WO2007119212A2 - Dispositif d'accès chirurgical - Google Patents
Dispositif d'accès chirurgical Download PDFInfo
- Publication number
- WO2007119212A2 WO2007119212A2 PCT/IB2007/051322 IB2007051322W WO2007119212A2 WO 2007119212 A2 WO2007119212 A2 WO 2007119212A2 IB 2007051322 W IB2007051322 W IB 2007051322W WO 2007119212 A2 WO2007119212 A2 WO 2007119212A2
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- tube
- access device
- surgical access
- surgical
- guide
- Prior art date
Links
- 238000006073 displacement reaction Methods 0.000 claims description 2
- 239000012528 membrane Substances 0.000 abstract description 8
- 238000000034 method Methods 0.000 abstract description 2
- 238000003780 insertion Methods 0.000 description 4
- 230000037431 insertion Effects 0.000 description 4
- 210000003679 cervix uteri Anatomy 0.000 description 2
- 238000001574 biopsy Methods 0.000 description 1
- 238000002674 endoscopic surgery Methods 0.000 description 1
- 239000000463 material Substances 0.000 description 1
- 210000000664 rectum Anatomy 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
- 210000001215 vagina Anatomy 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
- A61B1/018—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor for receiving instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00142—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with means for preventing contamination, e.g. by using a sanitary sheath
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
- A61B17/3431—Cannulas being collapsible, e.g. made of thin flexible material
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
- A61B17/3439—Cannulas with means for changing the inner diameter of the cannula, e.g. expandable
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
- A61B2017/3445—Cannulas used as instrument channel for multiple instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
- A61B2017/3445—Cannulas used as instrument channel for multiple instruments
- A61B2017/3447—Linked multiple cannulas
Definitions
- This invention relates to a surgical access device for use in performing endoscopic surgery through a bodily orifice such as a cervix, vagina, rectum, etc.
- Surgical access devices of a type having a semi-rigid main tube through which an endoscope can be inserted and an auxiliary tube having a radially flexible wall, for the insertion of endoscopic surgical instruments are known.
- Such a surgical access device is disclosed in US Patent 5,772,628.
- a disadvantage of the surgical access device disclosed in US Patent 5,772,628 is that when inserting an endoscopic surgical instrument into the auxiliary tube, the tube deforms significantly so that the endoscopic surgical instrument is able to move off-centre to one side of the main tube, in use.
- a surgical access device including:
- a semi-rigid first tube defining a first passage through which an endoscope can be inserted into the body of a patient
- a second tube which is located adjacent the first tube and which has a radially flexible wall having a collapsed condition wherein the second tube closely conforms to an outer surface of the first tube and a dilated condition wherein the second tube is expanded from its collapsed condition so as to provide a second passage through which an endoscopic surgical instrument can be inserted into the body of the patient;
- auxiliary guide means which is configured to prevent lateral displacement of an endoscopic instrument which is located in the second passage of the second tube, in use.
- the surgical device may have a proximal end and a distal end, with the first and second tubes extending substantially between the proximal and distal ends.
- the auxiliary guide means may be located approximate to the distal end of the surgical access device.
- the auxiliary guide means may be in the form of a rigid guide member which extends outwardly from the first tube. More particularly, the guide member may comprise a pair of spaced lateral guide plates which define a guide channel between them within which the endoscopic surgical instrument is slideably displaceable, in use.
- Each of the guide plates may define a tapered profile wherein the guide plate tapers towards the distal end of the surgical access device.
- Figure 1 shows a schematic side elevation of a surgical access device in accordance with the invention illustrating a partially inserted endoscope and a secondary instrument in a pre-introduction position
- Figure 2 shows an enlarged schematic side elevation of the distal tip of the surgical access device of Figure 1 , showing the secondary tube thereof in a collapsed condition;
- Figure 3 shows an enlarged schematic perspective view of the distal tip of the surgical access device of Figure 1 showing the secondary tube thereof in a collapsed condition;
- Figure 4 shows a schematic cross-sectional view of the surgical access of Figure 1 , sectioned along section line IV-IV of Figure 2;
- Figure 5 shows a schematic perspective view of the surgical access device of Figure 1 , showing the secondary tube in a dilated condition;
- Figure 6 shows a schematic cross-sectional view of the surgical access device of Figure 1 , sectioned along section line Vl-Vl of Figure 5.
- a surgical access device in accordance with the invention is designated generally by the reference numeral 10.
- the surgical access device 10 is in the form of an introducer for use in gynaecological procedures.
- the surgical access device 10 comprises a distal insertion portion 12 which is intended for insertion into a patient's body and a proximal housing portion 14 which generally remains outside the patient's body. Access to the patient's body is achieved via the cervix of the patient.
- an endoscope 16 is shown partially inserted into a main port 18 formed at the proximal end of the surgical access device 10.
- a secondary instrument in the form of a grasper 20 is shown in a position prior to insertion into a secondary port 22 also at a proximal end of the surgical access device.
- the housing 16 includes an inflow conduit 24 which is connected to the main port 18 and an outflow conduit 26 which is connected to the secondary port 22.
- the surgical access device 10 includes a semi-rigid main tube 28 which is connected to the main port 18 and a secondary tube 30 which is connected to the secondary port 22 and which is mounted to an exterior surface of the main tube.
- the main tube 28 defines a passage 32 through which the endoscope 16 can be inserted into the body of a patient.
- the main tube 28 is surrounded by a larger diameter split sheath 34.
- the split in the sheath 34 defines a longitudinal slit 36.
- a membrane 38 which forms the secondary tube 30 is sandwiched between the inner main tube 28 and the outer split sheath 34. The membrane 38 thus surrounds the inner main tube 28 but, due to its greater diameter extends out of the longitudinal slit 36 in the split sheath 34.
- the excess membrane material is folded back onto the outer surface of the split sheath 34 so as to form a double layer of the membrane along a partial circumference of the split sheath in a collapsed condition of the secondary tube.
- Folded back portions of the secondary tube 30 form pleats 42 in the collapsed condition of the secondary tube.
- the membrane 38 is radially flexible and is deployed into a dilated condition from the collapsed condition thereof when the grasper 20 is introduced into the secondary port 22.
- the secondary tube opens up so as to define a second passage 44 in which the grasper is received.
- the grasper 20 almost completely occupies the second passage 44.
- the surgical access device further includes auxiliary guide means comprising a pair of spaced lateral guide plates 46.1 and 46.2 which are mounted to and which extend upwardly from a distal tip 45 of the main tube 28 so as to define a guide channel 48 between them.
- Each of the guide plates 46.1 and 46.2 defines a tapered profile wherein the guide plates taper towards the distal end of the surgical access device. At its widest end, each plate projects outwardly from the main tube 28 a distance of three millimeters.
- the guide plate 46.1 and 46.2 guide the tip region of the surgical instrument between the guide plates preventing the surgical instrument from moving off-centre to one side of the main tube 28 as is the case with the surgical access device disclosed in US Patent 5,772,628 wherein the auxiliary tube deforms significantly near its distal end.
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Molecular Biology (AREA)
- Veterinary Medicine (AREA)
- Pathology (AREA)
- Public Health (AREA)
- General Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Animal Behavior & Ethology (AREA)
- Physics & Mathematics (AREA)
- Biophysics (AREA)
- Radiology & Medical Imaging (AREA)
- Optics & Photonics (AREA)
- Endoscopes (AREA)
Abstract
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
ZA2006/03026 | 2006-04-13 | ||
ZA200603026 | 2006-04-13 |
Publications (2)
Publication Number | Publication Date |
---|---|
WO2007119212A2 true WO2007119212A2 (fr) | 2007-10-25 |
WO2007119212A3 WO2007119212A3 (fr) | 2007-12-27 |
Family
ID=38473100
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/IB2007/051322 WO2007119212A2 (fr) | 2006-04-13 | 2007-04-12 | Dispositif d'accès chirurgical |
Country Status (1)
Country | Link |
---|---|
WO (1) | WO2007119212A2 (fr) |
Cited By (36)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2012122294A1 (fr) * | 2011-03-10 | 2012-09-13 | Interventional Spine, Inc. | Méthode et appareil pour l'insertion mini-invasive d'implants intervertébraux |
US9277928B2 (en) | 2013-03-11 | 2016-03-08 | Interventional Spine, Inc. | Method and apparatus for minimally invasive insertion of intervertebral implants |
US9839530B2 (en) | 2007-06-26 | 2017-12-12 | DePuy Synthes Products, Inc. | Highly lordosed fusion cage |
US9883951B2 (en) | 2012-08-30 | 2018-02-06 | Interventional Spine, Inc. | Artificial disc |
US9895236B2 (en) | 2010-06-24 | 2018-02-20 | DePuy Synthes Products, Inc. | Enhanced cage insertion assembly |
US9913727B2 (en) | 2015-07-02 | 2018-03-13 | Medos International Sarl | Expandable implant |
US9931223B2 (en) | 2008-04-05 | 2018-04-03 | DePuy Synthes Products, Inc. | Expandable intervertebral implant |
US9993353B2 (en) | 2013-03-14 | 2018-06-12 | DePuy Synthes Products, Inc. | Method and apparatus for minimally invasive insertion of intervertebral implants |
US9993349B2 (en) | 2002-06-27 | 2018-06-12 | DePuy Synthes Products, Inc. | Intervertebral disc |
US10058433B2 (en) | 2012-07-26 | 2018-08-28 | DePuy Synthes Products, Inc. | Expandable implant |
US10182842B2 (en) | 2011-03-10 | 2019-01-22 | DePuy Synthes Products, Inc. | Method and apparatus for minimally invasive insertion of intervertebral implants |
US10390963B2 (en) | 2006-12-07 | 2019-08-27 | DePuy Synthes Products, Inc. | Intervertebral implant |
EP3530218A1 (fr) * | 2018-02-27 | 2019-08-28 | Acclarent, Inc. | Instrument médical doté d'un canal auto-pliable |
US10398563B2 (en) | 2017-05-08 | 2019-09-03 | Medos International Sarl | Expandable cage |
US10413422B2 (en) | 2013-03-07 | 2019-09-17 | DePuy Synthes Products, Inc. | Intervertebral implant |
US10433977B2 (en) | 2008-01-17 | 2019-10-08 | DePuy Synthes Products, Inc. | Expandable intervertebral implant and associated method of manufacturing the same |
US10500062B2 (en) | 2009-12-10 | 2019-12-10 | DePuy Synthes Products, Inc. | Bellows-like expandable interbody fusion cage |
US10537436B2 (en) | 2016-11-01 | 2020-01-21 | DePuy Synthes Products, Inc. | Curved expandable cage |
US10548741B2 (en) | 2010-06-29 | 2020-02-04 | DePuy Synthes Products, Inc. | Distractible intervertebral implant |
US10888433B2 (en) | 2016-12-14 | 2021-01-12 | DePuy Synthes Products, Inc. | Intervertebral implant inserter and related methods |
US10940016B2 (en) | 2017-07-05 | 2021-03-09 | Medos International Sarl | Expandable intervertebral fusion cage |
CN113425343A (zh) * | 2021-07-02 | 2021-09-24 | 西安交通大学医学院第一附属医院 | 一种神经内镜立体定向手术辅助通道设备 |
US11344424B2 (en) | 2017-06-14 | 2022-05-31 | Medos International Sarl | Expandable intervertebral implant and related methods |
US11426286B2 (en) | 2020-03-06 | 2022-08-30 | Eit Emerging Implant Technologies Gmbh | Expandable intervertebral implant |
US11426290B2 (en) | 2015-03-06 | 2022-08-30 | DePuy Synthes Products, Inc. | Expandable intervertebral implant, system, kit and method |
US11446156B2 (en) | 2018-10-25 | 2022-09-20 | Medos International Sarl | Expandable intervertebral implant, inserter instrument, and related methods |
US11452607B2 (en) | 2010-10-11 | 2022-09-27 | DePuy Synthes Products, Inc. | Expandable interspinous process spacer implant |
US11510788B2 (en) | 2016-06-28 | 2022-11-29 | Eit Emerging Implant Technologies Gmbh | Expandable, angularly adjustable intervertebral cages |
US11596522B2 (en) | 2016-06-28 | 2023-03-07 | Eit Emerging Implant Technologies Gmbh | Expandable and angularly adjustable intervertebral cages with articulating joint |
US11612491B2 (en) | 2009-03-30 | 2023-03-28 | DePuy Synthes Products, Inc. | Zero profile spinal fusion cage |
US11752009B2 (en) | 2021-04-06 | 2023-09-12 | Medos International Sarl | Expandable intervertebral fusion cage |
US11850160B2 (en) | 2021-03-26 | 2023-12-26 | Medos International Sarl | Expandable lordotic intervertebral fusion cage |
US11911287B2 (en) | 2010-06-24 | 2024-02-27 | DePuy Synthes Products, Inc. | Lateral spondylolisthesis reduction cage |
USRE49973E1 (en) | 2013-02-28 | 2024-05-21 | DePuy Synthes Products, Inc. | Expandable intervertebral implant, system, kit and method |
US12090064B2 (en) | 2022-03-01 | 2024-09-17 | Medos International Sarl | Stabilization members for expandable intervertebral implants, and related systems and methods |
CN119302586A (zh) * | 2024-12-13 | 2025-01-14 | 湖南省华芯医疗器械有限公司 | 插入部膜组件及套膜工具 |
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Cited By (93)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US9993349B2 (en) | 2002-06-27 | 2018-06-12 | DePuy Synthes Products, Inc. | Intervertebral disc |
US10583015B2 (en) | 2006-12-07 | 2020-03-10 | DePuy Synthes Products, Inc. | Intervertebral implant |
US11712345B2 (en) | 2006-12-07 | 2023-08-01 | DePuy Synthes Products, Inc. | Intervertebral implant |
US11660206B2 (en) | 2006-12-07 | 2023-05-30 | DePuy Synthes Products, Inc. | Intervertebral implant |
US11642229B2 (en) | 2006-12-07 | 2023-05-09 | DePuy Synthes Products, Inc. | Intervertebral implant |
US10390963B2 (en) | 2006-12-07 | 2019-08-27 | DePuy Synthes Products, Inc. | Intervertebral implant |
US11497618B2 (en) | 2006-12-07 | 2022-11-15 | DePuy Synthes Products, Inc. | Intervertebral implant |
US11432942B2 (en) | 2006-12-07 | 2022-09-06 | DePuy Synthes Products, Inc. | Intervertebral implant |
US11273050B2 (en) | 2006-12-07 | 2022-03-15 | DePuy Synthes Products, Inc. | Intervertebral implant |
US10398566B2 (en) | 2006-12-07 | 2019-09-03 | DePuy Synthes Products, Inc. | Intervertebral implant |
US9839530B2 (en) | 2007-06-26 | 2017-12-12 | DePuy Synthes Products, Inc. | Highly lordosed fusion cage |
US10973652B2 (en) | 2007-06-26 | 2021-04-13 | DePuy Synthes Products, Inc. | Highly lordosed fusion cage |
US11622868B2 (en) | 2007-06-26 | 2023-04-11 | DePuy Synthes Products, Inc. | Highly lordosed fusion cage |
US10449058B2 (en) | 2008-01-17 | 2019-10-22 | DePuy Synthes Products, Inc. | Expandable intervertebral implant and associated method of manufacturing the same |
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US11701234B2 (en) | 2008-04-05 | 2023-07-18 | DePuy Synthes Products, Inc. | Expandable intervertebral implant |
US11707359B2 (en) | 2008-04-05 | 2023-07-25 | DePuy Synthes Products, Inc. | Expandable intervertebral implant |
US12097124B2 (en) | 2009-03-30 | 2024-09-24 | DePuy Synthes Products, Inc. | Zero profile spinal fusion cage |
US11612491B2 (en) | 2009-03-30 | 2023-03-28 | DePuy Synthes Products, Inc. | Zero profile spinal fusion cage |
US10500062B2 (en) | 2009-12-10 | 2019-12-10 | DePuy Synthes Products, Inc. | Bellows-like expandable interbody fusion cage |
US11607321B2 (en) | 2009-12-10 | 2023-03-21 | DePuy Synthes Products, Inc. | Bellows-like expandable interbody fusion cage |
US10966840B2 (en) | 2010-06-24 | 2021-04-06 | DePuy Synthes Products, Inc. | Enhanced cage insertion assembly |
US11872139B2 (en) | 2010-06-24 | 2024-01-16 | DePuy Synthes Products, Inc. | Enhanced cage insertion assembly |
US11911287B2 (en) | 2010-06-24 | 2024-02-27 | DePuy Synthes Products, Inc. | Lateral spondylolisthesis reduction cage |
US9895236B2 (en) | 2010-06-24 | 2018-02-20 | DePuy Synthes Products, Inc. | Enhanced cage insertion assembly |
US10548741B2 (en) | 2010-06-29 | 2020-02-04 | DePuy Synthes Products, Inc. | Distractible intervertebral implant |
US11654033B2 (en) | 2010-06-29 | 2023-05-23 | DePuy Synthes Products, Inc. | Distractible intervertebral implant |
US11452607B2 (en) | 2010-10-11 | 2022-09-27 | DePuy Synthes Products, Inc. | Expandable interspinous process spacer implant |
US10743915B2 (en) | 2011-03-10 | 2020-08-18 | DePuy Synthes Products, Inc. | Method and apparatus for minimally invasive insertion of intervertebral implants |
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CN103533904B (zh) * | 2011-03-10 | 2017-06-09 | 介入脊椎公司 | 椎间植入物的微创插入的方法和设备 |
WO2012122294A1 (fr) * | 2011-03-10 | 2012-09-13 | Interventional Spine, Inc. | Méthode et appareil pour l'insertion mini-invasive d'implants intervertébraux |
US8394129B2 (en) | 2011-03-10 | 2013-03-12 | Interventional Spine, Inc. | Method and apparatus for minimally invasive insertion of intervertebral implants |
CN103533904A (zh) * | 2011-03-10 | 2014-01-22 | 介入脊椎公司 | 椎间植入物的微创插入的方法和设备 |
US11547443B2 (en) | 2011-03-10 | 2023-01-10 | DePuy Synthes Products, Inc. | Method and apparatus for minimally invasive insertion of intervertebral implants |
US10729462B2 (en) | 2011-03-10 | 2020-08-04 | DePuy Synthes Products, Inc. | Method and apparatus for minimally invasive insertion of intervertebral implants |
AU2012225473B2 (en) * | 2011-03-10 | 2016-07-21 | Interventional Spine, Inc. | Method and apparatus for minimally invasive insertion of intervertebral implants |
US11547442B2 (en) | 2011-03-10 | 2023-01-10 | DePuy Synthes Products, Inc. | Method and apparatus for minimally invasive insertion of intervertebral implants |
US10743914B2 (en) | 2011-03-10 | 2020-08-18 | DePuy Snythes Products, Inc. | Method and apparatus for minimally invasive insertion of intervertebral implants |
US11484419B2 (en) | 2011-03-10 | 2022-11-01 | DePuy Synthes Products, Inc. | Method and apparatus for minimally invasive insertion of intervertebral implants |
US10743913B2 (en) | 2011-03-10 | 2020-08-18 | DePuy Synthes Products, Inc. | Method and apparatus for minimally invasive insertion of intervertebral implants |
US10744004B2 (en) | 2011-03-10 | 2020-08-18 | DePuy Synthes Products, Inc. | Method and apparatus for minimally invasive insertion of intervertebral implants |
US11484420B2 (en) | 2011-03-10 | 2022-11-01 | DePuy Synthes Products, Inc. | Method and apparatus for minimally invasive insertion of intervertebral implants |
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