Surgical hand access apparatus

• US 20050267419A1
• Filed: 04/05/2005
• Published: 12/01/2005
• Est. Priority Date: 04/05/2004
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Tyco Healthcare Group LP (Medtronic Plc)
• Inventors: Smith, Robert C.
• Granted Patent: US 7,717,847 B2
• Time in Patent Office: Days
• US Class Current: 604/256
• 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 2017/00265 Hand assisted surgery, i.e. minimally invasive surgery with at least part of an assisting hand inside the body
• CPC Class Codes: A61B 2017/00477 Coupling A61B2017/0046 takes precedence
• 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

Abstract

A surgical access apparatus adaptable to permit the sealed insertion of either the surgeon'"'"'s hand and/or surgical instruments during laparoscopic and endoscopic surgical procedures includes an access housing defining a central longitudinal axis and having a longitudinal opening extending therethrough for passage of a surgeon'"'"'s hand, a retractor base mounted to the access housing and having a flexible liner for positioning within the incision to engage tissue portions defining the incision, and a trocar adapter which is releasably mounted to the access housing. The trocar adapter includes a trocar sleeve positioned for reception within the longitudinal opening and a trocar valve adapted to receive a surgical instrument in fluid tight relation therewith. The access housing may include a seal adapted to form a seal about each of the surgeon'"'"'s arm and the trocar sleeve. The seal is adapted to close in absence of the surgeon'"'"'s arm or the trocar sleeve.

Claims

1. A surgical access apparatus, which comprises:

an access housing defining a central longitudinal axis and having a first internal passageway defining a first internal dimension configured and dimensioned to permit passage of an object;

a seal mounted to the housing across the first internal passageway, the seal adapted to receive the object in substantial fluid-tight relation; and

an adapter mountable to the access housing, the adapter including an access member having a second internal passageway defining a second internal dimension less than the first internal dimension of the access housing.

2. The surgical access apparatus according to claim 1 wherein the first internal passageway of the access housing is dimensioned to permit the passage of a hand of the surgeon.

3. The surgical access apparatus according to claim 1 wherein the second internal passageway of the adapter is dimensioned to permit the passage of a surgical instrument.

4. The surgical access apparatus according to claim 3 wherein the adapter includes a valve disposed relative to the second internal passageway, the valve adapted to establish a substantial fluid tight relation with the instrument.

5. The surgical access apparatus according to claim 4 wherein the seal of the access housing is adapted to form a substantial fluid tight seal about the access member of the adapter.

6. The surgical access apparatus according to claim 1 wherein the adapter is releasably mounted to the access housing.

7. The surgical access apparatus according to claim 1 wherein the seal comprises a gel material.

8. A surgical access apparatus which comprises:

an access housing having a first passageway for receiving an object; and

a base mountable to the access housing, the base including;

a flexible liner member positionable within an incision of a patient to at least partially line the incision;

a first member connected to one end of the liner member and adapted for positioning within the body to engage an inner surface of the body;

a second member connected to the other end of the liner member; and

an expandable member positioned adjacent the access housing to engage the second member of the base, the expandable member expandable to displace the second member whereby the liner member engages tissue forming the incision to at least partially retract the incision.

9. The surgical access apparatus according to claim 8 wherein the first member of the base is resilient.

10. The surgical access apparatus according to claim 9 wherein the base includes a housing mount mounted to the access housing and positioned adjacent the expandable member, the housing mount coupled to the second member of the base and movable relative to the access housing upon expansion of the expandable member to displace the second member.

11. The surgical access apparatus according to claim 9 wherein the expandable member includes a balloon member.

12. The surgical access apparatus according to claim 9 wherein the first and second members are each resilient annular members.

13. The surgical access apparatus according to claim 12 wherein the balloon member defines an annular shape.

14. The surgical access apparatus according to claim 8 wherein the access housing includes an outer trough, the expandable member being at least partially accommodated in the outer trough.

15. The surgical access apparatus according to claim 14 wherein the base includes a housing mount coupled to the second member and disposed adjacent the outer trough, the housing mount adapted to move relative to the access housing, whereby upon expansion of the expandable member, the housing mount is displaced from the first member.

16. The surgical access apparatus according to claim 8 wherein the access housing has a seal adapted to receive the object in substantial fluid-tight relation.

17. The surgical access apparatus according to claim 16 further comprising an adapter mountable to the access housing, the adapter having an access member defining a second passageway through the seal.

18. The surgical access apparatus according to claim 17 wherein the adapter has a valve disposed across the second passageway, the valve adapted to receive a surgical instrument in substantial fluid-tight relation.

19. The surgical access apparatus according to claim 8, wherein the expandable member is a balloon.

20. A surgical access apparatus, which comprises:

an access housing defining a central longitudinal axis and having a longitudinal opening extending therethrough for passage of a surgeon'"'"'s hand;

a retractor base mounted to the access housing, the retractor base including a flexible liner for positioning within the incision to engage tissue portions defining the incision; and

a trocar adapter releasably mounted to the access housing, the trocar adapter including a trocar sleeve positioned for reception within the longitudinal opening and a trocar valve adapted to receive a surgical instrument in fluid tight relation therewith.

21. The surgical access apparatus according to claim 20 wherein the access housing includes a seal adapted to form a seal about each of the surgeon'"'"'s arm and the trocar sleeve.

22. The surgical access apparatus according to claim 21 wherein the seal is adapted to close in absence of the surgeon'"'"'s arm or the trocar sleeve.

23. The surgical access apparatus according to claim 22 wherein the seal comprises a gel material.

24. The surgical access apparatus according to claim 20 wherein the retractor base includes first and second annular members connected to respective ends of the liner, the first annular member positionable through the incision to engage inner tissue portions within the body cavity, the second annular member mounted with respect to the access housing.

25. The surgical access apparatus according to claim 24 wherein the retractor base includes an expandable member mounted to the access housing and engagable with the second annular member, the expandable member adapted to expand to displace the second annular member relative to the first annular member to cause the liner to at least partially extract tissue defining the incision.

26. The surgical access apparatus according to claim 25 wherein the expandable member includes an annular balloon.

27. The surgical access apparatus according to claim 26 wherein the retractor base includes an annular mount coupled to the second annular member and positioned relative to the access housing to be engaged by the annular balloon, the annular mount adapted to more relative to the access housing upon expansion of the annular balloon to displace the second annular member relative to the first annular member.