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WO1994003116A1 - Trocar sleeve with valve - Google Patents

Trocar sleeve with valve Download PDF

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Publication number
WO1994003116A1
WO1994003116A1 PCT/FR1993/000783 FR9300783W WO9403116A1 WO 1994003116 A1 WO1994003116 A1 WO 1994003116A1 FR 9300783 W FR9300783 W FR 9300783W WO 9403116 A1 WO9403116 A1 WO 9403116A1
Authority
WO
WIPO (PCT)
Prior art keywords
elastic
valve
washer
trocar
chamber
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/FR1993/000783
Other languages
French (fr)
Inventor
Elizabeth Lafage
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Europeenne De Medecine Sa
Original Assignee
Europeenne De Medecine Sa
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Europeenne De Medecine Sa filed Critical Europeenne De Medecine Sa
Publication of WO1994003116A1 publication Critical patent/WO1994003116A1/en
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/02—Access sites
    • A61M39/06—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof
    • A61M39/0606—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof without means for adjusting the seal opening or pressure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3498—Valves therefor, e.g. flapper valves, slide valves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/02—Access sites
    • A61M39/06—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof
    • A61M2039/0626—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof used with other surgical instruments, e.g. endoscope, trocar
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/02—Access sites
    • A61M39/06—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof
    • A61M2039/0633—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof the seal being a passive seal made of a resilient material with or without an opening
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/02—Access sites
    • A61M39/06—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof
    • A61M2039/0633—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof the seal being a passive seal made of a resilient material with or without an opening
    • A61M2039/0653—Perforated disc
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/02—Access sites
    • A61M39/06—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof
    • A61M2039/0686—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof comprising more than one seal

Definitions

  • the present invention relates to a device for automatically closing a trocar sleeve for endoscopy of the body cavities, comprising in its distal part a tubular expansion chamber and in its proximal part a valve chamber maintained closed by a valve which must open when inserting an instrument or endoscope.
  • a valve which must open when inserting an instrument or endoscope.
  • This valve there is a relative and weak overpressure coming from the tubular conduit and due either to gases or to liquids of expansion of the body cavities.
  • This valve must ensure the tightness of the trocar with and without penetrating instrument as well as a good sliding of the instruments during the passage through the valve.
  • the trocar sleeves are currently closed by mechanical devices with piston, with hinged spring or magnetic valves, with ball, or by devices in molded elastic perforated or pre-perforated material.
  • the present invention proposes to provide for the trocar sockets with a valve made of elastic material, of simple manufacture and assembly while ensuring the sealing function of the trocar with and without penetrating instrument as well as good sliding of the instruments during of their passage through the valve.
  • this problem is solved by the use of superimposed elastic pellets and ron ⁇ , cut out with a punch in sheets of elastic material (silicone sheet in this application).
  • These elastic, cylindrical pellets are split symmetrically with respect to the center of the circle of the cylinder in the axis of the diameter and over the height of the cylinder when they are cut.
  • the elastic washer is cut so as to have a central circular opening
  • the elastic pads and washer must be held firmly at their periphery.
  • the elasticity is ensured by, crtre the nature of the material, the maintenance, for the elastic pad with distal slot, on the one hand H ar a clearing delimiting the lower part of the valve chamber and the upper part of the tubular chamber distal of the trocar sleeve and on the other hand by the elastic patch with proximal slot, itself held by an elastic washer with central circular opening, itself held by a rigid washer with central circular perforation snapped into the overlying position.
  • the diametrical axes of the slots of the elastic pads are not superimposed on each other, but form an angle (perpendicular in our application).
  • the edges of the slots circumscribe the instrument, except at the end of the slots where a small orifice appears.
  • the non-superposition of the diametrical axes of the slits makes it possible to partially and vice versa seal the other small elastic patch with slit the two small orifices created at the ends of each of the slits when the trocar is penetrated by an instrument.
  • the inner edge of the elastic washer the central circular opening of which has a diameter less than the minimum diameter of the instruments, the use of which is intended for the trocar in question, allows complete blockage of the valve when the trocar is penetrated by a instrument or during an accidental tearing of the slit elastic pads by an instrument.
  • the assembly formed by the two elastic pads, the elastic washer with a central circular opening and the rigid upper washer (made of nylon in this application) is held in place and in slight compression by snap-fastening under a slight internal overhang of the upper part of the valve chamber of the trocar sleeve. This compression is necessary to maintain the peripheries of the elastic pads and washer as well as to seal the trocar.
  • the longitudinal axes of the pads, washers, valve, valve chamber coincide with the longitudinal axis of the trocar.
  • a cylindrical transition zone is created between the trocar tube and the valve chamber.
  • This area called the expansion chamber, is in the distal part of the trocar sleeve. It has an internal diameter greater than that of the instruments whose passage is planned for the type of trocar considered.
  • This expansion chamber allows an elastic and free movement of the edges of the slots of the elastic pads and of the inner edge of the elastic washer with central circular opening entrained during the introduction of an instrument.
  • This expansion chamber is therefore located between the distal and tubular part of the trocar and the valve chamber. Its diameter is greater than that of the instruments whose passage is planned for the type of trocar considered.
  • its longitudinal axis merges with that of the trocar.
  • the inner diameter of the rigid washer is greater than that of instruments the passage of which is planned for the type of trocar considered.
  • the height of the valve chamber is slightly less than the total thickness of all of the elastic slit pads, of the elastic washer with central circular opening and of the rigid washer so as to participate, by a slight compression of the latter. , to the sealing of the trocar.
  • the diameter of the opening in the upper part of the valve chamber is very slightly less than the diameter of the washers and pellets to maintain it.
  • the rigid washer is mounted by snap-fastening through this opening with an internal overhang relative to the valve chamber.
  • the elastic washer with a central circular opening can be positioned in a distal position with respect to the elastic slit pads, between the lower shoulder of the valve chamber and the distal slit pad.
  • the slots of the elastic pads can be partially cut in their height to obtain only a pre-perforation of the valve.
  • Figures 1, 2 and 3 show in longitudinal section and in perspective the device according to the invention.
  • Figures 4 and 5 show in longitudinal section and in perspective a variant of this device.
  • the device comprises, inside a trocar sleeve (1), a valve chamber (2) limited in its distal part by a shoulder (5) of planar surface perpendicular to the axis. longitudinal of the trocar and surmounted in its proximal portion by an internal overhang (3).
  • Each elastic patch is split at its center in the axis of the diameter to form an elastic patch with a slot (7).
  • the slot is symmetrical with respect to the center of the circle of the base of the cylinder formed by the pellet.
  • the length of the slot is substantially equal to the half-circumference of the nominal diameter of the instruments whose use is intended for the trocar considered.
  • the elastic washer has a central circular opening with a diameter less than the nominal diameter of the instruments whose use is intended for the trocar considered to constitute an elastic washer with central circular opening (8).
  • the inside diameter of the valve chamber (2) is equal to the diameter of the elastic slit pads (7), the elastic washer with central circular opening (8) and the rigid washer (6).
  • the inside diameter of the overhang (3) is very slightly smaller than the diameter of the elastic slit pads (7), of the elastic washer with central circular opening (8) and of the rigid washer (6) so as to allow the passage in force. and maintaining the elastic slit pads (7), the elastic washer with central circular opening (8) and the rigid washer (6).
  • the interior height of the valve chamber (2) is very slightly less than the sum of the thicknesses of the elastic slit pads (7), of the elastic washer with central circular opening (8) and of the rigid washer (6) so as to maintain the elastic slits with slot (7), the elastic washer with circular central opening (8) and the rigid washer (6) in compression.
  • the trocar sleeve (1) also includes an expansion chamber (4), in a position distal to the valve chamber (2), the internal diameter of which is greater than that of the instruments whose passage is provided for the type trocar considered, and the height are sufficient so that, when inserting an instrument, the edges of the slots of the elastic slot pads (7) and the inner edge of the elastic washer with central circular opening (8) can be driven there without shearing contact between the instrument and the walls of the expansion chamber (4), in order to avoid shearing of the elastic slit pads (7) and of the elastic washer with central circular opening (8).
  • FIG. 2 represents the composition of the valve by the superposition, respectively of the proximal portion to the distal portion of the valve chamber (2), of a rigid washer (6), of an elastic washer with central circular opening ( 8), an elastic patch with a slot (7) and a second elastic patch with a slot (7) whose diametral axis of the slot is oriented, in this application, perpendicular to the diametrical axis of the slot of the elastic pad with slot (7) overlying.
  • the length of the slot is substantially equal to the half-circumference of the nominal diameter of the instruments.
  • the diameter of the central circular opening of the elastic washer with central circular opening (8) is less than the nominal diameter of the instruments whose use is intended for the trocar considered.
  • FIG. 3 shows the assembly of the valve inside the trocar sleeve (1).
  • the rigid washer (6) in the proximal position, has a diameter greater than the nominal diameter of the instruments whose use is intended for the trocar. It has been force fitted through the overhang (3) which keeps it in compression above the elastic washer with central circular opening (8).
  • the central circular opening elastic washer (8) is compressed between the proximal slot elastic pad (7) and the rigid washer (6).
  • the proximal slit elastic pad (7) is compressed between the distal slit elastic pad (7) and the elastic washer with central circular opening (8).
  • the longitudinal axis of its slot is perpendicular to the cutting plane.
  • the distal elastic slot pad (7) is compressed between the overlying elastic slot pad (7) and the shoulder (5) constituting the bottom of the valve chamber (2).
  • the longitudinal axis of its slot is in the cutting plane.
  • Figures 4 and 5 show a variant of the application of the invention in that the elastic washer with central circular opening (8) is in a distal position relative to the elastic slit pads (7), between the shoulder (5) produced by the bottom of the valve chamber (2) and the elastic pad with distal slot (7).
  • FIG. 4 represents, for this variant, the composition of the valve by the superposition, respectively of the proximal part to the distal part of the valve chamber (2), of a rigid washer (6), of an elastic pad with slot (7) and a second elastic patch with slot (7) and an elastic washer with central circular opening (8).
  • FIG. 5 shows, for this variant, the assembly of the valve inside the trocar sleeve (1).
  • the rigid washer (6) in the proximal position, has a diameter greater than the nominal diameter of the instruments whose use is intended for the trocar. It has been force fitted through the overhang (3) which keeps it in compression above the elastic patch with slot (7) proximal.
  • the proximal slit elastic pad (7) is compressed between the rigid washer (6) and the distal slit elastic pad (7).
  • the longitudinal axis of its slot is in the cutting plane.
  • the distal slot elastic pad (7) is compressed between the overlying proximal slot pad (7) and the elastic washer with central circular opening (8).
  • the longitudinal axis of its slot is perpendicular to the cutting plane.
  • the central circular opening elastic washer (8) is compressed between the distal elastic slot pad (7) and the shoulder (5) formed by the bottom of the valve chamber (2).
  • the device according to the invention is particularly intended for trocars for endoscopy of body cavities and in particular for single-use trocars.
  • the invention is not limited to the example of use described above, from which we can provide other forms and other embodiments, without departing from the scope of the invention.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Molecular Biology (AREA)
  • Medical Informatics (AREA)
  • Pathology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Pulmonology (AREA)
  • Anesthesiology (AREA)
  • Hematology (AREA)
  • Surgical Instruments (AREA)

Abstract

Sleeve of trocar for the endoscopic examination and surgery of body cavities. The invention relates to a sleeve (1) of a trocar, automatically held in closed position and which must open a passage for an instrument while preserving the sealing caracteristics, and comprising an elastic valve having elastic slotted discs (7), an elastic washer (8) with a circular central opening and a rigid washer (6) both held in compression relationship in a valve chamber (2) and force mounted through an internal flange (3). Shearing of the elastic slotted discs (7) and of the elastic washer with central circular opening (8) is avoided by selecting the diameters of the rigid washer (6) and of the expansion chamber (4) larger than the nominal diameter of instruments designed for use with the considered trocar. The device according to the invention is particularly intended for trocars used in endoscopy of body cavities, and particularly disposable trocars.

Description

DOUILLE DE TROCART AVEC SOUPAPE TROCAR BUSHING WITH VALVE

La présente invention concerne un dispositif de fermeture automatique d'une douille de trocart pour l'endoscopie des cavités corporelles, comportant dans sa partie distale une chambre d'expansion tubulaire et dans sa partie proximale une chambre à soupape maintenue fermée par une soupape qui doit s'ouvrir lors de l'introduction d'un instrument ou d'un endoscope. Sur cette soupape, s'exerce une surpression relative et faible venant du conduit tubulaire et due soit aux gaz soit aux liquides de dilatation des cavités corporelles. Cette soupape doit assurer l'étanchéité du trocart avec et sans instrument le pénétrant ainsi qu'un bon glissement des instruments lors du passage à travers la soupape. Les douilles de trocart sont actuellement fermées par des dispositifs mécaniques à piston, à clapets articulés à ressorts ou magnétiques, à bille, ou par des dispositifs en matière élastique perforée ou pré-perforée moulés. Les dispositifs mécaniques à piston, à clapets articulés à ressorts ou magnétiques ou à bille sont efficaces mais supposent des usinages et des assemblages complexes. Les dispositifs en matière élastique perforée ou pré-perforée n'assurent l'étanchéité que sous condition de disposer d'un conduit tubulaire élastique sus ou sous-jacent au diaphragme, d'un diamètre légèrement inférieur à celui de l'instrument les pénétrant. De plus, la fente laisse à ses extrémités un opercule, objet de fuite gazeuse ou liquidienne lorsqu'un instrument est en place. Enfin, ces dispositifs élastiques, pour remplir leurs fonctions et pour être maintenus solidaires de la douille du trocart, sont de formes complexes donc induisent la nécessité d'utilisation d'un procédé de fabrication par moulage.The present invention relates to a device for automatically closing a trocar sleeve for endoscopy of the body cavities, comprising in its distal part a tubular expansion chamber and in its proximal part a valve chamber maintained closed by a valve which must open when inserting an instrument or endoscope. On this valve, there is a relative and weak overpressure coming from the tubular conduit and due either to gases or to liquids of expansion of the body cavities. This valve must ensure the tightness of the trocar with and without penetrating instrument as well as a good sliding of the instruments during the passage through the valve. The trocar sleeves are currently closed by mechanical devices with piston, with hinged spring or magnetic valves, with ball, or by devices in molded elastic perforated or pre-perforated material. Mechanical devices with piston, hinged spring or magnetic valves or ball are efficient but require complex machining and assembly. The devices made of perforated or pre-perforated elastic material provide sealing only under the condition of having an elastic tubular conduit above or below the diaphragm, with a diameter slightly smaller than that of the penetrating instrument. In addition, the slot leaves at its ends a seal, the object of gas or liquid leakage when an instrument is in place. Finally, these elastic devices, to fulfill their functions and to be kept integral with the trocar sleeve, are of complex shapes therefore induce the need to use a manufacturing process by molding.

La présente invention se propose de fournir pour les douilles de trocarts une soupape en matière élastique, de fabrication et d'assemblage simples tout en assurant la fonction d'étanchéité du trocart avec et sans instrument le pénétrant ainsi qu'un bon glissement des instruments lors de leur passage à travers la soupape. Conformément à l'invention, ce problème est résolu par l'utilisation de pastilles et ron¬ delle élastiques superposées, découpées à P emporte-pièce dans des feuilles de matière élastique (feuille de silicone dans cette application). Ces pastilles élastiques, cylindriques, sont fendues symétriquement par rapport au centre du cercle du cylindre dans l'axe du diamètre et sur la hauteur du cylindre lors de leur découpe. La rondelle élastique est découpée de façon à disposer d'une ouverture circulaire centrale Pour conserver l'élasticité de la fente et du bord intérieur de la rondelle élastique à ouverture circulaire centrale, les pastilles et la rondelle élastiques doivent être maintenues fermement à leur périphérie. L'élasticité est assurée par, crtre la nature de la matière, le maintien, pour la pastille élastique à fente distale, d'une part Har un épauiement délimitant la partie inférieure de la chambre à soupape et la partie supérieure de la chambre tubulaire distale de la douille du trocart et d'autre part par la pastille élastique à fente proximale, elle même maintenue par une rondelle élastique à ouverture circulaire centrale, elle même maintenue par une rondelle rigide à perforation circulaire centrale encliquetée en position sus-jacente. Les axes diamétraux des fentes des pastilles élastiques ne sont pas superposées l'un à l'autre, mais forment un angle (perpendiculaire dans notre application).The present invention proposes to provide for the trocar sockets with a valve made of elastic material, of simple manufacture and assembly while ensuring the sealing function of the trocar with and without penetrating instrument as well as good sliding of the instruments during of their passage through the valve. According to the invention, this problem is solved by the use of superimposed elastic pellets and ron¬, cut out with a punch in sheets of elastic material (silicone sheet in this application). These elastic, cylindrical pellets are split symmetrically with respect to the center of the circle of the cylinder in the axis of the diameter and over the height of the cylinder when they are cut. The elastic washer is cut so as to have a central circular opening To maintain the elasticity of the slot and of the inner edge of the elastic washer with central circular opening, the elastic pads and washer must be held firmly at their periphery. The elasticity is ensured by, crtre the nature of the material, the maintenance, for the elastic pad with distal slot, on the one hand H ar a clearing delimiting the lower part of the valve chamber and the upper part of the tubular chamber distal of the trocar sleeve and on the other hand by the elastic patch with proximal slot, itself held by an elastic washer with central circular opening, itself held by a rigid washer with central circular perforation snapped into the overlying position. The diametrical axes of the slots of the elastic pads are not superimposed on each other, but form an angle (perpendicular in our application).

De la sorte, lorsque le trocart est vide, la fente inférieure vient, de par la surpression, en appui sur la pastille élastique à fente sus-jacente qui, elle-même vient en appui sur la rondelle élastique qui, elle-même, vient en appui sur la rondelle rigide. Ainsi les fentes ne peuvent pas s'ouvrir aux pressions gazeuses ou aux pressions liquidiennes normalement utilisées pour les dilatations des cavités corporelles par gaz ou sérums.In this way, when the trocar is empty, the lower slot comes, by the overpressure, in support on the elastic pad with overlying slot which, itself comes to bear on the elastic washer which, itself, comes resting on the rigid washer. Thus, the slits cannot open to the gas pressures or to the liquid pressures normally used for the dilations of the bodily cavities by gases or sera.

Lorsque le trocart est pénétré par un instrument, les bords des fentes circonscrivent l'instrument, si ce n'est en extrémité des fentes où apparaît un petit orifice. La non superposition des axes diamétraux des fentes permet de colmater partiellement et réciproque- ment par l'autre pastille élastique à fente les deux petits orifices créés aux extrémités de chacune des fentes lorsque le trocart est pénétré par un instrument. Le bord intérieur de la rondelle élastique, dont l'ouverture circulaire centrale a un diamètre inférieur au diamètre no¬ minal des instruments dont l'emploi est prévu pour le trocart considéré, permet le colmatage complet de la soupape lorsque le trocart est pénétré par un instrument ou lors d'une déchirure accidentelle des pastille élastiques à fente par un instrument.When the trocar is penetrated by an instrument, the edges of the slots circumscribe the instrument, except at the end of the slots where a small orifice appears. The non-superposition of the diametrical axes of the slits makes it possible to partially and vice versa seal the other small elastic patch with slit the two small orifices created at the ends of each of the slits when the trocar is penetrated by an instrument. The inner edge of the elastic washer, the central circular opening of which has a diameter less than the minimum diameter of the instruments, the use of which is intended for the trocar in question, allows complete blockage of the valve when the trocar is penetrated by a instrument or during an accidental tearing of the slit elastic pads by an instrument.

L'ensemble formé par les deux pastilles élastiques, la rondelle élastique à ouverture circulaire centrale et la rondelle supérieure rigide (en nylon dans cette application) est maintenu en place et en légère compression par encliquetage sous un léger débord intérieur de la partie supérieure de la chambre à soupape de la douille du trocart. Cette compression est nécessaire au maintien des périphéries des pastilles et rondelle élastiques ainsi qu'à l'étanchéité du trocart.The assembly formed by the two elastic pads, the elastic washer with a central circular opening and the rigid upper washer (made of nylon in this application) is held in place and in slight compression by snap-fastening under a slight internal overhang of the upper part of the valve chamber of the trocar sleeve. This compression is necessary to maintain the peripheries of the elastic pads and washer as well as to seal the trocar.

Les axes longitudinaux des pastilles, rondelles, soupape, chambre à soupape se confondent avec l'axe longitudinal du trocart.The longitudinal axes of the pads, washers, valve, valve chamber coincide with the longitudinal axis of the trocar.

Pour éviter un cisaillement des pastilles et rondelle élastiques, lors de l'introduction des instruments, entre l'instrument et une paroi tubulaire trop étroite, il est créé une zone cylindrique de transition entre le tube du trocart et la chambre à soupape. Cette zone, appelée chambre d'expansion, est dans la partie distale de la douille du trocart. Elle a un le diamètre intérieur supérieur à celui des instruments dont le passage est prévu pour le type de trocart considéré. Cette chambre d'expansion permet un déplacement élastique et libre des bords des fentes des pastilles élastiques et du bord intérieur de la rondelle élastique à ouverture circulaire centrale entraînés lors de l'introduction d'un instrument. Cette chambre d'expansion se situe donc entre la partie distale et tubulaire du trocart et la chambre à soupape. Son diamètre est supérieur à celui des instruments dont le passage est prévu pour le type de trocart considéré. Comme l'axe longitudinal de la chambre à soupape, son axe longitudinal se confond avec celui du trocart.To avoid shearing of the elastic discs and washer, during the introduction of the instruments, between the instrument and a too narrow tubular wall, a cylindrical transition zone is created between the trocar tube and the valve chamber. This area, called the expansion chamber, is in the distal part of the trocar sleeve. It has an internal diameter greater than that of the instruments whose passage is planned for the type of trocar considered. This expansion chamber allows an elastic and free movement of the edges of the slots of the elastic pads and of the inner edge of the elastic washer with central circular opening entrained during the introduction of an instrument. This expansion chamber is therefore located between the distal and tubular part of the trocar and the valve chamber. Its diameter is greater than that of the instruments whose passage is planned for the type of trocar considered. Like the longitudinal axis of the valve chamber, its longitudinal axis merges with that of the trocar.

Pour éviter un cisaillement des pastilles et de la rondelle élastique à ouverture circulaire centrale, lors du retrait des instruments, entre l'instrument et le bord intérieur de la rondelle rigide, le diamètre intérieur de la rondelle rigide est supérieur à celui des instruments dont le passage est prévu pour le type de trocart considéré.To avoid shearing of the pellets and of the elastic washer with central circular opening, when removing the instruments, between the instrument and the inner edge of the rigid washer, the inner diameter of the rigid washer is greater than that of instruments the passage of which is planned for the type of trocar considered.

La hauteur de la chambre à soupape est légèrement inférieure à l'épaisseur totale de l'ensemble des pastilles élastiques à fente, de la rondelle élastique à ouverture circulaire centrale et de la rondelle rigide de façon à participer, par une légère compression de ces dernières, à l'étanchéité du trocart.The height of the valve chamber is slightly less than the total thickness of all of the elastic slit pads, of the elastic washer with central circular opening and of the rigid washer so as to participate, by a slight compression of the latter. , to the sealing of the trocar.

Le diamètre de l'ouverture de la partie supérieure de la chambre à soupape est très légèrement inférieur au diamètre des rondelles et pastilles pour en assurer le maintien. Le montage de la rondelle rigide se fait par encliquetage à travers cette ouverture à débord intérieur par rapport à la chambre à soupape. Selon des modes particuliers de réalisation,The diameter of the opening in the upper part of the valve chamber is very slightly less than the diameter of the washers and pellets to maintain it. The rigid washer is mounted by snap-fastening through this opening with an internal overhang relative to the valve chamber. According to particular embodiments,

1 - On peut positionner la rondelle élastique à ouverture circulaire centrale en position distale par rapport aux pastilles élastiques à fente, entre Pépaulement inférieur de la chambre à soupape et la pastille à fente distale.1 - The elastic washer with a central circular opening can be positioned in a distal position with respect to the elastic slit pads, between the lower shoulder of the valve chamber and the distal slit pad.

2- Les fentes des pastilles élastiques peuvent être partiellement découpées dans leur hauteur pour n'obtenir qu'une pré-perforation de la soupape.2- The slots of the elastic pads can be partially cut in their height to obtain only a pre-perforation of the valve.

3- On peut donner une valeur variable non nulle à l'angle formé par la position relative des axes diamétraux des fentes.3- We can give a non-zero variable value to the angle formed by the relative position of the diametrical axes of the slots.

4- On peut produire des trocarts de diamètres différents par adaptation des côtes de la soupape au diamètre désiré. 5- On peut installer le dispositif dans la partie proximale d'un réducteur de diamètre de trocart. Les dessins annexés illustrent l'invention :4- Trocars with different diameters can be produced by adapting the valve ribs to the desired diameter. 5- The device can be installed in the proximal part of a trocar diameter reducer. The accompanying drawings illustrate the invention:

Les figures 1 , 2 et 3 représentent en coupe longitudinale et en perspective le dispositif selon l'invention. Les figures 4 et 5 représentent en coupe longitudinale et en perspective une variante de ce dispositif.Figures 1, 2 and 3 show in longitudinal section and in perspective the device according to the invention. Figures 4 and 5 show in longitudinal section and in perspective a variant of this device.

En référence à ces dessins, le dispositif comporte, à l'intérieur d'une douille (1) de trocart, une chambre à soupape (2) limitée dans sa partie distale par un épaulement (5) de surface plane perpendiculaire à l'axe longitudinal du trocart et surmontée dans sa portion proximale par un débord intérieur (3). Chaque pastille élastique est fendue en son centre dans l'axe du diamètre pour constituer une pastille élastique à fente (7). La fente est symétrique par rapport au centre du cercle de la base du cylindre que forme la pastille. La longueur de la fente est sensiblement égale à la demi-circonférence du diamètre nominal des instruments dont l'emploi est prévu pour le trocart considéré. La rondelle élastique a une ouverture circulaire centrale d'un diamètre inférieur au diamètre nominal des instruments dont l'emploi est prévu pour le trocart considéré pour constituer une rondelle élastique à ouverture circulaire centrale (8). Le diamètre intérieur de la chambre à soupape (2) est égal au diamètre des pastilles élastiques à fente (7), de la rondelle élastique à ouverture circulaire centrale (8) et de la rondelle rigide (6). Le diamètre intérieur du débord (3) est très légèrement inférieur au diamètre des pastilles élastiques à fente (7), de la rondelle élastique à ouverture circulaire centrale (8) et de la rondelle rigide (6) de façon à permettre le passage en force et le maintien des pastilles élastiques à fente (7), de la rondelle élastique à ouverture circulaire centrale (8) et de la rondelle rigide (6). La hauteur intérieure de la chambre à soupape (2) est très légèrement inférieure à la somme des épaisseurs des pastilles élastiques à fente (7), de la ron¬ delle élastique à ouverture circulaire centrale (8) et de la rondelle rigide (6) de façon à maintenir les pastilles élastiques à fente (7), la rondelle élastique à ouverture circulaire cen¬ trale (8) et la rondelle rigide (6) en compression. La douille (1 ) de trocart comporte aussi une chambre d'expansion (4), en position distale par rapport à la chambre à soupape (2), dont le diamètre intérieur, supérieur à celui des instruments dont le passage est prévu pour le type de trocart considéré, et la hauteur sont suffisants pour que, lors de l'introduction d'un instrument, les bords des fentes des pastilles élastiques à fente (7) et le bord intérieur de la rondelle élastique à ouverture circulaire centrale (8) puissent y être entraînés sans contact cisaillant entre l'instrument et les parois de la chambre d'expansion (4), afin d'éviter le cisaillement des pastilles élastiques à fente (7) et de la rondelle élastique à ouverture circulaire centrale (8).With reference to these drawings, the device comprises, inside a trocar sleeve (1), a valve chamber (2) limited in its distal part by a shoulder (5) of planar surface perpendicular to the axis. longitudinal of the trocar and surmounted in its proximal portion by an internal overhang (3). Each elastic patch is split at its center in the axis of the diameter to form an elastic patch with a slot (7). The slot is symmetrical with respect to the center of the circle of the base of the cylinder formed by the pellet. The length of the slot is substantially equal to the half-circumference of the nominal diameter of the instruments whose use is intended for the trocar considered. The elastic washer has a central circular opening with a diameter less than the nominal diameter of the instruments whose use is intended for the trocar considered to constitute an elastic washer with central circular opening (8). The inside diameter of the valve chamber (2) is equal to the diameter of the elastic slit pads (7), the elastic washer with central circular opening (8) and the rigid washer (6). The inside diameter of the overhang (3) is very slightly smaller than the diameter of the elastic slit pads (7), of the elastic washer with central circular opening (8) and of the rigid washer (6) so as to allow the passage in force. and maintaining the elastic slit pads (7), the elastic washer with central circular opening (8) and the rigid washer (6). The interior height of the valve chamber (2) is very slightly less than the sum of the thicknesses of the elastic slit pads (7), of the elastic washer with central circular opening (8) and of the rigid washer (6) so as to maintain the elastic slits with slot (7), the elastic washer with circular central opening (8) and the rigid washer (6) in compression. The trocar sleeve (1) also includes an expansion chamber (4), in a position distal to the valve chamber (2), the internal diameter of which is greater than that of the instruments whose passage is provided for the type trocar considered, and the height are sufficient so that, when inserting an instrument, the edges of the slots of the elastic slot pads (7) and the inner edge of the elastic washer with central circular opening (8) can be driven there without shearing contact between the instrument and the walls of the expansion chamber (4), in order to avoid shearing of the elastic slit pads (7) and of the elastic washer with central circular opening (8).

La figure 2 représente la composition de la soupape par la superposition, respectivement de la portion proximale à la portion distale de la chambre à soupape (2), d'une rondelle rigide (6), d'une rondelle élastique à ouverture circulaire centrale (8), d'une pastille élastique à fente (7) et d'une deuxième pastille élastique à fente (7) dont l'axe diamétral de la fente est orienté, dans cette application, à la perpendiculaire de l'axe diamétral de la fente de la pastille élastique à fente (7) sus-jacente. La longueur de la fente est sensiblement égale à la demi- circonférence du diamètre nominal des instruments. Le diamètre de l'ouverture circulaire cen¬ trale de la rondelle élastique à ouverture circulaire centrale (8) est inférieur au diamètre no- minai des instruments dont l'emploi est prévu pour le trocart considéré .FIG. 2 represents the composition of the valve by the superposition, respectively of the proximal portion to the distal portion of the valve chamber (2), of a rigid washer (6), of an elastic washer with central circular opening ( 8), an elastic patch with a slot (7) and a second elastic patch with a slot (7) whose diametral axis of the slot is oriented, in this application, perpendicular to the diametrical axis of the slot of the elastic pad with slot (7) overlying. The length of the slot is substantially equal to the half-circumference of the nominal diameter of the instruments. The diameter of the central circular opening of the elastic washer with central circular opening (8) is less than the nominal diameter of the instruments whose use is intended for the trocar considered.

La figure 3 représente l'assemblage de la soupape à l'intérieur de la douille (1 ) de trocart. La rondelle rigide (6), en position proximale, a un diamètre supérieur au diamètre nominal des instruments dont l'usage est prévu pour le trocart. Elle a été montée en force à travers le débord (3) qui la maintient en compression au dessus de la rondelle élastique à ouverture circulaire centrale (8). La rondelle élastique à ouverture circulaire centrale (8) est comprimée entre la pastille élastique à fente (7) proximale et la rondelle rigide (6). La pastille élastique à fente (7) proximale est comprimée entre la pastille élastique à fente (7) distale et la rondelle élastique à ouverture circulaire centrale (8). Dans ce dessin, l'axe longitudinal de sa fente est perpendiculaire au plan de coupe. La pastille élastique à fente (7) distale est comprimée entre la pastille élastique à fente (7) sus-jacente et l'épaulement (5) constituant le fond de la chambre à soupape (2). Dans ce dessin, l'axe longitudinal de sa fente est dans le plan de coupe.Figure 3 shows the assembly of the valve inside the trocar sleeve (1). The rigid washer (6), in the proximal position, has a diameter greater than the nominal diameter of the instruments whose use is intended for the trocar. It has been force fitted through the overhang (3) which keeps it in compression above the elastic washer with central circular opening (8). The central circular opening elastic washer (8) is compressed between the proximal slot elastic pad (7) and the rigid washer (6). The proximal slit elastic pad (7) is compressed between the distal slit elastic pad (7) and the elastic washer with central circular opening (8). In this drawing, the longitudinal axis of its slot is perpendicular to the cutting plane. The distal elastic slot pad (7) is compressed between the overlying elastic slot pad (7) and the shoulder (5) constituting the bottom of the valve chamber (2). In this drawing, the longitudinal axis of its slot is in the cutting plane.

Les figures 4 et 5 représentent une variante de l'application de l'invention en ce que la rondelle élastique à ouverture circulaire centrale (8) est en position distale par rapport aux pastilles élastiques à fente (7), entre l'épaulement (5) réalisé par le fond de la chambre à sou¬ pape (2) et la pastille élastique à fente (7) distale.Figures 4 and 5 show a variant of the application of the invention in that the elastic washer with central circular opening (8) is in a distal position relative to the elastic slit pads (7), between the shoulder (5) produced by the bottom of the valve chamber (2) and the elastic pad with distal slot (7).

La figure 4 représente, pour cette variante, la composition de la soupape par la superposition, respectivement de la partie proximale à la partie distale de la chambre à soupape (2), d'une rondelle rigide (6), d'une pastille élastique à fente (7) et d'une deuxième pastille élastique à fente (7) et d'une rondelle élastique à ouverture circulaire centrale (8).FIG. 4 represents, for this variant, the composition of the valve by the superposition, respectively of the proximal part to the distal part of the valve chamber (2), of a rigid washer (6), of an elastic pad with slot (7) and a second elastic patch with slot (7) and an elastic washer with central circular opening (8).

La figure 5 représente, pour cette variante, l'assemblage de la soupape à l'intérieur de la douille (1 ) de trocart. La rondelle rigide (6), en position proximale, a un diamètre supérieur au diamètre nominal des instruments dont l'usage est prévu pour le trocart. Elle a été montée en force à travers le débord (3) qui la maintient en compression au dessus de la pastille élastique à fente (7) proximale. La pastille élastique à fente (7) proximale est comprimée entre la rondelle rigide (6)et la pastille élastique à fente (7) distale. Dans ce dessin, l'axe longitudinal de sa fente est dans le plan de coupe. La pastille élastique à fente (7) distale est comprimée entre la pastille élastique à fente (7) proximale sus-jacente et la rondelle élastique à ouverture circulaire centrale (8). Dans ce dessin, l'axe longitudinal de sa fente est perpendi¬ culaire au plan de coupe. La rondelle élastique à ouverture circulaire centrale (8) est comprimée entre la pastille élastique à fente (7) distale et l'épaulement (5) réalisé par le fond de la chambre à soupape (2). Les axes longitudinaux des pastilles élastiques à fente (7), de la rondelle rigide (6), de la chambre à soupape (2), de la chambre d'expansion (4), et de la rondelle élastique à ouverture circulaire centrale (8), se confondent avec l'axe longitudinal du trocart.FIG. 5 shows, for this variant, the assembly of the valve inside the trocar sleeve (1). The rigid washer (6), in the proximal position, has a diameter greater than the nominal diameter of the instruments whose use is intended for the trocar. It has been force fitted through the overhang (3) which keeps it in compression above the elastic patch with slot (7) proximal. The proximal slit elastic pad (7) is compressed between the rigid washer (6) and the distal slit elastic pad (7). In this drawing, the longitudinal axis of its slot is in the cutting plane. The distal slot elastic pad (7) is compressed between the overlying proximal slot pad (7) and the elastic washer with central circular opening (8). In this drawing, the longitudinal axis of its slot is perpendicular to the cutting plane. The central circular opening elastic washer (8) is compressed between the distal elastic slot pad (7) and the shoulder (5) formed by the bottom of the valve chamber (2). The longitudinal axes of the elastic slit pads (7), the rigid washer (6), the valve chamber (2), the expansion chamber (4), and the elastic washer with central circular opening (8 ), merge with the longitudinal axis of the trocar.

Le dispositif selon l'invention est particulièrement destiné aux trocarts pour l'endoscopie des cavités corporelles et en particulier aux trocarts à usage unique. Bien entendu, l'invention n'est pas limitée à l'exemple d'utilisation décrit ci-dessus , à partir duquel on pourra prévoir d'autres formes et d'autres modes de réalisation, sans pour cela sortir du cadre de l'invention. The device according to the invention is particularly intended for trocars for endoscopy of body cavities and in particular for single-use trocars. Of course, the invention is not limited to the example of use described above, from which we can provide other forms and other embodiments, without departing from the scope of the invention.

Claims

REVENDICATIONS 1- Douille de trocart pour l'endoscopie des cavités corporelles, comportant une chambre d'expansion (4) distale sous-jacente à une chambre à soupape (2) proximale surmontée d'un débord intérieur (3), les deux chambres sont disposées de façon à ce qu'il y ait un épaulement (5) réalisé par le fond de la chambre à soupape (2), la chambre à soupape (2) étant pourvue d'une soupape maintenue automatiquement en position fermée et que doit ouvrir le passage d'un instrument tout en maintenant l'étanchéité, caractérisée en ce que la soupape ve¬ nant en appui sur l'épaulement de la chambre (2) est constituée par deux pastilles élastiques à fente (7) superposées dans la chambre à soupape (2), dont les axes diamétraux des fentes forment un angle non nul, une rondelle élastique à ouverture circulaire centrale (8) qui assure l'étanchéité du trocart lors du passage d'un instrument ou la déchirure accidentelle des pastilles à fente (7) par un instrument et une rondelle rigide (6) en position proximale dans la chambre à soupape (2) maintenue par un débord intérieur (3) en position proximale par rapport à la chambre à soupape (2) qui a un diamètre intérieur légèrement inférieur au diamètre de la rondelle rigide (6) ce qui permet le montage en force de la rondelle rigide (6) et le maintien ferme de la soupape dans la chambre à soupape (2).1- Trocar sleeve for endoscopy of the body cavities, comprising a distal expansion chamber (4) underlying a proximal valve chamber (2) surmounted by an internal overhang (3), the two chambers are arranged so that there is a shoulder (5) formed by the bottom of the valve chamber (2), the valve chamber (2) being provided with a valve maintained automatically in the closed position and which must open passage of an instrument while maintaining the seal, characterized in that the valve coming to bear on the shoulder of the chamber (2) is constituted by two elastic slit pads (7) superimposed in the valve chamber (2), whose diametrical axes of the slots form a non-zero angle, an elastic washer with central circular opening (8) which seals the trocar when an instrument passes or the accidental tearing of the slit pellets (7 ) by an instrument and a washer the rigid (6) in the proximal position in the valve chamber (2) held by an internal projection (3) in the proximal position relative to the valve chamber (2) which has an internal diameter slightly smaller than the diameter of the rigid washer (6) which allows the rigid mounting of the rigid washer (6) and the firm holding of the valve in the valve chamber (2). 2- Dispositif selon la revendication 1 caractérisé en ce que la chambre à soupape (2) a une hauteur légèrement inférieure à la hauteur de la soupape et tend au maintien en compres¬ sion de la soupape.2- Device according to claim 1 characterized in that the valve chamber (2) has a height slightly less than the height of the valve and tends to maintain in compression of the valve. 3- Dispositif selon l'une quelconque des revendications précédentes caractérisé en ce que la chambre d'expansion (4), en position distale par rapport à la chambre à soupape (2), a une hauteur et un diamètre intérieur, lequel est supérieur à celui des instruments dont le passage est prévu pour le type de trocart considéré, suffisants pour que, lors de l'introduction d'un instrument, les bords des fentes des pastilles élastiques à fente (7) et le bord intérieur de la rondelle élastique à ouverture circulaire centrale (8) puissent y être entraînés sans contact cisaillant entre l'instrument et les parois de la chambre d'expansion (4).3- Device according to any one of the preceding claims, characterized in that the expansion chamber (4), in position distal to the valve chamber (2), has a height and an internal diameter, which is greater than that of the instruments whose passage is provided for the type of trocar considered, sufficient so that, when inserting an instrument, the edges of the slits of the elastic slit pads (7) and the inner edge of the elastic washer at central circular opening (8) can be driven there without shearing contact between the instrument and the walls of the expansion chamber (4). 4- Dispositif selon l'une quelconque des revendications précédentes caractérisé en ce que la rondelle élastique à ouverture circulaire centrale (8) est placée entre les pastilles à fente (7) et l'épaulement (5) réalisé par le fond de la chambre à soupape (2).4- Device according to any one of the preceding claims, characterized in that the elastic washer with central circular opening (8) is placed between the slit pads (7) and the shoulder (5) produced by the bottom of the chamber. valve (2). 5- Dispositif selon l'une quelconque des revendications précédentes caractérisé en ce que la rondelle élastique à ouverture circulaire centrale (8) est placée entre les pastilles à fente (7) et la rondelle rigide (6). 5- Device according to any one of the preceding claims, characterized in that the elastic washer with central circular opening (8) is placed between the slit pads (7) and the rigid washer (6).
PCT/FR1993/000783 1992-07-31 1993-07-30 Trocar sleeve with valve Ceased WO1994003116A1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
FR92/09570 1992-07-31
FR9209570A FR2694181A1 (en) 1992-07-31 1992-07-31 Trocar sleeve for endoscopic examination and surgery of the body cavities.

Publications (1)

Publication Number Publication Date
WO1994003116A1 true WO1994003116A1 (en) 1994-02-17

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PCT/FR1993/000783 Ceased WO1994003116A1 (en) 1992-07-31 1993-07-30 Trocar sleeve with valve

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FR (1) FR2694181A1 (en)
WO (1) WO1994003116A1 (en)

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CN118477257A (en) * 2024-07-16 2024-08-13 上海玄宇医疗器械有限公司 Sealing disc, sealing valve and suction catheter

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Publication number Priority date Publication date Assignee Title
DE102011088337A1 (en) 2011-12-13 2013-06-13 Karl Storz Gmbh & Co. Kg Sealing device for sealing a passage for a medical instrument

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FR2517973A1 (en) * 1981-12-11 1983-06-17 Alby Albert Catheter tube holder assembly with elastomeric non-return valve - to allow catheter withdrawal and introduction of liq. anticoagulant or diluents
EP0143518A1 (en) * 1983-09-02 1985-06-05 Minntech Corporation Dispenser for peritoneal cavity
WO1990002579A2 (en) * 1988-09-15 1990-03-22 Mallinckrodt, Inc. Catheter introducer with flexible tip
EP0369314A2 (en) * 1988-11-18 1990-05-23 Edward Weck, Inc. Hemostasis valve
DE9103081U1 (en) * 1991-03-14 1991-06-13 REHAU AG + Co., 95111 Rehau Insertion aid for a catheter tube
DE9112550U1 (en) * 1991-10-09 1991-11-28 Richard Wolf Gmbh, 7134 Knittlingen Trocar sleeve for inserting a medical instrument
US5106054A (en) * 1990-08-23 1992-04-21 Thomas J. Fogarty Self-sealing hemostasis valve apparatus and method of forming the same

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FR2517973A1 (en) * 1981-12-11 1983-06-17 Alby Albert Catheter tube holder assembly with elastomeric non-return valve - to allow catheter withdrawal and introduction of liq. anticoagulant or diluents
EP0143518A1 (en) * 1983-09-02 1985-06-05 Minntech Corporation Dispenser for peritoneal cavity
WO1990002579A2 (en) * 1988-09-15 1990-03-22 Mallinckrodt, Inc. Catheter introducer with flexible tip
EP0369314A2 (en) * 1988-11-18 1990-05-23 Edward Weck, Inc. Hemostasis valve
US5106054A (en) * 1990-08-23 1992-04-21 Thomas J. Fogarty Self-sealing hemostasis valve apparatus and method of forming the same
DE9103081U1 (en) * 1991-03-14 1991-06-13 REHAU AG + Co., 95111 Rehau Insertion aid for a catheter tube
DE9112550U1 (en) * 1991-10-09 1991-11-28 Richard Wolf Gmbh, 7134 Knittlingen Trocar sleeve for inserting a medical instrument

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN118477257A (en) * 2024-07-16 2024-08-13 上海玄宇医疗器械有限公司 Sealing disc, sealing valve and suction catheter

Also Published As

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