Surgical instrument

Abstract

A surgical instrument (10) for puncturing a human or animal body, said instrument (10) comprising an inner part (11) movably disposed within a needle-like outer part (12) connected to the inner part (11) via a spring (13) such that the outer part (12) loads the inner part (11) during use, said outer part (12) comprising a proximal sleeve (14) providing a finger grip for the surgeon, the sleeve (14) being releasably connectable to the outer part (12), said instrument (10) comprising a release mechanism (17) for releasing the sleeve (14) from the outer part (12), said release mechanism (17) being actuable by movement of the inner part (11).

Description

Technical Field

[0001] The present invention relates to a surgical instrument for piercing a human or animal body, said instrument comprising an inner part movably arranged within a needle-shaped outer part, said outer part being connected to the inner part via a spring so as to load the inner part by the outer part during use, said outer part comprising a proximal sleeve providing a finger grip for the surgeon.

Background Art

[0002] A typical example of such a surgical instrument is the Veress needle, hereinafter referred to as VN. The known VN is used to initially access the patient's abdominal cavity to establish pneumoperitoneum. The use of VN involves blind insertion into the patient's abdominal cavity.

[0003] The widespread use of VN is probably due to its simplicity and effectiveness. This involves making a small incision near or in the umbilicus or in the upper left quadrant of the abdomen and inserting a needle into the peritoneal cavity through the subcutaneous tissue, abdominal wall, and parietal peritoneum with the eyes covered. After passing through all tissue layers, the VN technique is based on the function that when the resistance decreases, the rounded inner stylet pops forward (due to being spring-biased) to cover the outer cannula with a sharply beveled tip. However, the surgeon cannot completely rely on this mechanism and needs to develop an appropriate insertion angle and a proper sense of force to puncture the abdominal wall successfully without overshooting the underlying organs. When the reaction force generated from the abdominal wall suddenly becomes almost zero (inside the peritoneal cavity), the risk of damaging the lower tissue at the tip of the cannula increases. Such a rapid loss of resistance at the tip of the VN after puncture causes the needle to accelerate towards the lower tissue due to the slowness of the human control system's reaction, the absence of firm forearm / hand support, and the relatively large mass of the surgeon's arm. Therefore, the proficient and safe use of VN requires a long learning process to achieve the best instrument operation to prevent overshoot. Furthermore, each patient's abdomen has unique surgical conditions, the details of which are unknown to the surgeon even before the operation. This includes the presence or absence of adhesions, the position of the lower tissue and internal organs, and the thickness of the abdominal wall.

[0004] In the prior art, various proposals have been made to address the above overshoot problem.

[0005] Patent Document 1 proposes an instrument that allows the surgeon to set the maximum insertion depth. Unfortunately, since the thickness of the tissue layer is not necessarily known and the layer is flexible, it is difficult to adjust the insertion depth.

[0006] Patent Document 2 allows overshoot while fixing the Veress mechanism immediately when it enters the fixed position. However, even with a rounded stylet with the outer cannula locked, it seems possible to easily damage the internal structure.

[0007] Non-Patent Document 1 and Non-Patent Document 2 focus on expanding the rounded area at the tip immediately after insertion in order to reduce the stress when the tip hits the underlying organs or structures.

[0008] Non-Patent Document 3 and Non-Patent Document 4 report on the feasibility of obtaining information regarding the interaction of the in-vivo tissue tool at the VN tip by utilizing the acoustic emissions or optical information recorded at the outer end of the needle outside the body.

[0009] Non-Patent Document 5 teaches forming a vacuum cup around the VN. When air is sucked from the cup, the abdominal wall is separated from the important structure when the VN penetrates the tissue. The drawback of this is that since the configuration of the needle is fixed, the surgeon loses the flexibility of operation.

[0010] Finally, overshoot can be prevented by introducing a faster control system. This can be done by connecting a robotic arm with tactile sense, as proposed in Non-Patent Document 6, to the VN body that generates the driving force.

Prior Art Documents

Patent Documents

[0011]

Patent Document 1

Patent Document 2

Patent Document 3

Non-Patent Documents

[0012]

Non-Patent Document 1

Non-Patent Document 6

Summary of the Invention

Problems to be Solved by the Invention

[0013] Although some proposals have shown interesting results, the complex nature of the proposed systems and their impact on the workflow risk making them less widely accepted. In view of this, an object of the present invention is to provide a surgical instrument that does not have the complexity of known proposals, does not impair the operation of the surgeon as much as possible, and can approximate the existing operation methods of the surgeon.

Means for Solving the Problems

[0014] According to the present invention, there is proposed a surgical instrument as recited in one or more of the appended claims. The foregoing discussion has focused on the use of VN, but as the opening sentence above indicates, the present invention has a broader use and relates to any surgical instrument for puncturing the body of a human or animal, said instrument comprising an inner part movably disposed within a needle-like outer part, said outer part being connected to the inner part via a spring so as to apply a load to the inner part with the outer part during use, and it should be noted that said outer part comprises a proximal sleeve providing a finger grip for the surgeon. Examples thereof include the direct insertion of a sharp trocar during laparoscopic surgery and the emergency or selective surgical airway securing by means of a thoracic tube.

[0015] Patent Document 3 discloses an instrument having the features described in the preamble of claim 1, that is, a sleeve can be releasably connected to the outer part, the instrument comprises a release mechanism for releasing the sleeve from the outer part, and this release mechanism is operable by the movement of the inner part.

[0016] In the instrument of the present invention, the outer part is provided with a proximal ring or edge, and the sleeve is provided with a displaceable hook for engaging behind the ring or edge, whereby a connection is made between the outer part and the sleeve, and the release mechanism is operable on the hook to remove the hook from a position behind the ring or edge. Thereby, when the surgeon or robot uses the sleeve to push the outer part into the patient's abdominal cavity, due to the sudden decrease in resistance when the insertion is completed and the subsequent rapid forward movement of the spring-biased inner part, the inner part actuates the release mechanism, and by releasing from the outer part, the effect of neutralizing the driving force applied by the surgeon or robot to the sleeve is obtained.

[0017] Preferably, the release mechanism is attached to the proximal side of the inner part and is arranged to act on the hook of the sleeve to release the sleeve from the outer part when the inner part moves towards the sleeve.

[0018] The structure of the surgical instrument of the present invention is effective in operation and can be provided at a limited cost if the release mechanism has a first contact surface that is inclined to match a second contact surface that is inclined and provided on the hook.

[0019] When the inclined first contact surface of the release mechanism collides with the second contact surface provided on the hook, it is preferable that the hook is elastically attached to the sleeve so that the hook is displaced from a position behind the ring or edge of the outer portion.

[0020] Preferably, the release mechanism includes a lever arm attached to the proximal side of the inner portion.

[0021] Optionally, the proximal sleeve of the instrument comprises an extension having one of a breathing tube or a trocar tube. This relates to using the surgical instrument of the present invention for tracheal intubation or abdominal wall intubation using a trocar, respectively.

[0022] Hereinafter, the present invention will be further described with reference to the drawings of exemplary embodiments of the surgical instrument according to the present invention, which do not limit the appended claims.

Brief Description of the Drawings

[0023] When the same reference numerals are given in each drawing, those reference numerals represent the same or similar parts.

Figure 1

Figure 2

Figure 3

Figure 4

Figure 5

Best Mode for Carrying Out the Invention

[0024] The Veress needle as shown in the figure is used to puncture the human or animal body. As shown in FIGS. 1 and 2, the instruments 1, 10 include an inner portion 2, 11 that is movably disposed within a needle-like outer portion 3, 12, and the aforementioned outer portions 3, 12 are connected to the inner portions 2, 11 via springs. In the prior art instrument 1, the spring is illustrated by reference numeral 4. Detail A of the proximal portion of the instrument 10 of the present invention shown in FIG. 3 indicates that the spring is illustrated by reference numeral 13.

[0025] In both the prior art instrument 1 and the instrument 10 of the present invention, the spring serves to apply a load to the inner portions 2, 11 by the outer portions 3, 12 during use. In this connection, the aforementioned outer portions 3, 12 include proximal sleeves 5, 14 that provide a finger grip for the surgeon. So far, the prior art instrument 1 and the instrument 10 of the present invention have corresponding features, although the structure of the proximal sleeve 5 of the instrument 1 is different from that of the proximal sleeve 14 of the instrument 10.

[0026] The instrument 10 of the present invention is different from the prior art in that the sleeve 14 can be releasably connected to the outer portion 12, and the instrument 10 includes a release mechanism for releasing the sleeve 14 from the outer portion 12, and this release mechanism is operable by the movement of the inner portion 11. An embodiment in which this can be preferably embodied will be further described with reference to the details of the instrument of the present invention illustrated in FIG. 3.

[0027] In FIG. 3, it is shown that the outer portion 12 includes a proximal ring or edge 15, and the sleeve 14 includes a displaceable hook 16 that catches behind the ring or edge 15 to form a connection between the outer portion 12 and the sleeve 14. A release mechanism 17 including a lever arm attached to the proximal side of the inner portion 11 is operable on the hook 16 to remove the hook from a position behind the ring or edge 15 in the following description.

[0028] The release mechanism 17 is attached to the proximal side of the inner part 11 and is arranged to act on the hook 16 of the sleeve 14 when the inner part 11 moves towards the sleeve 14 to release the sleeve 14 from the outer part 12. For this purpose, it is preferable that the release mechanism 17 comprises a first contact surface 18 inclined to match a second contact surface 19 provided on the hook 16 and correspondingly inclined. The hook 16 is elastically attached to the sleeve 14 by an elastic support 20 such that when the inclined first contact surface 18 of the release mechanism 17 collides with the second contact surface 19 provided on the hook 16, the hook 16 can be displaced from a position behind the ring or edge 15 of the outer part 12.

[0029] Next, turning to FIG. 4, there is shown a surgical instrument of the present invention in which the proximal sleeve 14 has an extension in the form of a breathing tube 18'. This structure is used for tracheal intubation. After puncture, all parts of the instrument 10 except the sleeve 14 with the breathing tube 18' can bounce backwards and be removed from the surgical site. Thereafter, the proximal sleeve 14 is removed from the breathing tube 18 remaining in place for breathing.

[0030] FIG. 5 shows another use for puncturing the abdominal wall with a trocar. After puncture, all parts of the instrument 10 except the sleeve 14 with an extension implemented as a trocar tube 18'' can bounce backwards and be removed from the surgical site. Thereafter, the proximal sleeve 14 is removed from the trocar tube 18'' remaining in place to guide the instrument towards the abdominal cavity.

[0031] In the above, the present invention has been described with reference to exemplary embodiments of the surgical instrument of the present invention. However, the present invention is not limited to this specific embodiment and can be variously modified without departing from the gist of the present invention. Therefore, the exemplary embodiments described should not be used to strictly interpret the appended claims in this form. Rather, this embodiment is only intended to explain the description of the appended claims without intending to limit it to such exemplary embodiments. Therefore, the protection scope of the present invention should be interpreted only in accordance with the appended claims, and such exemplary embodiments are used for the purpose of resolving any ambiguity that may arise in the description of the claims.

Claims

1. A surgical instrument (10) for piercing the body of a human or animal, said instrument (10) comprising an inner part (11) movably disposed within a needle-like outer part (12), said outer part (12) being connected to said inner part (11) via a spring (13) so as to apply a load to said inner part (11) with said outer part (12) during use, said outer part (12) comprising a proximal sleeve (14) providing a finger grip for a person, usually a surgeon, said sleeve (14) being releasably connectable to said outer part (12), said instrument (10) comprising a release mechanism (17) for releasing said sleeve (14) from said outer part (12), said release mechanism (17) being operable by movement of said inner part (11) in a surgical instrument, said outer part (12) comprising a proximal ring or edge (15), said sleeve (14) comprising a displaceable hook (16) engaging behind said ring or said edge (15) to form a connection between said outer part (12) and said sleeve (14), said release mechanism (17) being operable on said hook (16) to remove said hook from a position behind said ring or said edge (15). A surgical instrument characterized by this.

2. The release mechanism (17) is attached to the proximal side of the inner part (11) and is arranged to act on the hook (16) of the sleeve (14) when the inner part (11) moves towards the sleeve (14) to release the sleeve (14) from the outer part (12). The surgical instrument according to Claim 1, characterized by this.

3. The release mechanism (17) comprises an inclined first contact surface (18), and said first contact surface is adapted to an inclined second contact surface (19) provided on said hook (16). The surgical instrument according to Claim 1 or 2, characterized by this.

4. The hook (16) is elastically attached to the sleeve (14) such that when the inclined first contact surface (18) of the release mechanism (17) strikes the second contact surface (19) provided on the hook (16), the hook (16) is displaced from a position behind the ring or the edge (15) of the outer part (12). The surgical instrument according to Claim 3, characterized by this.

5. The surgical instrument according to any one of claims 1 to 4, wherein the release mechanism (17) comprises a lever arm attached to the proximal side of the inner part (11).

6. The surgical instrument according to any one of claims 1 to 5, wherein the proximal sleeve (14) comprises an extension having one of a breathing tube (18') or a trocar tube (18'').

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