Laparoscopic Blade Deployment for Controlled Trocar Incision Widening
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Solution Overview
Problem
Surgeons face challenges in removing large specimens through small laparoscopic ports due to size mismatch, leading to complications such as bowel injury, fascial dehiscence, hematoma formation, and cosmetic asymmetry, which prolong procedures and increase patient risk.
Innovation Solution
A laparoscopic incision extender with motor-driven, spring-loaded, or threaded rod deployment mechanisms for controlled enlargement of trocar incisions using cutting blades, ensuring precise and symmetrical incision expansion.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Weight of moving object
If small laparoscopic trocars (5-15mm) are used to minimize patient trauma and maintain minimally invasive benefits, then patient trauma and recovery time are reduced, but the ability to remove large specimens is severely limited
Solution Approach 1:
The incision enlargement process is segmented into controlled stages using multiple cutting blades that can be deployed sequentially. The blades are arranged in a circular pattern and can be activated individually or in groups, allowing the incision to be enlarged in a stepwise manner rather than all at once, thereby maintaining control while achieving the necessary size increase for specimen removal
Solution Approach 2:
The cutting blade assembly is nested within the trocar shaft, allowing the entire incision enlargement device to be inserted through the small laparoscopic port. The blades are stored in a retracted position within the trocar during insertion, then deployed outward to cut the incision, effectively nesting a larger function within a smaller access device
2Adaptability or versatility
If blind transection of skin and fascia is performed using conventional instruments to enlarge incisions for specimen removal, then specimen extraction is enabled, but serious complications such as bowel injury and fascial dehiscence occur
Solution Approach 1:
The system incorporates visual feedback mechanisms that allow the surgeon to directly observe the cutting process and incision enlargement in real-time. This visibility provides continuous feedback on blade position and tissue interaction, enabling the surgeon to stop the cutting process at the precise moment the incision reaches the desired size, thereby preventing over-cutting and associated complications
Solution Approach 2:
The cutting blades are pre-positioned and controlled to cut only the necessary tissue layers (skin and fascia) to a predetermined depth and extent. The system performs the incision enlargement in a controlled, predetermined sequence before specimen removal is attempted, ensuring that the incision is adequately sized but not excessively enlarged, thereby preventing complications from uncontrolled cutting
3Productivity
If uncontrolled cutting is used to enlarge incisions, then specimen removal is possible, but cosmetic asymmetry and irregular fascial defects result
Solution Approach 1:
The cutting blade assembly is designed with asymmetric control capabilities, allowing the surgeon to selectively activate individual blades or groups of blades based on the specific anatomical requirements and specimen size. This asymmetric activation pattern enables precise control over the incision shape and size, creating symmetrical or appropriately shaped incisions rather than uniform circular enlargements
Solution Approach 2:
The system transitions from a static, fixed incision size to a dynamic, adjustable incision enlargement process. The cutting blades can be deployed and retracted dynamically, with the ability to pause, adjust, and control the cutting depth and extent in real-time, thereby achieving precise symmetrical incisions that are optimized for both specimen removal and cosmetic outcomes
4Adaptability or versatility
If improvised incision enlargement techniques are performed, then large specimens can be removed, but operative time is prolonged and patient risk increases
Solution Approach 1:
The system replaces manual, improvised cutting techniques with a motorized or mechanically actuated blade deployment system. This substitution provides automated control over the incision enlargement process, eliminating the time-consuming and imprecise manual manipulation required for traditional improvised techniques while enabling consistent, controlled incision enlargement that can be performed efficiently
Solution Approach 2:
The system enables rapid adjustment of incision parameters (size, shape, depth) through controlled blade deployment mechanisms. By changing the deployment parameters of the cutting blades, the incision can be quickly enlarged to the necessary size for specimen removal without the prolonged trial-and-error process associated with improvised techniques, thereby reducing operative time while maintaining safety
Data Source
AI summary
A surgical instrument for insertion through a laparoscopic trocar, the instrument having an elongated tubular body and a blade deployment assembly associated with the tubular body. One or more blades are coupled to the deployment assembly and movable between a retracted position within a diameter defined by the tubular body and an extended position projecting radially or outward from the tubular body.