A trocar

Abstract

A trocar comprising a cannula and an obturator; wherein the cannula includes a head and a shaft, wherein the shaft extends from the head, and the head has a greater diameter than the shaft; the cannula defines a working channel which is open at both ends; the working channel defines a working channel axis; a pair of opposed needle guide elements are carried by an exterior portion of the cannula, wherein each needle guide element defines therethrough a needle guide channel, and wherein each needle guide channel defines a guide channel axis that is inclined with respect to the working channel axis; each needle guide channel axis is aligned with a needle inlet port defined by a first portion of the cannula shaft, and a needle outlet port which is defined by a second portion of the cannula shaft; and the second portion of the cannula shaft is located distally of the first portion of the cannula shaft.

Description

[0001] A Trocar

[0002] The present invention relates to a trocar for use in minimally invasive surgery.

[0003] Trocars are known and typically define a working channel axially therethrough. However, it would be useful to provide a trocar that allows a user to suture a puncture wound made by the trocar before it is removed such that the suture may be tightened and the wound closed after the trocar has been removed.

[0004] Accordingly, it is desired to provide a trocar that permits a suture thread to be located on one side of the trocar in use, passed to the other side of the trocar and then collected from the opposite side of the trocar.

[0005] Trocars are known that include a suture insert that may be located within the working channel and which defines needle guide channels within the working channel. This requires a separate insert component which has to be inserted within the working channel. Such an arrangement is more expensive to produce and is more difficult to use.

[0006] According to a first aspect of the invention, there is provided a trocar comprising a cannula and an obturator; wherein the cannula includes a head and a shaft, wherein the shaft extends from the head, and the head has a greater diameter than the shaft; the cannula defines a working channel which is open at both ends; the working channel defines a working channel axis; a pair of opposed needle guide elements are carried by an exterior portion of the cannula, wherein each needle guide element defines therethrough a needle guide channel, and wherein each needle guide channel defines a guide channel axis that is inclined with respect to the working channel axis; and wherein each needle guide channel axis is aligned with a needle inlet port defined by a first portion of the cannula shaft, and a needle outlet port which is defined by a second portion of the cannula shaft; wherein the second portion of the cannula shaft is located distally of the first portion of the cannula shaft.

[0007] Accordingly, the claimed trocar may be used to guide a suture needle through a first one of the opposed needle guide channels to deposit a suture thread on one side of the trocar. The thread is then moved to the opposite side of the trocar. Finally, the thread is collected by a suture needle which has been guided through a second one of the opposed needle guide channels.

[0008] The needle guide elements are provided externally of the cannula so that they do not interfere with the working channel and make the manufacture and the use of the cannula easier.

[0009] In the context of the subject invention, the term “inclined” means that the angle subtended between the working channel axis and each of the guide channel axes is greater than 0°. For example, the angle subtended between the working channel axis and a guide channel axis may be from 5° to 85°, for example from 10° to 80°, or from 10° to 75°, or from 10° to 70°, or from 10° to 60°.

[0010] In the context of the subject invention, the term “distal” means furthest from the cannula head, and the term “proximal” means closest to the cannula head.

[0011] In an embodiment of the invention, the opposed needle guide elements are carried by an exterior portion of the cannula head.

[0012] Optionally, the guide channel axes intersect the working channel axis.

[0013] In an embodiment of the invention, each needle guide element is connected to an exterior portion of the cannula (e.g., the cannula head) via a connection member. For example, the connection member may be one or more arms or it may be a web of material. The connection member permits the needle guide element to be angled or inclined relative to the working channel axis by the desired angle such that the needle guide channel axes align properly with the inlet and outlet ports defined by the cannula shaft. It will be appreciated that while the needle guide elements may be carried by an exterior portion of the cannula head, a part of each of the needle guide elements may also be connected to an exterior portion of the cannula shaft.

[0014] The cannula shaft may comprise two or more shaft elements that are connected together. In such embodiments, the inlet ports (i.e., the opposed inlet ports) may be defined by first cannula shaft element. Accordingly, the first cannula shaft element may be a proximal shaft element (i.e., closest to the cannula head). Additionally, the outlet ports may be defined by a second cannula shaft element. The second cannula shaft element may be connected to a distal end of the first cannula shaft element or it may be connected to the first cannula shaft element via an intermediate shaft element.

[0015] For example, the cannula shaft may further include a third shaft element; wherein the third shaft element is coupled to a distal end of the second shaft element or is disposed between the first and second shaft elements.

[0016] Thus, the third shaft element may be a distal shaft element (e.g., a terminal shaft element) or it may be a medial shaft element.

[0017] On the basis that trocars are often used in conjunction with inflated body cavities, the inlet ports and the outlet ports suitably include a sealing element. The sealing element may be pierced by a needle (e.g., a suture needle). Accordingly, the sealing elements may be formed from a pierceable membrane. The sealing elements are suitably gas and / or liquid impermeable.

[0018] In a further embodiment of the invention, the obturator is detachably coupled to the cannula head. As is normal for trocars, the obturator may include a head portion which engages the cannula head, and a shaft portion which is disposed within a lumen defined by the cannula shaft. The shaft portion suitably terminates in a point to facilitate the insertion of the trocar into a biological body.

[0019] The obturator shaft portion may be a hollow tube and the terminal point may be formed from a transparent material such that a light may be directed through the obturator shaft and out from the point to illuminate an interior cavity of a patient.

[0020] Suitably, the obturator is coupled to the cannular head in a pre-determined orientation. In such embodiments, the obturator shaft may define a first needle channel therethrough and a second needle channel therethrough; and when the obturator is in its pre-determined orientation, the first obturator needle channel aligns with a first needle guide channel axis, and the second obturator needle channel aligns with a second needle guide channel axis. Thus, it is possible to pass a suture needle through one of the opposed needle guide elements, through the respective inlet port, through the respective obturator needle channel, through the respective outlet port and out of one side of the trocar.

[0021] Accordingly, a suture needle may be capable of passingthrough the trocarwith the obturator located within the working channel.

[0022] A portion of the cannula head may be detachable from the remainder of the cannula and / or the cannula head may be detachable from the cannular shaft. For example, the cannula head may be formed from at least two parts that are detachably coupled to each other. Additionally or alternatively, the cannula head may be detachably coupled to the cannula shaft. The ability to detach certain components of the cannula may make it easier to avoid catching or trapping the suture thread when suturing the aperture generated by the trocar in use.

[0023] According to a second aspect of the invention, there is provided a suturing apparatus comprising a trocar as defined anywhere herein in connection with the first aspect of the invention, and a suture needle; wherein the suture needle carries a suture thread; the suture needle is locatable within one of the opposed needle guide elements such that it is guided through the working channel of the cannula via the respective inlet and outlet ports.

[0024] In an embodiment of the second aspect of the invention, the suture needle includes a core and a barrel, wherein the core is slidably received within the barrel; the core has a retracted configuration in which it is entirely located within the barrel, and an extended configuration in which a distal end of the core projects beyond the end of the barrel. In such embodiments a user may control the core of the suture needle and move it from its retracted configuration to its extended configuration.

[0025] In such embodiments, the core may be biased towards its retracted configuration. Thus, the user may apply a force which is greater than the biasing force to move the core from its retracted configuration to its extended configuration. In such arrangements, the user only has to apply a force in one direction (e.g., to extend the core), as when the user force is removed, the biasing force will return the core to its retracted configuration. Suitably, the distal end of the core carries a clamp apparatus. The clamp apparatus may grip a suture thread. The clamp apparatus may include a pair of opposed jaws. The opposed jaws may be biased apart from each other. In such embodiments, when the clamp apparatus projects beyond the end of the barrel, the biasing force urges the jaws apart. However, as the core is retracted into the barrel, a surface of the barrel may engage a portion of one or both of the jaws and urge them together (i.e., into a closed or clamping configuration).

[0026] Thus, the clamp apparatus may be opened by moving the core to its extended configuration. In this configuration, a suture thread may be located within the clamp apparatus and the core may be urged back into its retracted configuration, which in turn closes the clamp apparatus and the suture thread is gripped by the clamp apparatus. When the core is urged back into its extended configuration, the clamp apparatus is opened and the suture thread is released.

[0027] In use, the obturator is located within the cannula and the trocar is inserted into a body. The obturator may then be removed to permit access to a body cavity via the working channel of the cannula. When the procedure has been completed, a suture thread is positioned on one side of the trocar by inserting a suture needle through one of the needle guide elements, through a respective one of the inlet ports, through the working channel, and out of the cannula via a respective one of the outlet ports. If the obturator is inserted in the working channel at the time, the needle will pass through one of the obturator needle channels between the inlet port and the corresponding outlet port. A suture thread carried by the suture needle is then released and moved to the opposite side of the cannula using conventional techniques. The suture needle is then inserted through the opposite needle guide channel, the corresponding inlet and outlet ports and out of the opposite side of the cannula, where it collects or grabs the suture thread. The needle is then withdrawn from the trocar with the suture thread. After the trocar is removed from the body, the incision made by the trocarwhen inserted into the body may be closed by tightening the suture thread.

[0028] The skilled person will appreciate that the features described and defined in connection with the aspects of the invention and the embodiments thereof may be combined in any combination, regardless of whether the specific combination is expressly mentioned herein. Thus, all such combinations are considered to be made available to the skilled person. An embodiment of the invention will now be described, byway of example only, with reference to the accompanying drawings in which:

[0029] Figure 1 shows a suturing apparatus according to the second aspect of the invention;

[0030] Figure 2 shows a perspective view of the apparatus shown in Figure 1 ;

[0031] Figure 3 shows the apparatus of Figure 1 with the suture needle removed for clarity;

[0032] Figure 4 shows the suture needle of the apparatus shown in Figure 1 ;

[0033] Figure 5 shows a partially disassembled view of the suture needle shown in Figure 4; Figure 6 shows the spring assembly of the suture needle shown in Figure 4; and Figure 7 shows an insufflation needle that may be used with the suturing apparatus shown in Figure 1 .

[0034] For the avoidance of doubt, the skilled person will appreciate that in this specification, the terms “up”, “down”, “front”, “rear”, “upper”, “lower”, “width”, etc. refer to the orientation of the components as found in the example when installed for normal use as shown in the Figures.

[0035] As illustrated in Figures 1 to 7, the suturing apparatus of the subject invention comprises a trocar which includes a cannula head 1 . A pair of opposed arms 11 are fixed to an exterior surface of the cannula head 1 . Each arm 11 includes a needle guide element 12 which defines therethrough a needle guide channel. A suture needle 3 is insertable into one of the needle guide elements 12.

[0036] Extending distally from the cannula head 1 is a cannula shaft which is formed from a proximal shaft portion 13, a medial shaft portion 14 and a distal shaft portion 15.

[0037] The trocar further includes an obturator 2, which is inserted within a working channel defined by the cannula head 1 and shaft (13, 14, 15). The obturator 2 consists of a shaft which terminates in a piercing tip, that is used to penetrate an abdominal wall, for example. After the puncture through the abdominal wall has been made, the obturator may be removed from the cannula.

[0038] Inlet ports 130 are defined by opposed sides of the proximal shaft portion 13 and corresponding outlet ports 131 are defined by the medial shaft portion 14. Each outlet port 131 is aligned with the opposite inlet port 130 and an axis of the needle guide channel associated with the inlet port 130. In use, the suture needle 3 passes through the needle guide channel, through the associated inlet port 130, through the working channel, and out of the corresponding outlet port 131 .

[0039] This configuration ensures precise suture spacing, resulting in neat and uniform wound closure, which aids in healing and reduces scarring.

[0040] Referring to Figures 1 , 2, 4, 5 and 6, the suture needle 3 comprises a suture needle housing 31 , an operating button 32, a spring 321 , a suture needle core 322 and a suture needle barrel 33.

[0041] The operating button 32 is coupled to the top of the housing 31 . The suture needle barrel 33 is located at the bottom of the housing 31 . The suture needle core 322 moves telescopically within the barrel 33, and its top end is connected to the bottom of the housing 31 . The bottom of the housing 31 is connected to the top of the barrel 33 via the spring 321 , and the needle core 322 is located within the spring 321 .

[0042] A clamp 34 is carried by the bottom end of the suture needle core 322 and the clamp 34 extends from and retracts within the barrel 33 as the core 322 is displaced by the housing 31 .

[0043] During suturing, the user presses the operating button 32 to displace the core 322 and extend the clamp 34 from the end of the barrel 33. A suture thread is grabbed by the clamp 34 and the operating button 32 is released, causing the spring 321 to urge the core 322 to be displaced in a proximal direction, thereby retracting the clamp 34 into the barrel 33 with the suture thread. Thus, the suture thread is pulled into the barrel 33.

[0044] The user inserts the suture needle 3 through the needle guide channel defined by the needle guide element 12, through the inlet port 130, through the working channel and out from the outlet port 131 into the abdominal incision. The user then presses the operating button 32 to extend the clamp 34 and release the suture thread. The suture needle 3 is then withdrawn.

[0045] The suture thread is moved to the opposite side of the cannula shaft by a separate apparatus. The user then inserts the suture needle 3 through the needle guide channel defined by the opposite needle guide element 12, through the inlet port 130 aligned with the opposite needle guide element 12, through the working channel and out from the outlet port 131 into the opposite side of the abdominal incision. The suture thread is then grabbed by the clamp 34 when the user presses the button 32 to extend the clamp 34 from the barrel 33 and aligns the clamp 34 with the suture thread.

[0046] The suture needle 3 is then again withdrawn to complete the suture loop.

[0047] The trocar is then withdrawn, separated from the suture thread and the ends of the suture thread are tied externally.

[0048] An insufflation needle 4 may be used with the subject trocar to inject gas into the abdominal cavity. The insufflation needle 4 may be any suitable insufflation needle. It may inserted through the working cavity defined by the cannula head 1 and shaft or it may be inserted in the same was as discussed above for the suture needle.

Claims

Claims1 . Atrocar comprising a cannula and an obturator; wherein the cannula includes a head and a shaft, wherein the shaft extends from the head, and the head has a greater diameter than the shaft; the cannula defines a working channel which is open at both ends; the working channel defines a working channel axis; a pair of opposed needle guide elements are carried by an exterior portion of the cannula, wherein each needle guide element defines therethrough a needle guide channel, and wherein each needle guide channel defines a guide channel axis that is inclined with respect to the working channel axis; and wherein each needle guide channel axis is aligned with a needle inlet port defined by a first portion of the cannula shaft, and a needle outlet port which is defined by a second portion of the cannula shaft; wherein the second portion of the cannula shaft is located distally of the first portion of the cannula shaft.

2. Atrocar according to Claim 1 , wherein each needle guide element is carried by an exterior portion of the cannula head.

3. Atrocar according to Claim 1 or Claim 2, wherein each needle guide element is connected to an exterior portion of the cannula via a connection member.

4. A trocar according to Claim 3, wherein the connection member comprises one or more arms and / or a web of material.

5. Atrocar according to any of Claims 1 to 4, wherein the cannula shaft is formed from a first shaft element connected to a second shaft element; and wherein the inlet ports are defined by the first shaft element.

6. A trocar according to Claim 5, wherein the outlet ports are defined by the second shaft element.

7. Atrocar according to any of Claims 1 to 6, wherein the inlet ports and the outlet ports include a pierceable seal.

8. A trocar according to any of Claims 1 to 7, wherein the obturator is detachably coupled to the cannula head.

9. A trocar according to Claim 8, wherein the obturator is coupled to the cannular head in a pre-determined orientation.

10. A trocar according to Claim 9, wherein the obturator defines a first needle channel therethrough and a second needle channel therethrough; and when the obturator is in its pre-determined orientation, the first obturator needle channel aligns with a first needle guide channel axis, and the second obturator needle channel aligns with a second needle guide channel axis.11 . A suturing apparatus comprising a trocar as defined in any of Claims 1 to 10 and a suture needle; wherein the suture needle carries a suture thread; the suture needle is locatable within one of the opposed needle guide elements such that it is guided through the working channel of the cannula via the inlet and outlet ports.

12. A suturing apparatus according to Claim 11 , wherein the suture needle includes a core and a barrel, wherein the core is slidably received within the barrel; the core has a retracted configuration in which it is entirely located within the barrel, and an extended configuration in which a distal end of the core projects beyond the end of the barrel.

13. A suturing apparatus according to Claim 12, wherein the core is biased towards its retracted configuration.

14. A suturing apparatus according to Claim 12 or Claim 13, wherein the distal end of the core carries a clamp apparatus.

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