APPARATUS AND METHOD FOR LOCATING A NERVE BLOCK SITE BY ESTABLISHING A REFERENCE PLANE AND DELIVERING ANESTHETIC TO THE SITE

Abstract

The present disclosure relates to a local anesthetic delivery device for delivering anesthetic to a nerve block site comprising a surgical mechanism for establishing a reference plane for identifying the nerve block site, wherein the surgical mechanism establishes the reference plane at the peritoneum and uses a known fixed distance to the nerve plane above to accurately locate the nerve block site and deliver anesthesia.

Claims

1. A local anesthetic delivery device for delivering anesthetic to a nerve block site, comprising: a surgical mechanism configured to determine a location of a nerve plane by establishing a fixed reference point against a peritoneum of a patient and positioning anesthesia delivery at the nerve block site relative to the fixed reference point.

2. The local anesthetic delivery device of claim 1, wherein: the surgical mechanism is configured to determine the location of the nerve block site by using a measured distance from the peritoneum outwards to the nerve plane.

3. The local anesthetic delivery device of claim 1, wherein: the surgical mechanism includes a trocar having a proximal end and a distal end, and at least one stop tab at the distal end, the at least one stop tab being configured to contact the peritoneum for establishing the fixed reference point.

4. The local anesthetic delivery device of claim 3, wherein: the at least one stop tab is movable between a first position, where the at least one stop tab extends parallel to a body of the trocar, and a second position, where the at least stop tab extends perpendicular to the body of the trocar.

5. The local anesthetic delivery device of claim 4, wherein: the at least one stop tab is rotatably connected to the body of the trocar.

6. The local anesthetic delivery device of claim 3, wherein: the surgical mechanism further includes a needle having at least one opening on a distal end, and a distance guide controller configured to advance the needle to the nerve block site.

7. The local anesthetic delivery device of claim 6, wherein: the distal guide controller includes a knob configured to engage threads on the needle; and wherein the knob is configured to advance the needle upon rotation of the knob.

8. The local anesthetic delivery device of claim 3, wherein: the trocar includes at least one passage for transporting an analgesic to the nerve block site, the at least one passage including an injector port accessible from a proximal end of the trocar, and at least one radial exit port located a fixed and predetermined distance above the at least one stop tab for delivering the analgesic to the nerve block site.

9. The local anesthetic delivery device of claim 8, wherein: the at least one radial exit port is a plurality of radial exit ports in fluid communication with the injector port.

10. The local anesthetic delivery device of claim 9, wherein: the at least one passage is a plurality of passages.

11. The local anesthetic delivery device of claim 1, wherein: the surgical mechanism includes: an elongated body having a stop tab at a distal end thereof configured to contact the peritoneum for establishing the fixed reference point; and at least one stylet being movable between a first position where the stylet is housed within the main body, and a second position where the stylet extends from the main body to a predetermined position relative to the stop; wherein in the predetermined position, a distal end of the at least one stylet is located in the nerve plane.

12. The local anesthetic delivery device of claim 11, wherein: the surgical mechanism includes a lever for moving the at least one stylet between the first position and the second position.

13. The local anesthetic delivery device of claim 12, wherein: the stop tab is rotatable between a retracted position and an extended position.

14. A method for delivering a local anesthetic to a nerve block site, comprising the steps of: establishing a reference plane for identifying a nerve block site, wherein the reference plane is established by using a peritoneum as a fixed point for locating a nerve plane; advancing a local anesthetic delivery device having a proximal end and a distal end into the nerve plane; positioning the distal end of the local anesthetic delivery device at the nerve block site in the nerve plane; and delivering anesthesia to the nerve block site in the nerve plane through at least one opening in a tip of the local anesthetic delivery device.

15. The method according to claim 14, further comprising the step of: controlling placement of local anesthetic delivery device in the nerve plane using a rotatable distance guide controller located at the proximal end of the local anesthetic delivery device.

16. The method according to claim 14, wherein: the step of advancing the local anesthetic deliver device into the nerve plane includes advancing the distal end of the local anesthetic deliver device outwardly so as to penetrate the peritoneum with the distal end prior to entering the nerve plane.

17. The method according to claim 14, wherein: the step of advancing the local anesthetic deliver device into the nerve plane and positioning the distal end of the local anesthetic delivery device at the nerve block site includes positioning the distal end at a predetermined distance from the reference plane.

18. The method according to claim 14, wherein: the step of establishing the reference plane for identifying the nerve block site includes inserting a trocar having a proximal end and a distal end, and at least one stop tab at the distal end into a body of a subject, and contacting the at least one stop tab with the peritoneum to establish the fixed reference point.

19. A local anesthetic delivery device for delivering anesthetic to a nerve block site, comprising: a trocar having a proximal end and a distal end, and at least one stop tab at the distal end, the at least one stop tab being configured to contact the peritoneum, wherein contact between the peritoneum and the at least one stop tab defines a reference plane; and a needle having at least one opening on a distal end, the needle being configured for placement at a predetermined distance from the reference plane.

20. The local anesthetic deliver device of claim 19, wherein: the at least one stop tab is movable between a first position, where the at least one stop tab extends parallel to a body of the trocar, and a second position, where the at least stop tab extends perpendicular to the body of the trocar.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0024] The preferred embodiments of the disclosure will hereinafter be described in conjunction with the appended drawings provided to illustrate and not to limit the disclosure, in which:

[0025] FIG. 1 shows a perspective view of one embodiment of a local anesthetic delivery device of the present disclosure and illustrates a specialized inverted surgical needle pre-deployed;

[0026] FIG. 2 shows a perspective view of another embodiment of a local anesthetic delivery device of the present disclosure and illustrates an alternative needle;

[0027] FIG. 3 shows a top view of another embodiment of a local anesthetic delivery device of the present disclosure and illustrates a specialized needle;

[0028] FIG. 4 shows a perspective view of another embodiment of a local anesthetic delivery device of the present disclosure and illustrates a specialized needle entering the peritoneum to reach the nerve plane;

[0029] FIG. 5 shows a perspective view of another embodiment of a local anesthetic delivery device of the present disclosure and illustrates a specialized Trocar device having specialized passages that lie along the nerve plane;

[0030] FIG. 6 shows a perspective view of another embodiment of a local anesthetic delivery device the present disclosures and illustrates a specialized anesthetic delivery device.

[0031] Like reference numerals refer to like parts throughout the several views of the drawings.

DETAILED DESCRIPTION

[0032] The following detailed description is merely exemplary in nature and is not intended to limit the described embodiments or the application and uses of the described embodiments. As used herein, the word “exemplary” or “illustrative” means “serving as an example, instance, or illustration.” Any implementation described herein as “exemplary” or “illustrative” is not necessarily to be construed as preferred or advantageous over other implementations. All of the implementations described below are exemplary implementations provided to enable persons skilled in the art to make or use the embodiments of the disclosure and are not intended to limit the scope of the disclosure, which is defined by the claims. For purposes of description herein, the terms “upper”, “lower”, “left”, “rear”, “right”, “front”, “vertical”, “horizontal”, and derivatives thereof shall relate to the disclosure as oriented in FIG. 1. Furthermore, there is no intention to be bound by any expressed or implied theory presented in the preceding technical field, background, brief summary or the following detailed description. It is also to be understood that the specific devices and processes illustrated in the attached drawings, and described in the following specification, are simply exemplary embodiments of the inventive concepts defined in the appended claims. Hence, specific dimensions and other physical characteristics relating to the embodiments disclosed herein are not to be considered as limiting, unless the claims expressly state otherwise.

[0033] Generally, the present disclosure teaches a local anesthetic delivery device for delivering anesthetic to a nerve block site comprising a surgical mechanism for establishing a reference plane for identifying the nerve block site, wherein the surgical mechanism establishes the reference plane at the peritoneum and uses a fixed distance to a nerve plane for locating the nerve block site and positioning the needle.

[0034] The local anesthetic delivery can further comprise a specialized surgical needle having a proximal end and a distal end, a grip handler located at the proximal end, a needle tip located at the distal end, and an inner cannula, wherein the inner cannula traverses an entire length of the specialized surgical needle and is capable of advancing an anesthetic from said proximal end of said specialized surgical needle toward said distal end of said specialized surgical needle, and the needle tip having multiple circular openings pre-configured to reach and deliver anesthesia to a nerve block site.

[0035] The surgical mechanism establishes the reference plane by measuring the distance from the parietal peritoneum outwards to the nerve block site. The distance from the peritoneum outwards to the nerve block site can be 0.1 cm to 1 cm, and the surgical mechanism can comprise a physical mechanism, a removable ultrasonic probe incorporated in the inner cannula of the specialized surgical needle, or a removable internal light source incorporated in inner cannula of the specialized surgical needle. Further, the multiple circular openings can be miniature openings.

[0036] The local anesthetic delivery device can further comprise a trocar that establishes a reference plane with a tubular stop tab at a distal end of the trocar. The trocar can comprise a guide ring wherein the guide ring orients and positions the specialized surgical needle to reach the nerve block site. The nerve block site can be a transversus abdominus plane, rectus sheath, or another nerve plane, to which the needle would be directed relative to the reference plane established by the trocar's distal stop tabs.

[0037] In general, the present disclosure teaches a method for delivering a nerve block by establishing a reference plane for identifying the nerve block site, wherein the reference plane is established by creating a stop feature positioned against the peritoneum as a fixed point for measuring a distance to the nerve plane. Said local anesthetic delivery device is guided into the abdominal wall from the outside of a body, positioning the local anesthetic delivery device in the nerve block site that was identified relative to the reference plane, and delivering anesthesia into the nerve plane through multiple openings along the tip of the local anesthetic delivery device.

[0038] The method can use various methods for establishing the reference plane. The mechanism can be a physical mechanism incorporated into the device, a removable ultrasonic probe incorporated in an inner cannula of the device, or a removable internal light source incorporated into the device. The surgical mechanism for establishing a reference plane can also be an incorporated into a trocar. A broad area of the nerve block site can be coated with anesthesia through miniature openings located at the distal end of the anesthetic delivery device. Pulling the trocar upward after insertion engages the at least one tubular stop tab located at the distal end of the trocar to stop the trocar from moving further inward into the coelom after the distal end has passed through the peritoneum and into the intraperitoneal space.

[0039] Anesthesia can be delivered to the nerve block site in the nerve plane through multiple openings the tip of the local anesthetic delivery device. The reference plane for identifying a nerve block site can be established by locating the nerve plane using a peritoneum as a fixed point for determining a distance to the nerve plane.

[0040] Turning now to the Figures, FIG. 1 illustrates one embodiment of a local anesthetic delivery device (10). A specialized surgical needle (100) is depicted going through a trocar device (106). The trocar device (106) comprises side walls has been inserted into the abdominal cavity (136) or coelom by making an incision that extends inward into the abdominal cavity (136) from the epidermis through the peritoneum (124). The trocar device (106) is used to insert and remove laparoscopic instruments during the procedure. The specialized surgical needle (100) has a curved end (102) that is designed to remain rigid and a needle tip having multiple circular openings (105) pre-configured to reach the nerve plane or sensory nerve plane (130), with the curved segment effectively creating the reference plane at the peritoneum (124). The needle rises a fixed distance relative to the peritoneum, and is thereby positioned in the nerve plane. The multiple circular openings near the needle tip (105) provide a means of distributing an analgesic substance to the sensory nerves (130). The specialized needle is guided to the correct distance in the sensory nerve plane (130) by the distance guide controller (125). As the guide controller (125) is spun it controls the movement of the specialized needle body (123). The device can also be operated without a guide controller (125), and can be pulled upwards manually until resistance is felt and the curved part of the needle is pressed up against the peritoneum. Unlike other methods and devices used for applying an abdominal wall nerve block, this embodiment utilizes the distance relationship between the peritoneum and the sensory nerve plane. The specialized surgical needle (100), such as an inverted specialized surgical needle, does not have to be exactly at the Rectus Sheath Plane in order to be effective. The length of the specialized surgical needle (100) can be adjusted to effectively reach the sensory nerve (130) plane by the distance guide controller (125). The specialized surgical needle (100) is designed so as not to injure, pierce, or otherwise harm the intestines (126) or other abdominal organs once it enters the abdominal cavity (136). The distance guide controller (125) controls the distance the specialized surgical needle (100) will travel once it is inside the body. The sensory nerve plane (130) can be located at 0.1 cm to 1 cm, or at any distance within that range, upward or outward of the peritoneum (124) towards the epidermis (108). More particularly, the sensory nerve plane (130) can be located at 0.1 cm to 0.9 cm, 0.1. to 0.8 cm, 0.1 cm to 0.7 cm, 0.1 cm to 0.6 cm, 0.1 to 0.5 cm, 0.1 to 0.4 cm., 0.1 cm to 0.3 cm, 0.2 cm to 1 cm, 0.2 cm to 0.9 cm, 0.2 cm to 0.8 cm, 0.2 cm to 0.7 cm, 0.2 cm to 0.6 cm., 02 cm to 0.5 cm, 0.2 to 0.4 cm, or at 0.2 to 0.3 cm upward or outward of the peritoneum (124) towards the epidermis (108).

[0041] With regards to FIG. 2, another embodiment of a local anesthetic delivery device (10) is illustrated. A trocar device (106) comprising a threaded needle (103) and a distance guide controller (125) is shown. The distance guide controller (125) comprises a knob that, when turned or spun, rotatably engages the threads (101) of the threaded needle (103) which moves the threaded needle (103) inward into the abdominal cavity (136). The threaded needle (103) comprises a distal end opening (105), and distal end opening (105) advances into the nerve plane (130) as the distance guide controller (125) is rotated. The trocar device (106) comprises at least one tubular stop tab (132), which is used to position the trocar device (106) inside the peritoneal space of the abdominal cavity (136). The at least one tubular stop tab (132) are oriented vertically or parallel to the side walls of the trocar device (106) when the trocar device (106) is inserted into the abdominal cavity (136) or coelom. Once the trocar device (106) is inserted into the peritoneal space of the abdominal cavity (106), it can be pulled upward or outward to engage the at least one tubular stop tab (132). The at least one tubular stop tab (132) is rotatably engaged with side walls of the trocar device (106) and can rotate at least 90 degrees. The at least one tubular stop stab will become oriented in a horizontal position or perpendicular to the side walls of the trocar device (106) when the trocar device (106) is pulled upward after entering the peritoneal space of the abdominal cavity (106). The at least one tubular stop tab (132) presses against the peritoneum (124) or lower abdominal wall, and the peritoneum becomes the fixed point or reference point for creating the reference plane. As a result of having the correct reference point, the distal end with openings (105) is positioned into the sensory nerve plane (130), and does not come into contact with, scrape, or puncture the intestines (126).

[0042] With respect to FIG. 3, presented is an abdominal top view (300) of one embodiment of the local anesthetic delivery device (10) illustrating a specialized needle used in RS or TAP blocks. Umbilicus 305 is illustrated without a trocar. A specialized bending tip needle (138) is shown inserted into the abdomen (300) using needlescopic methods. A grip handler (140) is used to control the functionality of the special tip needle (138) at the proximal end (310).

[0043] With respect to FIG. 4, another embodiment of the local anesthetic delivery device 10 is illustrated and shows an interior cavity view of the specialized bending tip needle (138) with a bended tip (144). At least one elbow (142) of this specialized bending needle (138) permits the tip to penetrate the nerve plane (130) from the inside cavity to the target plane, where through specialized miniature openings can saturate the plane with an anesthesia. The needle tip can be a bending tip needle (138), and the bending tip needle can point upwards or outward, protecting the internal organs such as the intestines (126) from cuts. Once the specialized needle tip (144) or bending tip needle (138) traverses the peritoneum and enters the abdominal cavity (136) or intraperitoneal space. it will only travel a few more millimeters before stopping because of a physical feature designed into the needle shaft at that distance will limit how far the specialized needle tip (144) can travel into an abdominal cavity (136).

[0044] With respect to FIG. 5 a perspective view of another embodiment of the local anesthetic delivery device (10) and illustrates a specialized trocar device (106) having specialized injector ports (505) and exiting ports (510) is presented used for transporting an analgesic (170) outwards from the proximal end to the distal end with multiple openings (105) to the sensory nerve plane (130). The at least one tubular stop tab (132) provide the correct reference plane (124), that allow the exiting port (510) to position the trocar analgesic exiting ports (510). No exposure to the intestines (126) takes place. A reference plane can be created with the aid of at least one tubular stop tab (132) located at the distal end of the trocar device (106).

[0045] With respect to FIG. 6, another embodiment of the local anesthetic delivery device 10 is shown and depicts a specialized delivery device having specialized fenestrated openings (160) are used to distribute an analgesic through a predetermined range along the stylet (158). The openings can be located along the outer surface of the stylet (158). The stylet (158) is initially embedded in the elongated main body (162) and is extended by moving a lever (not shown) in the down position causing the stylet (158) to extend to a predetermined position that is in the sensory nerve plane (130). Here again, there is no exposure of the local anesthetic delivery device (10) to the intestines (126) or other internal organs.

[0046] An alternate embodiment (not shown) has a needle device with a bright LED in its center, guided to the peritoneum. Looking from the abdominal cavity (136) as the lighted source approaches the peritoneum the light source becomes brighter. Letting the surgeon know that the sensory nerve plane has been reached.