Surgical Access Device

• US 20100081880A1
• Filed: 09/30/2008
• Published: 04/01/2010
• Est. Priority Date: 09/30/2008
• Status: Active Grant

• Current Assignee: Cilag Gmbh International (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Cropper, Michael S., Voegele, James Walden, Shelton, Frederick E. IV, Hess, Christopher J., Norvell, David K., Weisenburgh, William Bruce II, Murray, Michael A., Widenhouse, Christopher W., Gill, Robert P.
• Granted Patent: US 8,485,970 B2
• Time in Patent Office: Days
• US Class Current: 600/201
• CPC Class Codes: A61B 1/018 for receiving instruments
• 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 2017/3447 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 2505/05 Surgical care

Abstract

Various devices are provided for allowing multiple surgical instruments to be inserted through a single surgical access device at variable angles of insertion, allowing for ease of manipulation within a patient'"'"'s body while maintaining insufflation. Safety shields and release mechanisms are also provided for use with various surgical access devices.

Claims

1. A surgical access device, comprising:

a retractor having an opening extending therethrough for forming a pathway through tissue into a body cavity;

a housing coupled to the retractor and defining a longitudinal axis extending therethrough, the housing having a plurality of rigid sealing ports in communication with the opening in the retractor, each sealing port having a sealing element therein and having a central axis that forms an angle with the longitudinal axis of the housing that is greater than zero.

2. The surgical access device of claim 1, wherein the central axis of each sealing port is different than the central axis of every other sealing port.

3. The surgical access device of claim 1, wherein at least one of the sealing ports has an opening with a diameter different than a diameter of an opening in the other sealing ports.

4. The surgical access device of claim 1, wherein at least one of the sealing ports is rotatable relative to the housing.

5. The surgical access device of claim 1, wherein two or more sealing ports are rotatable as a unit with respect to the housing.

6. The surgical access device of claim 1, wherein each sealing element is configured for lateral and pivotal movement.

7. The surgical access device of claim 1, wherein each sealing port is freely movable relative to the housing such that the angular orientation of the central axis is adjustable.

8. The surgical access device of claim 1, further comprising an adapter removably matable to at least one of the sealing ports to change an effective diameter of the sealing port.

9. The surgical access device of claim 1, wherein the adapter has a non-circular cross-section to receive and form a seal with a surgical instrument having a non-circular cross-section.

10. The surgical access device of claim 1, wherein the housing is movable between a convex configuration and a concave configuration.

11. The surgical access device of claim 1, wherein the housing is rotatable relative to the retractor.

12. The surgical access device of claim 1, further comprising a flexible connector extending between the housing and the retractor to allow the housing to move polyaxially relative to the retractor.

13. The surgical access device of claim 12, wherein the flexible connector is a bellows.

14. The surgical access device of claim 1, wherein the housing is hingedly connected to the retractor.

15. The surgical access device of claim 1, wherein the retractor includes a proximal flange and a distal flange having a flexible cylindrical portion extending therebetween.

16. The surgical access device of claim 15, wherein the housing includes a distal annulus that releasably couples to the proximal flange of the retractor.

17. The surgical access device of claim 1, further comprising a release mechanism configured to allow selective engagement and disengagement of the housing with the retractor.

18. The surgical access device of claim 1, further comprising a flexible shield disposed within the retractor and configured to protect the retractor from damage caused by insertion of surgical instruments through the sealing ports and the retractor.

19. The surgical access device of claim 1, wherein the retractor includes a lighting element disposed thereon to allow illumination of a body cavity.

20. A surgical access device, comprising:

a housing having a plurality of rigid sealing ports with sealing elements therein for receiving surgical instruments, the plurality of sealing ports having central axes extending therethrough that differ from one another.

21. The surgical access device of claim 20, wherein the central axes of the sealing ports are different than a central longitudinal axis of the housing.

22. The surgical access device of claim 20, wherein at least one of the sealing ports is rotatable relative to the housing.

23. The surgical access device of claim 20, further comprising a flexible cannula extending distally from the housing for receiving surgical instruments inserted through the sealing ports.

24. The surgical access device of claim 23, wherein the housing is rotatable relative to the flexible cannula.

25. The surgical access device of claim 20, wherein the housing is flexible and movable between a convex configuration and concave configuration to allow reorientation of the central axes of the sealing ports.

26. A surgical access device, comprising:

a housing having a plurality of sealing ports, each sealing port having a seal with a non-circular opening configured to form a seal around an instrument having a non-circular cross-section, and each seal being rotatable relative to the housing to allow the seal to rotate with and maintain a seal around an instrument inserted therethrough.

27. The surgical access device of claim 26, wherein each seal has a different non-circular opening shape.

28. The surgical access device of claim 26, wherein the non-circular opening in at least one of the seals has a shape selected from the group consisting of triangular, quadrilateral, and oval.

29. The surgical access device of claim 26, further comprising a retractor extending from the housing and having an opening formed therethough for receiving surgical instruments.

30. The surgical access device of claim 29, wherein the housing is rotatable relative to the retractor.

31. The surgical access device of claim 29, wherein the seals float relative to the retractor.

32. A surgical access device, comprising:

a retractor having an opening extending therethrough; and

a housing coupled to the retractor and having a plurality of sealing ports, the housing being freely rotatable relative to the retractor to allow positioning of surgical instruments through the sealing ports during use.

33. The surgical access device of claim 32, wherein the sealing ports are positioned non-symmetrically within the housing.

34. The surgical access device of claim 32, further comprising a base ring disposed between the retractor and the housing and configured to allow rotation of the housing.

35. The surgical access device of claim 32, further comprising a release mechanism releasably mated to the retractor and the housing and configured to allow decoupling of the housing from the retractor.

36. The surgical access device of claim 32, wherein at least one of the sealing ports is oriented to have a central axis different than a central longitudinal axis of the housing and the retractor.

37. The surgical access device of claim 32, wherein at least one of the sealing ports is rotatable relative to the housing.

38. The surgical access device of claim 32, wherein at least one sealing port has a seal element that extends in a plane that forms an angle with a central longitudinal axis of the housing.

39. The surgical access device of claim 38, wherein the angle between the plane and the central longitudinal axis of the housing is adjustable.

40. A surgical access device, comprising:

a housing having a flexible cannula extending therefrom and configured for guiding a surgical instrument into a patient'"'"'s body and a sealing element disposed within the housing and configured to receive a surgical instrument, the sealing element being rotatable relative to the housing to allow a surgical device inserted through the sealing element and the flexible cannula to rotate therein without causing the flexible cannula to rotate.

41. The surgical access device of claim 40, wherein the sealing element is disposed within an opening formed through the housing and comprises at least one of an instrument seal for forming a seal around a surgical instrument and a channel seal for forming a seal in the opening when no instrument is inserted therethrough.

42. The surgical access device of claim 40, further comprising steering cables coupled to the flexible cannula and configured to steer the flexible cannula along a tortuous pathway.

43. The surgical access device of claim 40, further comprising a locking mechanism for locking rotational motion of the sealing element relative to the housing and the flexible cannula.