Trocar tube, Trocar, Obturator and/or Rectoscope for the Transluminal Endoscopic Surgery Via Natural Body Orifices
A trocar tube, trocar, obturator, rectoscope is suitable for transluminal endoscopic surgery via natural body cavities. A trocar tube ( 2 ) has a distal section ( 22 ) for positioning at least in the region of or outside the body cavity, and a proximal section ( 21 ) for positioning within the human or animal, wherein at least the proximal section has a substantially rigid or inflexible curvature. An obturator ( 3 ) and a rectoscope ( 5 ) may be adapted for use with such a trocar tube for this purpose.
1 . A trocar tube for use in transluminal endoscopic surgery via a natural body orifice of a human or an animal, the trocar tube comprising:
a distal portion ( 22 ) to be positioned at least in the region of or outside the natural body orifice; and
a proximal portion ( 21 ) to be positioned within the human or animal, wherein:
at least the proximal portion ( 21 ) comprises at least partially an essentially non-deformable curvature.
2 . The trocar tube according to claim 1 , wherein the entire trocar tube ( 2 ) is essentially non-deformable.
3 . The trocar tube according to claim 1 , wherein the curvature of the proximal portion ( 21 ) is essentially constant and has a curvature radius at a middle axis of the proximal portion ( 21 ) of about 45-75 mm.
4 . The trocar tube according to claim 1 , wherein the trocar tube ( 2 ) has an inner diameter of about 2-22 mm over an at least substantial part of its entire length.
5 . The trocar tube according to claim 1 , wherein the trocar tube ( 2 ) has a wall thickness of about 0.2-2 mm over at least a substantial part of its entire length.
6 . The trocar tube according to claim 1 , wherein the trocar tube ( 2 ) has an entire length of about 230-400 mm.
7 . The trocar tube according to claim 1 , wherein the effective length of a straight section of the trocar tube is about 180-300 mm.
8 . The trocar tube according to claim 1 , wherein:
the proximal portion ( 21 ) has an absolute total deflection towards one side of about 15-18 mm; and/or
the maximum angle between a longitudinal axis of a non-bent section of the trocar tube and the longitudinal axis of the most bent proximal section is about 20-70°.
9 . The trocar tube according to claim 1 , wherein a free end ( 24 ) of the proximal portion ( 21 ) is tapered.
10 . The trocar tube according to claim 1 , wherein at least the proximal portion ( 21 ) has an essentially uniform cross-section that is oval or round.
11 . The trocar tube according to claim 1 , further comprising connection means ( 25 ) for the liquid-tight and/or gas-tight connection to a trocar head.
12 . The trocar tube according to claim 11 , wherein the connection means ( 25 ) is a radial bulging to enable elastic engagement behind said bulging in an interlocking manner.
13 . The trocar tube according to claim 1 , wherein the trocar tube ( 2 ) externally has markings for providing readings of the radial orientation and/or its inserted length.
14 . The trocar tube according to claim 1 , wherein the trocar tube ( 2 ) externally has at least one working channel.
15 . A trocar comprising:
a trocar tube ( 2 ) for use in the transluminal endoscopic surgery via a natural body orifice of a human or an animal, the trocar tube comprising: a distal portion ( 22 ) to be positioned at least in the region of or outside the natural body orifice and a proximal portion ( 21 ) to be positioned within the human or animal, wherein at least the proximal portion ( 21 ) comprises at least partially an essentially non-deformable curvature; and
a trocar head ( 1 ) connected to a proximal end of the trocar tube ( 2 ).
16 . The trocar according to claim 15 , wherein:
the trocar tube ( 2 ) and the trocar head ( 1 ) are connected to each other in a liquid-tight and/or gas-tight manner by providing a seal ( 4 ) in between.
17 . The trocar according to claim 15 , wherein:
the trocar tube ( 2 ) and the trocar head ( 1 ) are releasably connected to each other.
18 . The trocar according to claim 15 , wherein:
the trocar head ( 1 ) is provided with at least one gas-tight valve ( 12 ).
19 . The trocar according to claim 15 , wherein:
the trocar head ( 1 ) comprises at least one inlet and/or outlet for gas(es) and/or liquid(s).
20 . The trocar according to claim 15 , further comprising:
a trocar head body ( 13 ) for fixing the trocar to a holder or manipulator.
21 . A trocar tube ( 2 ) in combination with an obturator ( 3 ), wherein:
the trocar tube is for use in transluminal endoscopic surgery via a natural body orifice of a human or an animal, and comprises:
a distal portion ( 22 ) to be positioned at least in the region of or outside the natural body orifice; and
a proximal portion ( 21 ) to be positioned within the human or animal, wherein:
at least the proximal portion ( 21 ) comprises at least partially an essentially non-deformable curvature; and
the obturator comprises a shaft having at least one proximal section ( 32 ) made of a flexible and compressible material so that it can adapt to the curvature of the proximal portion ( 21 ) of the trocar tube ( 2 ) when being introduced thereinto, said at least one proximal section ( 32 ) configured to undergo essentially no compression upon being introduced into the trocar tube.
22 . The trocar tube ( 2 ) in combination with the obturator ( 3 ) according to claim 21 , wherein
the obturator ( 3 ) comprises a tip ( 31 ) having a taper corresponding to the taper of the free end ( 24 ) of the proximal portion ( 21 ) of the trocar tube ( 2 ) to facilitate piercing an intestinal wall.
23 . The trocar tube ( 2 ) in combination with the obturator ( 3 ) according to claim 21 , wherein:
the tip ( 31 ) of the obturator ( 3 ) has a maximum outer diameter of about 2-21 mm.
24 . The trocar tube ( 2 ) in combination with the obturator ( 3 ) according to claim 21 , wherein a shaft ( 32 ) of the obturator arranged behind the tip ( 31 ) of the obturator ( 3 ) has a maximum outer diameter of about 6-19 mm.
25 . The trocar tube ( 2 ) in combination with the obturator ( 3 ) according to claim 21 , wherein the obturator ( 3 ) comprises a guide channel ( 83 ) configured essentially along the axial direction of the obturator in order to guide the obturator along a guide wire.
26 . A system comprising:
a trocar comprising:
a trocar tube ( 2 ) for use in the transluminal endoscopic surgery via a natural body orifice of a human or an animal, the trocar tube comprising: a distal portion ( 22 ) to be positioned at least in the region of or outside the natural body orifice and a proximal portion ( 21 ) to be positioned within the human or animal, wherein at least the proximal portion ( 21 ) comprises at least partially an essentially non-deformable curvature; and
a trocar head ( 1 ) connected to a proximal end of the trocar tube ( 2 ); and
an obturator ( 3 ) configured to be received into the trocar tube ( 2 ) and comprising:
a tip ( 31 ) and shaft ( 33 ) having at least one proximal section ( 32 ) made of a flexible and compressible material so that it can adapt to the curvature of the proximal portion ( 21 ) of the trocar tube ( 2 ) when being introduced thereinto, said at least one proximal section ( 32 ) configured to undergo essentially no compression upon being introduced into the trocar tube;
wherein:
when the obturator occupies the trocar tube ( 2 ), the system has a length of about 280-420 mm.
27 . The system according to claim 26 , wherein:
the obturator ( 3 ) is attached to the trocar by a retaining member ( 70 ) which preloads the obturator into a withdrawn position in order that the tip ( 31 ) of the obturator rests in a protected region within the trocar.
28 . The system according to claim 27 , wherein:
the retaining member ( 70 ) comprises a spring mechanism having at least one spring ( 71 ) for preloading.
29 . A rectoscope ( 5 ) having incorporated therewith a trocar comprising:
a trocar tube ( 2 ) for use in the transluminal endoscopic surgery via a natural body orifice of a human or an animal, the trocar tube comprising: a distal portion ( 22 ) to be positioned at least in the region of or outside the natural body orifice and a proximal portion ( 21 ) to be positioned within the human or animal, wherein at least the proximal portion ( 21 ) comprises at least partially an essentially non-deformable curvature; and
a trocar head ( 1 ) connected to a proximal end of the trocar tube ( 2 ); wherein:
the rectoscope ( 5 ) comprises a port ( 55 ) into which the trocar is receivable, the port ( 55 ) being configured to enable a tilting movement of the trocar, a piercing of the intestinal wall, or both.
30 . The rectoscope ( 5 ) according to claim 29 , comprising:
a tube shaft ( 52 ) whose proximal end ( 51 ) comprises a chamfer and is aligned such that the chamfer further supports the tilting movement of the trocar.
31 . The rectoscope ( 5 ) according to claim 30 , wherein:
the chamfer of the proximal end ( 51 ) has an angle towards a middle axis ( 57 ) of the tube shaft of about 45°-80°.
32 . The rectoscope ( 5 ) according to claim 29 , comprising:
a tube shaft ( 52 ) and at least two different caps provided with a quick closure for distally closing the tube shaft ( 52 ) in a gas-tight manner.
33 . The rectoscope ( 5 ) according to claim 29 , having a length of about 150-250 mm.
34 . A set comprising at least two of the following elements:
(a) a trocar tube ( 2 ) comprising:
a distal portion ( 22 ) to be positioned at least in the region of or outside a natural body orifice of a human or an animal; and
a proximal portion ( 21 ) to be positioned within the human or animal, wherein:
at least the proximal portion ( 21 ) comprises at least partially an essentially non-deformable curvature;
(b) a trocar comprising the trocar tube and a trocar head;
(c) an obturator ( 3 ) receivable into the trocar tube; and
(d) a rectoscope ( 5 ) having a port ( 55 ) into which the trocar is receivable.
35 . A method for treatment and/or diagnosis of a human or an animal entailing transluminal endoscopic surgery via a natural body orifice of said human or animal, comprising the steps of:
introducing a taurolidine solution into the abdominal cavity of said human or animal;
putting said human or animal in an appropriate position in order to achieve the exposure of the rectosigmoidal transition; and
inserting at least one or more of the following into said natural body orifice with at least a portion extending past said rectosigmoidal transition:
(a) a trocar tube ( 2 ) comprising:
a distal portion ( 22 ) to be positioned at least in the region of or outside the body orifice; and
a proximal portion ( 21 ) to be positioned within the human or animal, wherein:
at least the proximal portion ( 21 ) comprises at least partially an essentially non-deformable curvature;
(b) a trocar comprising the trocar tube and a trocar head;
(c) an obturator ( 3 ) receivable into the trocar tube; and
(d) a rectoscope ( 5 ) having a port ( 55 ) into which the trocar is receivable.
36 . The method for treatment and/or diagnosis according to claim 35 , comprising the steps of:
(a) introducing the rectoscope ( 5 ) into the rectum;
(b) introducing an ultrasound probe ( 90 ) and a guide instrument ( 80 ) into the rectoscope;
(c) positioning a puncture needle with a guide wire at a desired site in the intestine by means of the guide instrument ( 80 );
(d) removing the guide instrument and the ultrasound probe ( 90 ) and introducing the trocar comprising the obturator for piercing the intestine.
37 . The method according to claim 36 , further comprising:
leaving the guide wire in the rectoscope after step (c); and
steering the obturator along the guide wire to the desired site in the intestine.