Surgical access device

• US 20060247500A1
• Filed: 04/05/2006
• Published: 11/02/2006
• Est. Priority Date: 04/08/2005
• Status: Abandoned Application

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Voegele, James W., Hess, Christopher J., Murray, Michael A., Weisenburgh, William B. II, Gill, Robert P.
• Application Number:
  US11/399,172
• Publication Number:
  US 20060247500A1
• 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 17/0281 Abdominal wall lifters
• CPC Class Codes: A61B 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/0644 penetrating the tissue, deformable to closed position
• CPC Class Codes: A61B 17/115 Staplers for performing anastomosis in a single operation
• CPC Class Codes: A61B 17/122 Clamps or clips , e.g. for the umbilical cord for the vas deferens A61F6/206
• CPC Class Codes: A61B 17/1227 Spring clips
• CPC Class Codes: A61B 17/1285 for minimally invasive surgery
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/3417 Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating syringe needles A61M5/32; dilators A61M29/00
• 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 17/3474 Insufflating needles, e.g. Veress needles
• CPC Class Codes: A61B 17/3476 Powered trocars, e.g. electrosurgical cutting, lasers, powered knives
• CPC Class Codes: A61B 17/4241 Instruments for manoeuvring or retracting the uterus, e.g. during laparoscopic surgery
• 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 2017/00287 Bags for minimally invasive surgery
• CPC Class Codes: A61B 2017/00362 Packages or dispensers for MIS instruments A61B2017/0479 takes precedence
• CPC Class Codes: A61B 2017/00473 Distal part, e.g. tip or head A61B2017/00464 takes precedence
• CPC Class Codes: A61B 2017/00893 : pharmaceutically effective
• CPC Class Codes: A61B 2017/0419 : H-fasteners
• CPC Class Codes: A61B 2017/0461 : with features cooperating with special features on the suture, e.g. protrusions on the suture
• CPC Class Codes: A61B 2017/0462 : One way system, i.e. also tensioning the suture
• CPC Class Codes: A61B 2017/0464 : for soft tissue
• CPC Class Codes: A61B 2017/0647 : having one single leg, e.g. tacks
• CPC Class Codes: A61B 2017/2825 : Inserts of different material in jaws
• CPC Class Codes: A61B 2017/2829 : with a removable cover
• CPC Class Codes: A61B 2017/2931 : with releasable head
• CPC Class Codes: A61B 2017/306 : holding by means of suction
• CPC Class Codes: A61B 2017/3405 : using mechanical guide means
• CPC Class Codes: A61B 2017/3437 : with means for removing or absorbing fluid, e.g. wicks or absorbent pads
• CPC Class Codes: A61B 2017/3445 : used as instrument channel for multiple instruments
• CPC Class Codes: A61B 2017/3447 : Linked multiple cannulas
• 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 2090/3908 : Soft tissue, e.g. breast tissue
• CPC Class Codes: A61B 2090/3925 : ultrasonic
• CPC Class Codes: A61B 2090/3937 : Visible markers
• CPC Class Codes: A61B 2090/3954 : magnetic, e.g. NMR or MRI
• CPC Class Codes: A61B 2090/3987 : Applicators for implanting markers
• CPC Class Codes: A61B 90/30 : Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
• CPC Class Codes: A61B 90/39 : Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: A61B 90/50 : Supports for surgical instruments, e.g. articulated arms
• CPC Class Codes: A61F 2/0063 : Implantable repair or support meshes, e.g. hernia meshes
• CPC Class Codes: A61F 2002/0072 : Delivery tools therefor

Abstract

A surgical access device provides surgical access through an incision in the body wall to the inside of a body cavity of a patient. The surgical access device has a subassembly with an opening around a center axis and is adjustable between a closed configuration and an open configuration. The surgical access device has a sleeve attached to the subassembly and positionable in the incision. The sleeve defines a passageway through the body wall between the opening in the valve subassembly and the body cavity. The surgical access device also has at least one access channel extending from the subassembly. The access channel is outside the opening and the passageway and provides an access to the body cavity.

Claims

1. A surgical access device for providing surgical access through an incision in the body wall to the inside of a body cavity of a patient, the surgical access device having a center axis and comprising:

a subassembly having an opening around the center axis;

a sleeve attached to the subassembly and positionable in the incision, the sleeve defining a passageway through the body wall between the opening in the subassembly and the body cavity; and

at least one access channel extending from the subassembly, the access channel having a proximal end positionable outside the body cavity and a distal end positionable inside the body cavity, and the access channel being outside the opening and the passageway, whereby the access channel provides an access to the body cavity.

2. The surgical access device of claim 1, wherein the subassembly comprises a gel material that can be cut to provide the opening.

3. The surgical access device of claim 1, wherein the subassembly is adjustable between a closed configuration and an open configuration.

4. The surgical access device of claim 3, wherein the subassembly comprises:

an upper ring;

a lower ring coaxially aligned with the upper ring; and

a first cylindrical flexible member extending between and attached respectively to the upper and lower rings;

wherein the upper and lower rings are rotatable relative to one another, whereby rotating the upper and lower rings relative to one another causes the first cylindrical member to twist between the closed and open configurations.

5. The surgical access device of claim 4, further comprising an intermediate ring that is releasably and separately lockable to the upper ring and to the lower ring.

6. The surgical access device of claim 5, wherein the upper ring includes a locking element, wherein the locking element releasably locks the upper ring relative to the intermediate ring.

7. The surgical access device of claim 5, wherein the intermediate ring includes a plurality of upper teeth spaced apart on the intermediate ring and engageable with a plurality of lower teeth spaced apart on the lower ring, wherein the upper teeth are releasably lockable with the lower teeth to hold the access device in the closed configuration or a partially closed configuration.

8. The surgical access device of claim 4, wherein the sleeve comprises a second cylindrical flexible member that attaches to the subassembly and to a ring-shaped, resilient member, respectively, the resilient member being insertable through the surgical incision and into the body cavity.

9. The surgical access device of claim 8, wherein the second elastic member conforms to the outer surface of the sleeve.

10. The surgical access device of claim 8, wherein the sleeve comprises an inner wall and an outer wall, and the access channel is disposed therebetween.

11. The surgical access device of claim 4, wherein the access channel includes a sealable port.

12. The surgical access device of claim 11, wherein the sealable port includes a removable cap.

13. The surgical access device of claim 11, wherein the longitudinal axis of the sealable port forms an angle with the center axis of the access device approximately in the range of 0-90 degrees.

14. The surgical access device of claim 1, wherein the access channel comprises a flexible tube.

15. The surgical access device of claim 1, wherein the access channel comprises at least one conductive element electrically connectable to an electrical power source.

16. The surgical access device of claim 1, wherein the access channel comprises an electrical cable operably connectable to an electrosurgical generator.

17. The surgical access device of claim 1, wherein the access channel comprises an optical conduit operably connectable to a light source.

18. The surgical access device of claim 1, wherein the access channel comprises a multilumen tube.

19. The surgical access device of claim 1, wherein the access channel is in fluid communication with a fluid source.

20. The surgical access device of claim 1, wherein the access channel is in fluid communication with a vacuum source.

21. The surgical access device of claim 1, further comprising a plurality of access channels.

22. The surgical access device of claim 1, further comprising a flange extending from the subassembly and supporting the access channel.

23. A method for accessing a body cavity of a patient during a surgical procedure, the method comprising:

providing a surgical access device having a center axis and comprising;

a subassembly having an opening around the center axis;

a sleeve attached to the subassembly and positionable in the incision, the sleeve defining a passageway through the body wall between the opening in the subassembly and the body cavity; and

at least one access channel extending from the subassembly, the access channel having a proximal end positionable outside the body cavity and a distal end positionable inside the body cavity, and the access channel being outside the opening and the passageway, whereby the access channel provides an access to the body cavity;

making an incision through the body wall of the patient; and

inserting the sleeve of the access device into the incision.

24. The method of claim 23, wherein the subassembly further comprises:

an upper ring;

a lower ring coaxially aligned with the upper ring; and

a first cylindrical flexible member extending between and attached respectively to the upper and lower rings;

wherein the upper and lower rings are rotatable relative to one another, whereby rotating the upper and lower rings relative to one another causes the first cylindrical member to twist between the closed and open configurations.

25. The method of claim 24, wherein the subassembly further comprises an intermediate ring that is releasably and separately lockable to the upper ring and to the lower ring.

26. The method of claim 23, wherein the upper ring includes a locking element, wherein the locking element releasably locks the upper ring relative to the intermediate ring.

27. The method of claim 24, wherein the intermediate ring includes a plurality of upper teeth spaced apart on the intermediate ring and engageable with a plurality of lower teeth spaced apart on the lower ring, wherein the upper teeth are releasably lockable with the lower teeth to hold the access device in the closed configuration or a partially closed configuration.

28. The method of claim 24, wherein the sleeve comprises a second cylindrical flexible member that attaches to the subassembly and to a ring-shaped, resilient member, respectively, the resilient member being insertable through the surgical incision and into the body cavity.

29. The method of claim 28, wherein the second elastic member conforms to the outer surface of the sleeve.

30. The method of claim 28, wherein the sleeve comprises an inner wall and an outer wall, and the access channel is disposed therebetween.

31. The method of claim 24, wherein the access channel includes a sealable port.

32. The method of claim 30, wherein the sealable port includes a removable cap.

33. The method of claim 30, wherein the longitudinal axis of the sealable port forms an angle with the center axis of the access device approximately in the range of 0-90 degrees.

34. The method of claim 23, wherein the access channel comprises a flexible tube.

35. The method of claim 23, wherein the access channel comprises at least one conductive element operably and electrically connectable to an electrical apparatus.

36. The method of claim 35, wherein the electrical apparatus comprises an electrosurgical device.

37. The method of claim 23, wherein the access channel comprises an optical conduit operably connectable to a light source.

38. The method of claim 23, wherein the access channel comprises a multilumen tube.

39. The method of claim 23, wherein the access channel is in fluid communication with a fluid source.

40. The method of claim 23, wherein the access channel is in fluid communication with a vacuum source.

41. The method of claim 23, wherein the surgical access device further comprises a plurality of channels.

42. The method of claim 23, wherein the surgical access device further comprises a flange extending from the subassembly and supporting the access channel.