Bladeless optical obturator
The invention is directed to a bladeless trocar obturator to separate or divaricate body tissue during insertion through a body wall. In one aspect, the obturator of the invention comprises a shaft extending along an axis between a proximal end and a distal end; and a bladeless tip disposed at the distal end of the shaft and having a generally tapered configuration with an outer surface, the outer surface extending distally to a blunt point with a pair of side sections having a common shape and being separated by at least one intermediate section, wherein each of the side sections extends from the blunt point radially outwardly with progressive positions proximally along the axis, and the shaft is sized and configured to receive an optical instrument having a distal end to receive an image of the body tissue. With this aspect, the tapered configuration facilitates separation of different layers of the body tissue and provides proper alignment of the tip between the layers. The side sections include a distal portion and a proximal portion, the distal portion of the side sections being twisted radially with respect to the proximal portion of the side sections. The intermediate section includes a distal portion and a proximal portion, the distal portion of the intermediate section being twisted in a first radial direction and the proximal portion of the intermediate section being twisted in a second radial direction opposite the first radial direction.
1. A surgical access device comprising:
an obturator comprising:
an elongate shaft extending along a longitudinal axis between a proximal end and a distal end; the elongate shaft defining a first lumen and having an opening at the proximal end; the first lumen being sized and configured to receive an optical instrument; and
a transparent distal tip disposed at the distal end of the elongate shaft; at least part of the distal tip having a generally tapered configuration and an outer surface adapted for penetrating tissue;
wherein the distal end of the distal tip defines a circle in a cross-section of the distal tip taken perpendicular to the longitudinal axis; and the distal tip defines a rounded rectangle in a cross-section of the distal tip taken perpendicular to the longitudinal axis at a location proximal to the circle; wherein the rounded rectangle becomes more circular with progressive proximal positions along the longitudinal axis of the distal tip.
2. The surgical access device of claim 1 wherein the rounded rectangle becomes more circular with progressive proximal positions along the longitudinal axis of the distal tip such that the rectangle widens and the long sides of the rectangle become more arcuate.
3. The surgical access device of claim 1 wherein the distal tip is blunt.
4. The surgical access device of claim 1 wherein the distal tip is configured for separating tissue.
5. The surgical access device of claim 1 wherein the circle expands to have an increasing circular area with progressive proximal positions along the longitudinal axis.
6. The surgical access device of claim 1 wherein, with progressing proximal positions along the longitudinal axis, the circle expands with increasing circular area and the rectangle widens with a reduction in the ratio of length to width.
7. The surgical access device of claim 1 wherein
the tip has an inner surface with the outer surface extending distally to a point and the inner surface forming a hollow chamber in the tip; and
wherein the optical instrument has a distal end to receive an image of the body tissue and the tip is adapted to permit passage of an image.
8. The surgical access device of claim 7 wherein the tip includes a ledge at the inner surface of the tip configured to engage the distal end of the optical instrument.
9. The surgical access device of claim 7 including a cutout section in the tip that enables direct visualization of the body tissue through the cutout section by an optical instrument having an angled lens inserted inside the lumen of the obturator such that the angled lens is spaced proximally a distance from the tissue penetrating portion of the tip.
10. The surgical access device of claim 7 wherein the tip includes a bulbous section to accommodate the distal end of an optical instrument with an angled lens.
11. The surgical access device of claim 7 further including a lock disposed at the proximal end of the shaft configured to prevent an optical instrument inserted into the lumen from moving axially relative to the shaft while allowing the optical instrument to rotate freely inside the shaft.
12. The surgical access device of claim 11 wherein the lock includes an elastomeric element.
13. The surgical access device of claim 12 wherein the elastomeric element has an inner diameter that is smaller than an outside diameter of the optical instrument and in direct contact with the optical instrument when inserted in the lumen and frictionally engaging the optical instrument.
14. The surgical access device of claim 7 further including an obturator cap connected to the proximal end of the obturator; and
a trocar having a central lumen and configured receive the obturator within the central lumen; the obturator cap being configured to removably attach to the proximal end of the trocar.
15. The surgical access device of claim 7 further including a lock disposed at the proximal end of the shaft configured to prevent an optical instrument inserted into the lumen from moving axially relative to the shaft.
16. The surgical access device of claim 1 wherein the distal tip includes an imaging element and a light within the tip to illuminate tissue through the transparent tip.
17. The surgical access device of claim 1 further including a lock disposed at the proximal end of the elongate shaft configured to prevent an optical instrument inserted into the first lumen from moving axially relative to the elongate shaft while allowing the optical instrument to rotate freely inside the elongate shaft.
18. The surgical access device of claim 1 further including an obturator cap connected to the proximal end of the obturator; and
a trocar having a central lumen and configured receive the obturator within the central lumen; the obturator cap being configured to removably attach to the proximal end of the trocar.
19. The surgical access device of claim 18 further including a lock disposed at the proximal end of the shaft configured to prevent an optical instrument inserted into the lumen from moving axially relative to the shaft.
20. The surgical access device of claim 19 wherein the lock is made of elastomeric material and further comprises an optical instrument having an outside diameter, the elastomeric lock having an inner diameter smaller than the outside diameter of the optical instrument and in direct contact with the optical instrument when inserted in the first lumen and frictionally engaging the optical instrument.