to the surgeon during the surgical operation.

[0048] The holder 100 includes one or more instrument ports 102, for example, three instrument ports 102 as shown in FIG. 1. The holder 100 may include two, three, four, or five hand-held instrument ports. In preparing for a surgical operation, often the surgeon selects two, three, four, or five hand-held instruments and energy instruments or aspiration / irrigation devices according to the procedure and the surgeon.

[0049] Each port 102 is configured to hold a laparoscopic hand-held instrument so that the instrument can be conveniently inserted and removed manually into and out of the port 102 during the surgical operation. In use, the holder 100 includes up to one hand-held instrument in each port 102.

[0050] Those adjacent to port 102 (e.g., as shown in FIG. 1, adjacent ports 102A and 102B, or adjacent ports 102B and 102C) are connected at least at their upper openings so as to prevent a surgeon from manually (and inadvertently, i.e., mistakenly) inserting a laparoscopic instrument between adjacent ports (e.g., between 102A and 102B, or between 102B and 102C) during use. The upper openings are connected at adjacent upper openings by a connecting portion, such as a shared edge. By connecting adjacent ports 102 in this way, it can be more convenient and reliable compared to a collection of single instrument holders where the ports are completely separated, e.g., not connected.

[0051] Those adjacent to port 102 form one or more pairs of adjacent ports 102. The adjacent ports 102 in each pair are separated by a separating wall (or "dividing wall") 104 that provides a shared edge and side walls for both of the adjacent ports. For example, as shown in FIG. 1, dividing wall 104A is shared by and separates ports 102A and 102B, and similarly, dividing wall 104B is shared by and separates ports 102B and 102C. Dividing wall 104 functions as a divider that separates handheld instruments within holder 100 to prevent entanglement of the instruments. As shown in FIG. 8, dividing wall 104 can have a thickness between 1 and 3 mm, e.g., approximately 2 mm.

[0052] The upper opening of each port 102 includes a downwardly facing groove 106 (or “gutter” or “notch”) configured to receive and hold the handle of a laparoscopic handheld instrument within the corresponding port 102. For example, as shown in FIG. 1, port 102A includes groove 106A, port 102B includes groove 106B, and port 102C includes groove 106C. Since the holder 100 is mounted / positioned / oriented substantially vertically with the groove 106 at the upper opening facing upward and the bottom 108 facing downward (as shown in FIG. 1), the handheld instrument is held there by gravity when within the port 102. The groove 106 includes a centerline and a pair of upwardly inclined walls that slope upwardly on both sides of the centerline, so that by gravity, the handle is pushed down into the groove 106 and disengagement of the handle is prevented.

[0053] The groove 106 is configured and oriented such that during use, gravity that pushes the handle toward the centerline causes the handle to face toward the surgeon (i.e., adjacent the holder 100 on the side of the holder 100 opposite the patient, which is generally where the surgeon stands), or at least not move away from the surgeon. The orientation of the groove 106, and thus the handle, is defined by the position of the centerline of the groove 106 around the upper opening, and as shown in FIG. 1, the groove 106 generally faces toward the location where the surgeon stands during use ( “toward the surgeon”). (i) The handle is naturally oriented and aligned when it falls into the groove 106 even if the surgeon lowers / positions it at other angles within the width of the groove 106, and (ii) some handheld instruments are electrode posts that project upward when the handle projects downward, and may self-align with the corners of the rectangular port (the corners created by the junction of the adjacent side walls of the port), at approximately 45 degrees with respect to the rectangular slot, i.e., along the diagonal of the slot, and thus approximately 45 degrees away from the surgeon, particularly when an adjacent handle faces, for example, approximately 45 degrees in the opposite direction toward the first handle. Since the groove 106 includes electrode posts that tend to orient the handle in a position that overlaps with the adjacent handle, the groove 106 can improve the holder 100 compared to those having a straight-edged upper opening (without a groove).

[0054] (When there are multiple ports) The grooves 106 of adjacent ports 102 are oriented around their respective upper openings so as to guide the handles of adjacent hand-held instruments to avoid overlapping each other when they are within adjacent ports 102, and thus to align and separate the handles from each other when within adjacent ports 102. As shown in FIG. 1, the grooves 106A, 106B and 106C are oriented in the same direction, i.e., substantially parallel, and since the grooves 106A, 106B and 106C are substantially at the center of the left-right width of their respective corresponding ports 102A, 102B, 102C, they are spaced apart from each other by the left-right width of the ports.

[0055] The groove 106 includes an upwardly inclined wall. Each upwardly inclined wall provides two edges or surfaces that intersect at a centerline that results in a low point or line of the groove 106 such that, in use, the handle is pressed by gravity towards the low point / line, thereby causing the handle to face towards the surgeon. The groove may be a V-groove formed from two substantially linear edges, or a U-groove formed from curved edges. As shown in FIGS. 2 and 2A, the grooves 106A, 106B and 106C may be V-grooves, each located at the center of the left-right width of its respective port 102A, 102B, 102C and each including two linear edges that form a symmetric groove. The depth of the groove is between 6 and 24 mm (or between 10 and 14 mm), and the width of the groove is between 20 and 80 mm (or between 40 and 44 mm). Thus, each linear edge forms an angle of generally between 100 degrees and 130 degrees (or between 113 degrees and 119 degrees) from the horizontal direction in use.

[0056] Each port 102 includes a wall that includes a lower wall formed from a suitable injection molding of a waterproof material and a rigid material such as a hard plastic, such as polypropylene or polycarbonate. Each port 102 includes a lower portion surrounded by the lower wall so as to sterilely hold the distal end of the instrument including the tip portion. This lower portion includes a sealed bottom 108.

[0057] Each port 102 has a length extending from its upper opening to its sealed bottom that is selected based on the expected length of the instrument such that the depth of the port 102 is sufficient for the handle to rest on the upper opening (i.e., such that the instrument is supported by the handle on the upper opening rather than at the top reaching the bottom 108). The length of the port 102, i.e., the substantially vertical length in use, may be between 45 cm and 50 cm as shown in FIG. 6. The length of the holder (i.e., the height in use) includes the height of the shelf 110 and the leg bend 112, and as shown in FIG. 7, the height of the holder 100 including the leg bend 112 may be between 27 and 60 cm (or between 55 and 57 cm), and the height of the holder 100 including the shelf 110 may be between 45 and 50 cm (or between 46 and 48 cm). The height of the holder 100 including the leg bend 112 may be less than 60 cm or less than 70 cm for use with adult patients.

[0058] The length of the instrument is measured as the outer shaft length, including 250 mm, 330 mm (the most common), and 430 mm for large obese patients. The holder 100 is configured to receive not only the shaft length but also the rotating wheel and the joe. In addition to the rotating wheel having a length of about 60 mm, the size of the joe has a length ranging from 30 mm to 55 mm, and thus the port 102 is at least 445 mm from the deepest part of the groove 106 in the shelf 110 to the bottom "floor" 108 to accommodate an instrument with a shaft length of 330 mm.

[0059] Each port 102 has a throat for accommodating the rotary wheel of the handheld instrument such that the rotary wheel drops below the upper opening when inserted into the port 102. The throat has a cross-section slightly larger (e.g., 10% to 20% larger) than that of the rotary wheel so that when within the holder 100, the rotary wheel is held (constrained) laterally by the upper wall of the port 102 (the "throat wall"). For example, as shown in FIGS. 6 and 7, the throat may have a longitudinal width between 7.5 cm and 4 cm, and as shown in FIG. 2A, a lateral width between 3.5 cm and 5 cm (or 40 mm and 43 mm). The throat is configured to hold a wheel with a radius generally up to 40 to 50 mm. The rotary wheel varies according to the manufacturer's design and may have a length (measured parallel to the shaft) between 40 mm and 60 mm and a radius of the wheel itself generally between 40 mm and 50 mm. Each port 102 has a substantially rectangular cross-section at least at the upper part so that in use it spreads further away from the patient (front-to-back) than parallel to the longitudinal axis of the patient (left-to-right). However, towards the bottom 108 of the port 102, the cross-section may be substantially square or rectangular with side lengths between 3.5 cm and 5 cm, or between 40 mm and 43 mm, or between 10 mm and 15 mm (within 10 mm of the bottom 108).

[0060] As shown in FIGS. 1 and 8, the holder includes side walls 116B, 104A, 104B, 116A that form the left and right sides of the port 102, and these side walls 116B, 104A, 104B, 116A are substantially vertical in use. As shown in FIG. 8, the side walls 116A, 116B may have a thickness between 1 and 3 mm, for example, generally 2 mm, or generally 1.5 mm. The side wall 116B may also be referred to as the left end wall.

[0061] In some embodiments, the left end wall 116B and / or the right end wall 116A may have a linear / straight upper edge, as shown in FIG. 1. In other embodiments, at least one of the instrument ports may include two downward grooves configured to receive and hold the handle of a laparoscopic handheld instrument within the port, the downward grooves including a downward groove in the front wall of the port and a further downward groove in the side wall. In these embodiments, the upper edge of the left end wall 116B and / or the right end wall 116A may include a further downward groove (a "dimple" or a "girth" or a "notch") configured to receive and hold the handle of a laparoscopic handheld instrument within the corresponding port 102. Thus, the end ports 102A, 102C may each include a groove 106 for the front portion, which is one of the two grooves, and a dimple in the corresponding side walls 116A, 116B for the side portion. The dimples in the side walls 116A, 116B may be approximately 65 mm in width and approximately 20 mm in depth and may have a V-shape or a U-shape including a pair of upwardly inclined walls that are inclined upwardly on both sides of the center line and the center line. The dimples in the left end wall 116B and / or the right end wall 116A serve as additional grooves for holding the instrument handle and allow larger instrument handles to be hung on both sides of the holder without infringing on adjacent instruments within one or more of the central instrument ports 102B. The dimple in the left end wall 116B can direct the handle towards the surgeon's left hand during use. The dimple in the right end wall 116A can direct the handle towards the surgeon's right hand during use.

[0062] As shown in FIGS. 1 and 3, the holder includes a front wall 120A and a rear wall 120B that form the front and rear surfaces of the port 102. As shown in FIGS. 3 and 7, the rear wall 120B is substantially vertical during use, and the front wall 120A deviates partially from vertical between 0 degrees and 12 degrees (e.g., between 85 degrees and 86 degrees as shown in FIG. 7), and thus the port 102 is tapered inwardly from their upper openings to their bottom 108.

[0063] The upper opening of each instrument port 102 includes at least one angled guide that guides the distal end of the instrument (i.e., the end including the tip) into the throat of port 102 when the (in-use) instrument is inserted into port 102. The at least one angled guide provides an inwardly tapered opening to each port 102, thereby facilitating manual insertion of the instrument into port 102 by the surgeon, thereby improving the function of the holder 100 when the surgeon cannot directly and carefully guide the instrument accurately into port 102, and / or enabling port 102 to have a smaller throat while still having an easily accessible mouth.

[0064] The at least one angled guide may include a. a shelf 110 (or “deck” or “platform”) that projects from the upper opening towards the surgeon (in a first direction) during use, and / or b. a leg curvature 112 that projects from the upper opening away from the surgeon around / over / above the patient's leg (in a second direction opposite the first direction) during use as shown in FIG. 1, each port 102A, 102B, and 102C has a corresponding shelf 110A, 110B, and 110C that slopes downwardly into the corresponding port 102A, 102B, and 102C, respectively. In some embodiments, the angled guide includes both the shelf 110 and the leg curvature 112, whereas in some other embodiments, the angled guide is simply the shelf 110, i.e., the leg curvature 112 is not always required.

[0065]

[0066] ​As shown in FIG. 7, the shelf 110 substantially extends the front-to-back width of the opening, and thus the upper opening is actually at least 50%, 60% (e.g., from approximately 75 mm shown in FIG. 6 to approximately 120 mm shown in FIG. 7), 70%, 80%, 100% (i.e., doubling the width of the opening), 150%, or 200% (e.g., as shown in FIG. 7, from approximately 40 mm to approximately 120 mm, i.e., tripling the width of the opening, for holding the rotating wheel within the throat) larger.

[0067] The shelf 110 may include a substantially linear tapered portion or a sliding surface into the upper opening. Alternatively, or in addition thereto, as shown in FIG. 3, the shelf 110 may include a shelf curvature that curves into the upper opening with an increasing slope, e.g., substantially following a radius. This shelf radius may be between 3 cm and 5 cm, and the shelf curvature may extend over approximately 1 / 4 of a circle having the shelf radius. The shelf 110 may at least partially protrude from the upper opening at an angle of approximately 120 degrees from the longitudinal direction of the port 102 towards the surgeon, and thus extends along the instrument handle when the instrument shaft is within the port 102 (when the instrument shaft is at 120 degrees with respect to the longitudinal axis of the handle of the handheld instrument).

[0068] As shown in FIG. 1, the shelf 110 includes a groove 106 that not only aligns the handle towards the center of the port 102 but also urges / guides the instrument into the port 102 during insertion.

[0069] As shown in FIG. 1, the leg curvature 112 is on the other side of the shelf 110 of the port 102 and cooperates with the shelf 110 to provide an angled guide.

[0070] The leg bending portion 112 further helps to stably hold the holder 100 as it at least partially rests on the patient (especially the patient's leg). Thus, the holder 100 does not simply hang down from a sterile drape (also referred to as a "surgical drape") placed over the patient's upper leg, but at least partially rests on or at least leans against the patient's leg (especially the upper leg or thigh), thereby potentially improving the stability of the holder 100 during use.

[0071] As shown in FIG. 1, the leg bending portion 112 includes a plurality of fixing points (which may be in the form of holes 114) configured to be attached to the patient via a sterile drape (itself fixed to the patient). The plurality of fixing points prevent and make it difficult for the holder 100 to rotate (including at least left - right rotation when fixed in place). The fixing points include holes 114 passing through the leg bending portion 112 configured to receive clips (such as towel clips or surgical clips) for fixing the leg bending portion 112 to the sterile drape.

[0072] As shown in FIG. 8, the holes 114 include two holes 114A and 114B disposed substantially near the left edge 122A and the right edge 122B of the leg bending portion 112, for example, between about 1 and 2 cm from the edges 122A and 122B respectively. The holes 114 may have an average diameter between 1 cm and 2 cm (or 15 mm or 17 mm).

[0073] As shown in FIG. 3, the leg bend portion 112 includes a curvature that substantially matches the curvature of an adult's thigh, for example, an average adult's thigh, or a large adult's thigh with a curvature often seen in patients with obesity or gynecological surgery. The curvature may include a radius between 4 cm and 20 cm, including between 8 cm and 9 cm. As shown in FIG. 3, the leg bend portion 112 may protrude from the upper opening of the port and / or from the substantially linear rear wall 120B over at least 1 / 4 circle, or at least 1 / 8 circle, or at least 1 / 16 circle. Increasing the leg bend portion 112 can increase the stability and support provided to the holder 100 during surgical use, while decreasing the leg bend portion 112 can make stacking and storage during transportation and storage before surgical use easier.

[0074] The leg bend portion 112 is a rigid body, including being formed from rigid plastic and / or other rigid materials, and has a thickness from 1 mm to 5 mm, or from 2 mm to 4 mm.

[0075] The holder 100 may have a wall thickness from 1 mm to 3 mm. The holder 100 may be formed from a disposable material, including one or more instrument ports and the leg bend portion. The holder 100 may be formed from one or more injection-molded polymers that form an integral injection-molded holder, including one or more instrument ports and the leg bend portion.

[0076] The holder 100 may include an attachable D-shaped port ("D-port") 402 configured to hold a laparoscopic energy instrument or a suction / irrigation device that includes a power cord / cable and / or a pipe / hose during surgery.

[0077] The D-port 402 and the end port (102C) of the instrument port are configured to be connected at least at their upper openings so as to prevent a surgeon from manually inserting a laparoscopic instrument between the D-port and the end during use (i.e., the D-port 402 can be fixed to the hand-held instrument ports 102A, 102B, 102C by connection with the end port 102C).

[0078] As shown, for example, in FIG. 1, the terminal port 102C may have a right side (terminal) wall 116A shaped to receive the cooperating wall 404 of the D-port 402 so as to optionally align the D-port 402 adjacent to the terminal port 102C. As shown in FIGS. 1 and 4, the end wall 116A may be substantially flat, and the cooperating wall 404 may correspondingly be substantially flat. The D-port 402 and the terminal port 102C may optionally include cooperating fastening elements that fasten the D-port 402 to the terminal port 102C. The cooperating fastening elements (also known as "D-component fixtures") are configured, as shown in FIG. 1, to receive a cooperating protrusion 406 ("stud") of the D-port 402 in the end wall (i.e., dimensioned and arranged, for example, in two vertical rows each consisting of three slots). Alternatively and / or in addition, as shown in FIG. 4, the cooperating fastening elements may include slots 118 formed in the D-port 402 to receive cooperating studs 406 formed in the end wall 116A (at the location of the slots 118 in FIG. 1). As shown in FIG. 5, the slots 118 may each include a wide upper hole 502 and a narrow lower hole 504. The cooperating protrusion may include a stem that fits through the narrow lower hole 504 and a head that fits through the wide upper hole 502 rather than the narrow lower hole 504, and thus, when manually aligning and joining the wall 116A and the wall 404 together, the cooperating protrusion can be easily slipped into the slot and then lowered (since the D-port 402 hangs by gravity from the terminal port 102C supported by the leg bend 112 or other means), whereby the head is fixed by the narrow lower hole 504, and thereby the D-port 402 remains held against the terminal port 102C during surgical use (although, if necessary, the D-port 402 can be manually removed from the hand port 102 after use, for example, for cleaning and / or disposal).As shown in FIG. 5, the wide upper hole 502 can have an average radius of approximately from 3 mm to 4 mm, the narrow lower hole 504 can have an average radius of approximately from 2 mm to 3 mm, and the centers of the wide upper hole 502 and the narrow lower hole 504 in each pair can be separated by approximately from 3 mm to 4 mm. The head of the stud can have a diameter of approximately 6 mm.

[0079] As shown in FIG. 4, the upper opening of the D-port 402 includes a substantially straight edge 408 and a substantially curved edge 410 cooperating with the straight edge 408 so as to form a "D" shape. Different from the hand-held instrument port 102, the D-port 402 supports the handle of a laparoscopic energy instrument or a suction / irrigation device, and has a substantially flat upper opening that allows the handle of the laparoscopic energy instrument or the suction / irrigation device to rotate around the curved edge 410 when, for example, the power cord / cable and / or the pipe / hose moves during a surgical operation (i.e., there is no groove in the curved edge 410, and thus the energy instrument or the suction / irrigation device can move freely). In other words, the D-port 402 has a flat side surface 404 for facing and connecting to the terminal port 102C (and thus other interconnected ports 102) that forms the D-shaped horizontal cross-section of the D-port 402, and an opposite curved side surface 412. As shown in FIG. 9, the curved edge can have an average radius between 3 cm and 5 cm, or approximately 4 cm. As shown in FIG. 9, the wall thickness of the flat side surface 404 can be between 1 mm and 3 mm, or approximately 2 mm. The wall thickness of the curved side surface 412 can also be between 1 mm and 3 mm, or approximately 2 mm. As shown in FIG. 9, the D-bottom 414 of the D-port 402 is smaller (e.g., the average radius is between 1 cm and 3 cm, such as half of the radius of the upper opening, or approximately 2 cm), but mimics the D-shape of the upper opening, and can have a D-shaped bottom surface that is aligned to connect to the bottom 108 of the hand-port 102 (in particular, the bottom 108C of the terminal port 102C) such that the flat side surface 404 abuts against the end wall 116A of the hand-port 102 as described above in this specification.

[0080] The energy instrument held in the D-port 402 may include an elongated electrocautery device that is commonly used in laparoscopic surgery, becomes extremely hot, and needs to be stored in a fixed position to prevent contact with the patient and / or flammable materials such as drapes. These instruments have electrical cables that need to be separated from other surgical instruments to prevent entanglement.

[0081] As shown in FIG. 10, in some embodiments, the D-port 402 may include a D-port portion (or "D-port leg bend") 112A consisting of a leg bend having approximately the same length, thickness, and radius as the leg bend 112 (i.e., approximately the same dimensions except for the left-right width which may be smaller depending on the size of the "D" shape). As shown in FIG. 10, the D-port portion 112A includes a plurality of fixing points for fixing to the surgical drape, and these fixing points may include holes 114C and 114D having substantially the same dimensions as the holes 114A and 114B. Instead of including cooperating fixing elements in its wall 404, the D-port 402 may include a D-port leg bend 112A such that, as shown in FIG. 10, the D-port 402 is hung on the surgical drape using clips passing through the holes 114C and 114D adjacent to the end port 102C. Thus, the apparatus 100 may include a D-port 402 configured to hold one laparoscopic instrument during surgery, and a leg bend 112A that projects around / over / above the patient's leg away from the surgeon from the upper opening of the D-port so as to partially rest on the patient's upper leg when in use.

[0082] As shown in FIG. 4, the substantially straight edge 408 may be configured and used to remain adjacent to the end port 102C. Alternatively, as shown in FIG. 10, the substantially straight edge 408 may be attached to and form part of the leg bend 112A.

[0083] Each hand-held instrument port 102 may include a window of transparent waterproof material configured to show the surgeon the distal end of the instrument (including the tip of the instrument) within the port (such that the surgeon can see the tip of the instrument when the instrument is within the port). Since typical hand-held instruments have a handle and interchangeable tips, it can be difficult to distinguish the type of tip based on the handle, and thus hand-held instruments may have different tips for performing different functions but may all appear the same when stored. The window allows the tip of the instrument to be identified even while it is within the holder 100.

[0084] The window may include a transparent waterproof wall of the port 102. The window portion may include a transparent plastic material.

[0085] The window may extend from the bottom 108 of the port 102 on the same side as the deck / shelf 110 such that the surgeon can see the tip of the instrument during use. The window may extend across all ports 102 and may be at a height of at least 50 mm to 100 mm from the bottom 108. Alternatively, at least the front face 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 holder 100 may include two ports and may be configured to be assembled to other holders 100 using slots and studs of the same configuration as the slots 118 and studs 406 described above in this specification.

[0087] Embodiments The holders described herein can mitigate problems in a cylindrical instrument holder ("laparoscope barrel") where instruments are stored randomly inside, making access to and exchange of the instruments difficult, and as a result, the handles and / or cables / hoses of energy instruments or aspiration / irrigation devices within the cylindrical holder become entangled.

[0088] The holders described herein can reduce the problems in opaque instrument holders, which are made of, for example, opaque plastics. The opaque nature of such holders hinders the visualization of the individual instrument tips. When all the gripping mechanisms look the same, it can be difficult for surgeons / nurses to identify which instrument is needed.

[0089] The holders described herein can reduce the problems in cylindrical or very rigid linear holders that are configured to be fixed to the sterile drape at only one point. Such rigid cylindrical holders do not easily fit over the curved upper leg of a patient and thus often come off, resulting in the instrument falling onto the operating room floor.

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

[0091] “ / ” in the context of the drawings or this specification is understood to mean “and / or” unless otherwise indicated. The recitation of a particular numerical value or range of values in this specification includes, or is understood to include, a recitation of approximate numerical values or ranges of values, such as within the range of ±20%, ±15%, ±10%, ±5%, ±2.5%, ±2%, ±1%, ±0.5%, ±0%. The term “substantially” can indicate a proportion of 80% or 90%, for example 92.5%, 95%, 97.5%, 99%, or 100% or more.

[0092] References to prior publications (or information derived therefrom) or known facts in this specification are not to be construed as any admission, approval or suggestion that such prior publication (or information derived therefrom) or known fact forms part of the common general knowledge in the field of the attempts related to this specification, nor should it be so construed.

[0093] In this specification and the following claims, unless the context requires otherwise, the term "comprise", and variations such as "comprises" and "comprising", are to be understood as implying the inclusion of a stated integer or step or group of integers or steps but not as precluding the inclusion of any other integer or step or group of integers or steps.

Claims

Claim 1 An apparatus comprising one or more instrument ports configured to hold one or more laparoscopic instruments during surgery and wherein an upper opening of each instrument port includes a downward groove configured to receive and hold a handle of a laparoscopic hand-held instrument within the port such that the handle faces the surgeon during use. Claim 2 The apparatus of claim 1, wherein the one or more instrument ports include a plurality of ports, and the grooves of adjacent ports are oriented around respective upper openings thereof such that handles of adjacent hand-held instruments are guided to avoid overlapping when within the adjacent ports. Claim 3 The apparatus of claim 1 or 2, wherein the groove includes at least two edges intersecting at a low point or low line of the groove such that during use, the handle is moved by gravity towards the low point / low line of the groove and thereby faces the surgeon. Claim 4 The apparatus of claim 3, wherein the groove is a V-groove formed from two straight edges or a U-groove formed from curved edges, and / or at least one of the instrument ports includes two downward grooves configured to receive and hold a handle of a laparoscopic hand-held instrument within the port, the two downward grooves including the downward groove in a front wall of the port and a further downward groove in a side wall. Claim 5 The apparatus according to any one of claims 1 to 4, wherein each port includes a wall including a lower wall formed from a waterproof material and a rigid material such as rigid plastic, each port includes a lower portion surrounded by the lower wall for sterilely holding a distal end of the instrument including a tip, the lower portion including a sealed bottom, and / or each port has a length extending from its upper opening to its sealed bottom and is configured to hold a hand-held instrument having a length of approximately 250 mm, 330 mm, and / or 430 mm. Claim 6 Each port has a throat that accommodates the rotating wheel of the hand-held instrument such that when the rotating wheel is inserted into the port, the rotating wheel is lower than the upper opening, and / or the throat has a cross-section slightly larger than that of the rotating wheel such that when the rotating wheel is within the holder, including in the case of a wheel with a radius generally from 40 to 50 mm, the rotating wheel is laterally held by the upper wall of the port. The device according to any one of claims 1 to 5.

7. Each port has a rectangular cross-section that extends further away from the patient than parallel to the longitudinal axis of the patient during use, and / or the wall is substantially perpendicular during use, including an inner taper from the upper opening to the bottom. The device according to any one of claims 1 to 6.

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

9. The upper opening of each instrument port includes at least one angled guide that guides the distal end of the instrument into the throat of the port when the instrument is inserted into the port during use. The device according to any one of claims 1 to 8.

10. The at least one angled guide provides an inner tapered opening in the port, thereby making it easier for the surgeon to manually insert the instrument into the port. The device according to claim 9.

11. The at least one angled guide includes a shelf that projects from the upper opening towards the surgeon in a first direction during use, and / or a leg curvature that projects from the upper opening away from the surgeon around / above / over the patient's leg in a second direction during use The device according to claim 9 or 10.

12. The shelf includes the groove of each port. The device according to claim 11.

13. A leg curvature that projects from the upper opening of the port away from the surgeon around / above / over the patient's leg such that it partially rests on the upper leg of the patient during use The device according to any one of claims 1 to 10.

14. A device One or more instrument ports configured to hold one or more laparoscopic instruments respectively during a surgical operation, A leg bending portion protruding around / above / above the patient's leg away from the surgeon from the upper opening of the port so as to partially rest on the upper leg of the patient when in use, An apparatus comprising.

15. The apparatus according to claim 14, wherein the leg bending portion includes a plurality of fixing points configured to be attached to the patient, including attachment to a sterile drape fixed on the patient.

16. The apparatus according to claim 15, wherein the fixing points include holes passing through the leg bending portion configured to receive clips for fixing the leg bending portion to the sterile drape.

17. The apparatus according to any one of claims 14 to 16, wherein the leg bending portion includes a curvature substantially matching the curvature of the thigh of an adult.

18. The apparatus according to any one of claims 14 to 17, wherein the leg bending portion is a rigid body, including formation from a rigid plastic.

19. The apparatus according to any one of claims 14 to 18, wherein the leg bending portion protrudes from the upper opening of the port and / or from a substantially straight rear wall over at least 1 / 4 circle, or at least 1 / 8 circle, or at least 1 / 16 circle.

20. The apparatus according to any one of claims 14 to 19, wherein the leg bending portion may include an average radius between 4 cm and 20 cm, including between 8 cm and 9 cm.

21. The apparatus according to any one of claims 14 to 20, wherein the upper opening of each instrument port includes at least one angled guide for guiding the distal end of the instrument into the throat of the port when the instrument is inserted into the port during use.

22. The apparatus according to claim 21, wherein the at least one angled guide provides an inwardly tapered opening in the port, thereby making it easier for the surgeon to manually insert the instrument into the port.

23. The at least one angled guide, A shelf protruding towards the surgeon from the upper opening in a first direction when in use, The leg bending portion protruding around / above / above the patient's leg away from the surgeon from the upper opening in a second direction when in use, The apparatus according to claim 21 or 22, comprising.

24. The one or more instrument ports include a D-shaped port ("D-port") configured to hold a laparoscopic energy instrument or a suction / irrigation device that includes a power cord / cable and / or a pipe / hose during a surgical procedure, the upper opening of the D-port including a substantially straight edge and a substantially curved edge that cooperates with the straight edge to form a "D" shape, the apparatus according to any one of claims 1 to 23.

25. The upper opening of the D-port is substantially flat such that it supports the handle of the laparoscopic energy instrument or the suction / irrigation device while allowing the handle of the laparoscopic energy instrument and / or the suction / irrigation device to rotate around the curved edge when, for example, the power cord / cable and / or the pipe / hose moves during a surgical procedure, the apparatus according to claim 24.

26. The D-port and the end port of the instrument port are configured to be connected at least at their upper openings so as to prevent a surgeon from manually inserting a laparoscopic instrument between the D-port and the end during use, the end port having an end wall shaped to receive a cooperating wall of the D-port to align the D-port adjacent to the end port, optionally, the end wall being substantially flat and the cooperating wall being correspondingly substantially flat, optionally, the D-port and the end wall including cooperating fixing elements that fix the D-port to the end port, optionally, the cooperating fixing elements including a slot in the end wall to receive a cooperating protrusion ("stud") of the D-port, or the cooperating fixing elements including a slot in the D-port to receive a cooperating protrusion ("stud") of the end wall, optionally, the slot including a wide upper hole and a narrow lower hole, the cooperating protrusion including a stem that fits through the narrow lower hole and a head that fits through the wide upper hole rather than the narrow lower hole, the apparatus according to claim 24 or 25.

27. The device according to any one of claims 1 to 26, wherein the one or more instrument ports include a plurality of ports, and adjacent ones of the ports are connected at least at their upper openings so as to prevent a surgeon from manually inserting a laparoscopic instrument between the adjacent ports during use.

28. The device according to claim 27, wherein adjacent ones of the ports form one or more pairs of adjacent ports, and the adjacent ports in each pair are separated by a separating wall ("dividing wall") that provides a wall for both of the adjacent ports.

29. The device according to any one of claims 1 to 28, wherein each instrument port includes a window of a transparent waterproof material configured to show the surgeon the distal end of the instrument within the port, including the tip of the instrument, so that the surgeon can see the tip of the instrument when the instrument is within the port.

30. The device according to claim 29, wherein the window is provided by a transparent waterproof wall of the port.

31. The device according to claim 29 or 30, wherein the window extends from the bottom of the port on the same side as the deck so that the surgeon can see the tip of the instrument during use.

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