Search Images Maps Play YouTube News Gmail Drive More »
Sign in
Screen reader users: click this link for accessible mode. Accessible mode has the same essential features but works better with your reader.

Patents

  1. Advanced Patent Search
Publication numberUS3653388 A
Publication typeGrant
Publication dateApr 4, 1972
Filing dateDec 4, 1969
Priority dateDec 4, 1969
Also published asDE2021290A1
Publication numberUS 3653388 A, US 3653388A, US-A-3653388, US3653388 A, US3653388A
InventorsTenckhoff Heinrich A M
Original AssigneeBattelle Development Corp
Export CitationBiBTeX, EndNote, RefMan
External Links: USPTO, USPTO Assignment, Espacenet
Catheter insertion trocar
US 3653388 A
Abstract
A trocar for insertion of catheters into a body wall is described. The trocar comprises a bivalved type tapered tip with a handle attached to each portion of the tapered tip, a tubular member adapted to encircle the rearward portion of the tapered tip and a stylet which is adapted to fit inside both the tubular member and the bivalved tapered tip. This device permits insertion of a flexible tubing catheter into a body member wall for prolonged intermittent access to a cavity beyond the body wall. This device is particularly useful in insertion of cuffed catheters into the abdominal wall.
Images(1)
Previous page
Next page
Description  (OCR text may contain errors)

[451 AprAJWZ Tenclthoit States Watut OTHER PUBLICATIONS Anand, J. K., A New Cannula For lntroducin Catheters Into Pleural Cavities." 65, p. 1370.

g Ballon- Heinrich A. M. Tencltlhoff, Seattle, Wash.

Battelle Development Corporation, Columbus, Ohio in The Lancet," 6- 26- Assignee:

Lo R

n A n a& n Ce m am ".5 ir mh C I W m mm m FA U

A trocar for insertion of catheters into a body wall is described. The trocar comprises a bivalved type tapered ti with a handle attached to each portion of the tapered ti ....A61b 17/34, A6lm 27/00 Field of Search.......................

L C L n I .1 1 5 .l.

P p, a tu- References Cited bular member adapted to encircle the rearward portion of the tapered tip and a stylet which is adapted to fit inside both the tubular member and the bivalved tapered tip. This device per- UNITED STATES PATENTS Summerfeldt......................

mits insertion of a flexible tubing catheter into a body member wall for prolonged intermittent access to a cavity beyond the body wall. This device is particularly useful in insertion of cuffed catheters into the abdominal wall.

4 Claims, 3 Drawing Figures CATHETER INSERTION TROCAR BACKGROUND OF THE INVENTION vention further relates to a method of and surgical apparatus for applying a cathetertube to a location within an animal body. More specifically this invention relates to a trocar apparatus which may be used to insert a catheter through a body wall with a minor amount of injury to the adjacent body parts and which trocar may be dismantled and removed leaving the catheter installed in the body wall.

The invention described herein was made in the course of work under a grant or award from the Department of Health, Education and Welfare.

Attempts in the prior art to provide apparatus for inserting catheter tubes into a body member have resulted in adequate emplacement of a catheter into the body wall. However, the trocar apparatus used usually remained in the body wall causing serious problems with manipulation of the patient. Heretofore, surgical implantation of catheters has frequently been required, usually necessitating the use of an operating room and application of general anesthesia to the patient. For this operation, a rather large incision is made in the body wall and the catheter tube inserted. The incision is then sewn up by the usual surgical techniques. This procedure, while adequately implanting the catheter in the body wall, is expensive to the patient and of course involves a rather high degree of morbidity due to the traumatic effects of the operation and the general anesthesia required.

OBJECTS OF THE INVENTION This invention has as one of its primary objects the provision of apparatus for insertion of a catheter into a body wall. Another object of this invention is to provide apparatus which permits insertion of a catheter into a body wall without a major surgical operation and under local anesthesia. A related object is to provide for insertion of a catheter at the patients bedside without lengthy preparation by several medical personnel. An additional primary object of this invention is to provide a trocar apparatus for insertion of cuffed peritoneal catheters into a body wall under minor surgical conditions using local anesthesia at the bedside to reduce the morbidity and cost of the emplacement of catheters.

Another object of this invention is to provide an apparatus and method for insertion of a cuffed silastic tube into a body wall for purposes of prolonged intermittent access to a body cavity such as is necessary in peritoneal dialysis. A related object is to provide apparatus and method for insertion of a catheter which reduces the incidence of bleeding and leakage. An additional related object of this invention is to provide apparatus and method for inserting cuffed catheters which positively prevent the cuff from entering the abdominal cavity.

SUMMARY OF THE INVENTION This invention provides a trocar for inserting a catheter through a body wall into a body cavity which trocar may be removed by manipulation of the component parts thereof leaving the catheter installed in the body wall. The trocar is constructed of a substantially cylindrical tip section, a retainer tube into which one end of the cylindrical tip section is inserted and a stylet which can be inserted through the bore of the retainer tube and the bore of the cylindrical tip section. The sharpened end portion of the stylet protrudes out of the cylincrical tip section. The stylet is sized so that it can be replaced by a catheter tube when the trocar is inserted through an incision in a body wall with a portion of the cylindrical tip section protruding into the body cavity defined by the body wall. The cylindrical tip section is divided axially into a pluralityiof segments each of which has a handle attached to it to facilitate individual manipulation of the segment. The segments may be individually manipulated and removed from an incision leaving the catheter emplaced in the incision.

The interior of the preferred embodiment'of this invention has a first bore section extending through a portion of the cylindrical tip and through the length of the retainer tube. A

second bore section having a smaller diameter extends through the remainder of the cylindrical tip section. The first bore section is of an adequate diameter to accommodate the felt cuff of a cuffed peritoneal dialysis catheter tube and the second bore section is of a diameter which will accommodate the catheter tube itself but not the felt cuff.

These and other objects, advantages and attributes of this invention will become more readily apparent from an evaluation of the following description of the preferred embodiments with reference to the attached drawings.

IN THE DRAWINGS FIG. 1 is an exploded top perspective view of the elements of this invention;

FIG. 2 is a top perspective view of the device of this invention assembled without the stylet inserted therein;

FIG. 3 is a longitudinal sectional view of the assembled device with the catheter installed therein shown inserted through an incision in a body cavity wall taken on a plane containing the central axis of the device of this invention.

DESCRIPTION OF THE PREFERRED EMBODIMENT Referring more particularly to the drawings wherein like nu merals indicate like parts, there is seen in FIG. 1 a trocar comprising a bivalve tapered tip made up of two elements numbered 10 and 11. Manipulator handles 12 and 13 are attached to elements 10 and 11 respectively. The forward portion 14 of element 10 and the forward portion 15 of element 11 are tapered to form a sharp annular surface. The rearward portion 16 of element 10 and the rearward portion 17 of element 11 have cylindrical outer surfaces adapted to be inserted within the cylindricalbore of a tubular member 20. When thus inserted into tubular member 20, the interior of elements 10 and 11 form a cylindrical bore 40 of such a diameter as to permit insertion of the tip section 22 of stylet 24. The end of tip section 22 of stylet 24 is sharpened for insertion through an incision in the wall of a body member. The body portion 26 of stylet 24 has an outer diameter that will fit into the interior bore of cylindrical member 20.

The trocar may be assembled as shown in FIG. 2 with the cylindrical portion 16 and 17 of the two elements 10 and 11 inserted into the interior of tubular member 20 to firmly but releasably hold the elements of the trocar together. Stylet 24 is then inserted inside tubular member 20 with the tip section 22 of stylet 24 extending out of the forward portion of elements 10 and 1 1.

In FIG. 3 the trocar is shown assembled and inserted into an incision in a body membrane. The stylet 24 has been removed and replaced by catheter tube 31. The exposed end 32 of catheter tube 31 extends out of the tip of the trocar and into the body cavity shown generally as 33. The small incision necessary to insert the trocar extends through epidermis 34, sub-cutaneous fat 35, the fascia 36, and through the peritoneal membrane 37 into body cavity 33.

The catheter shown in FIG. 3 is of the cuffed peritoneal catheter type which is extensively used in dialysis procedures when partial or complete kidney failure requires the external removal of wastes from a body. The catheter is usually a flexible tubing made of an elastomeric material which has a cuff constructed of dacron felt or similar material. The dacron felt cuff serves to seal the incision and must be positioned near the epidermis in an extra-peritoneal position. The felt must not be permitted to enter the body cavity.

Use of such cuffed peritoneal catheters installed through the use of this invention permits frequent intermittent access to the peritoneal cavity without the severe operation previously required. The catheter may be inserted at the patients bedside by a single doctor with the use of local anesthesia, thus eliminating the greater portion of the morbidity formerly associated with implanting the catheter in a body wall.

When the catheter is installed as shown in FIG. 3, it is inserted as far as it will go into tubular member 20 such that the felt cuff 30 engages the constriction 41 in the bore of elements 10 and 11 which prevents passage of the felt cuff material 30 into the body cavity 33. The trocar may then be dismantled by removing tubular member 20 from its engagement with elements 10 and 11 and manipulating elements 10 and 11 by use of handles 12 and 13 respectively to remove the trocar from the incision leaving only the catheter tube 31 with its attached felt cuff 30 inserted into the incision. The felt cuff 30 substantially eliminates bleeding problems and leakage from the incision, usually without need of further surgical repair techniques.

The catheter tube 31 is securely implanted into the body membrane wall for purposes of irrigation of the interior body cavity, removal of fluids, administration of fluids or drugs or similar operations. One specific use for the device is insertion of the catheter into the abdominal cavity for dialysis procedure in acute and chronic renal failure.

The apparatus taught by this invention may be constructed of any one of a number of structural materials, such as metal, plastics and the like. Metals are frequently preferred because of their desirable strength characteristics and ability to be repeatedly used yet thoroughly sterilized by autoclaving or similar laboratory techniques. A disposable trocar could be constructed ofinjection molded plastic material.

From the foregoing detailed description, it will be evident that there are a number of changes, adaptions, modifications and the like to the present invention which are within the ability of those skilled in the art. The inventor has described his invention by way of specific examples. However, simple modifications to these specific examples will be readily apparent to those skilled in the art and are considered to be within the scope and spirit of this invention.

I claim as my invention:

1. A trocar for insertion of cuffed catheters into a body wall incision comprising:

a tapered tip segmented axially into at least two elements, said tip having a first axial bore therethrough to receive a forward tubular portion of a cufied catheter and a cylindrical rearward portion having a second larger bore axially aligned with the first bore to receive the cuffed portion of said cuffed catheter;

a tubular member adapted to encircle said cylindrical rearward portion of said tapered tip and to releasably hold the elements ofsaid tip in cylindrical relationship; and,

a stylet adapted to slidably engage both bores of said tip, said stylet having a sharpened forward portion extending beyond said tapered tip when said stylet is inserted therein.

2. The apparatus of claim 1 having a manipulator handle extending rearwardly from each of said elements to facilitate removal of said elements.

3. A trocar for insertion of a cuffed catheter tube into a body wall incision comprising:

a hollow, rigid insertion tip, said tip being divided axially into at least two parts and having a first axial bore to receive a forward tubular portion of a cuffed catheter and a cylindrical rearward portion having a second larger bore axially aligned with the first bore to receive the cuff of said cuffed catheter and adapted to prevent passage of said cuff into said first axial bore;

grasping means attached to each ofsaid parts, and;

means to maintain each of said parts in cylindrical relationship, said means permitting separation and removal of said parts.

4. The apparatus of claim 3 having a removable pointed stylet slidably engaging both bores of said tip.

Patent Citations
Cited PatentFiling datePublication dateApplicantTitle
US737293 *Nov 1, 1900Aug 25, 1903George H SummerfeldtVeterinary surgical instrument.
US1248492 *Apr 10, 1917Dec 4, 1917A D HaskellParacentesis needle or trocar.
US2001638 *Nov 14, 1932May 14, 1935Res Foundation IncSurgical needle
Non-Patent Citations
Reference
1 *Anand, J. K., A New Cannula For Introducing Ballon-Catheters Into Pleural Cavities. in The Lancet, 6 26 65, p. 1370.
Referenced by
Citing PatentFiling datePublication dateApplicantTitle
US3719186 *Apr 22, 1971Mar 6, 1973Univ Alabama In BirminghamSurgical instrument for placement of bone pins and holes therefor
US3788326 *Aug 3, 1972Jan 29, 1974H JacobsDistally perforated catheter for use in ventilating system
US3817250 *Oct 24, 1972Jun 18, 1974Int Medical Devices IncInstrument for performing a tracheostomy and other surgical procedures
US3856021 *Oct 1, 1973Dec 24, 1974A McintoshDevice for treatment of bloat of ruminants
US3903893 *Oct 16, 1973Sep 9, 1975Alexander L ScheerNasal hemostatic device
US3913566 *Jul 17, 1974Oct 21, 1975Illinois Tool WorksBiopsy tool and method
US3960153 *Feb 22, 1972Jun 1, 1976Jane Towne CareyApparatus for the palliative treatment of pleural effusions
US3994287 *Jul 1, 1974Nov 30, 1976Centre De Recherche Industrielle Du QuebecTrocar
US4167939 *Dec 20, 1976Sep 18, 1979Karl StorzMethod of treating patients with rectoscopes
US5108392 *Aug 14, 1991Apr 28, 1992United States Surgical CorporationCoagulation forceps and method of fabricating the same
US5125904 *Jul 9, 1991Jun 30, 1992Lee Hongpyo HSplittable hemostatic valve and sheath and the method for using the same
US5250033 *Oct 28, 1992Oct 5, 1993Interventional Thermodynamics, Inc.Peel-away introducer sheath having proximal fitting
US5279553 *Apr 2, 1992Jan 18, 1994Martin J. WinklerTranspyloric jejunostomy cannulating system
US5312355 *Jun 26, 1992May 17, 1994H L Medical Inventions, Inc.For use with a lead or catheter
US5334150 *Nov 17, 1992Aug 2, 1994Kaali Steven GVisually directed trocar for laparoscopic surgical procedures and method of using same
US5360406 *Jul 7, 1993Nov 1, 1994Minnesota Mining And Manufacturing CompanyStylet for retrograde coronary sinus cannula
US5376076 *Nov 17, 1993Dec 27, 1994Kaali; Steven G.Visually directed trocar for laparoscopic surgical procedures and method of using same
US5380291 *Nov 17, 1993Jan 10, 1995Kaali; Steven G.Visually directed trocar for laparoscopic surgical procedures and method of using same
US5401244 *Apr 28, 1994Mar 28, 1995Minnesota Mining And Manufacturing CompanyMethod of, and stylet apparatus for, installing a retrograde coronary cannula
US5407427 *Mar 10, 1993Apr 18, 1995Loma Linda University Medical CenterTrocar facilitator for endoscopic surgery
US5441504 *Nov 23, 1993Aug 15, 1995Medtronic, Inc.Splittable lead introducer with mechanical opening valve
US5443484 *Mar 14, 1994Aug 22, 1995Loma Linda University Medical CenterTrocar and method for endoscopic surgery
US5551947 *Nov 17, 1993Sep 3, 1996Worldwide Optical Trocar Licensing CorporationVisually directed trocar for laparoscopic surgical procedures and method of using same
US5577993 *Jan 13, 1995Nov 26, 1996Loma Linda University Medical CenterTrocar facilitator for endoscopic surgery and method of using the same
US5609562 *Nov 16, 1993Mar 11, 1997Worldwide Optical Trocar Licensing CorporationVisually directed trocar and method
US5720761 *Jul 29, 1994Feb 24, 1998Worldwide Optical Trocar Licensing Corp.Visually directed trocar and method
US5899854 *Apr 20, 1998May 4, 1999University Of New MexicoSpeculum and method for inserting an elongated instrument into an animal's body
US6004341 *Dec 5, 1996Dec 21, 1999Loma Linda University Medical CenterVascular wound closure device
US6036699 *Mar 26, 1997Mar 14, 2000Perclose, Inc.Device and method for suturing tissue
US6190396Sep 14, 1999Feb 20, 2001Perclose, Inc.Device and method for deploying and organizing sutures for anastomotic and other attachments
US6287322Jun 4, 1999Sep 11, 2001Loma Linda University Medical CenterTissue opening locator and everter and method
US6355050Jun 26, 1997Mar 12, 2002Abbott LaboratoriesDevice and method for suturing tissue
US6358258Sep 14, 1999Mar 19, 2002Abbott LaboratoriesDevice and method for performing end-to-side anastomosis
US6361541Jul 17, 1998Mar 26, 2002The University Of Iowa Research FoundationSurgical instrument for extracting tissue ingrowth from a permeable member of an implanted catheter
US6425901Dec 4, 1997Jul 30, 2002Loma Linda University Medical CenterVascular wound closure system
US6517553Jan 24, 2001Feb 11, 2003Abbott LaboratoriesDevice and method for suturing of internal puncture sites
US6524326Jun 5, 1998Feb 25, 2003Loma Linda University Medical CenterTissue opening locator and everter and method
US6558399Jun 30, 2000May 6, 2003Abbott LaboratoriesDevices and method for handling a plurality of suture elements during a suturing procedure
US6730102Nov 6, 2000May 4, 2004Abbott LaboratoriesSystems, devices and methods for deploying needles
US6890342Aug 1, 2001May 10, 2005Loma Linda UniversityMethod and apparatus for closing vascular puncture using hemostatic material
US6964668May 20, 2002Nov 15, 2005Abbott LaboratoriesArticulating suturing device and method
US6964675Aug 13, 2001Nov 15, 2005Loma Linda University Medical CenterTissue opening locator and everter and method
US7001400Aug 29, 2000Feb 21, 2006Abbott LaboratoriesArticulating suturing device and method
US7029481Nov 6, 2000Apr 18, 2006Abbott LaboratoriesSystems, devices and methods for suturing patient tissue
US7048747Nov 20, 2001May 23, 2006Abbott LaboratoriesDevice and method for performing end-to-side anastomosis
US7192433Mar 14, 2003Mar 20, 2007Oscor Inc.Locking vascular introducer assembly with adjustable hemostatic seal
US7235087Aug 29, 2003Jun 26, 2007Abbott ParkArticulating suturing device and method
US7377927Mar 27, 2006May 27, 2008Abbott LaboratoriesSystems, devices and methods for suturing patient tissue
US7390328Dec 19, 2003Jun 24, 2008Abbott LaboratoriesDevice and method for suturing of internal puncture sites
US7445626Dec 16, 2003Nov 4, 2008Abbott LaboratoriesDevice and method for suturing tissue
US7462188Sep 22, 2004Dec 9, 2008Abbott LaboratoriesDevice and method for suturing intracardiac defects
US7780699Jun 16, 2003Aug 24, 2010Loma Linda University Medical CenterVascular wound closure device and method
US7837696Dec 5, 2003Nov 23, 2010Abbott LaboratoriesArticulating suturing device and method
US7842047Feb 27, 2006Nov 30, 2010Abbott LaboratoriesArticulating suturing device and method
US7842048Aug 18, 2006Nov 30, 2010Abbott LaboratoriesArticulating suture device and method
US7842049Oct 25, 2006Nov 30, 2010Abbott LaboratoriesSystems for anchoring a medical device in a body lumen
US7846170Mar 20, 2007Dec 7, 2010Abbott LaboratoriesArticulating suturing device and method
US7850701Aug 2, 2004Dec 14, 2010Abbott LaboratoriesArticulating suturing device and method
US7883517Aug 8, 2005Feb 8, 2011Abbott LaboratoriesVascular suturing device
US8012167Aug 16, 2004Sep 6, 2011Loma Linda University Medical CenterVascular wound closure device and method
US8038688Nov 14, 2005Oct 18, 2011Abbott LaboratoriesArticulating suturing device and method
US8048092Dec 6, 2010Nov 1, 2011Abbott LaboratoriesArticulating suturing device and method
US8048108Feb 4, 2009Nov 1, 2011Abbott Vascular Inc.Vascular closure methods and apparatuses
US8057491Dec 13, 2010Nov 15, 2011Abbott LaboratoriesArticulating suturing device and method
US8083754Aug 8, 2005Dec 27, 2011Abbott LaboratoriesVascular suturing device with needle capture
US8088145 *Oct 5, 2006Jan 3, 2012Loma Linda University Medical CenterVascular wound closure device and method
US8137317Sep 14, 2004Mar 20, 2012Oscor Inc.Locking vascular introducer assembly with adjustable hemostatic seal
US8137364Sep 11, 2003Mar 20, 2012Abbott LaboratoriesArticulating suturing device and method
US8172860Dec 12, 2008May 8, 2012Abbott LaboratoriesArticulating suturing device and method
US8202281Nov 29, 2010Jun 19, 2012Abbott LaboratoriesSystems for anchoring a medical device in a body lumen
US8211122Aug 9, 2007Jul 3, 2012Abbott LaboratoriesDevice for suturing intracardiac defects
US8252008Nov 29, 2010Aug 28, 2012Abbott LaboratoriesArticulating suturing device and method
US8257368Aug 9, 2007Sep 4, 2012Abbott LaboratoriesDevice for suturing intracardiac defects
US8267947Jul 21, 2006Sep 18, 2012Abbott LaboratoriesVascular suturing device
US8313498Feb 7, 2011Nov 20, 2012Abbott LaboratoriesVascular suturing device
US8323298Nov 19, 2010Dec 4, 2012Abbott LaboratoriesArticulating suturing device and method
US8361088Oct 23, 2008Jan 29, 2013Abbott LaboratoriesDevice and method for suturing intracardiac defects
US8372098 *Feb 8, 2007Feb 12, 2013Merit Medical Systems, Inc.Fluid line removal device for removing a fluid line from a body and related methods
US8419753Oct 7, 2008Apr 16, 2013Abbott LaboratoriesSuturing device with split arm and method of suturing tissue
US8425552Apr 4, 2005Apr 23, 2013Loma Linda University Medical CenterApparatus for closing vascular puncture
US8430893Aug 23, 2012Apr 30, 2013Abbott LaboratoriesArticulating suturing device and method
US8491628Aug 24, 2010Jul 23, 2013Loma Linda University Medical CenterVascular wound closure device and method
US8574244Dec 19, 2007Nov 5, 2013Abbott LaboratoriesSystem for closing a puncture in a vessel wall
US8597309Sep 13, 2012Dec 3, 2013Abbott LaboratoriesSuturing device with split arm and method of suturing tissue
US8617253Dec 1, 2011Dec 31, 2013Loma Linda University Medical CenterVascular wound closure device and method
US8663248Dec 12, 2008Mar 4, 2014Abbott LaboratoriesArticulating suturing device and method
US8663252Sep 1, 2010Mar 4, 2014Abbott Cardiovascular Systems, Inc.Suturing devices and methods
US8702750Mar 22, 2013Apr 22, 2014Loma Linda UniversityApparatus for closing vascular puncture
US20120059410 *Sep 6, 2011Mar 8, 2012Loma Linda University Medical CenterWound closure device and method
US20130103103 *Oct 24, 2011Apr 25, 2013Warsaw Orthopedic, IncSurgical system methods for spinal access
DE3347150A1 *Dec 27, 1983Jul 4, 1985Beiersdorf AgBladder puncturing set
WO1993000947A1 *Jul 6, 1992Jan 21, 1993H L Medical Inventions IncSplittable sheath assembly and method for using
WO2008098262A1 *Mar 19, 2008Aug 14, 2008Tran Holdings LlcFluid line removal device for removing a fluid line from a body and related methods
Classifications
U.S. Classification604/170.1, 604/161
International ClassificationA61M25/06, A61B17/34
Cooperative ClassificationA61B17/3415, A61B17/3468, A61M25/0668, A61B17/3417
European ClassificationA61B17/34G, A61M25/06H1