Laparoscopic instrument and trocar systems and related surgical method
Laparoscopic instruments and trocars are provided for performing laparoscopic procedures entirely through the umbilicus. A generally C-shaped trocar provides increased work space between the hands of the surgeon as well as S-shaped laparoscopic instruments placed through the trocar when laparoscopic instrument-trocar units are placed through the umbilicus. In order to facilitate retraction of intra-abdominal structures during a laparoscopic procedure, an angulated needle and thread with either one- or two sharp ends is provided. Alternatively, an inflatable unit having at least one generally C-shaped trocar incorporated within the unit's walls can be placed through the umbilicus following a single incision. Generally S-shaped laparoscopic instruments may be placed through the generally C-shaped trocars to facilitate access to intra-abdominal structures.
1. A trocar holder for holding multiple spaced-apart trocars comprising:
an upper plate;
a separate lower plate spaced from and disposed below the upper plate; and
an outer wall connected between the upper plate and the lower plate, the outer wall defining a cavity, a flexible distal portion of which forms a portion of the surgical site,
multiple spaced apart passageways independent of the outer wall and defined through the upper plate and the lower plate that are configured to enable multiple trocars to be disposed through the upper plate, and wherein at least one of the multiple trocars has a straight configuration,
wherein the upper and lower plates are configured such that the multiple trocars can move in relation to the outer wall, and
wherein the multiple trocars each have a proximal portion and a distal portion and wherein the proximal portion extends proximally of the upper plate.
2. The trocar holder as in claim 1 , wherein the at least one passageway is formed by resilient material.
3. The trocar holder as in claim 1 , wherein the outer wall is configured and dimensioned to be positioned at least partially within a surgical incision in a subject.
4. The trocar holder as in claim 3 , wherein the lower plate cooperates with the outer wall to seal the upper plate in position with respect to a surgical incision in the subject.
5. The trocar holder as in claim 4 , wherein the upper plate, the outer wall and the lower plate together define a working access for surgical instruments positioned in the multiple trocars.
6. The trocar holder as in claim 5 , wherein at least the outer wall is deformable between a first position for insertion into a surgical incision and a second position in sealing contact with the surgical incision.
7. The trocar holder as in claim 1 , wherein the trocar holder is configured such that the multiple trocars define spaced apart trocars and the at least one passageway enables the spaced apart multiple trocars to be inserted into the at least one passageway prior to insertion of the lower plate in a surgical incision of a subject.
8. The trocar holder as in claim 7 , wherein the trocar holder is configured such that the at least one passageway enables the spaced apart multiple trocars to be inserted into the at least one passageway after insertion of the lower plate in a surgical incision of a subject.
9. A trocar holder for holding multiple spaced-apart trocars comprising:
a flexible sleeve defining a portion of a surgical site, the flexible sleeve having a proximal portion and an open distal portion defining a cavity therein, the distal portion forming the portion of the surgical site;
an upper plate;
a separate lower plate spaced from and disposed below the upper plate; and
an outer wall connected between the upper plate and the lower plate,
at least one passageway defined by the upper plate, the lower plate and the outer wall, the trocar holder upper plate having multiple spaced-apart openings configured to enable multiple trocars to be disposed through the upper plate,
wherein at least one of the trocars has a straight configuration, and wherein the at least one of the trocars having a straight configuration is at least partially disposed, at the upper plate, through the at least one passageway,
wherein the upper and lower plates are configured such that the trocars can move in relation to the outer wall, and
wherein the trocars each have a proximal portion and a distal portion and wherein the proximal portion extends proximally of the upper plate.
10. The trocar holder as in claim 9 , wherein the at least one passageway is formed by resilient material.
11. The trocar holder as in claim 10 , wherein the at least one passageway extends from the upper plate to the lower plate.
12. The trocar holder as in claim 9 , wherein the outer wall is configured and dimensioned to be positioned within a surgical incision in a subject.
13. The trocar holder as in claim 12 , wherein the lower plate cooperates with the outer wall to seal the upper plate in position with respect to the surgical incision in the subject.