Abstract
A trocar sleeve that isolates the surgical device or movement thereof to inhibit or prevent an established non-jet streaming condition from becoming a jet streaming condition and a method of inhibiting or preventing a jet streaming condition from occurring due to instrument obstruction.
Claims
1. A method of performing a surgical procedure, comprising: inserting a trocar sleeve into a body cavity, the trocar sleeve comprising an outer wall with the trocar sleeve having a first lumen, the first lumen further comprising a plurality of apertures in theouter wall, the trocar sleeve further comprising an inlet port adapted to receive an insufflation gas, the inlet port in flow communication with the first lumen; directing a flow of a received insufflation gas through the first lumen via the inlet port, where at least a portion of the received insufflation gas exits the first lumen and enters the body cavity through the plurality of apertures; wherein the trocar sleeve is adapted such that instruments cannot be inserted into the first lumen; and wherein the distal end of the trocar sleeve is inserted into the body, the distal end being closed such that gas cannot flow through it.
2. The method of claim 1, wherein the portion of the flow of received insufflation gas that exits the first lumen discharges from the plurality of apertures in a non-jet streaming condition.
3. The method of claim 1, wherein the plurality of apertures is regularly spaced from one another.
4. The method of claim 1, wherein the plurality of apertures is randomly spaced from one another.
5. The method of claim 1, wherein the gas comprises carbon dioxide.
6. The method of claim 1, wherein the trocar sleeve further comprises an inner wall wherein the first lumen is located between the outer wall and the inner wall and a second lumen is located within the inner wall, the method further comprising inserting and removing an instrument from the second lumen.
7. The method of claim 6, wherein the inlet port does not supply any gas to the second lumen.
8. The method of claim 6, wherein the second lumen is not used to deliver insufflation gas to the patient while the gas is flowing through the first lumen.
9. The method of claim 6, wherein the instrument comprises a trocar.
10. The method of claim 6, wherein the instrument comprises a surgical device.
11. The method of claim 6, wherein the instrument comprises a camera.
12. The method of claim 6, wherein the first lumen is coaxial with the second lumen.
13. The method of claim 6, wherein the portion of the flow of received insufflation gas that exits the first lumen discharges from the plurality of apertures in a non-jet streaming condition.
14. The method of claim 13, wherein the first lumen is coaxial with the second lumen.
15. The method of claim 14, wherein the instrument comprises a trocar.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0014] FIG. 1 is a side view of the trocar sleeve;
[0015] FIG. 2 is a cross-sectional view of the trocar sleeve taken along lines 2-2 of FIG. 1 illustrating the flow of fluid;
[0016] FIG. 3 is side view of the alternate embodiment blind trocar sleeve; and
[0017] FIG. 3A is a cut away and enlarged view of a portion of the alternative embodiment the blind trocar sleeve of FIG. 3.
DESCRIPTION OF THE PREFERRED EMBODIMENT
[0018] Referring to FIG. 1 and to FIG. 2 the present invention provides a trocar sleeve 10 for insufflating a body cavity while minimizing or eliminating damage to a tissue in the body cavity that can occur proximate the cylindrical member 11 of trocar sleeve 10. Typically, the trocar sleeve is inserted into the body cavity 13 of an animal or human by creating an opening within the body that extends through many layers of tissue 20, which include skin, fat, muscle, and pre-pleural or pre-peritoneal in either the thoracic or abdominal cavities, respectively.
[0019] FIG. 1 shows trocar 10 that addresses the problem of transient jet streaming conditions that can occur because of partial obstructions within the lumen caused by the insertion of an instruments such as a surgical device through the trocar sleeve 10. Such obstructions, which reduce the diameter of the lumen, can result in high-pressure fluid delivery to the body cavity at localized region proximate the trocar sleeve 10 and thus cause damage to the tissues and/or organs of the body.
[0020] FIG. 1 shows trocar sleeve sleeve 10 in a partial cut away view. The trocar sleeve includes a housing 16. Attached to the housing is an inlet port 15. A cylindrical member or tube 11 is attached to the housing and is formed about a central longitudinal axis A.sub.x of the trocar sleeve. The cylindrical member 11 has a proximal end 12 and spaced distally therein is a distal end 14. A spaced plurality of apertures 19 is defined within the exterior of the body surface of the cylindrical member 11. The plurality of apertures 19 are regularly spaced from one another and extend at least partially from the distal end 14 toward the proximal end 12 of the trocar sleeve. The plurality of apertures 19 can extend the entire length of the trocar sleeve if so desired, or for any desired length along the trocar sleeve. It is anticipated that although the respective apertures may extend along the entire length of the trocar sleeve if so desired, the apertures will preferably be spaced from the proximal ends.
[0021] Within the cylindrical member 11 and attached to the housing 16 is a cylindrical member or tube 22 having a sidewall 22a which is impervious or substantially impervious to fluid flow therethrough.
[0022] FIG. 2 shows a cross section view revealing the outer elongated tube or cylindrical member 11 having the apertures 19 therein. Located concentrically within cylindrical member 11 is a further elongated tube or cylindrical member 22 having the sidewall 22a impervious to fluid flow with sidewall 22a spaced from inner sidewall 11a of tube 11 to form an annular chamber 30 for fluid to flow therethrough. Positioned within lumen 31 of cylindrical member 22 is the instrument comprising trocar 21, which is shown occupying a central portion of the lumen 31. In use, the trocar 21 might occupy more or less of the lumen 31. The lumen 31 is used for manipulating the instruments and is isolated from the annular chamber 30. That is, the lumen 31 is not used to deliver the insufflation gas to the patient any consequently manipulation of the surgical device 21 within the lumen 31 does not have any effect on the flow through the annular chamber 30 and hence through the radial apertures 19. Thus, once a non jet streaming condition is established at apertures 19 any changes in the position of the instrument or the type of instrument in the lumen 31 will not have any effect on the velocity of the fluids escaping from the apertures since the flow through the apertures is isolated from the instruments located in the lumen 31 of the trocar sleeve 10. Thus, the present invention is well suited for those applications where the instruments inserted through the trocar sleeve are of different size or shape since the size, shape or the position of the instrument does not effect the flow through the trocar sleeve 11. In addition, any repositioning of the instruments in the lumen 31 will not have any effect on flow conditions through the trocar sleeve since the fluid flow is independent of conditions in lumen 31.
[0023] FIG. 2 illustrates the radial fluid flow through trocar sleeve 10. An insufflating fluid,F, which may be gas, liquid containing drugs, anesthetic or other substances placed or mixed within a pharmaceutically acceptable carrier or any combination thereof. The fluid F is delivered under pressure from an external source via inlet port 15, travels through the annular fluid flow chamber 30 and is discharged at below a jet streaming velocity through the plurality of apertures 19 as indicated by the arrows. Thus regardless of whether an instrument is present in lumen 31 or whether an instrument is manipulated in lumen 31 it will not have an effect on the fluid conditions through the apertures or fluid ports 19.
[0024] FIG. 3 illustrate an alternate embodiment 40 of the invention wherein a non-jet streaming condition can also be maintained. Specifically, the embodiment 40 includes a housing 46 and attached to the housing is an inlet port 45 and a tube or cylindrical member 41 having a proximal end 42 and spaced therefrom a distal end 44. Along the exterior surface of the cylindrical member 41 is a plurality of fluid ports or apertures 49. As can be seen in FIG. 3 the arrows indicate an insufflation fluid is directed radially outward from the apertures 49 and is maintained at a non-jet streaming velocity by control pressure conditions within cylindrical member 41. Thus by having member 41 having a chamber 47 therein with 41 apertures sufficiently small to preclude insertions of instruments therethrough one ensures that instruments will not be inserted into trocar sleeve 40 and adversely affect the established non jet streaming conditions.
[0025] FIG. 3A is a partial cut away view of the cylindrical member 41 revealing an end member 48 blocking the end of cylindrical member 41 to provide a closed end of trocar sleeve 40 to prevent extension of an instrument or other device into plenum chamber 47. This allows one to establish fluid flow conditions in plenum chamber 47 that produce fluid velocities through apertures 49 that are below a jet streaming velocity and will remain at below a jet streaming velocity since no instruments or other devices are inserted into the plenum chamber 47 to affect the velocity of the fluid discharged through apertures 49.
[0026] FIG. 3 and FIG. 3A show insufflating fluid flow delivered from within the blind trocar sleeve 40. In operation fluid flows from an external source under pressure through the inlet port 45, is carried through the cylindrical member 41 and flows into plenum chamber 47 and through the plurality of apertures 49 into the body cavity 43. In the embodiment of FIGS. 3 and 3A because the trocar sleeve is blind no instrument can be inserted therethrough. Since no instrument can be inserted therein one need not be concerned with the size, shape or type of instrument as well as the position of the instrument affecting the fluid flow conditions proximate the cylindrical member 41. Thus once the non-jet streaming condition is established in trocar sleeve 40 one can be assured that the non-jet streaming condition can be maintained proximate the trocar sleeve 40. However, if a surgical instrument needs to be inserted into the body cavity it can be inserted into a companion or separate trocar sleeve that does not contain the insufflation gas. The end 48 may or may not have apertures 49 to allow fluid flow as well as from the side wall.
[0027] Thus, the invention includes the method of insufflating a body cavity without damaging a tissue in the body cavity that can occur during transient conditions within the trocar sleeve by directing a fluid flow from a first chamber in a trocar sleeve through apertures in the trocar sleeve at a velocity less than a jet streaming velocity while inserting or manipulating an instrument in a further chamber that is isolated from the first chamber to prevent the instrument therein from affecting the flow of fluid from the first chamber to thereby maintain the velocity of the fluid at less than the jet streaming velocity.
