CA2079516A1

CA2079516A1 - Instrument for applying an adhesion prophylaxis for endoscopic surgery

Info

Publication number: CA2079516A1
Application number: CA002079516A
Authority: CA
Inventors: Kurt Semm
Original assignee: Individual
Current assignee: Individual
Priority date: 1991-10-02
Filing date: 1992-09-30
Publication date: 1993-04-03
Also published as: US5350387A; JPH06169926A; EP0535506A1; DE4132855A1; KR930007417A; ATE136756T1; DE59206019D1; EP0535506B1; AU2616792A

Abstract

Abstract of the Disclosure Instrument for applying an adhesion prophylaxis for endoscopic surgery.

The invention relates to an instrument for the application of an adh-esion prophylaxis, particularly in the manner of a film for endoscopic surgery. The instrument comprises a circular cylindrical application sleeve for insertion in a trocar cannula or for direct insertion in a pneumoperitoneum. The application sleeve can receive a rod-like film carrier onto which is wound the film-like adhesion prophylaxis.
For this purpose in the front area of the film carrier is provided an elongated, particularly axial reception area, in which the adhesion prophylaxis is received in interlocking or frictional manner.

Description

~z~

2~95~ 6 Tn.~Ll~ent for ~plyin~ ~n a~hesio~ pro~hYla~is for endoscopic sur~e~.

Background of the I~e~t~o~.

Field of the l~e~tio~

The in7ention relates to an i~strDme~t for apply~ng a~ adhesio~ proph-yla~is for endoscopic s~rgery.

B2ck~.ro~nd of the Tn~ention Tn co~ve~tio~al ~QrOery, ~axtic~l~rly in the abdominal re~ion, it i9 k~own to insert a ~'lm in the abdomen s~ order to preve~t the form-atio~ of coalescences between the intern~l organs and the abdominal wall.

The use of sueh adhesion prophyla~e~, paxtic~larly in ~he form of fil~s? would also be desi~able for a~doscopic sor~ y . E~eYer, it has not been possible hitherto, because it ss necessary ~or the films to be creased to a mn~imnm and ~Iso to be ~mfoldable ;~ a simple way to th~;r f~ll size.

S~mmary of the Inve~ion The ob~ect of the lnvention is to pro~ide an i~strument of:the arore-mentio~ed type, whic~ permits the applicatio~ of a~ adhesion prop~
a~ns, ~nclud~ng for endoscopic surL y - 2 - Z~79~6 Accor~i~.O to ~he in~e~tion t ;s ob~'ect is Prh;e~ed b~ the features of cl~im 1. Ad~n~geo~s f~rther developments of the ~eutiQ~ ~orm ~he subje~t matter of subol~im.~.

Accord~ g ~o the in~e~tion, the instrument ha~ a rod-like f~lm carrier wi~h a receptio~ area ~or ~he l~te~locki2g or ~iGtional recept~o~
o a film o~ z ,ilm end. I~ the simplest case said rec~ption ~re3 can be i~ t~e ~n~ ol n a~ial, elonO~ated slot i~ the ~o~ide rod.
~e length of -~his elongated slot i~ ~refer2bly appro~mately 20 c~.
Ihe film is i~ser~ed appro~m~tel~ ce~trally into the elonga~ed slot and ~s ~hen rolled onto t~e fi~m carr7er by t~e rotatio~ of the lat~er~
The film carrier with the ~olled up film is the~ i~troduced into a~
~pplicatio~ slee~e, whi~h ca~ ;n tlr~ be ~r.troduced by mea~s of a trocar ~leè~e or ca~ula, or directl~ into the abdom;n~ all. Prerer-ably ~he slotted area of ~he film carrier has a diameter of appro~-;m~telv 5 ~m, whilst the ap~l~c~tion slee~e has an e~tornal di~meter of approgim2tely 10 mm. The wou~d up film is then loczted in the ~ap between the film c~lrier and the application slee~e. To the 20 ~m long slotted are~ of the f;1m carr~er is co~nected an ~slotted area wlth a le~gth of app~o~imately 30 c~. ~he slotted ~ilm carrier area c n consequentl~ be mo~ed from the a~pro~ m~tely 20 cm loDg appli-cation slee~e com~letely into the abdome~ ~d is opened o~t there b~ win~;ng ~p. The op.~n;n~ out o~ ~he f;l~ ca~ be assis~ed by grlp-pers, which are i~trod~ced by ~ur~her trocar c~nulas ~to ~he pne~-moperi~o~e~.

~he~ the receptio~ ~rea of the f~l~ carrier is co~s~ ucted as a~ elon-gated ~lot, the ~ or ~n ~nflatable ~lm c~shion is inserted ro~ghl~
centr~ to the elo~tea dot, 90 that the `lm pro~ects by ro~ghly the q~me distance from the slot oQ bot~ sides.

EoweYer, t~e film carrier receptio~ area ca~ also be co~str~cted a~
a rl~pi~g de~ice for receiYing one longitud~al end of the film.
I~ the receptio~ ~rea sho~ld the~ be constr~cted at least two e3g~e-~e~ su~ces, which ca~ be pressad agaa~st one another, so that ~he long~di~al e~d o~ the f~lm is sec~red. A rele~3e o~ ~he film foll-owing ~nro11;ng i~ the abdome~ can onl~ be broug~ about by the d~e~-agement of the e~gageme~t surf~ces.

Preferabl~ the cor~ers o, the rolled ~D ~ilm are fi~ed ~ the corres-~o~ding 2xeas of the abdomen, so that a ~ilm displacemen~ is preve~ted.
When ~sing a cush~o~-like, infla~ble ;7m .or a desired greater spac-ing of tbe i~tern~l org~ns from the abdom;n~ 1, fi~ng f~n ~ce placc in a simple ma~ner, be~use thP d;mensio~al st~hility o~ ~he ~ lm cush; 0~ eY~sts per e.

The fi or the c~shion c2n be e~doscopicall~ remo~ed, e.o. after two to ~hree days~ r2moval ca~ once again ~ake plaee by the ;n~tn3me~t accord~g to the invention.

The instrume~ pe~its a~ endosoopic i~trod~ction or the ~ lm, wh;l~t leading to sigD~ifican~ s~mpl:fications comDared with t~e sllroery used UD to now. According to the prio~ art t~e rilm has been i~troducèd under ge~eral a~esthesia a~d with cut~ing by ~ea~s of a t~pe of 7 pper and lmost e~ery day thOEe is a replacPmP~t of the fil~ a~d/or an evaL~atio~ of ths he~ling process ;n the ~iCi3iLy o~ ~he film~

The ~ ca~rier permit~ the reception of both single, sterile, th~n films and also mul~ er f~lms, whicn can be i~lated ~s air c-l~h~o~s.

~he use o~ the applicatio~ sleeve or simply k~own ~s an applicator, ~erm~ts an easier rotatio~ of the ~ilm oarrier or windin~ the film o~ and off. Tn the case of dire~t insertion o~ the ~ilm carrier i~to a trocar r~nn~la~ this rotatio~ could be pre~ented by ~he ca~ula val~e~ When n.q~ng the applicator, the ~ l~e is a~tom3ti~ held the ope~ positio~ through the outer ~all o~ the ap~licator, s~
t~t the film carr~r c?n be rota~ed witho~t impe~ nt.

- 4 - 2~ 9r~Çj ~rief descriptio~ of the ~rawinas.

~he invention ~s described in greater detail hereis~fter relati7e to the d~awings, wherein show:

Fig. 1 a perspec~ive view of a~ application sleeve or applicator.
i~. 2 a perspecti~e ~iew of the rod-~ike f;lm carrier for i~sert-ing ~n the a~plicator of fig. 1.

Figs. 3a the ront view of the fil~ ca~rie~ at the star~ ~hd ff 's~
to 3c of the il~ wi~d~ng protess ~ith the engaged application sleeve at ~he e~d.

De~iled description of the invention.

Fig. 1 shows a~ application sleeve lO wieh a stop ring i2 for e~ga~in$
on the ma~ body of a troc2x can~la. ~he app1;cation slee~e lO rec-eives a ff 1~ carrier 14 show~ in ~ig. 2. The ff1~ carrier iS subdiy-ided into a longit~d;n~11y slotted, fro~t area 16 with a lengt~ o~
app~o~imately 20 cm a~d a rear, unslot~ed area 18 with a length of appro~m~tely 30 om. The app~ca~or 10 has a lemgth of zppro~ma~ely 20 om. The elongated slot 20 with a w~dth of e.g. 1 to 1.5 mm i~
the ~ro~t a~ea l6 o~ the ~lm carrier 14 ser~es as the receptio~ area ~or a film 22 ~ig. 3).

As bhow~ ;~ fig. 3, the ff 1~ is threaded i~to the elo~gated sloe 20 o~ the film carrier 14 a~d the~ by rotati~g the film carrier in the ~;reC ~O~ A i5 rolled o~to the latter. As th~ ~lm carrier 14 ha~
an ~ternal diameter of appro~ima~el~ 5 ~n 2~d ~he ehi~-walled appli-cato~ 10 a~ s~ternal diameter of appro~im~tsl~ 10 mm, the ro11ed ~
film 22, as show~ ig. 3~, i5 ho&sed ~n ~he re~aining free space.
The ap~licator leDgth ~ such that ~he ent;re length ol the fro~t, slotted area 16 of ~he ilm c3rrler 14 ~a~ be receired ~n the appl;~2-tor 10~ With i~s es~erDal ~;~m~ter of appro~Imatel~ 10 mm the 2Z~7.~5~ ~i appl~c~tor 10 is appropriate for iQsertion in a troczr slee~e or ca~-~la. The appl~cator lO holds the f;~m cerrie_ in rotatable m~ner, rotation not beizg im~eded by ~he trocar ca~n~t~ YalYe. ~h~s, tha applicator 1~ is e~gaged on ~he ~ro~ar c2~nl~ ~til the stop ~
12 st~iXes a~ainst the ~2i~ body o~ ~he cannul . ~ its rear end the applicstor c~ have a se~l wi~h respect to the f;l~ carrier 14, which pxeve~ts an esc2~e of gas be~ween the 2~p~icator 1~ ~nd the rear ena 18 of the film ~rier 14. ~eYeX~ ~n escape of air can also be s~b~tanti~lt~ pre~e~ted if the e~ter~21 ~i?meter of the rear area 18 OI the fil~ carrier YiLtually correspo~ds to ~he inter~al dlameter of the a~plic~tor lO. As a result o_ the ~ ~1 mo~me~t of the f;lm Garr~er 14 i~ the direction o~ the abdomen, the front area ~6 of the film c~rrier 14 is mo~ed out o~ ~he ap~llcator 10.
Thro~h t~e qubseq~ent rotatio~ of ~he ;1m carrier 14 the wound ~p fi~m ~ is opesed out i~ the abdomen and ~he lz~ter ca~ be assisted by fcrther endoscopic instruments, ~uch as e.~. ~r~p~er~, which can be i~troduced throug~ other t~o OE ~a~ulas into the p~e~moperi~oneum.

The fil~S ca~ be made both from ~iolog~.all~ resistant ~ter~al a~d from a mPter~al~ which dissol~es o~er a period of time. ~he ~ilm pre~e~tg coalescences betwee~ the abdomi~el wall and the ~nterDal or~aDs e~gag~Pg on the latter ~n ~he pe~i~d ~ollownng an operaeio~.
T~e film can be re~oyed aOai ter xo~ghly 2 ;o ~ days by i~troduci~g the ~ carrier and w~ding ~p the ~1m. ~hen ~si~g a self-dissolY~nO
_ilm, ~o f~rther endo~copic s~FOery is re~ired. In principle, it is also co~ei~able to use the trocar r~nnula oirectly as t~e applic-*tio~ slee~, b~t ~his co~ld ~ake more ~;ffic~lt or impede film carlier rota~ion~
.
~u~, a~ a~ e~dosco~ic film applica~or, the i~strume~t according to the i~Ye~tion`proYides ~ery ad~a~tageaus adhesio~ proph~la~s _or endo~cop`~c surgery.

Claims

1. An instrument for the application of an adhesion prophylaxis for endoscopic surgery, with a circular cylindrical application sleeve (10) for introduction into a trocar cannula or for direct introduction into a pneumoperitoneum and with a rod-like film carrier (14) for receiving a film-like adhesion prophylaxis (22), on which is formed an elongated, axial reception area (20) for receiving the adhesion prophylaxis (22).

2. An instrument according to claim 1, wherein reception area (20) is constructed for interlocking and frictional reception of the adhesion prophylaxis (22).

3. An instrument according to claim 1, wherein the reception area (20) is constructed as an axially directed, elongated slot and has a length of approximately 20 cm and a width of approximately 0.5 to 2 mm.

4. An instrument according to claim 3, wherein the width of the elongated slot is approximately 1 to 1.5 mm.

5. An instrument according to claim 1, wherein the lengths of the application sleeve (10) and the elongated slot (20) are adapted to one another.

6. An instrument according to claim 3, wherein the film carrier (14) is constructed as a round rod with a total length, which is greater than twice the length of the elongated slot (20).

7. An instrument according to claim 1, wherein the longitudinal end of the film carrier (14) is rounded.

8. An instrument according to claim 1, wherein a seal is provided between the application sleeve (10) and the film carrier (14).

9. An instrument according to claim 1, wherein the film carrier (14) has a front and a rear area (16,18), wherein the front area (16) is longitudinally slotted (20) and has a smaller exter-nal diameter than the rear area (18) and wherein the external diameter of the rear area (18) of the film carrier (14) corres-ponds to the internal diameter of the application sleeve (10).

10. An instrument according to claim 1, wherein the external diameter of the application sleeve (10) roughly corresponds to the inter-nal diameter of a trocar cannula.

11. An instrument according to claim 10, wherein the application sleeve (10) has a radial, all-round stop region (12) for engage-ment on the main body of the trocar cannula.

12. An instrument according to claim 1, wherein the reception area is slot-like.

13. An instrument according to claim 1, wherein bearing surfaces adjustable against one another are formed in the reception area.

14. An instrument according to claim 13, wherein the bearing surfaces are constructed as roughened adhesion surfaces for the adhesion prophylaxis.