Methods and devices for providing access into a body cavity

• US 10,039,542 B2
• Filed: 05/04/2016
• Issued: 08/07/2018
• Est. Priority Date: 03/06/2009
• Status: Active Grant

• Current Assignee: Cilag Gmbh International (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery LLC (Johnson & Johnson)
• Inventors: Widenhouse, Christopher W., Shelton, IV, Frederick E.
• Primary Examiner(s): Philogene, Pedro
• Application Number:
  US15/145,954
• Publication Number:
  US 20160242758A1
• Time in Patent Office: 825 Days
• Field of Search: 600201, 600203-209, 600101, 600104-107, 600114, 600121-125, 600137-139, 600153-159, 600162-165, 600184, 600141, 604 43, 604 44, 604 9401, 60416401, 606108, 606191, 606192, 606197
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/3423 Access ports, e.g. toroid shape introducers for instruments or hands access sites for liquids A61M39/0247
• CPC Class Codes: A61B 17/3462 with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals expandable cannulas A61B17/3417
• CPC Class Codes: A61B 2017/00862 elastic or resilient for sutures A61B2017/0618
• CPC Class Codes: A61B 2017/3419 Sealing means between cannula and body
• CPC Class Codes: A61B 2017/3445 used as instrument channel for multiple instruments catheters A61B2017/22072
• CPC Class Codes: A61B 2017/3447 Linked multiple cannulas
• CPC Class Codes: A61B 2017/3449 whereby the instrument channels merge into one single channel
• CPC Class Codes: A61B 2017/3464 with means acting on inner surface of valve or seal for expanding or protecting, e.g. inner pivoting fingers
• CPC Class Codes: A61B 2017/3466 for simultaneous sealing of multiple instruments

Abstract

Methods and devices are provided for providing surgical access into a body cavity. In one embodiment, a surgical access device is provided that includes a housing coupled to a retractor. The housing can be have one or more movable sealing ports for receiving surgical instruments. Each movable sealing port can include one or more sealing elements therein for sealing the port and/or forming a seal around a surgical instrument disposed therethrough. Each movable sealing port can be rotatable relative to the housing and each sealing element can be rotatable relative to the housing along a predetermined orbital path.

Claims

1. A surgical device, comprising:

a distal retractor having a passageway extending therethrough, the distal retractor being configured to be positioned within tissue to provide access through the tissue via the passageway;

a proximal housing coupled to the distal retractor; and

a base coupled to the proximal housing and having first and second holes formed therein that have first and second sealing elements respectively positioned therein, the first and second sealing elements each being configured to form a seal around a surgical instrument inserted therethrough and into the passageway, a center point of the first hole being laterally offset from a center point of the base and from a center point of the second hole, a center point of the first sealing element being laterally offset from the center point of the first hole, the center point of the second hole being laterally offset from the center point of the base, and a center point of the second sealing element being laterally offset from the center point of the second hole;

wherein the first sealing element has a first range of motion in which the first sealing element is rotatable 360°

with the second sealing element in a first orbital path around the center point of the base relative to the proximal housing and the distal retractor, and the first sealing element has a second range of motion in which the first sealing element is rotatable 360°

in a second orbital path around the center point of the first hole relative to the second sealing element, the proximal housing, and the distal retractor.

2. The device of claim 1, wherein the first sealing element is seated in a first support member movably disposed in the first hole and having a same center point as the first hole, and the second sealing element is seated in a second support member movably disposed in the second hole and having a same center point as the second hole.

3. The device of claim 1, wherein the base is configured to rotate about the center point of the base relative to the proximal housing and the distal retractor to allow the first range of motion of the first sealing element.

4. The device of claim 1, further comprising a resilient member that forms a seal between the proximal housing and the distal retractor.

5. The device of claim 4, wherein the resilient member includes a foam material or a spring.

6. The device of claim 1, wherein the base is removably and replaceably coupled to the distal retractor and the proximal housing.

7. The device of claim 6, wherein the proximal housing is removably and replaceably coupled to the distal retractor.

8. A method of providing access through tissue to a body cavity, comprising:

positioning a surgical access device within an opening formed through tissue such that the surgical access device forms a working channel extending through the tissue and into a body cavity, the surgical access device including a base having a surface defining a horizontal plane;

inserting a first surgical instrument through a first sealing element in the surgical access device and through the working channel of the surgical access device to position a distal end of the first surgical instrument within the body cavity; and

moving the first surgical instrument to cause the first sealing element to move in the horizontal plane along a first orbital path from a first position, in which the first sealing element is located a first distance from a center point of the surgical access device, to a second position, in which the first sealing element is located a second distance from the center point of the surgical access device that is different from the first distance;

wherein moving the first surgical instrument causes rotation of the base of the surgical access device.

9. The method of claim 8, wherein the rotation of the base causes a second sealing element in the surgical access device having a second surgical instrument inserted therethrough to move in the horizontal plane along a second orbital path from a third position, in which the second sealing element is located a third distance from the center point of the surgical access device, to a fourth position, in which the second sealing element is located a fourth distance from the center point of the surgical access device that is different from the third distance.

10. The method of claim 9, wherein the first orbital path is defined by a perimeter of a first opening formed in the base, and the second orbital path is defined by a perimeter of a second opening formed in the base.

11. The method of claim 8, wherein the working channel extends through a housing of the surgical access device, the base is coupled to the housing, and the rotation of the base rotates the base relative to the housing.