METHODS AND DEVICES FOR ACCESSING A BODY CAVITY

• US 20100261975A1
• Filed: 04/23/2010
• Published: 10/14/2010
• Est. Priority Date: 03/06/2009
• Status: Active Grant

• Current Assignee: Cilag Gmbh International (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Holcomb, Matthew D., Huey, Kevin M.
• Granted Patent: US 9,737,334 B2
• Time in Patent Office: Days
• US Class Current: 600/208
• 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 17/3498 Valves therefor, e.g. flapper valves, slide valves haemostasis valves A61M39/06; check valves A61M39/24
• CPC Class Codes: A61B 2017/3445 used as instrument channel for multiple instruments
• CPC Class Codes: A61B 2017/3449 whereby the instrument channels merge into one single channel
• 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
• CPC Class Codes: A61B 2017/3466 for simultaneous sealing of multiple instruments
• CPC Class Codes: A61B 2017/347 Locking means, e.g. for locking instrument in cannula
• CPC Class Codes: A61B 2017/3492 against the outside of the body
• CPC Class Codes: A61B 2090/0801 Prevention of accidental cutting or pricking

Abstract

Methods and devices are provided for accessing a body cavity. In one embodiment, a surgical access device is provided that includes a housing having at least one access or sealing port for receiving a surgical instrument, and a retractor removably coupled to the housing and having a working channel configured to extend into a body cavity. The housing can include releasably matable upper and lower portions, with the upper portion being configured to freely rotate 360° relative to the lower portion and to the retractor when the housing is mated thereto.

Claims

1. A surgical device, comprising:

a distal housing defining a working channel; and

a proximal housing having at least one sealing port formed therein for receiving a surgical instrument therethrough, the at least one sealing port being configured to form at least one of a seal around the surgical instrument inserted therethrough and a channel seal configured to form a seal when no surgical instrument is inserted therethrough, and the proximal housing being removably and rotatably coupled to the distal housing such that the proximal housing can freely rotate 360°

relative to the distal housing.

2. The device of claim 1, wherein, when the proximal and distal housings are not coupled together, the proximal housing is configured to be coupled to the distal housing at any 360°

rotational orientation relative to the distal housing.

3. The device of claim 1, wherein, when the proximal and distal housings are coupled together, the proximal housing is configured to be removed from the distal housing at any 360°

rotational orientation relative to the distal housing.

4. The device of claim 1, wherein one of the proximal and distal housings includes at least one living hinge for removably and rotatably coupling the proximal and distal housings.

5. The device of claim 1, wherein the proximal and distal housings include threads for removably and rotatably coupling the proximal and distal housings to one another.

6. The device of claim 5, wherein the proximal and distal housings have a threaded position, in which the threads are engaged for coupling the proximal and distal housings to one another, and an unthreaded position, in which the threads are not engaged and the proximal and distal housings are coupled together such that the proximal housing can freely rotate 360°

relative to the distal housing.

7. The device of claim 5, wherein one of the proximal and distal housings includes at least one flange extending therefrom, the at least one flange being configured to engage at least one corresponding track formed in the other of the proximal and distal housings.

8. The device of claim 7, wherein the proximal housing is configured to be removed from the distal housing when coupled thereto by moving the at least one flange and the at least one corresponding track from being out of threaded engagement to being in threaded engagement and moving the proximal housing in a proximal direction relative to the distal housing.

9. The device of claim 7, wherein the at least one corresponding track has an open distal terminal end such that when the proximal and distal housings are threaded together to couple the proximal and distal housings together, the open distal terminal end allows the at least one flange to threadably disengage from and be positioned distal to the at least one corresponding track such that the proximal and distal housings are coupled together with the proximal housing configured to freely rotate 360°

relative to the distal housing.

10. The device of claim 1, wherein the proximal housing is freely rotatable 360°

relative to the distal housing in a substantially fixed plane substantially perpendicular to a longitudinal axis of the working channel.

11. The device of claim 1, further comprising a retractor mated to the distal housing and configured to be positioned in an opening in tissue for forming a pathway through the tissue and into a body cavity.

12. The device of claim 1, wherein a fluid tight seal is formed between the proximal and distal housings when the proximal and distal housings are coupled together such that the proximal housing can freely rotate 360°

relative to the distal housing without release of the fluid tight seal.

13. A surgical device, comprising:

a retractor configured to be positioned in an opening in tissue such that an instrument inserted into a working channel extending through the retractor can pass through the opening in the tissue and into a body cavity underlying the tissue; and

a housing removably coupled to the retractor and having a plurality of sealing ports in communication with the working channel in the retractor, each of the sealing ports having a sealing element disposed therein, the housing including

a distal base removably coupled to the retractor, and

a proximal cap removably coupled to the distal base and freely rotatable 360°

relative to the distal base and the retractor.

14. The device of claim 13, wherein the proximal cap is freely rotatable 360°

clockwise and counterclockwise relative to the distal base and the retractor.

15. The device of claim 13, wherein the proximal cap is removably coupled to the distal base by at least one living hinge formed on one of the proximal cap and the distal base.

16. The device of claim 13, wherein the proximal cap is removably coupled to the distal base by a threaded engagement.

17. A surgical method, comprising:

positioning a retractor within an opening formed through tissue such that the retractor forms a working channel extending through the tissue and into a body cavity, the retractor being removably coupled to a housing having a sealing port including a sealing element;

inserting a surgical instrument through the sealing element and the working channel to position a distal end of the surgical instrument within the body cavity; and

with the distal end of the surgical instrument within the body cavity, moving the surgical instrument to cause at least a portion of the housing to rotate 360°

relative to the retractor.

18. The method of claim 17, further comprising releasably mating a proximal portion of the housing including the sealing port to a distal portion of the housing coupled to the retractor by engaging at least one mating element formed on one of the proximal and distal portions with at least one complementary mating feature formed on the other of the proximal and distal portions to releasably mate the proximal and distal portions such that proximal portion is freely rotatable 360°

relative to the distal portion and the retractor.

19. The method of claim 18, wherein releasably mating the proximal and distal portions comprises aligning the proximal portion at any 360°

rotational orientation relative to the distal portion and snapping the proximal and distal portions together such that the proximal portion is freely rotatable 360°

relative to the distal portion and the retractor.

20. The method of claim 18, wherein releasably mating the proximal and distal portions together comprises moving the proximal and distal portions from a threaded position in which the proximal and distal portions are threadably engaged, to an unthreaded position in which the proximal and distal portions are not threadably engaged and the proximal portion is freely rotatable 360°

relative to the distal portion and the retractor.