Systems for the prevention of surgical site infections

• US 10,085,734 B2
• Filed: 06/17/2016
• Issued: 10/02/2018
• Est. Priority Date: 01/10/2012
• Status: Active Grant

• Current Assignee: Board of Trustees of the Leland Stanford Junior University (Stanford Management Co.)
• Original Assignee: Board of Trustees of the Leland Stanford Junior University (Stanford Management Co.)
• Inventors: Suh, Insoo, Coe, Jonathan, Gnanashanmugam, Swaminadhan, Koehler, Jeremy, Welton, Mark
• Primary Examiner(s): Ku, Si Ming
• Application Number:
  US15/186,141
• Publication Number:
  US 20160287240A1
• Time in Patent Office: 837 Days
• Field of Search: 600204-208
• 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 17/0293 with ring member to support retractor elements
• 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 2017/00539 hydraulically
• CPC Class Codes: A61B 2017/00544 pneumatically
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/0225 flexible, e.g. fabrics, meshes, or membranes
• CPC Class Codes: A61B 2017/3437 with means for removing or absorbing fluid, e.g. wicks or absorbent pads
• CPC Class Codes: A61B 2017/3492 against the outside of the body
• CPC Class Codes: A61B 2217/005 with suction drainage system
• CPC Class Codes: A61B 2217/007 with irrigation system

Abstract

A surgical access system facilitates access to a surgical site within a patient'"'"'s body through an incision in the body. Surgical access systems can have at least one retention member and a fluid transportation member configured to deliver fluid to a surgical site or to remove fluid from a surgical site. In some embodiments, a surgical access device irrigates a surgical site to reduce surgical site infections and removes fluid from the surgical site to increase a physician'"'"'s visibility into the surgical site.

Claims

1. A surgical access system adapted to facilitate access to a surgical site within a body of a patient through an incision in the body, the surgical access system comprising:

a first retention member;

a second retention member configured to expand from a collapsed configuration to an expanded configuration, wherein the second retention member comprises at least four linkages pivotably coupled to one another such that actuation of the at least four linkages causes the linkages to pivot relative to one another thereby radially expanding or collapsing the second retention member, wherein the second retention member is configured to lie in a plane above the incision, and wherein the at least four linkages pivot radially outward to expand in the plane, and wherein the second retention member has a perimeter, the perimeter being larger in the expanded configuration than the perimeter in the collapsed configuration;

a pliable membrane extending between the first retention member and the second retention member, the pliable membrane configured to engage and expand the incision to facilitate access to the surgical site by the second retention member when the second retention member is in the expanded configuration.

2. The surgical access system of claim 1, further comprising a fluid delivery member fluidly coupled to the pliable membrane for introducing fluid into the surgical access system.

3. The surgical access system of claim 2, wherein the pliable membrane comprises a first group of perforations in fluid communication with the fluid delivery member to allow the fluid to irrigate the surgical site.

4. The surgical access system of claim 1, wherein the pliable membrane comprises an inner wall and an outer wall, wherein the pliable membrane comprises a space between at least a portion of the inner wall and the outer wall, and wherein the space is configured to enable a fluid to pass through at least a portion of the pliable membrane.

5. The surgical access system of claim 1, further comprising a fluid removal member coupled with at least one of the first retention member and the pliable membrane.

6. The surgical access system of claim 1, wherein the pliable membrane further comprises a radially expandable channel extending axially therealong to provide access to the surgical site.

7. The surgical access system of claim 6, wherein the radially expandable channel remains open when the second retention member is in the expanded configuration and in the collapsed configuration.

8. The surgical access system of claim 1, wherein the second retention member is an expandable retention ring, and wherein the at least four linkages are pivotably coupled together in a closed shape.

9. The surgical access system of claim 1, wherein the first retention member is a closed and deformable retention ring.

10. The surgical access system of claim 1, wherein the first retention member is a closed and expandable retention ring.

11. The surgical access system of claim 1, wherein the second retention member comprises a locking mechanism configured to selectively maintain the second retention member in the expanded configuration.

12. The surgical access system of claim 11, wherein the locking mechanism comprises ratchet teeth on the second retention member configured to selectively maintain the expanded configuration.

13. The surgical access system of claim 12, wherein the locking mechanism comprises a ratchet pawl on the second retention member configured to selectively maintain the second retention member in the expanded configuration by engaging at least a portion of the ratchet teeth with the ratchet pawl.

14. The surgical access system of claim 13, wherein the surgical access device comprises a release mechanism configured to disengage the ratchet pawl from the ratchet teeth to enable the second retention member to return to the collapsed configuration from the expanded configuration.

15. The surgical access system of claim 11, wherein the locking mechanism comprises an indentation and a protrusion, wherein the protrusion is received in the indentation to selectively lock the second retention member in the expanded configuration.

16. The surgical access system of claim 1, wherein the pliable membrane comprises a tubular membrane, wherein the tubular membrane comprises a first end and a second end, wherein the first end is coupled to the first retention member and the second end is coupled to the second retention member.

17. The surgical access system of claim 1, wherein the first retention member is sized for advancement through the incision into the body and wherein the second retention member is configured for placement outside the body.

18. The surgical access system of claim 1, wherein the second retention member comprises at least ten linkages pivotably coupled to one another.

19. The surgical access system of claim 1, wherein the end of the pliable membrane expands radially outward in the plane as the second retention member is radially expanded.

20. The surgical access system of claim 1, wherein the at least four linkages pivotably coupled together comprise pivots which move radially outward when the second retention member expands from the collapsed configuration to the expanded configuration.