Laparoscopic port assembly

• US 20080255519A1
• Filed: 03/27/2008
• Published: 10/16/2008
• Est. Priority Date: 03/30/2007
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Pnavel Systems, Inc.
• Inventors: Battles, Christopher, Shikhman, Oleg, Piskun, Gregory, Rende, Frank, Abrams, Michael
• Granted Patent: US 8,888,695 B2
• Time in Patent Office: Days
• US Class Current: 604/174
• CPC Class Codes: A61B 1/3132 for laparoscopy
• 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 17/3421 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 17/3439 with means for changing the inner diameter of the cannula, e.g. expandable A61B17/3423, A61B17/3431 take precedence; catheters A61M25/0662
• CPC Class Codes: A61B 2017/3427 for intercostal space
• CPC Class Codes: A61B 2017/3445 used as instrument channel for multiple instruments catheters A61B2017/22072
• CPC Class Codes: A61B 2017/3447 Linked multiple cannulas
• CPC Class Codes: A61B 2017/3466 for simultaneous sealing of multiple instruments
• CPC Class Codes: A61B 2017/349 Trocar with thread on outside

Abstract

Various embodiments of a laparoscopic trocar assembly are disclosed. The port assemblies include inserted parts that protect the patient'"'"'s tissues at the point of deployment. The port assemblies include seals for maintaining pneumoperitoneum both when instrument are being used and when instruments are not inserted.

Claims

1. A surgical port assembly comprising:

a body attachable to a patient at an incision in a skin surface of the patient to facilitate deployment of instruments in the patient via the incision, said body having a main axis oriented substantially transversely to the patient'"'"'s skin surface upon disposition of said body in the incision;

a main first plate mounted to said body substantially transversely to said axis, said first plate having a first opening and a second opening;

a second plate rotatably disposed in said first opening for turning about an auxiliary axis substantially parallel to said main axis;

at least one first tubular member attached to said second plate and extending in at least one direction away from said second plate; and

a second tubular member attached to said first plate at said second opening extending in at least one direction away from said first plate.

2. The port assembly defined in claim 1 wherein said body has an outer side facing away from the patient and an inner side facing inwardly of or towards the patient'"'"'s skin surface during a surgical procedure, said first tubular member extending only upwardly or outwardly away from said second plate, on the outer side of said body.

3. The port assembly defined in claim 2 wherein said first tubular member is one of a plurality of first tubular members all attached to said second plate and extending only upwardly or outwardly away from said second plate, on the outer side of said body.

4. The port assembly defined in claim 3 wherein at least one of said first tubular members is flexible at least at a point of attachment to said second plate, enabling a pivoting and a swiveling at said second plate of a surgical instrument inserted through said at least one of said first tubular members.

5. The port assembly defined in claim 3 wherein said first tubular members are each provided with at least one seal for-maintaining pneumoperitoneum when a surgical instrument shaft longitudinally traverses such first tubular member and at least one seal for maintaining pneumoperitoneum in the absence of a surgical instrument shaft longitudinally traversing such first tubular member.

6. The port assembly defined in claim 1 wherein said body has an outer side disposable outside of the patient and an inner side disposable inside the patient, inwardly of the patient'"'"'s skin surface during a surgical procedure, said first tubular member extending only downwardly or inwardly away from said second plate, on the inner side of said body.

7. The port assembly defined in claim 6 wherein said first tubular member is one of a plurality of first tubular members all attached to said second plate and extending only downwardly or inwardly away from said second plate, on the inner side of said body.

8. The port assembly defined in claim 7 wherein at least one of said first tubular members is flexible at least at a point of attachment to said second plate, enabling a pivoting and a swiveling at said second plate of a surgical instrument inserted through said at least one of said first tubular members.

9. The port assembly defined in claim 7 wherein said first tubular members are each provided with at least one seal for maintaining pneumoperitoneum when a surgical instrument shaft longitudinally traverses such first tubular member and at least one seal for maintaining pneumoperitoneum in the absence of a surgical instrument shaft longitudinally traversing such first tubular member.

10. The port assembly defined in claim 1 wherein said first tubular member is provided with at least one seal for maintaining pneumoperitoneum when a surgical instrument shaft longitudinally traverses said first tubular member, said first tubular member being provided with at least one seal for maintaining pneumoperitoneum in the absence of a surgical instrument shaft longitudinally traversing said first tubular member.

11. The port assembly defined in claim 1 wherein said second plate is dome-shaped.

12. The port assembly defined in claim 1 wherein said second plate is removably attached to said first plate.

13. A surgical port assembly comprising:

a body attachable to a patient at an incision in a skin surface of the patient to facilitate deployment of instruments in the patient via the incision, said body having an outer side facing away from the patient and an inner side facing inwardly of or towards the patient'"'"'s skin surface during a surgical procedure; and

at least one tubular member depending downwardly or inwardly from said body so that said tubular member is disposed only on said inner side of said body.

14. The port assembly defined in claim 13 wherein said tubular member is one of a plurality of tubular members all depending downwardly or inwardly from said body so that said tubular members are disposed only on said inner side of said body.

15. The port assembly defined in claim 14 wherein each of said tubular members is provided with at least one seal for maintaining pneumoperitoneum when a surgical instrument shaft longitudinally traverses such tubular member, each of said tubular members being provided with at least one seal for maintaining pneumoperitoneum in the absence of a surgical instrument shaft longitudinally traversing such tubular member.

16. The port assembly defined in claim 15 wherein said tubular members are each provided along an inner surface with a rigid sleeve.

17. The port assembly defined in claim 16 wherein said tubular members are each pivotable about a point of attachment to said body.

18. The port assembly defined in claim 16 wherein said body has a funnel shape, said tubular members being attached to said funnel shape at an apical end thereof.

19. The port assembly defined in claim 14 wherein said outer side of said body is free of upwardly or outwardly extending tubular cannula members.

20. The port assembly defined in claim 14 wherein said body comprises a rim portion and a plate surrounded by said rim portion, said tubular members being connected to said plate and extending only on an inner side of said plate.

21. The port assembly defined in claim 13 wherein said tubular member is detachably attached to said body.

22. The port assembly defined in claim 21 wherein said tubular member is fixed to a coupling member that in turn is detachably attached to said body at an aperture in said body, further comprising a plug to temporarily seal said aperture upon removal of said coupling member from said aperture.

23. The port assembly defined in claim 13 wherein said tubular member carries a camera at a free end, further comprising directional control means for changing an orientation of said free end and said camera.

24. A surgical port assembly comprising:

a body attachable to a patient at an incision in a skin surface of the patient to facilitate deployment of instruments in the patient via the incision, said body having an outer side facing away from the patient and an inner side facing inwardly of or towards the patient'"'"'s skin surface during a surgical procedure; and

a funnel-shaped extension on said outer side of said body.

25. An obturator for deployment of a surgical port assembly through a skin surface, comprising:

a body member;

locking formations on said body member releasably engageable with cooperating locking formations on the port assembly;

at least two finger contact surfaces on said body member, said finger contact surfaces facing in substantially opposed directions, for enabling manual application of a torque to said body member; and

at least one elongate rigid member extending away from said body member on a side thereof opposite said finger contact surfaces, for penetrating through a skin surface.

26. The obturator defined in claim 25 wherein said rigid member is one of a plurality of parallel elongate rigid members extending away from said body member on a side thereof opposite said finger contact surfaces, for penetrating through a skin surface.

27. A surgical access assembly comprising the obturator of claim 26 and further comprising the surgical port assembly, said port assembly including:

a port assembly body attachable to a patient at an incision in a skin surface of the patient to facilitate deployment of instruments in the patient via the incision, said body having an outer side facing away from the patient and an inner side facing inwardly of or towards the patient'"'"'s skin surface during a surgical procedure; and

a plurality of elastomeric tubular members all depending downwardly or inwardly from said port assembly body so that said tubular members are disposed only on said inner side of said body, said tubular members receiving respective ones of said elongate rigid members.

28. The obturator defined in claim 25 wherein said locking formations include projections on said body member and recesses on said port assembly.

29. The obturator defined in claim 25 wherein said body member comprises a disk, said disk being provided with at least one cutout for enabling passage of an insufflation tube.

30. A surgical port assembly comprising:

a body member having a first opening and a separate second opening through which surgical instruments may pass;

a cannula carrier disposed in said first opening, said cannula carrier being attached to a plurality of first tubular members each provided with at least one instrument seal; and

at least one second tubular member attached to said body member at said second opening, said second tubular member being provided with a seal, said cannula carrier and said first tubular members being rotatably attached to said body member for turning about an axis substantially parallel to a main axis of said body member.

31. The surgical port assembly defined in claim 30 wherein said second tubular member is fixed with respect to said body member.

32. The surgical port assembly defined in claim 30 wherein said cannula carrier and said first tubular members are removably attached to said body member.

33. The surgical port assembly defined in claim 30 wherein said first tubular members extend upwardly or in a proximal direction away from said cannula carrier.

34. A surgical port assembly comprising:

a body attachable to a patient at an incision in a skin surface of the patient to facilitate deployment of instruments in the patient via the incision, said body having an outer side facing away from the patient and an inner side facing inwardly of or towards the patient'"'"'s skin surface during a surgical procedure; and

an at least partially flexible skirt member attached to said body on said inner side thereof.

35. The port assembly defined in claim 34, further comprising a trocar member insertable through said body and traversing said body during a deployment procedure, said skirt member having a collapsed or folded-in insertion configuration, said skirt member being releasably attached to said trocar member during said deployment procedure.

36. The port assembly defined in claim 34 wherein said skirt member has a tapered expanded configuration wherein a free end of said skirt member, opposite said body member, has a larger transverse dimension that an end of said skirt attached to said body member.

37. The port assembly defined in claim 34 wherein said skirt member includes a flexible web member and a resilient support wire connected to said web member for expanding said web member from a folded-in insertion configuration to an expanded use configuration.

38. The port assembly defined in claim 34 wherein said skirt member includes flexible strip areas interleaved or alternating with more rigid areas.

39. The port assembly defined in claim 34 wherein said body includes a cylindrical portion, a dome on an upper or proximal side of said cylindrical portion, and a circumferential or annular disk-shaped flange, said dome being formed with a plurality of openings for passage of laparoscopic or thoracoscopic instrument shafts and a laparoscope or endoscope, said skirt member including a cylindrical section engaging said cylindrical portion of said body and further including a tapered or conical portion.

40. A surgical port element comprising a skirt made at least partially of flexible material and means for attaching the skirt to a cannula or instrument holder in turn removably attachable to a patient at an opening in a skin surface, said skirt having a folded-in insertion configuration and an expanded use configuration.

41. A surgical port component comprising:

a body including a cylindrical portion formed by a plurality of cylindrical sections or flaps, said body further including a ring-shaped base member, said cylindrical sections or flaps being swingably coupled to said base member, said cylindrical sections or flaps being made of at least a substantially rigid material, base member being provided with at least one upwardly or proximally extending arcuate flange section receivable into a distal or lower end of a cylindrical body of a flexible-cannula port member.

42. The surgical port component defined in claim 41, further comprising an at least partially flexible skirt including a cylindrical proximal sleeve fitting over said cylindrical sections or flaps, thereby coupling said skirt to said body.

43. A surgical port assembly comprising:

a body member attachable to a patient at an incision in a skin surface of the patient to facilitate deployment of instruments in the patient via the incision, said body member having an outer side facing away from the patient and an inner side facing inwardly of or towards the patient'"'"'s skin surface during a surgical procedure; and

a flexible scope arm connected to said body member and extending from an underside of said body member, said scope arm incorporating a digital camera at a distal end, said camera being maneuverable via cables in said scope arm, said scope arm being operatively connectable at a proximal end to an endoscope functional module enabling operation of said camera.

44. A surgical port assembly comprising:

a downwardly tapering, substantially flexible, upper or proximal part;

an upwardly tapering, substantially flexible lower or distal part connected to said upper or proximal part, said lower or distal part being extendable in between the ribs of a patient into a pleural space;

a substantially rigid ring-like structure disposed proximate a junction between said upper or proximal part and said lower or distal part, said structure being locatable, during use of the port assembly, on top of a patient'"'"'s ribs; and

a flexible membrane proximate said structure, said membrane having a plurality of openings for passage of the instruments.

45. A surgical port assembly comprising:

a rigid mounting ring disposable on and releasably attachable a patient'"'"'s skin surface;

a body member attachable to said ring to depend downwardly therefrom through an incision in the patient'"'"'s skin surface to facilitate deployment of instruments in the patient via the incision, said body member having an outer side facing away from the patient and an inner side facing inwardly of or towards the patient'"'"'s skin surface during a surgical procedure, said body member being rotatably attachable to said ring for turning about an axis oriented perpendicularly to a plane defined by said ring; and

a cannula unit attachable to said body member and carrying a plurality of cannulas.

46. A surgical port assembly comprising:

a body attachable to a patient at an incision in a skin surface of the patient to facilitate deployment of instruments in the patient via the incision, said body having an outer side facing away from the patient and an inner side facing inwardly of or towards the patient'"'"'s skin surface during a surgical procedure; and

a cannula unit including an elastomeric dome-shaped base and a plurality of upwardly extending tubular members or cannulas.

47. A surgical port assembly comprising:

a body attachable to a patient at an incision in a skin surface of the patient to facilitate deployment of instruments in the patient via the incision, said body having an outer side facing away from the patient and an inner side facing inwardly of or towards the patient'"'"'s skin surface during a surgical procedure, said body having an outer surface disposable in contact with the patient; and

at least one outwardly extending rib or thread on said outer surface.