VAGINAL ENTRY SURGICAL DEVICES, KIT, SYSTEM, AND METHOD

• US 20110105850A1
• Filed: 11/05/2009
• Published: 05/05/2011
• Est. Priority Date: 11/05/2009
• Status: Active Grant

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Griffith, David B., Voegele, James W., Zeiner, Mark S.
• Granted Patent: US 8,608,652 B2
• Time in Patent Office: Days
• US Class Current: 600/207
• CPC Class Codes: A61B 1/303 for the vagina, i.e. vaginoscopes
• 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 2017/345 for introduction into a natural body opening
• CPC Class Codes: A61B 2017/3466 for simultaneous sealing of multiple instruments
• CPC Class Codes: A61B 2017/348 Means for supporting the trocar against the body or retaining the trocar inside the body

Abstract

A surgical method, system, kit, and various devices are provided for use in, among other things, vaginal entry during a natural orifice translumenal endoscopic surgical procedure. A system and/or method provide for the rapid creation of a conduit and/or multiple ports in a natural orifice, such as a patient'"'"'s vagina, while accommodating anatomical variation to reduce the need to excise additional tissue from the patient.

Claims

1. A surgical method, comprising:

inserting a speculum into a patient'"'"'s vagina, the speculum including two or more blades movable with respect to each other;

expanding the speculum by moving the blades apart from each other such that the blades move apart walls of the vagina;

obtaining a surgical delivery device coupled to a transorifice device, the transorifice device including a flexible conduit;

inserting a portion of the surgical delivery device through the speculum such that a distal portion of the flexible conduit is also inserted through the speculum;

creating an incision in the vagina;

passing a tip of the surgical delivery device through the incision and into a body cavity of the patient; and

releasing the transorifice device from the surgical delivery device such that the distal portion of the flexible conduit is located within the body cavity.

2. The surgical method of claim 1, further comprising adding at least one suture to the vaginal wall such that the vaginal wall is drawn taught before creating the incision.

3. The surgical method of claim 1, further comprising removing the surgical delivery device through the flexible conduit of the transorifice device.

4. The surgical method of claim 1, wherein the transorifice device further comprises a pliable ring located at the distal portion of the flexible conduit, the method further comprising releasing the pliable ring within the body cavity to seal the distal portion of the flexible conduit within the body cavity.

5. The surgical method of claim 1, further comprising extending a sleeve of the transorifice device such that a distal end of the sleeve is extended beyond the distal portion of the conduit and into the body cavity.

6. A speculum, comprising:

a base defining an opening therethrough, the base comprising a proximal surface;

a first blade attached to the base, the first blade comprising a first distal end;

a second blade attached to the base, the second blade comprising a second distal end, wherein the first blade and the second blade are movable with respect to each other; and

at least one locking assembly configured to releasably hold the first blade and the second blade relative to each other in at least one locked position, wherein, when the first blade and the second blade are in the at least one locked position, a shortest distance between the first distal end and a plane defined by the proximal surface is substantially equal to another shortest distance between the second distal end and the plane defined by the proximal surface.

7. The speculum of claim 6, wherein the first blade and the second blade are movable with respect to each other without a handle.

8. The speculum of claim 6, wherein when the first blade and the second blade are in the at least one locked position, the first blade and the second blade are substantially parallel with respect to each other.

9. The speculum of claim 6, wherein the first blade and the second blade are movable with respect to each other such that the first distal end and the second distal end substantially move in the same plane.

10. The speculum of claim 6, further comprising a third blade attached to the base.

11. The speculum of claim 6, wherein the at least one locking assembly comprises at least one ratchet assembly or at least one linkage assembly.

13. The transorifice device of claim 11, further comprising an extendable sleeve extending from the at least one port and located at least partially within the flexible conduit.

14. The transorifice device of claim 11, wherein the flexible conduit further comprises a suture connected to one of the pliable ring and the distal portion.

15. The transorifice device of claim 11, further comprising at least one support member movably associated with the distal portion of the flexible conduit and extendable to the distal side of the port assembly.

16. The transorifice device of claim 14, wherein the at least one support member comprises an expandable bladder.

18. The surgical delivery device of claim 16, further comprising a suture holder located near the distal end of the body, wherein the suture holder is configured to releasably hold a suture.

19. The surgical delivery device of claim 16, wherein the tip is configured to incise tissue.

20. The surgical delivery device of claim 16, wherein the tip comprises a material that is at least partially transparent.

12. A transorifice device, comprising:

a port assembly defining at least one port therein, the port assembly including a proximal side and a distal side; and

a flexible conduit extending from the distal side of the port assembly, the flexible conduit including a proximal portion adjacent to the port assembly and a distal portion, wherein the flexible conduit further comprises a pliable ring located at the distal portion.

17. A surgical delivery device, comprising:

a body including a proximal end and a distal end, the body defining a tool receiving passageway therein including a proximal opening located at the proximal end and a distal opening located at the distal end;

a tip movably mounted to the distal end of the body such that the tip can move between an opened position and a closed position; and

an expandable member surrounding at least part of the body and located adjacent the distal end of the body.