WO2019193410A1

WO2019193410A1 - Surgical apparatus

Info

Publication number: WO2019193410A1
Application number: PCT/IB2018/057001
Authority: WO
Inventors: Manish Gupta
Original assignee: Manish Gupta
Priority date: 2018-04-04
Filing date: 2018-09-13
Publication date: 2019-10-10

Abstract

A surgical apparatus for allowing easy access to incision is described. The surgical apparatus may include a first cylindrical portion (102) and a second cylindrical portion (104) each having two longitudinal edges. Further, the first cylindrical portion (102) and the second cylindrical portion (104) are hinged to each other to form a cylindrical passage for a surgical instrument to pass through when the longitudinal edges of the first cylindrical portion (102) and the second cylindrical portion (104) are in a closed configuration. The surgical apparatus (100) may also include head portions (106, 108) coupled to proximal end of the first cylindrical portion (102) and the second cylindrical portion (104). The head portions (106, 108) comprises a slit that extends in a direction perpendicular to the abutting longitudinal edges of the first cylindrical portion (102) and the second cylindrical portion (104).

Description

SURGICAL APPARATUS

TECHNICAL FIELD

[0001] The present subject matter, in general relates to surgical instruments.

BACKGROUND

[0002] It is generally desirable that surgical procedures may so performed such that there is minimal trauma. This may increase patient comfort, and may also ensure quicker and infection free recovery after the surgical procedure has been carried out. Present techniques and surgical devices are such that they intend to cause minimal incisions, to this end. During the course of the surgical procedure, the incision may have to kept open to provide a view for the medical practitioner and also to provide access to the site, which is to be operated upon. In such cases, certain apparatus referred to as retractors may be used.

[0003] Such retractors secure organic tissue as the incision is held open for providing access to the site to be operated. Certain type of retractors includes clamps or other prying means which hold portions of the tissue in order to keep the incision open. Such prying means may engage with portion of the tissue around the incision. As a result, the tissue around the incision may become sore and the patient being operated upon, may experience discomfort in the post-surgical period. Furthermore, such retractors to be functional may require long incision lengths, thereby increasing the trauma and also increasing the likelihood of patient discomfort. BRIEF DESCRIPTION OF THE DRAWINGS

[0004] The following detailed description references the drawings, wherein:

[0005] FIG. 1 is a front perspective view of an example surgical apparatus;

[0006] FIG. 2 is a top perspective view of an example surgical apparatus;

[0007] FIGS. 3(A)-(B) are top and bottom view of a surgical apparatus in a closed configuration, as per an example;

[0008] FIGS. 4(A)-(B) are front and rear views of a surgical apparatus in an open configuration, as per an example; and

[0009] FIGS. 5(A)-(B) are perspective and top views of a surgical apparatus in an open configuration, as per an example. [0010] Throughout the drawings, identical reference numbers designate similar, but not necessarily identical, elements. The figures are not necessarily to scale, and the size of some parts may be exaggerated to more clearly illustrate the example shown. Moreover, the drawings provide examples and/or implementations consistent with the description; however, the description is not limited to the examples and/or implementations provided in the drawings.

DETAILED DESCRIPTION

[0011] As described previously, various surgical apparatus may be used during surgical procedures. Certain types of apparatus may be used for providing access of other surgical devices for carrying out the desired surgical procedure. Any surgical procedure may require an incision to be made to the outer epidermal layer. Once the incision is made, a surgical apparatus may be used for maintaining the incision in an open configuration. The incision is to be maintained open so as to allow a medical practitioner access to a point beneath the skin tissue for performing the surgical procedure.

[0012] As explained previously, conventional surgical apparatus may include means which locally may secure portion of tissue through which an incision may have been made. During the surgical procedure, the incision may be maintained in an open configuration and the medical practitioner may utilize a variety of a surgical devices for performing surgery at the desired site. More specifically, the surgical apparatus provide a pathway which enables access of surgical devices to the desired site within an animal body. In such cases, the surgical apparatus may engage specifically with portions of the tissue, e.g., by using anchoring sutures, which may result in soreness and patient discomfort in the post-operative stage. Furthermore, conventionally existing surgical apparatus may require a long incision length for which again may not be desired for patient discomfort or for ensuring quicker healing of the surgical sight.

[0013] The present subject matter is for a surgical apparatus. The surgical apparatus overcomes the deficiencies and disadvantages of conventional surgical apparatus. For example, the surgical length needed by the present surgical apparatus is less thereby ensuring minimal trauma at the surgical sight, less patient discomfort post-surgery, and in turn ensuring quicker healing of the surgical wound. In one example, the surgical apparatus as claimed possesses a cylindrical profile. The claimed surgical apparatus provides a passageway which in turn facilitates insertion of a surgical device through an incision in an animal tissue. In one example, the surgical apparatus comprises of at least two portions, with each portion having a cylindrical profile. Each of the cylindrical portions further have two longitudinal edge which extends along the length of the surgical apparatus. The two cylindrical portions may further be coupled to each other at one of the longitudinal edges. In one example, the two cylindrical portion may be hinged with each other at the one of the longitudinal edges.

[0014] The two cylindrical portions, once hinged, may be moved with respect to each other in an open and closed configuration. When in a closed configuration, the two cylindrical portions form a cylindrical passage for a surgical instrument to pass through. The surgical apparatus may further include head portion coupled to one of the proximal end of the longitudinal edges of each of the cylindrical portions. In one example, head portion too has a cylindrical profile. When in a closed configuration, the head portions allow the surgical apparatus to be accommodated onto an incision such that the cylindrical portions may extend beneath the skin of an animal body, and is supported by the head portion. In one example, the head portions are to guide the surgical instrument through the cylindrical passage formed by the first cylindrical portion and the second cylindrical portion.

[0015] These and other examples of the surgical apparatus are described in conjunction with the FIGS. 1 -5. It should be noted that the present examples are not limiting and should not be construed as a preferred embodiment of implementing the present subject matter. Other embodiments or examples although not described herein, may also be covered within the scope of the pending claims.

[0016] FIG.1 illustrates a perspective view of a surgical apparatus 100 as per one example. The surgical apparatus 100 (referred to as apparatus 1 00) may be used for maintaining an incision in an open configuration during any surgical procedure to allow insertion of a surgical instrument. In one example, the surgical instrument may be a laparoscope and the apparatus 1 00 may be a cannula. The apparatus 100 may further include a first cylindrical portion 102 and a second cylindrical portion 104.

Both the first cylindrical portion 1 02 and the second cylindrical portion 104 are such that they possess semi-cylindrical profile. As per the illustrated example, each of the portions 102, 104 of the apparatus 100 may further include a respective head portions. For example, the first cylindrical portion 102 may be provided with a first head portion 1 06. In a similar manner, the second cylindrical portion 104 may include a second head portion 108. The first head portion 106 and the second head portion 108 are provided on one end of the respective first cylindrical portion 102 and the second cylindrical portion 1 04. The cross-sectional area of each of the first head portion 106 and the second head portion 108 are greater than the respective cross- sectional area of the first cylindrical portion 102 and the second cylindrical portion 104.

[0017] The first cylindrical portion 102 and the second cylindrical portion 104 may be coupled with each other. In the example as illustrated, the apparatus 100 may further include a coupling element 1 10. The coupling element 1 10 may be provided between the first head portion 106 and the second head portion 108 to affect the coupling between the first cylindrical portion 102 and the second cylindrical portion 104. The first cylindrical portion 102 and the second cylindrical portion 104 may move with respect to each about the hinge such that the apparatus 100 may be in either a closed configuration or in an open configuration. In the open configuration, the first cylindrical portion 102 and the second cylindrical portion 104 may be apart from each other. On the other hand, in the closed configuration, the first cylindrical portion 102 and the second cylindrical portion 1 04 may abut against each other such that the first cylindrical portion 102 and the second cylindrical portion 104 defined a cylindrical passage. The cylindrical passage thus formed may be used for accessing a spot through an incision, and for performing the desired surgical procedure. These and other aspects of the apparatus 100 are further described in detail, in conjunction with the other figures.

[0018] The surgical apparatus 100 may be made of metal, and/or alloy. In one example, the surgical apparatus 100 may be formed of stainless steel.

[0019] FIGS. 2(A)-2(C) provide illustrative views of the apparatus 100, as per other examples. For example, FIG. 2(A) provides a top perspective view of the apparatus 100 in a closed configuration. As per FIG. 2(A), the first cylindrical portion 102 along with the first head portion 106 may move about the coupling element 1 10 with respect to the second cylindrical portion 104 and the second head portion 108. In the closed configuration, the first cylindrical portion 1 02 may abut along one of its longitudinal edges as depicted by edges 202. Similarly, the second cylindrical portion 104 may abut along one of its longitudinal edge 204. The edges 202, 204 may extend along the length of the apparatus 100. Since the first head portion 106 and the second head portion 108 are integral to the first cylindrical portion 102 and the second cylindrical portion 104, respectively, the first head portion 106 and the second head portion 1 08 may come together about the edges 202, 204. In one example, the head portions 1 06, 108 may include a slit that may extend in a direction perpendicular to the abutting longitudinal edges of the first cylindrical portion 102 and the second cylindrical portion 104. Further, the head portions 106, 108 may include a clamping mechanism in the slit for clamping the first cylindrical portion 1 02 and the second cylindrical portion 104 so that the cylindrical shape is maintained when the longitudinal ends are in the closed configuration. As the first cylindrical portion 102 and the second cylindrical portion 104 (and in turn the first head portion 106 and the second head portion 108), abuts against each other at the edges 202, a cylindrical passage 206 may be formed as illustrated. Once in the closed configuration, the first cylindrical portion 102 and the second cylindrical portion 104 collectively form the cylindrical portion 208, whereas the first head portion 106 and the second head portion 108 form the head portion 210. In one example, the inner diameter of the cylindrical passage 206 may be about 0.5 centimetres. Other diameters may also be used without limiting the scope of the present subject matter.

[0020] When to be used, the apparatus 100 may be inserted into the incision. In one example, the cylindrical portion 208 of the apparatus 100 may be inserted into the incision first. In one example, a length of the first cylindrical portion 102 and the second cylindrical portion 104 may be of 2.5, 3.5 and 4.5 centimetres, and more. Further, the length may be kept such so as to traverse the depth of body fat and tissues to offer easy access to the site of surgery. As the cylindrical portion 208 is inserted, the tissue around the incision may be accommodated about the outer surface of the cylindrical portion 208. Owing to the cylindrical outer profile of the cylindrical portion 208, any urging forces maintaining the incision in an open configuration are distributed evenly about the outer profile. This may reduce the trauma and may enhance patient comfort. In another example, the profile of the cylindrical portion 208 may be slightly tapered to facilitate insertion of the apparatus 100.

[0021] FIGS. 3(A)-(B) depict the top and the bottom views, respectively, of the apparatus 100 in a closed configuration. As illustrated, the first cylindrical portion 102 and the second cylindrical portion 104 in the closed configuration to form the cylindrical portion 208. The cross-sectional area of the cylindrical portion 208 (as is visible in FIG. 3(B)), is less than the cross-section area of the head portion 21 0. In other words, the head portion of the cylindrical portion has a wider external diameter to allow the head portion of the cylinder to sit on the external surface of the incision. The cylindrical portion 208 of the apparatus 100 may be inserted into an incision. The apparatus 100, as it is inserted, may continue to be inserted till the head portion 210 contacts the skin layer onto which the incision was made. At this stage, the head portion 210 may rest on the skin layer at the mouth of the incision, providing the support for the apparatus 100.

[0022] FIGS. 4(A)-(B) depict the front and rear views of the apparatus 100, in an open configuration as per an example of the present subject matter. The apparatus 100 may be in an open configuration either prior to insertion into the incision or once a surgical device has been inserted into the incision for performing a desired surgical procedure. For example, once a surgical instrument is inserted through the cylindrical passage 206, the apparatus 100 may be gradually withdrawn from the incision. As the apparatus 100 is withdrawn, with portion of the surgical instrument yet present within the cylindrical passage 206, the apparatus 100 may be opened by moving the first cylindrical portion 102 and the second cylindrical portion 104 away with respect to each other. As a result, the first cylindrical portion 102 and the second cylindrical portion 104 may move about the coupling element 1 1 0, to assume the open configuration as represented by either of the FIGS. 4(A)-(B). Once the apparatus 1 00 is opened, it may be removed and the surgical procedure may be thus resumed.

[0023] FIGS. 5(A)-5(B) provide the perspective views of the apparatus 100, in the open configuration, as per yet another example of the present subject matter. In the example as depicted (specifically in FIG. 5(B)), when in an open position, a diametric axis of the each of the first head portion 106 and the second head portion 108 may be such that they can subtend a predefined range of angle with respect to each other. According to the illustrated aspect, first cylindrical portion 102 is fixed at the head portion 106 and the second cylindrical portion 104 is to swing by about 90-120 degrees on the non-hinged longitudinal edge with respect to the first cylindrical portion 102. For example, the diametric axis of the first head portion 106 may be represented by axis 502. Similarly, the diametric axis of the second head portion 108 may be represented by axis 504. In one example, in an open configuration, the angle formed between the axis 502 and 504 may be about 90° when the first head portion 106 and the second head portion 108 are the farthest apart. In another example, the angle formed between the axis 502 and 504 may form any obtuse or an acute angle. Example Embodiment

[0024] In the present example, the apparatus 100 has been utilized for performing total extra-peritoneal (TEP) repair of inguinal hernia. Although the present example has been described on conjunction with the present surgical procedure, any other surgical procedure may also be performed, without deviating from the scope of the claimed subject matter. Furthermore, it should be noted that the present example is represented to explain the use and operation of the apparatus 100. The present example, nor the present application is aimed at claiming any surgical procedure as is exemplified.

[0025] Returning to the present example, the TEP repair may involve creation of a preperitoneal space (PPS). As would be understood, one of the most conventional techniques for creating such a PPS may be performed using a Hasson trocar. The procedure may be initiated by a 5 millimetre incision made in the infra-umbilical region lateral to a midline. The incision is then deepened in subcutaneous fat. The apparatus 100 may then be inserted into the incision such that its length is accommodated into incision to a predefined or required depth, with the apparatus 100 being supported by the head portion 210 when the apparatus 100 is inserted till the point where the surgical procedure is performed. It should be noted that while insertion, the apparatus 100 is in a closed configuration. As would be noted, the cylindrical portion 208 of the apparatus 100 has a cylindrical outer profile owing to which the apparatus 100 displaces the fat outward. In the present example, suction is used to clear the remaining fat above the rectus sheath. At this stage, a further incision may be made through the apparatus 100 using an incision tool.

[0026] Thereafter, a 5 mm trocar, with a telescope mounted thereon may be inserted into the PPS under vision. The trocar is than introduced through the slit into the rectus muscle and finally into the PPS. On further introducing the trocar, the trocar crosses the arcuate line that can be clearly defined under vision. Further insertion of trocar leads to entry in the PPS, which can be easily identified by the appearance of preperitoneal fat. At this stage, with the trocar in place the apparatus 100 may be gradually withdrawn from the incision, along the length of the trocar. The apparatus 1 00 may then be opened and removed from the trocar.

[0027] Although examples for the present disclosure have been described in language specific to structural features, it should be understood that the appended claims are not necessarily limited to the specific features described. Rather, the specific features are disclosed and explained as examples of the present disclosure.

Claims

I/We Claim:

1 . A surgical apparatus (100) to allow insertion of a surgical instrument in an incision through an animal tissue, the surgical apparatus (100) comprising:

a first cylindrical portion (102) having two longitudinal edges;

a second cylindrical portion (104) having two longitudinal edges, wherein the first cylindrical portion (102) and the second cylindrical portion (104) are hinged to each other on one of the longitudinal edges such that the first and second cylindrical portion (104) are to form a cylindrical passage for a surgical instrument to pass through when the longitudinal edges of the first cylindrical portion (102) and the second cylindrical portion (104) are to abut each other moving about the hinged longitudinal edge in a closed configuration; and

head portions (106, 1 08) coupled to proximal end of the longitudinal edges of each of the first cylindrical portion (102) and the second cylindrical portion (104) with the head portions (106, 108) comprising a slit along thickness of the head portion, wherein the slit extends in a direction perpendicular to the abutting longitudinal edges of the first cylindrical portion (102) and the second cylindrical portion (104).

2. The surgical apparatus (100) as claimed in claim 1 , wherein the head portions (106, 108) comprises a clamping mechanism in the slit for clamping the first cylindrical portion (102) and the second cylindrical portion (1 04) to maintain the cylindrical shape when the longitudinal ends in the closed configuration.

3. The surgical apparatus (100) as claimed in claim 1 , wherein first cylindrical portion (102) is fixed at the head portion (106) and second cylindrical portion (104) is to swing by about 90-120 degrees on the non-hinged longitudinal edge with respect to the first cylindrical portion (102).

4. The surgical apparatus (100) as claimed in claim 1 , wherein the surgical instrument is a laparoscope.

5. The surgical apparatus (100) as claimed in claim 1 , wherein an inner diameter of the cylindrical portion is 0.5 centimetres.

6. The surgical apparatus (1 00) as claimed in claim 1 , wherein the head portion of the cylindrical portion has a wider external diameter to allow the head portion of the cylinder to sit on the external surface of the incision.

7. The surgical apparatus (100) as claimed in claim 1 , wherein a length of the first and second cylindrical portion (104) slides inside the incision to create a cylindrical passage for the surgical instrument.

8. The surgical apparatus (100) as claimed in claim 1 , wherein a length of the first and second cylindrical portion (104) is one of 2.5, 3.5 and 4.5 centimetres, and more in length to traverse the depth of body fat and tissues to offer easy access to the site of surgery.

9. The surgical apparatus (100) as claimed in claim 1 , wherein the surgical apparatus (100) is made of one of metal and alloy.

10. The surgical apparatus (100) as claimed in claim 7, wherein the surgical apparatus (100) is made of stainless steel.

1 1 . The surgical apparatus (100) as claimed in claim 1 , wherein the surgical apparatus (100) is a cannula.

12. The surgical apparatus (1 00) as claimed in claim 1 , wherein the head portion is to guide the surgical instrument through the cylindrical passage formed by the first cylindrical portion (102) and the second cylindrical portion (104).