Instrument access device

• US 20060247498A1
• Filed: 10/11/2005
• Published: 11/02/2006
• Est. Priority Date: 12/01/1998
• Status: Active Grant

• Current Assignee: Atropos Limited
• Original Assignee: Atropos Limited
• Inventors: Vaugh, Trevor, Bonadio, Frank, Butler, John
• Granted Patent: US 7,998,068 B2
• Time in Patent Office: Days
• US Class Current: 600/208
• CPC Class Codes: A61B 1/32 Devices for opening or enlarging the visual field, e.g. of a tube of the body dilators A61M29/00
• 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 17/3421 Cannulas
• 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 17/3474 Insufflating needles, e.g. Veress needles
• 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 2017/0225 flexible, e.g. fabrics, meshes, or membranes
• CPC Class Codes: A61B 2017/3429 having a unitary compressible body, e.g. made of silicone or foam
• 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 2017/347 Locking means, e.g. for locking instrument in cannula
• CPC Class Codes: A61B 2017/3482 inside
• CPC Class Codes: A61B 2017/3492 against the outside of the body
• CPC Class Codes: A61B 90/40 Apparatus fixed or close to patients specially adapted for providing an aseptic surgical environment
• CPC Class Codes: A61M 13/003 Blowing gases other than for carrying powders, e.g. for inflating, dilating or rinsing

Abstract

An instrument access device (500) comprises a distal O-ring (11) for insertion into a wound interior, a proximal member for location externally of a wound opening and a sleeve (12) extending in two layers between the distal O-ring (11) and the proximal member. The proximal member comprises an inner proximal ring member (25) and an outer proximal ring member (24) between which the sleeve (12) is led. A seal housing (300) is mounted to the inner proximal ring member (25). A gelatinous elastomeric seal (302) with a pinhole opening (303) therethrough is received in the housing (300). An instrument may be extended through the seal (302) to access the wound interior through the retracted wound opening in a sealed manner.

Claims

1. An instrument access device comprising:

—

a distal anchoring member for insertion into a wound interior;

an elongate member extending proximally from the distal anchoring member to retract laterally the sides of a wound opening; and

an instrument working channel through which an instrument may extend to access the wound interior.

2. An access device as claimed in claim 1 wherein the device comprises a proximal member for location externally of a wound opening.

3. An access device as claimed in claim 2 wherein the proximal member comprises a ring member.

4. An access device as claimed in claim 2 wherein the proximal member comprises a proximal inner element and a proximal outer element.

5. An access device as claimed in claim 4 wherein the elongate member is led between the proximal inner element and the proximal outer element.

6. An access device as claimed in claim 4 wherein the proximal inner element and/or the proximal outer element comprises a ring element.

7. An access device as claimed in claim 4 wherein the proximal outer element is mounted to the proximal inner element.

20. An access device as claimed in claim 1 wherein the device comprises at least one instrument seal or valve.

21. An access device as claimed in claim 20 wherein the seal or valve comprises a gelatinous elastomeric material.

22. An access device as claimed in claim 20 wherein the seal or valve comprises at least one opening extending therethrough through which an instrument may be extended.

23. An access device as claimed in claim 22 wherein the opening is biased towards a closed configuration.

24. An access device as claimed in claim 22 wherein the opening comprises a pinhole opening.

29. An access device as claimed in claim 1 wherein the device comprises a housing for an instrument seal or valve.

30. An access device as claimed in claim 29 wherein the housing comprises a reception space for receiving an instrument seal or valve.

31. An access device as claimed in claim 30 wherein the reception space has an inlet through which an instrument seal or valve may be located in the reception space.

32. An access device as claimed in claim 31 wherein the inlet faces proximally.

33. An access device as claimed in claim 30 wherein the housing comprises a retainer to retain an instrument seal or valve in the reception space.

34. An access device as claimed in claim 33 wherein the retainer comprises a cap for at least partially closing the inlet.

35. An access device as claimed in claim 33 wherein the retainer comprises an opening to facilitate access to an instrument seal or valve in the reception space.

36. An access device as claimed in claim 35 wherein the retainer is substantially annular in shape.

37. An access device as claimed in claim 29 wherein the housing comprises a locator to assist in locating a seal or valve in the reception space.

38. An access device as claimed in claim 37 wherein the locator comprises at least one male member for co-operative association with at least one corresponding female member.

48. An access device as claimed in claim 29 wherein the housing is mounted to the proximal member.

49. An access device as claimed in claim 48 wherein the housing is mounted to the proximal inner element.

50. An access device as claimed in claim 49 wherein the housing extends distally of the proximal inner element.

51. An access device as claimed in claim 49 wherein the housing is located radially inwardly of the proximal inner element.

59. An access device as claimed in claim 29 wherein the housing at least in part defines the instrument working channel.

76. An access device as claimed in claim 1 wherein the elongate member comprises a sleeve.

77. An access device as claimed in claim 76 wherein at least a portion of the sleeve comprises two material layers.

78. An access device as claimed in claim 77 wherein the sleeve is wrapped around the distal anchoring member.

79. An access device as claimed in claim 77 wherein the sleeve is slidably movable relative to the distal anchoring member.

82. An access device as claimed in claims 2 wherein the elongate member extends from the distal anchoring member to at least the proximal member.

83. An access device as claimed in claim 82 wherein the elongate member is slidably movable over at least a portion of the proximal member.

84. An access device as claimed in claim 83 wherein the elongate member is slidably movable over the proximal inner element.

85. An access device as claimed in claim 82 wherein an end of the elongate member is fixed to the proximal member.

87. An access device as claimed in claim 85 wherein the elongate member is fixed to the proximal member at one end, the elongate member extends from the proximal member to the distal anchoring member to define an inner material layer, and the elongate member extends from the distal ring anchoring member to the proximal member to define an outer material layer.

88. An access device as claimed in claim 1 wherein the distal anchoring member comprises a distal ring.

89. An access device as claimed in claim 88 wherein the distal ring is formed from an elastomeric material.

8-19. -19. (canceled)

25-28. -28. (canceled)

39-47. -47. (canceled)

52-58. -58. (canceled)

60-75. -75. (canceled)

80-81. -81. (canceled)

86. (canceled)

90. (canceled)

91. An instrument access device comprising:

—

a distal ring;

a proximal ring;

a sleeve having a portion between the distal ring and the proximal ring that includes two material layers; and

an instrument seal or valve mounted to the proximal ring.

92. An access device as claimed in claim 91 wherein the sleeve is fixed to the proximal ring at one end, the sleeve extends from the proximal ring to the distal ring to define an inner material layer, and the sleeve extends from the distal ring to the proximal ring to define an outer material layer.

93. An access device as claimed in claim 92 wherein the sleeve is slidingly received over a portion of the proximal ring.

94. An access device as claimed in claim 91 wherein the proximal ring comprises an inner proximal ring member and an outer proximal ring member between which the sleeve is led.

95. An instrument access device comprising:

a

distal ring;

a proximal ring;

a sleeve having a portion between the distal ring and the proximal ring; and

an instrument seal or valve comprising a gelatinous elastomeric material for receiving an instrument.

96. An access device as claimed in claim 95 wherein the gelatinous elastomeric material has a pinhole to receive an instrument.

97. An instrument access device comprising:

—

a distal anchoring member for insertion into a wound interior;

a proximal member for location externally of a wound opening;

a sleeve extending in two layers at least between the distal anchoring member and the proximal member; and

an instrument seal or valve comprising a gelatinous elastomeric material for receiving an instrument.

98. An instrument access device comprising:

—

a distal anchoring member for insertion into a wound interior;

a proximal member for location externally of a wound opening;

an elongate member extending at least between the distal anchoring member and the proximal member;

the proximal member comprising a proximal inner element and a proximal outer element between which the elongate member is led; and

an instrument seal or valve mounted to the proximal inner element.

99-127. -127. (canceled)

128. A method of retracting a wound opening, the method comprising the steps of:

—

inserting a distal anchoring member through a wound opening into a wound interior;

locating a proximal member externally of the wound opening with an elongate member extending at least between the distal anchoring member and the proximal member; and

by means of a single actuation step, moving the proximal member relative to the elongate member to retract laterally the sides of the wound opening.

129. A method as claimed in claim 128 wherein the entire circumference of the proximal member is moved together relative to the entire circumference of the elongate member.

130. A method as claimed in claim 128 wherein the proximal member is pushed distally relative to the elongate member.

131. A method as claimed in claim 128 wherein the elongate member is pulled proximally relative to the proximal member.

132. A method as claimed in claim 128 wherein the proximal member is moved relative to the elongate member in a single direction.

133. A method as claimed in claim 132 wherein the proximal member is moved relative to the elongate member in a direction substantially parallel to the longitudinal axis of the wound opening.

134. A method as claimed in claim 128 wherein the method comprises the step of gripping the proximal member.

135. A method as claimed in claim 134 wherein the proximal member is gripped by a single hand of a user.

136. A method as claimed in claim 135 wherein opposite sides of the proximal member are gripped by a single hand of a user.

137. A method as claimed in claim 128 wherein the method comprises the step of gripping the elongate member.

138. A method as claimed in claim 137 wherein the elongate member is gripped by a single hand of a user.

139. A method as claimed in claim 138 wherein the entire circumference of the elongate member is gripped by a single hand of a user.

140. A method of retracting a wound opening, the method comprising the steps of:

—

inserting a distal anchoring member through a wound opening into a wound interior;

locating a proximal member externally of the wound opening with an elongate member extending at least between the distal anchoring member and the proximal member; and

moving the entire periphery of the proximal member together relative to the entire periphery of the elongate member to retract laterally the sides of the wound opening.