Methods and Devices for Providing Access into a Body Cavity

• US 20110144442A1
• Filed: 12/11/2009
• Published: 06/16/2011
• Est. Priority Date: 12/11/2009
• Status: Active Grant

• Current Assignee: Cilag Gmbh International (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Morgan, Jerome R., Shelton, Frederick E. IV, Farrell, Theodore R.
• Granted Patent: US 8,414,483 B2
• Time in Patent Office: Days
• US Class Current: 600/206
• 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 17/3431 being collapsible, e.g. made of thin flexible material A61B17/3423 takes precedence
• 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 2017/3443 with means for adjusting the length of a cannula
• CPC Class Codes: A61B 2017/3466 for simultaneous sealing of multiple instruments
• CPC Class Codes: A61B 2017/3484 Anchoring means, e.g. spreading-out umbrella-like structure

Abstract

Methods and devices are provided for providing surgical access into a body cavity. In general, the methods and devices allow a surgical access device to be securely positioned within an opening in tissue to provide access to a body cavity underlying the tissue. An actuator can be rotatably disposed on or in a housing of a surgical access device such that rotation of the actuator relative to the housing is effective to move a cannula of the surgical access device between an insertion configuration in which the cannula has a reduced profile enabling it to easily be inserted into a tissue opening, and an expanded profile enabling it to form an anchor against and/or within the tissue opening.

Claims

1. An adjustable access device, comprising:

a housing having a cannula extending distally therefrom, the housing and the cannula defining a working channel extending therethrough for receiving surgical instruments; and

at least one seal disposed in the working channel and configured to form at least one of a seal around an instrument disposed through the working channel and a seal across the working channel when no instrument is disposed through the working channel;

an actuator rotatably disposed on the housing such that rotation of the actuator relative to the housing is effective to move the cannula between

an insertion configuration in which the cannula has a first outer diameter and a first length, the first outer diameter being less than the first length of the cannula, and

a deployed configuration in which the cannula has a second outer diameter and a second length, the second outer diameter being greater than the first outer diameter and the second length being less than the first length, and the second outer diameter being less than the second length of the cannula.

2. The adjustable access device of claim 1, wherein the cannula comprises a flexible band formed into a helix having a plurality of coils.

3. The adjustable access device of claim 2, wherein adjacent coils are mated to one another by a mating feature formed on the coils.

4. The adjustable access device of claim 3, wherein the mating feature comprises one of a male track and a female track formed on a first edge of each coil, and one of a complementary male track or female track formed on a second opposite edge of each coil.

5. The adjustable access device of claim 2, wherein a proximal portion of the flexible band is mated to the actuator.

6. The adjustable access device of claim 5, where rotation of the actuator to move the cannula to the insertion configuration is effective to wind the proximal portion of the flexible band around the actuator to cause the cannula to increase in length and decrease in diameter to facilitate insertion of the cannula into and removal of the cannula from a tissue opening.

7. The adjustable access device of claim 5, wherein rotation of the actuator to move the cannula to the deployed configuration is effective to unwind the proximal portion of the flexible band from around the actuator to cause the cannula to decrease in length and increase in diameter.

8. The adjustable access device of claim 1, wherein the cannula is configured to engage a tissue opening in the deployed configuration to thereby stabilize the access device.

9. The adjustable access of device of claim 1, wherein the housing includes multiple ports formed therein for receiving multiple surgical instruments.

10. An adjustable access device, comprising:

a housing having an adjustable cannula extending therefrom, the housing and the cannula defining a working channel extending therethrough, the adjustable cannula including a flexible band wound into a helical spring such that a proximal end of the flexible band is coupled to the housing and a distal end of the flexible band is positioned at a distal end of the adjustable cannula, the adjustable cannula having an insertion configuration with an increased length and decreased diameter for insertion into a tissue opening and a deployed configuration with a decreased length and increased diameter for anchoring within a tissue opening.

11. The adjustable access device of claim 10, wherein the housing includes an actuator coupled to the proximal end of the flexible band and configured to rotate the proximal end of the flexible band to move the cannula between the insertion and deployed configurations.

12. The adjustable access device of claim 10, wherein the adjustable cannula has a substantially constant first diameter in the insertion configuration and a substantially constant second diameter in the deployed configuration.

13. The adjustable access device of claim 10, wherein the flexible band is formed into a helix, the helix having a plurality of coils mated together.

14. A method of providing access through tissue to a body cavity, comprising:

positioning the cannula in an opening in tissue such that a working channel of the cannula provides access through the tissue and into a body cavity; and

rotating an actuator to move the cannula from an insertion configuration to a deployed configuration in which the cannula decreases in length and increases in diameter to increase a size of the opening in the tissue.

15. The method of claim 14, wherein rotating the actuator to move the cannula to the deployed configuration anchors the cannula against the tissue through which it extends.

16. The method of claim 14, further comprising rotating the actuator to move the cannula to the insertion configuration in which the cannula increases in length and decreases in diameter, and removing the cannula from the opening in tissue.

17. The method of claim 16, wherein rotating the actuator to move the cannula to the insertion configuration winds a proximal end of a flexible band around the actuator to tighten a helix formed by the flexible band.

18. The method of claim 14, wherein rotating the actuator to move the cannula to the deployed configuration unwinds a proximal end of a flexible band from around the actuator to loosen a helix formed by the flexible band.