WO2010041900A2

Movatterモバイル変換

Info

Publication number: WO2010041900A2
Application number: PCT/KR2009/005795
Authority: WO
Inventors: Chang Wook Jeong
Original assignee: Chang Wook Jeong
Priority date: 2008-10-10
Filing date: 2009-10-09
Publication date: 2010-04-15
Also published as: WO2010041900A3; KR20100040633A

Abstract

The present invention relates to port and port assembly for use with an easy-to-control tool for minimally invasive surgery or a surgical robotic system that adopts the principles of the tool for minimally invasive surgery, and a method of using the same.

Description

PORT AND PORT ASSEMBLY FOR USE WITH TOOL FOR MINIMALLY INVASIVE SURGERY, AND METHOD OF USING SAME PORT AND PORT ASSEMBLY

Minimally invasive surgery is a surgical approach that involves use of instruments inserted through several tiny incision openings to perform a surgery causing minimal tissue trauma.

This minimally invasive surgery relatively reduces changes in metabolism of the patient in the period of post-surgical care, so it is beneficial to rapid recovery of the patient. Therefore, using such minimally invasive surgery shortens length of a hospital stay of the patient after the surgery and allows patients to return to normal physical activities more quickly. In addition, minimally invasive surgery causes less pain and reduces scar to patients after surgery.

The most general form of the minimally invasive surgery is endoscopy. Among them, a laparoscopy that involves minimally-invasive inspection and operation inside abdominal cavity is known as the most general form of endoscopy. To operate the standard laparoscopic surgery, an abdomen of the patient is insufflated with gas, and small incisions (about 1/2 inch or less) are formed for use as an entrance of a tool for the laparoscopic surgery, through which a trocar is inserted. In general, laparoscopic surgical tools include a laparoscope (for observation of a surgical site) and other working tools. Here, the working tools are similar in structure to the conventional tools used for small incision surgery, except that the end effector or working end of each tool is separated from its handle by an elongated shaft. For instance, working tools may include a clamp, a grasper, scissors, a stapler, needle holder, and so forth. To perform the surgery, a user, such as a surgeon, puts the working tool into a surgical site through the trocar, and manipulates it from the outside of abdominal cavity. Then, the surgeon monitors the procedure of the surgery through a monitor that displays the image of the surgical site that is taken by the laparoscope. The endoscopic approach similar to this is broadly used in retroperitoneoscopy, pelviscopy, arthroscopy, cisternoscopy, sinuscopy, hysteroscopy, nephroscopy, cystoscopy, urethroscopy, pyeloscopy, and so on.

Although this minimally invasive surgery has a number of advantages, it has shortcomings in the difficulty of approaching the conventional minimally invasive surgical tools to a surgical site and the inconvenient or complicate manipulation of such tools because of an end effector connected to a rigid and long shaft. As attempts to solve the above problems, the present inventor has devised a novel tool for minimally invasive surgery as described in Korean Patent Application Nos. 2008-51248, 2008-61894, 2008-79126 and 2008-90560 filed prior to this application, the contents of which are herein incorporated by reference in their entirety.

In particular, among these applications, the minimally invasive surgical tools disclosed in Korean Patent Application Nos. 2008-79126 and 2008-90560 are very useful in a case where only a single incision is formed in a patient's body to perform surgery. Accordingly, the inventor devised a port for use with the minimally invasive surgical tool described in at least one of the prior applications or with a surgical robotic system which adopts the principles of the tool.

The present invention is directed to solve all of the problems mentioned above.

It is, therefore, an object of the present invention to provide a port suitable for use with a tool for carrying out a minimally invasive surgery in a dexterous and convenient manner with the least number of incisions in a patient's body, most preferably, with only one incision.

As described above, the present invention provides the port suitable for use with a tool for carrying out a minimally invasive surgery in a dexterous and convenient manner with the least number of incisions in a patient's body, most preferably, with only one incision. By the combination use of the two, minimally invasive surgery causes less pain, reduces scar to patients during or after surgery, and shortens length of a hospital stay of the patient after the surgery.

The above and other objects and features of the present invention will become apparent from the following description of preferred embodiments, given in conjunction with the accompanying drawings, in which:

Fig. 1 is a perspective view showing the outer appearance of aport 100 in accordance with a first embodiment of the present invention;

Fig. 2 is a perspective view showing the configuration of amain body 200 in accordance with the first embodiment of the present invention, and Figs. 3 and 4 are a front through view and a top through view of themain body 200 in accordance with the first embodiment of the present invention;

Fig. 5 is a perspective view showing the configuration of a cannulainsert part 300 in accordance with the first embodiment of the present invention, and Fig. 6 is a perspective view showing a state whereplugs 350cover cannulas 330 that constitute the cannulainsert part 300 in accordance with the first embodiment of the present invention;

Figs. 7, 8 and 9 respectively show a perspective view and a front through view showing the configuration of aplug 350 in accordance with the first embodiment of the present invention;

Figs. 10 and 11 show a perspective view showing an example of configurations to maintain a coupled state between themain body 200 and the cannula insertpart 300 in accordance with the first embodiment of the present invention;

Fig. 12 is a perspective view showing another example of configurations to maintain a coupled state between themain body 200 and the cannula insertpart 300 in accordance with the first embodiment of the present invention;

Figs. 13 and 14 show a perspective view showing still another example of configurations to maintain a coupled state between themain body 200 and the cannula insertpart 300 in accordance with the first embodiment of the present invention;

Figs. 15 and 16 show a perspective view showing an example of configurations ofmain body 200 andobturator 400 in accordance with the first embodiment of the present invention;

Figs. 17, 18 and 19 are a perspective view showing a state where a plurality of obturators used for the present invention is inserted into themain bodies 200, respectively;

Figs. 20 and 21 show a state where aninsert port 100 in accordance with the first embodiment of the present invention is inserted into a patient s abdominal wall and secured with suture;

Fig. 22 shows an example of how a minimally invasive surgical tool 1 and anendoscope 2 are inserted throughcannulas 330 in accordance with the first embodiment of the present invention;

Fig. 23 shows another example of how a minimally invasive surgical tool 1 and anendoscope 2 are inserted throughcannulas 330 in accordance with the first embodiment of the present invention;

Fig. 24 is a perspective view showing the configuration of aninsert port 100A in accordance with a second embodiment of the present invention;

Fig. 25 is a perspective view showing the configuration of acannula insert part 300A used for theinsert port 100A in accordance with the second embodiment of the present invention;

Figs. 26 and 27 show a perspective view and a front through view showing the configuration of the cannula insertpart 300A in accordance with the second embodiment of the present invention, respectively;

Fig. 28 is a perspective view showing the configuration of aninsert port 100B in accordance with a third embodiment of the present invention;

Fig. 29 is a perspective view showing the configuration of a cannulainsert part 300B in accordance with the third embodiment of the present invention; and

Figs. 30 and 31 show a perspective view and a side view showing a state where minimally invasive surgical tools 1 and anendoscope 2 are inserted and operated through aninsert port 100A in accordance with the second embodiment of the present invention, respectively.

In accordance with one aspect of the present invention, there is provided a port for minimally invasive surgery comprising, a main body, and a cannula insert part positioned in the main body, having an insert main body and a plurality of cannulas, wherein at least two cannulas of the plurality of cannulas are substantially parallel to each other.

In accordance with another aspect of the present invention, there is provided a method for using the above port for minimally invasive surgery comprising, inserting at least one tool for minimally invasive surgery through at least one of the plurality of cannulas, and inserting at least another tool for minimally invasive surgery through at least another cannula.

In accordance with yet another aspect of the present invention, there is provided a method for using the above port for minimally invasive surgery comprising, inserting an endoscope through the at least one cannula inclined at a predetermined angle, and inserting a tool for minimally invasive surgery through one of the two cannulas substantially parallel to each other.

In the following detailed description, reference is made to the accompanying drawings that show, by way of illustration, specific embodiments in which the invention may be practiced. These embodiments are described in sufficient detail to enable those skilled in the art to practice the invention. It is to be understood that the various embodiments of the invention, although different, are not necessarily mutually exclusive. The following detailed description is, therefore, not to be taken in a limiting sense, and the scope of the present invention is defined only by the appended claims that should be appropriately interpreted along with the full range of equivalents to which the claims are entitled. In the drawings, like reference numerals identify similar or like elements through the several views.

Hereinafter, preferred embodiments of the present invention will be explained in detail with reference to the accompanying drawing so that the invention can easily be carried out by those skilled in the art.

Embodiment I

Fig. 1 is a perspective view showing the outer appearance of a port 100 (hereinafter, referred to as an "insert port" or simply "port") in accordance with a first embodiment of the present invention.

As shown in Fig. 1, theinsert port 100 in accordance with the first embodiment of the present invention has a barrel shape of predetermined diameter and length (it should be noted, however, that the shape of theinsert port 100 is not always limited to the barrel shape). Theinsert port 100 includes amain body 200 at least a portion of which is inserted into a patient's body, and a cannula insertpart 300 positioned in themain body 200, to which an endoscope, minimally invasive surgical tools, etc., are inserted. In some cases, theinsert port 100 may further include an obturator positioned inside themain body 200, for forming an incision, securing a path for inserting a surgical tool, protecting internal organs, and so on. More details on this will be provided below.

Fig. 2 is a perspective view showing the configuration of amain body 200 in accordance with the first embodiment of the present invention, and Figs. 3 and 4 are a front through view and a top through view of themain body 200 in accordance with the first embodiment of the present invention.

A plurality ofinsert corrugations 210 is protrusively formed at regular intervals, along the outer contour of themain body 200. As shown in Fig. 3, one cross section of theinsert corrugation 210 looks close to a right-angled triangle. This allows easy insertion of themain body 200 into a patient's body and for ensuring the insertedmain body 200 stay secure inside the patient's body.

Afirst insert groove 220 of a predetermined depth is formed inside themain body 200. Thefirst insert groove 220 is matched with an insert ring of the cannula insertpart 300 to be described later, thereby coupling themain body 200 to the cannula insertpart 300. Preferably, thefirst insert groove 220 and the insert ring are configured in a manner that once they are matched and coupled, they are not easily separated from each other.

In order to help themain body 200 stay inserted into an incision, a plurality of (preferably three)fixing rods 230 are protrusively attached to an upper end of themain body 200. The fixingrods 230 each have a fixinghole 232 at the tip, through which a suture thread is inserted to stitch each of the fixingroads 230 together with the epidermis of the body. In this way, themain body 200 and further, theinsert port 100 can be fixed.

Fig. 5 is a perspective view showing the configuration of thecannula insert part 300 in accordance with the first embodiment of the present invention, and Fig. 6 is a perspective view showing a state where plugs 350 cover cannulas that constitute thecannula insert part 300 in accordance with the first embodiment of the present invention. The following is a detailed explanation about the configuration of thecannula insert part 300 with reference with the drawings.

Aninsert ring 320 which is to be inserted into thefirst insert groove 220 mentioned above is formed on the outside of an insertmain body 310. This allows themain body 200 to couple to the insertmain body 310.

Also, a plurality ofcannulas 330 is positioned inside the insertmain body 310. Preferably, at least part of the plurality ofcannulas 330 that are arranged adjacent to or in contact with each other have their central axes substantially parallel to each other. Preferably, thecannulas 330 are sufficiently long for a surgical tool to insert into them and be in position stably.

Since all kinds of surgical tools, such as an endoscope or minimally invasive surgical tools, can be inserted into thecannulas 330, thecannulas 330 come in diverse sizes (diameters) to meet user's needs. Here, thecannulas 330 are preferably made of hard, non-bendable materials to continuously keep their straight barrel shape.

In addition, two ormore cannulas 330 are included in thecannula insert part 300. Preferably, the number ofcannulas 330 ranges 3 to 5. Figs. 5 and 6 illustrate threecannulas 330 in a bundle.

Meanwhile, after thecannula insert part 300 is placed inside themain body 200, it is desirable to secure thecannula insert part 300 to thebody 200 to keep the state. Also, in order to prevent inflow or outflow of gas into or from a patient's body for minimally invasive surgery, thecannulas 330 are coupled to the insertmain body 310 in an airtight manner. For example, the plurality ofcannulas 330 covered withplugs 350 to be described later is positioned inside the insertmain body 310 for theinsert port 100 to stay in airtight state. To be more specific, the plurality ofcannulas 330 is positioned inside the insertmain body 310 in a manner that there is no gap between them and the bottom of the insertmain body 310.

At least onecannula 330 out of the plurality ofcannulas 330 is provided with agas supply pipe 340. Thegas supply pipe 340 has acock valve 342 to control an inflow/outflow of gas. More details on this will follow.

As depicted in Fig. 6, each of theplural cannulas 330 is covered by aplug 350 such that gas cannot flow in or flow out through the cannulas having no surgical tool being inserted thereto and foreign matters cannot get into a patient's body either. More details on the configuration of the plug will be given below.

Referring now to Figs. 7, 8 and 9, theplug 350 coverscannula 330, closing one end of thecannula 330. Preferably, theplug 350 is made of flexible materials in double layer to let an endoscope or minimally invasive surgical tools go through it. Aslit 352 is formed on each layer of theplug 350 in non-parallel directions (preferably, perpendicular to each other). Preferably, theplug 350 is made of silicon materials excellent in resilience and restoring force. The silicon plugs 350 prevent the inflow/outflow of gas and the intrusion of foreign matters through thecannulas 330 and facilitate the insertion of any kind of surgical tools through thecannulas 330. If necessary, a person skilled in the art may adopt a different gas inflow/outflow prevention mechanism besides theplug 350.

Thecannula insert part 300 in accordance with this embodiment may further adopt the following configuration.

While a user conducts surgery, thecannula insert part 300 may rotate inside themain body 200. That is to say, although thecannula insert part 300 is closely coupled to the inside of themain body 200, if an external force that is not quite small is continuously applied, it may rotate. Depending on the type of surgery, it may not be always desirable to make thecannula insert part 300 rotate about themain body 200. To prevent this occurrence if necessary, as shown in Figs. 10 and 11, alinear protrusion 360 may be formed in the outer face of the insertmain body 310. Preferably, thelinear protrusion 360 is formed over theinsert ring 320. Correspondingly, alinear groove 240 may be formed on the inside of themain body 200 to receive thelinear protrusion 360. As thelinear protrusion 360 is fitted into thelinear groove 240, thecannula insert part 300 will not rotate unnecessarily.

A configuration to maintain the coupled state between thecannula insert part 300 and themain body 200 may be an example as shown in Fig. 12. That is, asecond insert groove 322 may be formed on the outer face of an insertmain body 310 and a fixingring 324 made of resilient materials is fitted into thesecond insert groove 322. Thus, when the insertmain body 310 is inserted into themain body 200, the fixingring 324 is inserted into thefirst insert groove 220 and thesecond insert groove 322 at the same time, thereby more easily achieving a strong fixation of thecannula insert part 300. Here, thecannula insert part 300 may further include aswitch 370 for controlling the restoring force of the fixingring 324. Thefirst insert groove 220 into which thefixing ring 324 is inserted has a sectional configuration to ensure that the fixingring 324 is not slipped out accidently after insertion. For example, thefirst insert groove 220 may have an edged or rounded cross section.

In order to help thecannula insert part 300 stay coupled to themain body 200, as depicted in Figs. 13 and 14, a plurality ofsupport rods 380 are protrusively formed on the outer face of thecannula insert part 300, and "L" shaped fixinggrooves 250 are formed in themain body 200 to receive thesupport rods 380. In this case, the fixinggrooves 250 may take any shape as long as thesupport rods 380 are safely seated therein.

Meanwhile, anobturator 400 may be inserted into themain body 200. As illustrated in Figs. 15 and 16, theobturator 400 is insertedly fixed into themain body 200. The fixation principle or mechanism is substantially the same as above.

Figs. 17. 18 and 19 show a state where a plurality ofobturators 400 in accordance with the present invention is inserted into themain bodies 200, respectively. As shown, the end portion of theobturator 400 may be rounded (Fig. 17) or edged (Fig. 18), or may include a blade 430 (Fig. 19).

Theinsert port 100 having the above-described configuration in accordance with the first embodiment of the present invention is basically used as follows.

First, a user inserts theobturator 400, as shown in Fig. 15, into themain body 200, and fits the fixingring 420 of theobturator 400 into thefirst insert groove 220 on the inside of themain body 200. In this manner, as depicted in Fig. 16, theobturator 400 is fixed on themain body 200.

Next, the user inserts theobturator 400 being fixed on themain body 200 into an incision the user has formed by using a scalpel or the like. And then, the user separates theobturator 400 from themain body 200. After that, the user inserts thecannula insert part 300 into themain body 200. In result, theinsert ring 320 of the insertmain body 310 is fitted into thefirst insert groove 220 on the inside of themain body 200, thus allowing thecannula insert part 300 to fix or couple to themain body 200.

In the course of the above, the user may anchor themain body 200 to a patient's body, using suture. Fig. 20 and Fig. 21 well illustrate a state where theinsert part 100 in accordance with the first embodiment of the present invention is inserted into a patient's abdominal wall and secured with suture.

Next, the user inserts minimally invasive surgical tools 1 or anendoscope 2 as shown in Fig. 22 through thecannulas 330 of thecannula insert part 300 to conduct surgery (as shown in the drawing, the minimally invasive surgical tools 1 are preferably positioned in symmetric with each other). As shown in Fig. 22, when two or more minimally invasive surgical tools 1 are used, they are preferably inserted through thecannulas 330 which are positioned substantially in parallel with each other. By nature of the minimally invasive surgery, in the state shown in Fig. 21, it may need to open thecock valve 342 provided to thegas supply pipe 340 to insufflate gas into a patient's body and to close thecock valve 342 if the insufflation of a required amount of gas is complete. This operation may also be need during surgery.

The plurality of cannulas 330 (especially thecannulas 330 into which the minimally invasive surgical tools 1 are inserted) are positioned with their central axes substantially parallel to each other, so the user may conduct surgery using an endoscope in 0 to 5 degree direction of view.

Depending on the type of surgery, it can be more useful to obtain images that are taken at an angle by theendoscope 2. In this case, as shown in Fig. 23, a light-receiving lens of theendoscope 2 may crook at a predetermined angle to help the user conduct surgery more conveniently. As theendoscope 2 suitable for the present invention, any of endoscopes that are bent at diverse angles such as a joint which are described in the previously-filed Korean Patent Application Nos. 2008-51248, 2008-61894, 2008-79126 and 2008-90560, or any of freely bending flexible endoscopes can be used.

Embodiment II

Fig. 24 is a perspective view showing the configuration of aninsert port 100A in accordance with a second embodiment of the present invention, and Fig. 25 is a perspective view showing the configuration of acannula insert part 300A used for theinsert port 100A in accordance with the second embodiment of the present invention.

Theinsert port 100A and thecannula insert part 300A in accordance with the second embodiment of the present invention have many similarities with the configuration in accordance with the first embodiment of the present invention, so configuration, positions, etc. of individual elements thereof will be omitted here.

However, in accordance with this embodiment, as shown in Figs. 24 and 25, one ofplural cannulas 330A included in thecannula insert part 300A is inclined at a predetermined angle to theother cannulas 330A. Here, the predetermined angle is about 15 degrees. It should be noted that although any of theplural cannulas 330A arranged in a bundle may be tilted as mentioned above, theother cannulas 330A should be positioned on both sides of theinclined cannula 330A.

As noted above, theinclined cannula 330A may be used in many applications, but it is particularly useful for receiving an endoscope that needs to be positioned for the user's eye direction. Figs. 26 and 27 are a perspective view and a front through view showing the configuration of thecannula insert part 300A in accordance with the second embodiment of the present invention, respectively.

According to the views shown in Figs. 24 to 27, it can be seen that agas supply pipe 340A may be connected directly to the bottom of an insertmain body 310A, instead of being attached to thecannula 330A as in the first embodiment. The position and the configuration of thegas supply pipe 340A may not be limited thereto, but can be modified as desired.

Figs. 30 and 31 are provided for further description in relation to this embodiment. Fig. 30 is a perspective view showing a state where minimally invasive surgical tools 1 and anendoscope 2 are inserted and operated through theinsert port 100A in accordance with the second embodiment of the present invention, and Fig. 31 is a side view of Fig. 30.

As shown, theendoscope 2 can be inserted through thecannula 330A this is inclined at a predetermined angle. Since theendoscope 2 itself has approximately 30 degree direction of view, the user uses theinsert port 100A of the second embodiment of the present invention to thus observe an operation field of a patient almost equally to a case where he or she watches it directly with his or her eyes.

Preferably, theendoscope 2 used for this embodiment may be a rigid endoscope, and the inclination angle of thecannula 330A to theother cannulas 330A or the angle of theendoscope 2 itself may vary depending on user's needs.

Embodiment III

A third embodiment of the present invention will now be explained with reference to Figs. 28 and 29.

Figs. 28 and 29 respectively show perspective views illustrating the configuration of aninsert port 100B and the configuration of acannula insert part 300B, in accordance with the third embodiment of the present invention.

Theinsert port 100B and thecannula insert part 300B in accordance with the third embodiment of the present invention have many similarities with the configuration in accordance with the first embodiment of the present invention, so configuration, positions, etc. of individual elements thereof will be omitted here.

In accordance with this embodiment, as shown in Figs. 28 and 29, thecannula insert part 300B may further includeauxiliary cannulas 332B. Theauxiliary cannulas 332B may be used for an assistant of the user to insert other surgical tools that are different from ones the main user operates and push aside retracting organ(s) or tissue(s) during surgery, or to do other things to help the surgery go smoothly.

Although twoauxiliary cannulas 332B are illustrated, this is for illustrative purposes only. Theauxiliary cannulas 332B are preferably closed byplugs 350 to prevent the undesired inflow or outflow of gas. In addition, Figs. 28 and 29 illustrate that theauxiliary cannulas 332B are smaller in diameter than thecannulas 330B, but the diameter of theauxiliary cannulas 332B may vary depending on needs. Moreover, during actual surgery, thecannulas 330B and theauxiliary cannulas 332B may be undistinguishably used by the main user and the assistant of the user.

While the present invention has been described with respect to certain preferred embodiments, it will be apparent to those skilled in the art that various changes and modifications may be made without departing from the scope of the invention as defined in the following claims.

Claims

Port for minimally invasive surgery comprising,
a main body, and
a cannula insert part positioned in the main body, having an insert main body and a plurality of cannulas,
wherein at least two cannulas of the plurality of cannulas are substantially parallel to each other.
The port as claimed in claim 1, wherein at least one of the plurality of cannulas is inclined at a predetermined angle to the at least two cannulas substantially parallel to each other.
The port as claimed in claim 2, wherein the at least one cannula inclined at a predetermined angle is positioned between the at least two cannulas substantially parallel to each other.
The port as claimed in claim 1, wherein the plurality of cannulas are coupled to the insert main body in an airtight manner.
The port as claimed in claim 1, further comprising at least one gas supply pipe.
The port as claimed in claim 5, wherein the at least one gas supply pipe is connected to at least one of the plurality of cannulas.
The port as claimed in claim 5, wherein the at least one gas supply pipe is independent of the plurality of cannulas.
The port as claimed in claim 1, further comprising a plurality of plugs for closing each one end of the plurality of cannulas,
wherein each of the plurality of plugs comprises at least one slit,
wherein at least a portion of the plurality of plugs comprise at least two slits that are not parallel to each other.
The port as claimed in claim 1, wherein the main body is coupled to the insert main body, and at least part of the coupling is achieved by a rotation prevention element comprised in the main body and/or the insert main body.
The port as claimed in claim 9, wherein the rotation prevention element comprises at least one groove and at least one protrusion.
The port as claimed in claim 9, wherein the rotation prevention element comprises at least one fixing groove and at least one supporting rod.
Port assembly for minimally invasive surgery comprising,
the port for minimally invasive surgery as claimed in any of claims 1 to 11, and
at least one obturator,
wherein the at least one obturator is configured to be coupled to the main body.
Method for using the port for minimally invasive surgery as claimed in claim 1, comprising,
inserting at least one tool for minimally invasive surgery through at least one of the plurality of cannulas, and
inserting at least another tool for minimally invasive surgery through at least another cannula.
Method for using the port for minimally invasive surgery as claimed in claim 2, comprising,
inserting an endoscope through the at least one cannula inclined at a predetermined angle, and inserting a tool for minimally invasive surgery through one of the two cannulas substantially parallel to each other.