Trocar assembly with pneumatic sealing

Abstract

A trocar for use in a minimally invasive surgical procedure includes an elongated body, nozzle means and means for delivering a pressurized flow of fluid to the nozzle means. The elongated body has a generally tubular configuration with coaxially arranged inner and outer walls and longitudinally opposed proximal and distal end portions, with the inner wall defining a lumen to accommodate passage of an instrument therethrough. The nozzle means is operatively associated with the inner wall of the body for directing pressurized fluid into the lumen to develop a pressure differential in an area within a region extending from a location adjacent a distal end portion of the lumen to a location adjacent a proximal end portion of the lumen, to form a fluid seal around an instrument passing therethrough.

1 . A method of sealing a pressurized cavity of a patient for a surgical procedure, the method comprising the steps of:
 a) providing a trocar for use in a minimally invasive surgical procedure, the trocar including:
 i) an elongated body having a generally tubular configuration with coaxially arranged inner and outer walls, the body having longitudinally opposed proximal and distal end portions, the inner wall defining a lumen to accommodate passage of an instrument therethrough; 
 ii) nozzle means operatively associated with the inner wall of the body for directing pressurized fluid into the lumen to develop a pressure differential in an area within a region extending from a location adjacent a distal end portion of the lumen to a location adjacent a proximal end portion of the lumen, to form a fluid seal around an instrument passing therethrough; and 
 iii) means for delivering a pressurized flow of fluid to the nozzle means. 
   c) supplying a flow of pressurized fluid to the trocar; and   d) inserting a surgical instrument through the lumen of the trocar, whereby the pressurized fluid supplied to the trocar forms a seal around the surgical instrument, thereby preventing loss of pressure within the cavity of the patient.   
     
     
         2 . The method of  claim 1 , further comprising the step of:
 inserting a second surgical instrument through the lumen of the trocar, whereby the pressurized fluid supplied to the trocar seals around and between the first and second surgical instruments, preventing loss of pressure within the cavity of the patient.   
     
     
         3 . A method of sealing a pressurized cavity of a patient for a surgical procedure, the method comprising the steps of:
 a) providing a trocar having means to direct a stream of fluid through a lumen of the trocar to prevent loss of pressure within the cavity of the patient, due to loss of insufflation fluid past a surgical instrument inserted therethrough;   b) supplying a pressurized fluid stream into the lumen of the trocar; and   c) inserting a surgical instrument through the lumen of the trocar, whereby the pressurized fluid supplied to the trocar seals around the surgical instrument, thereby preventing loss of pressure within the cavity of the patient.   
     
     
         4 . The method of  claim 3 , further comprising the step of providing means to direct a stream of fluid that includes at least a first nozzle arranged in a proximal end portion of the trocar. 
     
     
         5 . The method of  claim 4 , further comprising the step of providing means to direct a stream of fluid that includes at least a first nozzle arranged in a proximal end portion of the trocar and a second nozzle arranged in the trocar, axially spaced from the first nozzle. 
     
     
         6 . The method of  claim 4 , further comprising the step of providing means to direct a stream of fluid that includes at least one nozzle which extends substantially circumferentially about the lumen of the trocar. 
     
     
         7 . A system for providing pressurized fluid to an insufflation trocar, the system comprising:
 a) a supply for providing insufflation fluid to the system;   b) pressure sensing means for taking a measurement indicative of a pressure inside a body cavity of a patient;   c) a pressure reservoir for storing pressurized fluid and for maintaining a constant output pressure to the insufflation trocar; and   d) pressure regulating means, for regulating pressure output from the reservoir to the trocar based upon a measured pressure detected by the pressure sensing means.   
     
     
         8 . The system of  claim 7 , wherein the pressurization means and pressure sensing means are provided in a surgical insufflator. 
     
     
         9 . The system of  claim 7 , wherein the pressurization means is a compressor. 
     
     
         10 . The system of  claim 7 , wherein the pressure sensing means is an adjustable diaphragm-type pneumatic actuator. 
     
     
         11 . The system of  claim 7 , wherein the pressure sensing means is an electro-pneumatic transducer. 
     
     
         12 . The system of  claim 7 , wherein the pressure regulating means includes:
 a) a control element, for setting by a user to select a desired pressure for the surgical cavity; and   b) an electromechanical flow-control valve for adjusting a flow of insufflation gas to maintain the desired pressure within the surgical cavity.   
     
     
         13 . The system of  claim 7 , further comprising pressurization means for pressurizing the insufflation gas to a predetermined pressure. 
     
     
         14 . The system of  claim 7 , wherein:
 a) the gas supply is connected to a pressure reservoir, to supply insufflation gas thereto;   b) a surgical insufflator is configured and adapted to receive gas from the gas supply, pressurize the gas and supply the pressurized gas to the reservoir, the insufflator having a pressure sensing conduit in fluid communication with the surgical cavity;   c) the pressure reservoir is connected to and supplies pressurized insufflation gas through the pressure regulating means; and   d) the pressure regulating means allows an amount of insufflation gas into the trocar to maintain a predetermined pressure within the surgical cavity.   
     
     
         15 . The system of  claim 14 , wherein a pressure sensing conduit is connected between the trocar and the pressure regulating means to control the volume of insufflation gas being provided to the trocar. 
     
     
         16 . The system of  claim 7 , wherein:
 a) the gas supply is connected to the pressurization means, to supply insufflation gas thereto;   b) the pressurization means is provided and is connected to the pressure reservoir to provide pressurized insufflation gas to the reservoir;   c) the pressure reservoir is connected to and supplies pressurized insufflation gas through the pressure regulating means;   d) the pressure regulating means allows an amount of insufflation gas into the trocar to maintain a predetermined pressure within the surgical cavity; and wherein   e) a pressure sensing conduit is connected between the trocar and the pressure regulating means to control the volume of insufflation gas being provided to the trocar.   
     
     
         17 . A connection kit for use in conjunction with a trocar assembly with pneumatic sealing, the kit comprising:
 a) a first tube for connection between an insufflation port on the trocar and a fluid supply port on a pressure regulating means;   b) a second tube for connection between a pressure sense port on the trocar and a pressure sense port on the pressure regulating means; and   c) a sterile package containing the first and second tubes.   
     
     
         18 . The connection kit of  claim 17 , wherein the first tube is coaxially arranged within the second tube, the kit further including a splitter on at least one end to separate the first and second tubes for connection to respective ports on the pressure regulating means. 
     
     
         19 . The connection kit of  claim 17 , further including:
 a third tube for connection between a proximally arranged pressure chamber on the trocar and a pressurized fluid supply.   
     
     
         20 . The connection kit of  claim 19 , further including:
 a fourth tube for connection to the proximally arranged pressure chamber and a recycling means for removal of fluid from the chamber.   
     
     
         21 . The connection kit of  claim 18 , further comprising a reservoir for connection between the fluid supply port on the pressure regulating means and the first tube.