Surgical trocar

Claim 2

An obturator for creating an incision through a tissue barrier, including: a rod having a longitudinal axis and an outer surface which converges toward a distal tip; portions of the rod defining a slot extending transverse to the axis at the distal tip of the rod; means disposed in the slot for conducting energy to the distal tip of the rod; and means for energizing the conducting means to cut the tissue when the distal tip of the rod is moved into proximity with the tissue and when the rod is advanced through the tissue to create the incision.

Claim 3

The obturator recited in claim 1 further comprising: means for sensing penetration of the tissue barrier by the distal tip of the rod; and means for inhibiting the energizing means when penetration is sensed by the sensing means.

Claim 4

The obturator recited in claim 2 wherein the inhibiting means includes a switch disposed along the conducting means and being responsive to the sensing means to inhibit conduction of the energy to the distal tip of the rod, whereby cutting of the tissue ceases upon penetration of the tissue barrier.

Claim 5

The obturator recited in claim 1 wherein the portions of the rod comprise a pair of lips defining the slot at the distal tip of the rod, the lips extending distally of the energy conducting means in the slot.

Claim 6

The obturator recited in claim 4 wherein: the energy conducting means comprises a wire having a diameter and extending through the slot transverse to the axis of the rod; and the lips extend distally a distance greater than the diameter of the wire.

Claim 7

The obturator recited in claim 1 wherein the rod is formed of insulative materials having properties non-conductive of the energy.

Claim 8

A surgical trocar assembly for penetrating a barrier of tissue and for providing an operative channel through the tissue barrier and into a body cavity, including: an operative sleeve having a distal end and being adapted for disposition across the tissue barrier with the distal end of the sleeve located in the body cavity, the sleeve defining the operative channel with a size sufficient to receive surgical instruments for performing surgery within the body cavity; an obturator removably disposed in the sleeve and including an axis and a distal end extending beyond the distal end of the sleeve; a source of energy; a cutting element disposed at the distal end of the obturator and adapted to be moved axially into contact with the tissue and to be moved axially through the tissue barrier out of contact with the tissue; means for conducting the energy from the source to the cutting element and for energizing the cutting element to cut the tissue; at least one conductor included in the conducting means and disposed along a conduction path extending from the source of energy to the distal end of the obturator assembly; switch means included in the conducting means and disposed in the conductive path for permitting the conduction of energy to the cutting element in a first state and for inhibiting the conduction of energy to the cutting element in a second state; means responsive to the cutting element being out of contact with the tissue for placing the switch means in the second state; and whereby the distal end of the obturator and the distal end of the sleeve can be advanced through the cut tissue to penetrate the tissue barrier, and the obturator can be removed from the sleeve leaving the sleeve operatively disposed across the tissue barrier with the channel appropriately sized to receive the surgical instruments.

Claim 9

A surgical trocar assembly for penetrating a barrier of tissue and for providing an operative channel through the tissue barrier and into a body cavity, including: an operative sleeve having a distal end and being adapted for disposition across the tissue barrier with the distal end of the sleeve located in the body cavity, the sleeve defining the operative channel with a size sufficient to receive surgical instruments for performing surgery within the body cavity; an obturator removably disposed in the sleeve and including an axis and a distal end extending beyond the distal end of the sleeve; a source of energy; a cutting element disposed at the distal end of the obturator and adapted to be moved axially into contact with the tissue and to be moved axially through the tissue barrier out of contact with the tissue; means for conducting the energy from the source to the cutting element and for energizing the cutting element to cut the tissue; at least one conductor included in the conducting means and disposed along a conduction path extending from the source of energy to the distal end of the obturator assembly; switch means included in the conducting means and disposed in the conductive path for permitting the conduction of energy to the cutting element in a first state and for inhibiting the conduction of energy to the cutting element in a second state; means responsive to the cutting element being out of contact with the tissue for placing the switch means in the second state; and whereby the distal end of the obturator and the distal end of the sleeve can be advanced through the cut tissue to penetrate the tissue barrier, and the obturator can be removed from the sleeve leaving the sleeve operatively disposed across the tissue barrier with the channel appropriately sized to receive the surgical instruments.

Claim 10

The surgical trocar assembly recited in claim 7 wherein the source of energy is a laser.

Claim 11

The surgical trocar assembly recited in claim 7 wherein the cutting element is a bi-polar radio frequency electrode including a first electrode, a second electrode and insulation means disposed between the first electrode and the second electrode.

Claim 14

The method recited in claim 10 further comprising the step of de-energizing the cutting element when the distal end of the device penetrates the wall of the cavity.

Claim 15

The method recited in claim 11 further comprising the step of providing the cutting element with at least one pole of an electrosurgical cutter.

Claim 16

The method recited in claim 12 wherein the providing step includes the step of providing the energy conductive cutting element with at least one electrosurgical wire.

Claim 17

The method recited in claim 11 further comprising the step of providing the energy conductive cutting element with a blade.

Claim 18

A surgical apparatus for creating an incision through a tissue barrier, including; a rod having walls disposed along a longitudinal axis, the walls converging generally toward a line extending transverse to the axis at the distal end of the rod, portions of the walls defining a pair of opposing lips which extend laterally of the rod at the distal end of the rod; means disposed at the distal end of the rod and extending at least a portion of the distance along the line for conducting energy at the distal tip to cut the tissue barrier, the lips defining a slot extending transverse to the axis of the rod and being configured to receive the energy conducting means; and means for energizing the conducting means to cut the tissue when the rod is placed in proximity to the tissue and when the rod is moved axially through the tissue to create the incision.

Claim 19

A surgical apparatus for creating an incision through a tissue barrier, including; a rod having walls disposed along a longitudinal axis, the walls converging generally toward a line extending transverse to the axis at the distal end of the rod, portions of the walls defining a pair of opposing lips which extend laterally of the rod at the distal end of the rod; means disposed at the distal end of the rod and extending at least a portion of the distance along the line for conducting energy at the distal tip to cut the tissue barrier, the lips defining a slot extending transverse to the axis of the rod and being configured to receive the energy conducting means; and means for energizing the conducting means to cut the tissue when the rod is placed in proximity to the tissue and when the rod is moved axially through the tissue to create the incision.

Claim 20

The apparatus recited in claim 15 wherein the line has a length which extends generally perpendicular to the axis of the rod.

Claim 21

The apparatus recited in claim 16 wherein the energy conducting means is disposed across the entire length of the line.

Claim 22

The apparatus recited in claim 15 wherein the slot has an axial dimension and the energy conducting means comprises a wire having a length extending along the slot and a diameter which is less than the axial dimension of the slot.

Claim 23

A trocar system for creating an incision through the body tissue, including: a cannula forming a channel adapted to receive surgical instruments; an obturator sized and configured to extend through the instrument channel of the cannula, the obturator having a longitudinal axis and a cross-sectional dimension which narrows to form a tip at a distal end of the obturator; the distal tip of the obturator being defined by at least one ramp which has an angular relationship with the axis of the obturator, and which extends into proximity with a line extending transverse to the axis generally at the distal end of the obturator; means disposed along the line for conducting energy at the distal end of the obturator; and means for energizing the conducting means to cut the tissue when the obturator is placed in close proximity to the tissue and when the obturator is moved through the tissue to create the incision.

Claim 24

A trocar system for creating an incision through the body tissue, including: a cannula forming a channel adapted to receive surgical instruments; an obturator sized and configured to extend through the instrument channel of the cannula, the obturator having a longitudinal axis and a cross-sectional dimension which narrows to form a tip at a distal end of the obturator; the distal tip of the obturator being defined by at least one ramp which has an angular relationship with the axis of the obturator, and which extends into proximity with a line extending transverse to the axis generally at the distal end of the obturator; means disposed along the line for conducting energy at the distal end of the obturator; and means for energizing the conducting means to cut the tissue when the obturator is placed in close proximity to the tissue and when the obturator is moved through the tissue to create the incision.

Claim 25

The trocar system recited in claim 19 wherein the ramp has a generally planar surface.

Claim 26

The trocar system recited in claim 20, wherein: the ramp comprises a first ramp having a first generally planar surface extending distally to a first lip; the obturator further comprises a second ramp having a second generally planar surface extending distally to a second lip; and the line extends between the first lip and the second lip and generally parallel to the first lip and second lip.

Claim 27

The trocar system recited in claim 21 wherein: the second surface is a generally planar surface and has an angular relationship with the axis of the obturator; and the line is a straight line.

Claim 28

A trocar system for creating an incision in tissue including: a cannula forming a channel adapted to receive surgical instruments; an obturator sized and configured for removable disposition in the instrument channel of the cannula, the obturator having a longitudinal axis extending between a proximal end and an opposing distal end of the obturator; a conductor disposed at the distal end of the obturator and having a side surface with a length and a width, the side surface being oriented to face distally outwardly of the obturator with its length disposed generally transverse to the axis of the obturator; and means for energizing the conductor at the distal end of the obturator to cut the tissue and create the incision when the obturator is placed in proximity to the tissue.

Claim 29

A trocar system for creating an incision in tissue including: a cannula forming a channel adapted to receive surgical instruments; an obturator sized and configured for removable disposition in the instrument channel of the cannula, the obturator having a longitudinal axis extending between a proximal end and an opposing distal end of the obturator; a conductor disposed at the distal end of the obturator and having a side surface with a length and a width, the side surface being oriented to face distally outwardly of the obturator with its length disposed generally transverse to the axis of the obturator; and means for energizing the conductor at the distal end of the obturator to cut the tissue and create the incision when the obturator is placed in proximity to the tissue.

Claim 30

The trocar system recited in claim 23 wherein the conductor comprises at least one pole of an electrosurgical instrument.

Claim 31

The trocar system recited in claim 24 wherein the conductor comprises one pole of a bi-polar electrosurgical instrument.

Claim 32

The trocar system recited in claim 23 wherein the conductor has a longitudinal configuration and extends laterally of the obturator and transverse to the axis at the distal tip of the obturator.

Claim 33

The trocar system recited in claim 26 wherein: the obturator in axial cross-section has a maximum width; and the length of the surface of the conductor is at least as long as the maximum width of the obturator.

Claim 36

The method recited in claim 28 wherein: the step of providing the obturator further comprises the step of providing the energy conductive element in the form of a wire; and the penetrating step includes the step of positioning the wire to extend generally perpendicular to the axis of the obturator shaft.