Puncture access procedures are frequent in medicine but can lead to complications due to over-puncture. When tissue membranes yield under applied stress, the device suddenly accelerates forward into the patient. Factors contributing to greater acceleration and increased risk of over-puncture are identified. A novel flexure-based tip-retraction mechanism is proposed and relevant analysis presented. A preload feature improves functionality and ease of use, and accompanying modified design equations are presented. Prototypes are tested to validate analysis and reliability. The proposed device has the potential to improve safety during puncture access procedures by actively opposing forward acceleration of the device upon break-through thus reducing over-puncture incidents.

References

1.
Tambe
,
P.
, and
Krishnakumar
,
S.
,
2009
, “
Entry Complications in Laparoscopic Surgery
,”
J. Gynecol. Endoscopy Surg.
,
1
(
1
), pp.
4
11
.10.4103/0974-1216.51902
2.
Norris
,
M. C.
,
Leighton
,
B. L.
, and
DeSimone
,
C. A.
,
1989
, “
Needle Bevel Direction and Headache After Inadvertent Dural Puncture
,”
Anesthesiology
,
70
(
5
), pp.
729
731
.10.1097/00000542-198905000-00002
3.
Sprigge
,
J. S.
, and
Harper
,
S. J.
,
2008
, “
Accidental Dural Puncture and Post Dural Puncture Headache in Obstetric Anaesthesia: Presentation and Management: A 23-Year Survey in a District General Hospital
,”
Anaesthesia
,
63
(
1
), pp.
36
43
.10.1111/j.1365-2044.2007.05285.x
4.
Barnes
,
T. W.
,
Morgenthaler
,
T. I.
,
Olson
,
E. J.
,
Hesley
,
G. K.
,
Decker
,
P. A.
, and
Ryu
,
J. H.
,
2005
, “
Sonographically Guided Thoracentesis and Rate of Pneumothorax
,”
J. Clin. Ultrasound
,
33
(9), pp.
442
446
.10.1002/jcu.20163
5.
Feller-Kopman
,
D.
,
Berkowitz
,
D.
,
Boiselle
,
P.
, and
Ernst
,
A.
,
2007
, “
Large-Volume Thoracentesis and the Risk of Reexpansion Pulmonary Edema
,”
Ann. Thorac. Surg.
,
84
(
5
), pp.
1656
1661
.10.1016/j.athoracsur.2007.06.038
6.
Bhoyrul
,
S.
,
Vierra
,
M. A.
,
Nezhat
,
C. R.
,
Krummel
,
T. M.
, and
Way
,
L. W.
,
2001
, “
Trocar Injuries in Laparoscopic Surgery
,”
J. Am. Coll. Surg.
,
192
(
6
), pp.
677
683
.10.1016/S1072-7515(01)00913-9
7.
Fuller
,
J.
,
Walter
,
S.
,
Binita
,
A.
, and
Julia
,
C.
,
2003
, “
Laparoscopic Trocar Injuries: A Report from a U.S. Food and Drug Administration (FDA) Center for Devices and Radiological Health (CDRH) Systematic Technology Assessment of Medical Products (STAMP) Committee
,” F.A.D.A. U.S. Department of Health and Human Services, Editor.
8.
Passerotti
,
C. C.
,
Begg
,
N.
,
Penna
,
F. J.
,
Passerotti
,
A. M.
,
Leite
,
K. R.
,
Antunes
,
A. A.
,
Srougi
,
M.
,
Retik
,
A. B.
, and
Nguyen
,
H. T.
,
2009
, “
Safety Profile of Trocar and Insufflation Needle Access Systems in Laparoscopic Surgery
,”
J. Am. Coll. Surg.
,
209
(
2
), pp.
222
232
.10.1016/j.jamcollsurg.2009.03.022
9.
Paul Loschak
,
K. X.
,
Hao
,
P.
,
Kesner
,
S. B.
,
Thomas
,
A. J.
, and
Conor
,
W.
,
2012
, “
Cranial Drilling Tool With Retracting Drill Bit Upon Skull Penetration
,”
J. Med. Dev.
,
6
(
1
), p. 017522.
10.
Costa
,
P. F.
,
Holmes
,
W. A.
, and
Moll
,
F. H.
,
1998
, “
Trocar With Retracting Tip
,” US patent EP0600921 B1.
11.
Green
,
D. T.
,
1994
, “
Safety Trocar
,”.
12.
Shafer
,
D. M.
,
Khajanchee
,
Y.
,
Wong
,
J.
, and
Swanstrom
,
L. L.
,
2006
, “
Comparison of Five Different Abdominal Access Trocar Systems: Analysis of Insertion Force, Removal Force, and Defect Size
,”
Surg. Innov.
,
13
(
3
), pp.
183
189
.10.1177/1553350606294247
13.
Fanning
,
J.
,
Shah
,
M.
, and
Fenton
,
B.
,
2011
, “
Reduced-Force Closed Trocar Entry Technique: Analysis of Trocar Insertion Force Using a Mechanical Force Gauge
,”
J. Soc. Laparoendoscopic Surg.
,
15
(
1
), pp.
59
61
.10.4293/108680811X13022985131219
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