Trocars and Veress-type needles with illuminated guidance and safety features
The present disclosure provides devices and methods for insufflating abdomens of subjects under direct visualization. Such devices and methods, in some implementations, include features for cleaning the devices, and certain implementations of the methods permit procedures wherein it is not necessary to use a typical obturator to place a cannula, resulting in safer procedures.
1. A surgical instrument, comprising:
a distal outer assembly including a distal housing having a hollow distally extending needle extending distally therefrom, the hollow distally extending needle having a distal end and a proximal end, wherein the distal outer assembly forms a passageway to pass at least one of fluid and instruments therethrough;
a visualization stylet assembly at least partially disposed within the passageway of the distal outer assembly, the visualization stylet assembly being removably coupled to the distal outer assembly, the visualization stylet assembly including:
an elongate body having a proximal end and a distal end;
an electronic photodetector chip mounted proximate the distal end of the elongate body, the electronic photodetector chip having a distally facing surface to detect incoming light traveling along a proximal direction;
a light source at least partially integrated into the elongate body to project light beyond the electronic photodetector chip in a distal direction to provide direct illumination; and
a sleeve slidably disposed about at least a distal tip region of the removable visualization stylet assembly, the sleeve including a lens element disposed at a distal end thereof to direct light through the lens element toward the electronic photodetector chip, wherein at least a portion of the sleeve extends proximally through the hollow distally extending needle and terminates in a location proximal to the proximal end of the hollow distally extending needle, and further wherein the distal outer assembly and the removable visualization stylet assembly can be decoupled to permit removal of the sleeve after the hollow distally extending needle has been introduced into a patient.
2. The surgical instrument of claim 1 , wherein the visualization stylet assembly further includes a connector body disposed concentrically about a proximal region of the elongate body, the connector body including a distally facing connector to removably couple to a handle portion of the sleeve.
3. The surgical instrument of claim 1 , wherein the visualization stylet assembly further includes a connector body disposed concentrically about a proximal region of the elongate body, the connector body including a distally facing connector to removably couple to a handle portion of the sleeve, the connector body being received at least partially within the proximal housing of the surgical instrument.
4. The surgical instrument of claim 3 , wherein the handle portion of the sleeve includes a female locking member that is received by a male locking member of the connector body to permit the sleeve to be selectively decoupled from the visualization stylet assembly to expose the electronic photodetector chip.
5. The surgical instrument of claim 4 , wherein the proximal housing defines a distally extending boss to be sealingly received by the distal outer assembly, and further wherein the distally extending boss is surrounded by a fluid tight seal to interface with an inwardly facing surface of the distal outer assembly.
6. The surgical instrument of claim 5 , wherein the distal outer assembly further includes a guide tube disposed within the passageway of the distal outer body to guide the visualization stylet assembly into the hollow distally extending needle.
7. The surgical instrument of claim 6 , wherein the visualization stylet assembly further includes a heat sink at least partially disposed within the proximal housing to dissipate heat generated by the surgical instrument.
8. The surgical instrument of claim 7 , wherein the proximal housing defines a proximal cavity in which the elongate body of the visualization stylet assembly terminates at the proximal end of the elongate body, and further wherein at least one cable extends from the proximal end of the elongate body through the proximal cavity, through the heat sink, and to a connector located within a proximal cap of the proximal housing.
9. The surgical instrument of claim 7 , wherein the heat sink includes a proximal end, a distal end and defines a bore at least partially therethrough, and further wherein a LED chip is mounted at least partially within the bore of the heat sink, the LED chip including a distally facing LED to direct light into the visualization stylet to provide forward illumination.
10. The surgical instrument of claim 1 , wherein the distal housing includes a flush port operably coupled thereto, the flush port being configured to direct a liquid from a source of liquid through the flush port, into the housing and through the hollow distally extending needle.
11. A method comprising providing a device according to claim 10 , operably coupling the flush port to the source of liquid, and directing liquid from the liquid source through the hollow distally extending needle into an anatomical region of a patient.
12. The surgical instrument of claim 1 , wherein the lens element includes at least one edge for dissecting tissue.
13. The device of claim 12 , wherein the at least one edge includes at least one fin.
14. The device of claim 12 , wherein the at least one edge includes a plurality of fins.
15. A method comprising providing a device according to claim 1 , introducing the hollow distally extending needle into an anatomical region of a patient, and inspecting at least one anatomical feature inside the patient using the visualization stylet.
16. The method of claim 15 , further comprising withdrawing the visualization stylet assembly and from the hollow distally extending needle, removing the sleeve from the visualization stylet assembly, and introducing the visualization stylet assembly through the hollow distally extending needle into the anatomical region of the patient.
17. The method of claim 15 , further comprising insufflating the peritoneum, wherein the at least one anatomical feature resides within the peritoneum.
18. The surgical instrument of claim 1 , wherein the lens element includes an atraumatic distal tip.
19. The surgical instrument of claim 1 , further comprising at least one cable extending proximally from a proximal end of the visualization stylet assembly.
20. The surgical instrument of claim 19 , further comprising a strain relief operably coupled to the proximal end of the visualization stylet assembly to provide a transition in stiffness for the at least one cable.