Insufflating Optical Obturator for Safe First-Entry Trocar Placement
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Solution Overview
Problem
Inserting the first trocar in minimally invasive surgery poses a high risk of damaging internal organs due to direct contact with internal structures before pneumoperitoneum is established, as the abdominal wall is not distended away from internal organs.
Innovation Solution
A surgical access system comprising a trocar with an insufflating optical obturator and a laparoscope, where the obturator tip has a transparent, thin-wall design with vent holes connected to an insufflation gas flow channel, allowing for precise visualization and safe traversal of the body wall, enabling controlled insufflation and access to body cavities.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If a traditional trocar is used for first entry, then the abdominal wall can be accessed, but the risk of damaging internal organs is high due to direct contact
Solution Approach 1:
A transparent obturator tip serves as an intermediary between the surgeon's visual system and the tissue being penetrated. The obturator material (polycarbonate, acrylic, or glass) allows light transmission so surgeons can directly observe tissue separation and penetration in real-time, enabling precise control and reducing the risk of accidental organ damage during first entry
Solution Approach 2:
The obturator tip utilizes optical properties including transparency and light refraction to provide visual feedback. As tissue is separated and the trocar advances, the transparent obturator allows surgeons to observe color changes and visual cues in the tissue, enabling precise control of penetration depth and direction to avoid organ damage
2Ease of operation
If the abdominal wall is not distended, then the first trocar can be inserted, but direct contact with internal organs increases the risk of damage
Solution Approach 1:
The transparent obturator provides real-time visual feedback to the surgeon during insertion. The surgeon can directly observe tissue separation, penetration depth, and the appearance of internal structures through the transparent obturator, enabling immediate adjustment of insertion force and angle to prevent organ contact while maintaining ease of operation
Solution Approach 2:
The obturator tip performs preliminary tissue separation and dilation before the sharp trocar edge makes full contact. The transparent obturator allows visualization of this preliminary action, ensuring that tissue is properly separated and the path is clear before complete penetration, reducing the risk of direct organ contact
3Measurement precision
If a transparent obturator is used for visualization, then precise placement is enabled, but the device complexity increases
Solution Approach 1:
The transparent obturator is nested within the trocar shaft, and the laparoscope is nested within the obturator. This nested configuration allows the transparent obturator to provide visualization without requiring a separate external imaging system, maintaining a compact structure while enabling precise placement through direct visual observation
Solution Approach 2:
The transparent obturator serves multiple functions: it provides structural support for the trocar, acts as a visual window for tissue observation, and serves as a dilating element for tissue separation. This multi-functionality reduces the need for additional separate components, thereby limiting the increase in device complexity while achieving high measurement precision
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
The system allows for precise and accurate placement of the trocar into body cavities, reducing the risk of organ damage by enabling visualization of tissue separation and insufflation, thus facilitating safe access and minimizing injury to internal structures.
Implementation Method 1
a distal end of the obturator comprises a tip, at least a portion of which comprises a wall with a generally uniform thickness comprising a transparent material
Implementation Method 2
at least one vent hole disposed at the obturator tip is fluidly connected to a gas flow channel defined by an interior surface of the obturator and the laparoscope, which is fluidly connected to an insufflation gas inlet disposed at a proximal end of the trocar
Data Source
AI summary
A surgical access system comprises a trocar, an insufflating optical obturator slidably insertable into the trocar, and a laparoscope slidably insertable into the obturator. A distal end of the obturator comprises a tip, at least a portion of which comprises a wall with a generally uniform thickness comprising a transparent material. At least one vent hole disposed at the obturator tip is fluidly connected to a gas flow channel defined by an interior surface of the obturator and the laparoscope, which is fluidly connected to an insufflation gas inlet disposed at a proximal end of the trocar. Improved optical characteristics of the trocar system permit precise and accurate visual placement thereof into a body cavity. Accordingly the access system is suitable as a first entry surgical access system. Embodiments of the trocar access are also useful for drug delivery, and/or for fluid and/or tissue aspiration.