Instrument access device

• US 10,537,360 B2
• Filed: 07/11/2016
• Issued: 01/21/2020
• Est. Priority Date: 06/05/2007
• Status: Active Grant

• Current Assignee: Atropos Limited
• Original Assignee: Atropos Limited
• Inventors: Bonadio, Frank, Vaugh, Trevor, McManus, Ronan B., MacNally, Shane J., Butler, John
• Primary Examiner(s): Hammond, Ellen C
• Application Number:
  US15/207,392
• Publication Number:
  US 20170000522A1
• Time in Patent Office: 1,289 Days
• 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 17/3431 being collapsible, e.g. made of thin flexible material A61B17/3423 takes precedence
• 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 17/3468 for implanting or removing devices, e.g. prostheses, implants, seeds, wires devices for implanting seeds A61M37/0069
• CPC Class Codes: A61B 17/3498 Valves therefor, e.g. flapper valves, slide valves haemostasis valves A61M39/06; check valves A61M39/24
• CPC Class Codes: A61B 2017/00477 Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61B 2017/3445 used as instrument channel for multiple instruments catheters A61B2017/22072
• CPC Class Codes: A61B 2017/3449 whereby the instrument channels merge into one single channel
• CPC Class Codes: A61B 2017/3466 for simultaneous sealing of multiple instruments
• CPC Class Codes: A61B 2017/3484 Anchoring means, e.g. spreading-out umbrella-like structure
• CPC Class Codes: A61B 2017/3492 against the outside of the body

Abstract

An instrument access device comprises first, second and third instrument seals for sealing around instruments extended through the device. The seals have respective connector sleeves. Each sleeve connects a base to one of the instrument seals. The device also comprises two insufflation/desufflation ports. Each of the ports comprises a connector extending from the base, a tube extending from the connector, a luer connector and a removable cap. The luer connector is used for connection to any suitable supply line for insufflation gas or for discharge if insufflation gas. In use, the insufflation/desufflation ports facilitate independent control of insufflation and desufflation as may be required during a surgical procedure. Access sleeve at the proximal end is cut-off, folded over the inner proximal ring and is held in place between the base and the inner proximal ring when the base is fitted. The proximal end of the sleeve that is generated when the sleeve is pulled upwardly to retract an incision is removed from the field of use.

Claims

1. An instrument access device, comprising:

a wound retractor, including;

a proximal ring,

a distal ring, and

a retractor sleeve extending proximally from the distal ring to the proximal ring, wherein at least a portion of the retractor sleeve is configured to extend proximally of the proximal ring; and

a proximal assembly, including;

an instrument seal assembly mounted to the proximal ring, wherein the instrument seal assembly includes a plurality of tubular portions, each of the plurality of tubular portions having a single and distinct sealing element at an end of each of the plurality of tubular portions, wherein a distal end of the instrument seal assembly includes at least one surface that faces radially outwardly away from a central longitudinal axis of the wound retractor, and wherein the instrument seal assembly includes a flexible base mounted to the proximal ring, and the plurality of tubular portions extend proximally from the flexible base; and

an outer ring mounted to the proximal ring, wherein the outer ring includes at least one surface that faces radially inwardly toward the central longitudinal axis of the wound retractor, wherein the at least one surface of the outer ring faces the at least one surface of the distal end of the instrument seal assembly.

2. The instrument access device of claim 1, wherein the retractor sleeve directly contacts the proximal ring.

3. The instrument access device of claim 1, wherein the wound retractor includes a central passage extending through the proximal ring, distal ring, and retractor sleeve, and the instrument seal assembly extends across a proximal end of the central passage.

4. The instrument access device of claim 3, wherein the instrument seal assembly is mounted to the proximal ring such that a seal is formed by the instrument seal assembly at the proximal end of the central passage.

5. The instrument access device of claim 1, wherein the plurality of tubular portions hold the sealing elements proximal to the proximal ring and the outer ring.

6. The instrument access device of claim 1, wherein the sealing elements are spaced equidistantly from a proximalmost surface of the flexible base by the plurality of tubular portions.

7. The instrument access device of claim 1, wherein each of the sealing elements includes a valve.

8. An instrument access device, comprising:

a wound retractor, including;

a proximal ring,

a distal ring, and

a retractor sleeve extending proximally from the distal ring to the proximal ring; and

a proximal assembly mounted to the proximal ring, the proximal assembly including;

an instrument seal assembly, wherein the instrument seal assembly includes a plurality of tubular portions, each of the tubular portions having a sealing element at an end thereof, and wherein the sealing elements are laterally spaced from each other and do not overlap in an axial direction, and

an outer ring extending radially around;

(i) an outer periphery of the proximal ring, and (ii) an outer periphery of a distal end of the instrument seal assembly,

wherein a portion of the retractor sleeve is configured to extend into a region between (i) a radially outermost edge of the proximal ring, and (ii) the outer ring.

9. The instrument access device of claim 8, wherein the outer ring includes a wall that circumscribes the outer periphery of the proximal ring, and a flange projecting radially-inwardly from the wall to a location distal to the proximal ring, wherein the flange is at a distalmost end of the outer ring.

10. The instrument access device of claim 8, wherein each of the plurality of tubular portions protrudes proximally of a proximalmost end of at least one of the proximal ring and the outer ring, such that each of the sealing elements is substantially equidistant from the proximalmost end.

11. The instrument access device of claim 10, wherein the instrument seal assembly includes a base mounted to the proximal ring, and wherein each of the plurality of tubular portions extends proximally from the base.

12. The instrument access device of claim 11, wherein the sealing elements are spaced equidistantly from a proximalmost surface of the base by the plurality of tubular portions.

13. The instrument access device of claim 11, wherein a flexibility of the base facilitates movement of the sealing elements relative to the proximal ring.

14. An instrument access device, comprising:

a wound protector, including;

a proximal ring,

a distal ring, and

a sleeve extending proximally from the distal ring to the proximal ring for protecting lateral sides of a wound opening; and

an instrument seal assembly mounted to the proximal ring, the instrument seal assembly including;

a first elongate tubular portion having a free end,

a first sealing element coupled to the first elongate tubular portion, the first sealing element having a central longitudinal axis extending therethrough,

a second elongate tubular portion having a free end, and

a second sealing element coupled to the second elongate tubular portion at the free end of the second elongate tubular portion, the second sealing element having a central longitudinal axis extending therethrough, wherein the central longitudinal axis of the first sealing element is parallel to the central longitudinal axis of the second sealing element,

wherein the wound protector includes a central longitudinal axis, and the central longitudinal axes of the first sealing element and the second sealing element are offset from the central longitudinal axis of the wound protector.

15. The instrument access device of claim 14, wherein the wound protector includes a central longitudinal axis, and the central longitudinal axes of the first sealing element and the second sealing element are offset from the central longitudinal axis of the wound protector.

16. The instrument access device of claim 15, wherein the central longitudinal axes of the first sealing element and the second sealing element are parallel to the central longitudinal axis of the wound protector, in the absence of one or more external forces being applied to the first and second elongate tubular portions.

17. The instrument access device of claim 14, wherein at least one of the first sealing element and the second sealing element includes a valve.

18. The instrument access device of claim 14, wherein the distal ring is an O-ring, and the sleeve is coupled to a surface of the O-ring.

19. The instrument access device of claim 14, wherein the instrument seal assembly includes a base mounted to the proximal ring, and wherein each of the plurality of tubular portions extends proximally from the base.