First-entry trocar system
A surgical access system comprises a trocar, an insufflating optical obturator slidably insertable into the trocar, and a laparoscope slidably insertable into the obturator. A distal end of the obturator comprises a tip, at least a portion of which comprises a wall with a generally uniform thickness comprising a transparent material. At least one vent hole disposed at the obturator tip is fluidly connected to a gas flow channel defined by an interior surface of the obturator and the laparoscope, which is fluidly connected to an insufflation gas inlet disposed at a proximal end of the trocar. Improved optical characteristics of the trocar system permit precise and accurate visual placement thereof into a body cavity. Accordingly the access system is suitable as a first entry surgical access system. Embodiments of the trocar access are also useful for drug delivery, and/or for fluid and/or tissue aspiration.
1. A surgical access system comprising:
a trocar comprising a longitudinal axis, a proximal end, a distal end, an elongate cannula, and a seal assembly disposed at a proximal end of the cannula; and
an obturator slidably insertable into the proximal end of the cannula and through the seal assembly, the obturator comprising a longitudinal axis, a proximal end, a distal end, a tubular obturator shaft, a tapered obturator tip disposed at a distal end of the obturator shaft, at least one vent hole disposed on the obturator tip in fluid communication with a fluid inlet, and a handle disposed at a proximal end of the obturator shaft; the handle having a funneled entry disposed at a proximal end and a seal assembly disposed distally thereof, the seal assembly configured to seal with instruments of varying diameters and providing a zero seal in the absence of an instrument; the obturator tip having an inner surface that defines an inner contour and an outer surface that defines an outer contour with the obturator tip having a wall thickness defined between the inner surface and the outer surface; the obturator being sized and configured to receive a laparoscope;
wherein in transverse cross-section of the obturator tip, the obturator tip has a generally rectangular cross-section having two oppositely disposed first sides being longer than two oppositely disposed second sides, with the two oppositely disposed first sides being interconnected by the two oppositely disposed second sides; wherein the obturator is configured such that a gas flow channel is defined between the two oppositely disposed first sides of the obturator tip, the inner surface of the tip and an outer surface of a laparoscope inserted into the obturator.
2. The surgical access system of claim 1 wherein a cross-sectional area of the gas flow channel is at least about 1.6 mm 2 .
3. The surgical access system of claim 2 wherein a flow rate through the gas flow channel is at least about 3.5 L/min at an insufflator pressure of about 1.6-2 KPa.
4. The surgical access system of claim 2 , in transverse cross-section of the tip, the outer contour has a generally rectangular transverse cross-section which substantially matches the inner contour which also has a generally rectangular transverse cross-section.
5. The surgical access system of claim 2 wherein the wall thickness at the obturator tip is substantially uniform to reduce distortion of an image observed through the obturator tip.
6. The surgical access system of claim 2 wherein the two oppositely disposed first sides are outwardly curved.
7. The surgical access system of claim 2 wherein the two oppositely disposed second sides are straight.
8. The surgical access system of claim 2 wherein the two oppositely disposed second sides are straight and the two oppositely disposed first sides are outwardly curved.
9. The surgical access system of claim 2 further comprising a gas flow alarm configured to indicate that gas flow is blocked.
10. The surgical access system of claim 1 further comprising an audible indicator configured to indicate gas flowing through the gas flow channel.
11. The surgical access system of claim 10 wherein the audible indicator produces a sound by mechanically modulating the gas flow.
12. The surgical access system of claim 11 wherein the audible indicator is positioned within a stopcock Luer fitting connected to the seal assembly disposed at the proximal end of the cannula.
13. The surgical access system of claim 1 further comprising a laparoscope stop being elongate and parallel to and offset with the longitudinal axis of the obturator.
14. The surgical access system of claim 13 wherein the laparoscope stop is disposed within an interior surface of the obturator shaft and at the intersection of the obturator shaft and obturator tip.
15. The surgical access system of claim 14 wherein the laparoscope stop is for a 10 mm laparoscope.