Device

• US 20050192483A1
• Filed: 07/30/2004
• Published: 09/01/2005
• Est. Priority Date: 12/01/1998
• Status: Abandoned Application

• Current Assignee: Atropos Limited
• Original Assignee: Atropos Limited
• Inventors: Cuschieri, Alfred, Vaugh, Trevor, Bonadio, Frank, Butler, John, Reid, Alan, MacNally, Shane Joseph, McManus, Ronan Bernard
• Application Number:
  US10/902,440
• Publication Number:
  US 20050192483A1
• Time in Patent Office: Days
• US Class Current: 600/208
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, 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 17/3498 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 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/22051 with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation A61B2017/22048, A61B2017/3486 take precedence
• CPC Class Codes: A61B 2017/3435 using everted sleeves
• CPC Class Codes: A61B 2017/3443 with means for adjusting the length of a cannula
• CPC Class Codes: A61B 2017/3482 inside
• 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
• CPC Class Codes: A61F 2/958 Inflatable balloons for placing stents or stent-grafts
• CPC Class Codes: A61M 2025/0062 having features to improve the sliding of one part within another by using lubricants or surfaces with low friction coatings A61M2025/0046
• CPC Class Codes: A61M 2025/109 having balloons for removing solid matters, e.g. by grasping or scraping plaque, thrombus or other matters that obstruct the flow
• CPC Class Codes: A61M 25/0119 Eversible catheters
• CPC Class Codes: A61M 29/02 Dilators made of swellable material balloon catheters for angioplasty A61M25/104

Abstract

An instrument access port comprises a retractor (811) for retracting the sides of an incision (813) and a valve (829) for sealing around an instrument (814) inserted through the retracted incision (813). The retractor (811) comprises a distal member for insertion into the incision (813), a proximal member for location externally of the incision (813) and a retracting member for extending between the distal member and the proximal member. The valve (829) is coupled to the retractor (811) to define a low profile sealed instrument access port.

Claims

1. An instrument access port comprising:

a retractor for retracting the sides of an incision;

the retractor comprising a distal member for insertion into the incision, a proximal member for location externally of the incision, and a retracting member for extending between the distal member and the proximal member; and

a valve for sealing around an instrument inserted through a retracted incision;

the valve being coupled to the retractor to define a low profile sealed instrument access port.

2. A port as claimed in claim 1 wherein the retractor is configured to retract the sides of a laparoscopic incision.

3. A port as claimed in claim 1 wherein the retractor is configured to retract the sides of an incision to a diameter substantially equal to a diameter of an instrument to be inserted through the retracted incision.

4. A port as claimed in claim 3 wherein the retractor is configured to retract the sides of an incision to a diameter substantially equal to a diameter of a laparoscopic instrument to be inserted through the retracted incision.

5. A port as claimed in claim 1 wherein the retractor is configured to retract the sides of an incision to a diameter of less than 40 mm.

6. A port as claimed in claim 5 wherein the retractor is configured to retract the sides of an incision to a diameter of between 3 mm and 35 mm.

7. A port as claimed in claim 6 wherein the retractor is configured to retract the sides of an incision to a diameter of between 5 mm and 12 mm.

8. A port as claimed in claim 1 wherein the retracting member is fixedly attached to at least port of the proximal member.

9. A port as claimed in claim 1 wherein the retracting member is movably coupled to the distal member.

10. A port as claimed in claim 9 wherein the retracting member is looped around the distal member.

11. A port as claimed in claim 1 wherein the retracting member extends between the distal member and the proximal member in a two-layer arrangement.

12. A port as claimed in claim 11 wherein the retracting member extends distally from the proximal member to the distal member in a first layer and extends proximally from the distal member to the proximal member in a second layer, the first layer being located radially inwardly of the second layer.

13. A port as claimed in claim 1 wherein the retractor member comprises a sleeve.

14. A port as claimed in claim 1 wherein the distal member comprises a ring.

15. A port as claimed in claim 1 wherein the proximal member comprises a ring arrangement.

16. A port as claimed in claim 15 wherein the proximal member comprises an inner ring part and an outer ring part.

17. A port as claimed in claim 16 wherein at least part of the retracting member is movably received between the inner ring part and the outer ring part.

18. A port as claimed in claim 1 wherein the valve is configured to seal around a laparoscopic instrument.

19. A port as claimed in claim 1 wherein the valve is configured to seal around an instrument having a diameter of less than 40 mm.

20. A port as claimed in claim 19 wherein the valve is configured to seal around an instrument having a diameter of between 3 mm and 35 mm.

21. A port as claimed in claim 20 wherein the valve is configured to seal around an instrument having a diameter of between 5 mm and 12 mm.

22. A port as claimed in claim 1 wherein the valve comprises at least one sealing valve.

23. A port as claimed in claim 22 wherein the valve comprises a first sealing valve and a second sealing valve.

24. A part as claimed in claim 23 wherein the first sealing valve is located distally of the second sealing valve.

25. A port as claimed in claim 22 wherein the sealing valve comprises an iris valve.

26. A port as claimed in claim 22 wherein the sealing valve comprises a lip seal.

27. A port as claimed in claim 22 wherein the sealing valve comprises a duck-bill valve.

28. A port as claimed in claim 22 wherein the sealing valve is biased towards a closed, sealing configuration.

29. A port as claimed in claim 28 wherein the sealing valve comprises a biasing element to bias the sealing valve towards the closed, sealing configuration.

30. A port as claimed in claim 29 wherein the biasing element comprises a coiled spring.

31. A port as claimed in claim 1 wherein the port comprises a coupling element for coupling at least part of the valve to the retractor.

32. A port as claimed in claim 31 wherein the coupling element extends between the valve and the retractor to couple at least part of the valve to the retractor.

33. A port as claimed in claim 31 wherein the coupling element is substantially flexible to accommodate movement of the valve relative to the retractor while maintaining the coupling.

34. A port as claimed in claim 33 wherein the coupling element comprises a sleeve.

35. A port as claimed in claim 31 wherein the coupling element comprises a proximally extending portion of the retracting member.

36. A port as claimed in claim 1 wherein the valve is engagable with the retractor to couple at least port of the valve to the retractor.

37. A port as claimed in claim 36 wherein the valve is engagable with the retractor in a snap-fit manner to couple at least part of the valve to the retractor.

38. A port as claimed in claim 36 wherein the valve and the retractor comprise corresponding inter-engagement parts.

39. A port as claimed in claim 38 wherein the inter-engagement parts comprise a male projecting part on one of the valve or the retractor and a corresponding female recess part on the other of the retractor or the valve.

40. A port as claimed in claim 36 wherein at least part of the valve is engagable with at least part of the proximal member of the retractor.

41. A port as claimed in claim 40 wherein at least part of the valve is engagable with the outer ring part of the retractor.

42. A port as claimed in claim 1 wherein the valve is sized for effecting a gas-tight seal with an instrument no larger than a laparoscopic instrument.

43. (canceled)

44. A cannula comprising:

a proximal instrument insertion portion having a seal for sealingly engaging with an instrument shaft; and

a distal tubular portion defining an access channel for extension of an instrument therethrough;

the proximal portion being movably coupled to the distal portion to facilitate relative movement between the proximal portion and the distal portion to accommodate lateral movement of an instrument passing therethrough whilst maintaining sealing engagement between the seal and an instrument shaft.

45. A cannula as claimed in claim 44 wherein the cannula comprises a flexible coupling portion to movably couple the proximal portion to the distal portion.

46. A cannula as claimed in claim 45 wherein the coupling portion is substantially tubular.

47. A cannula as claimed in claim 45 wherein a longitudinal axis of the coupling portion is substantially parallel to a longitudinal axis of the distal portion.

48. A cannula as claimed in claim 45 wherein the coupling portion is concertinaed along at least part of the length of the coupling portion.

49. A cannula as claimed in claim 45 wherein the coupling portion comprises a sheath.

50. A cannula as claimed in claim 44 wherein the seal is provided at a proximal end of the proximal portion.

51. A cannula as claimed in claim 50 wherein the proximal portion comprises a proximal opening through which an instrument may be inserted into the proximal portion, and the seal is provided at the proximal opening.

52. A cannula as claimed in claim 44 wherein the seal comprises a lip seal.

53. A cannula comprising:

a proximal instrument insertion portion;

a distal tubular portion defining an access channel for extension of an instrument therethrough; and

a seal for sealingly engaging with an instrument shaft;

the seal being movably coupled to the proximal portion to accommodate lateral movement of an instrument passing therethrough while maintaining sealing engagement between the seal and an instrument shaft.

54. A cannula as claimed in claim 53 wherein the seal is located externally of the proximal portion.

55. A cannula as claimed in claim 54 wherein the seal is located proximally of a proximal end of the proximal portion.

56. A cannula as claimed in claim 55 wherein the proximal portion comprises a proximal opening through which an instrument may be inserted into the proximal portion, and the seal is located proximally of the proximal opening.

57. A cannula as claimed in claim 53 wherein the seal comprises a lip seal.

58. A cannula as claimed in claim 53 wherein the cannula comprises a flexible coupling portion to movably couple the seal to the proximal portion.

59. A cannula as claimed in claim 58 wherein the coupling portion is substantially tubular.

60. A cannula as claimed in claim 58 wherein a longitudinal axis of the coupling portion is substantially parallel to a longitudinal axis of the proximal portion.

61. A cannula as claimed in claim 58 wherein the coupling portion is concertinaed along at least part of the length of the coupling portion.

62. A cannula as claimed in claim 58 wherein the coupling portion comprises a sheath.

63. (canceled)

64. A method of accessing a wound interior with an instrument, the method comprising the steps of:

retracting the sides of an incision;

sealing around an instrument; and

sealingly inserting the instrument through the retracted incision to access the wound interior.

65. A method as claimed in claim 64 wherein the incision is a laparoscopic incision.

66. A method as claimed in claim 65 wherein the sides of the incision are retracted to a diameter of less than 40 mm.

67. A method as claimed in claim 66 wherein the sides of the incision are retracted to a diameter of between 3 mm and 35 mm.

68. A method as claimed in claim 67 wherein the sides of the incision are retracted to a diameter of between 5 mm and 12 mm.

69. A method as claimed in claim 64 wherein the sides of the incision are retracted to a diameter substantially equal to a diameter of the instrument.

70. A method as claimed in claim 64 wherein the instrument is a laparoscopic instrument.

71. A method as claimed in claim 70 wherein the instrument has a diameter of less than 40 mm.

72. A method as claimed in claim 71 wherein the instrument has a diameter of between 3 mm and 35 mm.

73. A method as claimed in claim 72 wherein the instrument has a diameter of between 5 mm and 12 mm.

74. A method as claimed in claim 64 wherein the method comprises the steps of:

opening a seal to extend the instrument therethrough; and

closing the seal around the instrument to seal around the instrument.

75. A method as claimed in claim 74 wherein the seal is opened by inserting the instrument through the seal.

76. A method as claimed in claim 74 wherein the seal is opened before extending the instrument through the seal.

77. A method as claimed in claim 64 wherein the method comprises the step of creating the incision.

78. A method as claimed in claim 64 wherein the method comprises the step of mounting a retractor in the incision.

79. A method as claimed in claim 78 wherein the method comprises the step of coupling a seal to a retractor.

80. A method as claimed in claim 79 wherein the seal is coupled to the retractor by engaging the seal with the retractor.

81. (canceled)