INTEGRAL FOAM PORT
A surgical apparatus includes a seal anchor member. The seal anchor member includes a first end, a second end, at least one longitudinal port extending between the two ends, and a seal assembly disposed within the at least one longitudinal port. The seal assembly can be positioned at any location along the length of the at least one longitudinal port. The seal assembly comprises a seal housing which is dimensioned to receive a surgical instrument inserted into the at least one longitudinal port and form a substantially fluid-tight seal therewith. The seal housing may comprise a pivotable member to pivot the surgical instrument inserted therein. The at least one longitudinal port may define two gradually enlarging openings to facilitate the maneuverability of the surgical instrument inserted therein. The at least one longitudinal port may comprise a protective sleeve to protect it from accidental penetration by the surgical instrument.
This application is a continuation of U.S. patent application Ser. No. 13/223,700 filed Sep. 1, 2011, which claims the benefit of and priority to U.S. Provisional Patent Application Ser. No. 61/424,748 filed on Dec. 20, 2010, the entire contents of which are incorporated herein by reference.
BACKGROUND1. Technical Field
The present disclosure relates generally to surgical portals for use in minimally invasive surgical procedures, such as endoscopic and/or laparoscopic procedures, and more particularly, relates to a surgical portal that allows multiple surgical instruments to be inserted through a single incision.
2. Description of Related Art
Today, many surgical procedures are performed through small incisions in the skin, as compared to the larger incisions typically required in traditional procedures, in an effort to reduce both trauma to the patient and recovery time. Generally, such procedures are referred to as “endoscopic”, unless performed on the patient's abdomen, in which case the procedure is referred to as “laparoscopic”. Throughout the present disclosure, the term “minimally invasive” should be understood to encompass both endoscopic and laparoscopic procedures.
During a typical minimally invasive procedure, surgical objects, such as surgical access devices (e.g., trocar and cannula assemblies) or endoscopes, are inserted into the patient's body through the incision in tissue. In general, prior to the introduction of the surgical object into the patient's body, insufflation gas is used to enlarge the area surrounding the target surgical site to create a larger, more accessible work area. Accordingly, the maintenance of a substantially fluid-tight seal is desirable so as to inhibit the escape of the insufflation gas and the deflation or collapse of the enlarged surgical site.
To this end, various access devices with sealing features are used during the course of minimally invasive procedures to provide an access for surgical objects to enter the patient's body. Generally, an access device is made of resilient material and has one or more ports, and each port is designed to accommodate one surgical object to be inserted therethrough. In the prior art, when a surgical object advances through a port, the resilient material is adapted to frictionally engage the surgical object, thus forming a seal between the surgical object and the port along the length of the port.
Further, in the prior art, each port is open-ended. Therefore, before the insertion of surgical objects through the open-ended ports, the insufflation gas may escape from the patient's body cavity through the open-ended ports. For the same reason, foreign matter may inadvertently enter into the patient's body cavity through the open-ended ports. To overcome this problem, cannula assemblies have been used heretofore to couple with the prior access devices together providing a sealed passage for the surgical objects to access the patient's body. A cannula is a tubular member that is positioned within the prior access device through the port, providing a passage for a surgical object to access the patient's body. Typically, the cannula includes respective proximal and distal ends, an elongate member disposed therebetween, and a seal housing positioned at the proximal end. The elongate member defines an opening dimensioned to permit the passage of surgical object. Further, the elongate member is longer in length than that of the open-ended port. Thus, upon positioning, the distal end of the elongate member of the cannula reaches beyond the distal end of the open-ended port and extends into the patient's body cavity. Furthermore, the seal housing of the cannula is adapted to receive the surgical object inserted through the elongate member so as to form a substantially fluid-tight seal with the surgical object. Because the diameter of the seal housing is substantially larger than the diameter of the open-ended port, the seal housing is thus inhibited from entering the open-ended port. Therefore, upon positioning, the seal housing is positioned outside the access device, e.g. positioned above the opening of the open-ended port. Further, the cannula includes a closure valve which is normally closed in the absence of a surgical instrument. The closure valve thus inhibits gas leakage and introduction of foreign matter in its closed state, therefore serving as a complement to the open-ended ports.
In the prior art, during the operation of the access device, a surgeon introduces the access device into the incision either before or after introducing insufflation gas into the surgical site. After placing the prior access device into the incision, the surgeon inserts a cannula into each open-ended port of the access device, and then inserts a surgical instrument into each cannula. In multiple port access devices, cannulas are often staggered relative to the access device to facilitate movement of the surgical instruments. When multiple cannulas are positioned within the access device concurrently, the seal housings of the cannulas are all positioned above the access device. The seal housings may clash against each other as the surgeon manipulates multiple surgical instruments that are inserted through the multiple cannulas simultaneously. The collisions among the seal housings not only cause great interference with the movements of the surgical instruments, but also limit the number of cannulas that can coexist within an access device of a given size, thereby reducing the number of surgical instruments that can simultaneously operate through the access device. Similarly, the distal ends of the cannulas, which are positioned inside the patient's body cavity, may also cause interference with the instrument motion, as the distal ends of the cannulas clash within the body cavity. Further, in the prior art, the surgical instruments that are inserted through a single access port via cannulas have a limited freedom of movement constrained by the physical characteristics of the cannulas and the open-ended ports. For instance, an open-ended port provides an open channel in a longitudinal direction of the access port. For that reason, the elongate member of the cannula, when positioned within the open-ended port, provides a channel for the surgical instruments to maneuver in a longitudinal direction relative to the access port. However, to reach a desired operation site within the patient's body cavity, the surgeon often needs to move the surgical instrument in a slanting or sloping direction relative to the access port.
Thus, to facilitate and provide greater freedom of movement of the surgical instruments and to avoid potential interferences therewith, a continuing need exists for an access device with enhanced sealing features and enhanced port features.
SUMMARYThe present disclosure pertains to a surgical apparatus that includes a seal anchor member. The seal anchor member includes a first end, a second end, at least one longitudinal port extending between the two ends, and a seal assembly disposed within the at least one longitudinal port. The seal assembly comprises a seal housing which is configured to receive a surgical instrument inserted into the at least one longitudinal port and form a substantially fluid-tight seal therewith, thereby inhibiting the loss of insufflation gas between the at least one longitudinal port and the surgical instrument, thus precluding the need of a separate cannula. The seal assembly further comprises a closure valve which inhibits the escape of insufflation gas from the underlying peritoneal cavity of the patient, in the absence of the surgical instrument.
In one embodiment, the seal assembly is an integrated part of the seal anchor member. The seal assembly and the remaining parts of the seal anchor member are formed in one piece. Alternatively, the seal assembly is permanently attached to the remaining portion of the seal anchor member by glue or by an overmolding process.
In another embodiment, the seal assembly is detachably connected to the remaining parts of the seal anchor member. The seal assembly can be adjusted to various positions along the length of the at least one longitudinal port. The seal assembly can be securely engaged with the at least one longitudinal port through frictional engagement.
In a third embodiment, the seal anchor member comprises a plurality of longitudinal ports and a plurality of seal assemblies, each seal assembly being disposed in one of the plurality of longitudinal ports. Each seal assembly is positioned at a different elevation with respect to the height of the seal anchor member, thereby minimizing lateral interferences that could occur between adjacent seal assemblies.
In a fourth embodiment, the seal anchor member further comprises a protective sleeve disposed on an inner surface of the at least one longitudinal port along the length thereof. The protective sleeve protects the inner surface of the longitudinal port from accidental penetration by the surgical instruments as the surgical instruments insert through the seal anchor member. The protective sleeve may include a layer of coating made of a non-stick, lubricant material on its inner surface to reduce friction between the protective sleeve and the surgical instruments.
In a fifth embodiment, the seal anchor member comprises a seal assembly that includes a pivotable member to pivot the surgical instrument inserted therein with respect to a longitudinal axis of the seal anchor member, thereby facilitating the surgical instrument to move in a slanting or sloping direction (e.g., an off-axis direction with respect to the longitudinal axis).
In addition, while certain aspects of this disclosure are described as relating to laparoscopic surgery via the abdominal wall, it should be understood that the present invention is equally relevant to, and may be employed in connection with, other types of surgery such as incision-less surgery, whereby access to a body cavity is provided via a natural orifice such as the vagina, anus, mouth, ear, nasal passage, etc.
The above and other aspects, features, and advantages of the present disclosure will become more apparent in light of the following detailed description when taken in conjunction with the accompanying drawings in which:
Particular embodiments of the present disclosure will be described herein with reference to the accompanying drawings. As shown in the drawings and as described throughout the following description, and as is traditional when referring to relative positioning on an object, the term “proximal” or “trailing” refers to the end of the apparatus that is closer to the user and the term “distal” or “leading” refers to the end of the apparatus that is farther from the user. In the following description, well-known functions or constructions are not described in detail to avoid obscuring the present disclosure in unnecessary detail.
One type of minimal invasive surgery described herein employs a device that facilitates multiple instrument access through a single incision. This is a minimally invasive surgical procedure, which permits a surgeon to operate through a single entry point, typically the patient's navel. The disclosed procedure involves insufflating the peritoneal cavity and positioning a portal member within, e.g., the navel of the patient. Instruments including an endoscope and additional instruments such as graspers, staplers, forceps or the like may be introduced within the portal member to carry out the surgical procedure. An example of such a surgical portal is disclosed in commonly assigned U.S. patent application Ser. No. 12/244,024, filed Oct. 2, 2008, published as U.S. Patent Publication 2009/0093752, the entire contents of which are hereby incorporated by reference herein.
Referring now to the drawings, in which like reference numerals identify identical or substantially similar parts throughout the several views,
With continued reference to
With reference to
In one embodiment, the seal assembly 140 forms an integrated part of the seal anchor member 100, such that the seal assembly 140 and the remaining parts of the seal anchor member 100 are formed in one piece produced by the same assembly process. Alternatively, the seal assembly 140 and remaining parts of the seal anchor member 100 are produced by different assembly processes, and they are later attached together by glue or by an overmolding process.
In another embodiment, the seal assembly 140 is detachably connected to the seal anchor member 100 such that the seal assembly 140 can move along the length of the longitudinal port 130 or be removed from the longitudinal port 130 completely. In one example, the seal assembly 140 has a relatively larger radial dimension than that of the longitudinal port 130. As illustrated in
In a preferred embodiment as illustrated in
With continued reference to
Further, the seal assembly 140 defines an inner diameter “D3.” The inner diameter “D3” is configurable to any size, thereby permitting reception of any surgical instrument no greater than the size of the seal assembly 140 in diameter. In one embodiment, the inner diameter “D3” of the seal assembly 140 is about 5 mm. In another embodiment, the inner diameter “D3” of the seal assembly 140 is between about 5 mm and about 12 mm.
With reference to
With reference to
With reference to
With continued reference to
As illustrated in
The seal anchor member 100 of the present disclosure precludes the need a separate cannula assembly, because the seal assembly 140 disposed within the seal anchor member 100 is capable of forming fluid-tight seals with surgical instruments and inhibiting insufflation gas leakage which is normally done by the separate cannula assembly.
In use, the freedom of movement of the surgical instruments is greatly increased. Potential interferences with the instruments motion are substantially reduced by disposing seal assemblies 140 within the longitudinal ports 130, thus avoiding collisions that otherwise would occur when using cannulas. Further, because the present disclosure obviates the needs of a separate cannula assembly, clashes among the distal ends of cannulas are avoided. Further, by positioning multiple seal assemblies at different elevations within the seal anchor member, multiple instruments can simultaneously operate through the seal anchor member with a negligible degree of interferences among each other. Still further, the surgical instrument can easily move in off-axis directions through motion of the seal assemblies. Hence, the present disclosure provides increased latitude for instrument motion.
Furthermore, the surgical instruments of various shapes, such as curved surgical instruments, can be inserted into the seal anchor member 100, without requiring any particular shape.
While several embodiments of the disclosure have been shown in the drawings and/or discussed herein, it is not intended that the disclosure be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. Therefore, the above description should not be construed as limiting, but merely as exemplifications of particular embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.
Claims
1-20. (canceled)
21. A surgical apparatus for positioning within a tissue tract accessing an underlying body cavity, comprising:
- a seal anchor member including proximal and distal ends, the seal anchor member defining first and second ports extending between the proximal and distal ends; and
- first and second seal assemblies disposed within first and second ports, respectively, at least one of the first or second seal assemblies being selectively movable within the respective first and second ports towards the proximal end or the distal end of the seal anchor member.
22. The surgical apparatus according to claim 21, wherein the first and second seal assemblies are configured for sealed reception of a surgical object therein.
23. The surgical apparatus according to claim 21, wherein the first seal assembly defines a first diameter and the first port defines a second diameter smaller than the first diameter.
24. The surgical apparatus according to claim 21, wherein the seal anchor member is formed of at least one of foam, gel, or rubber.
25. The surgical apparatus according to claim 21, wherein the first and second ports of the seal anchor member define first and second longitudinal axes, respectively, the first and second longitudinal axes being non-collinear.
26. The surgical apparatus according to claim 21, wherein each of the first and second seal assemblies includes a seal housing configured to engage the respective first and second ports of the seal anchor member in a sealing relation.
27. The surgical apparatus according to claim 26, wherein each of the first and second seal assemblies includes a closure valve biased towards a closed position in the absence of a surgical objection.
28. The surgical apparatus according to claim 21, wherein the first seal assembly is positioned at a first distance from the proximal end of the seal anchor member, and the second seal assembly is positioned at a second distance from the proximal end of the seal anchor member.
29. A surgical apparatus for positioning within a tissue tract accessing an underlying body cavity, comprising:
- a seal anchor member defining first and second ports extending between proximal and distal ends of the seal anchor member; and
- first and second seal assemblies disposed within the first and second ports, respectively, the first and second seal assemblies being selectively movable such that the first seal assembly is longitudinally displaced from the second seal assembly.
30. The surgical apparatus according to claim 29, wherein the first and second seal assemblies are configured to receive a surgical object in a sealing relation.
31. The surgical apparatus according to claim 29, wherein the first seal assembly defines a first diameter and the first port defines a second diameter smaller than the first diameter.
32. The surgical apparatus according to claim 31, wherein the second seal assembly defines a third diameter and the second port defines a fourth diameter smaller than the third diameter.
33. The surgical apparatus according to claim 29, wherein the first and second ports define first and second longitudinal axes, respectively, the first and second longitudinal axes being non-collinear.
34. The surgical apparatus according to claim 29, wherein each of the first and second seal assemblies includes a seal housing for receiving a surgical object in a sealing relation.
35. The surgical apparatus according to claim 29, wherein each of the first and second seal assemblies includes a closure valve biased towards a closed position in the absence of a surgical object.
36. The surgical apparatus according to claim 29, wherein the seal anchor member is formed of at least one of foam, gel, or rubber.
Type: Application
Filed: Jul 27, 2015
Publication Date: Nov 19, 2015
Inventors: Gennady Kleyman (Brooklyn, NY), Greg Okoniewski (North Haven, CT)
Application Number: 14/809,805