INVERTED CONICAL EXPANDABLE RETRACTOR

• US 20110144589A1
• 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: Patil, Dhananjay V., Livingston, Brandon L., Morgan, Jerome R., Ortiz, Mark S., Shelton, Frederick E. IV
• Granted Patent: US 8,231,570 B2
• Time in Patent Office: Days
• US Class Current: 604/164.03
• 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 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 2017/3443 with means for adjusting the length of a cannula
• CPC Class Codes: A61B 2017/3466 for simultaneous sealing of multiple instruments

Abstract

Access devices and related methods are disclosed that generally involve flexible or adjustable cannulas that have a substantially cylindrical insertion configuration and a substantially conical expanded configuration. Various methods and features are provided for transitioning the cannula from the insertion configuration to the expanded configuration while the access device is inserted through tissue to form a conical opening through the tissue. Examples include cables, biasing elements, retaining elements, bimodal rings, and coil springs. The devices and methods disclosed herein can allow for improved retention of the access device, improved angulation of instruments passed through the access device, and can increase the integrity of a seal formed between the access device and surrounding tissue.

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 instruments; and

at least one seal element disposed within 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 therethrough;

wherein the cannula has an insertion configuration with a substantially constant outer diameter between a proximal end and a distal end, and an expanded configuration wherein the diameter increases from the proximal end of the cannula to the distal end of the cannula, the cannula being folded in the expanded configuration and unfolded in the insertion configuration.

2. The device of claim 1, wherein the cannula comprises a flexible outer sheath having a plurality of folding walls disposed therein, each folding wall comprising a plurality of segments.

3. The device of claim 2, wherein the plurality of segments comprise a plurality of long segments separated from each other by at least one short segment.

4. The device of claim 3, wherein the segments are defined by a plurality of living hinges formed in the folding walls.

5. The device of claim 4, wherein the living hinges alternate between being formed in an interior surface of the folding walls and being formed in an exterior surface of the folding walls.

6. The device of claim 5, wherein the plurality of long segments have progressively increasing lengths from the proximal end of the folding walls to the distal end of the folding walls.

7. The device of claim 6, wherein each of the short segments have substantially the same length.

8. The device of claim 1, further comprising an actuator coupled between the housing and the cannula and configured to move the cannula between the insertion configuration and the expanded configuration.

9. The device of claim 8, wherein the actuator comprises at least one cable extending distally from the housing to the distal end of the cannula.

10. The device of claim 9, wherein the housing includes a rotatable member coupled to the at least one cable and configured to rotate to selectively tension the at least one cable.

11. The device of claim 1, further comprising at least one biasing element disposed within the cannula and configured to bias the cannula towards the expanded configuration.

12. The device of claim 11, further comprising a horizontal retaining element coupled to the biasing element such that the cannula is maintained in the insertion configuration.

13. The device of claim 12, further comprising a vertical retaining element coupled to the biasing element such that the cannula is maintained in the expanded configuration.

14. An adjustable access device, comprising:

a cannula defining a working channel extending therethrough for receiving instruments, the cannula having an insertion configuration with a substantially constant outer diameter between a proximal end and a distal end, and an expanded configuration wherein the outer diameter increases from the proximal end of the cannula to the distal end of the cannula; and

a plurality of springs disposed circumferentially around the cannula, the springs being biased such that they apply an inward force to the cannula to bias the cannula to the expanded configuration;

wherein the cannula is configured such that insertion of an obturator into the cannula is effective to radially expand the plurality of springs to move the cannula to the insertion configuration and removal of the obturator from the working channel allows the springs to decrease in diameter to move the cannula to the expanded configuration.

15. The access device of claim 14, further comprising an obturator insertable through the working channel of the cannula that is effective, when inserted, to radially expand the plurality of springs such that the cannula is shifted to the insertion configuration.

16. The access device of claim 14, wherein the cannula comprises a flexible outer sheath having a plurality of folding walls disposed therein, each folding wall comprising a plurality of long segments separated from each other by at least one short segment, wherein the segments are defined by a plurality of living hinges formed in the folding walls.

17. A method for accessing a surgical site, comprising:

inserting a cannula through a tissue wall;

folding a plurality of folding walls of the cannula to form a conical shaped opening through the tissue wall.

18. The method of claim 17, wherein folding the plurality of folding walls further comprises inserting an obturator through the cannula to sever at least one retaining element and allow at least one spring to expand radially.

19. The method of claim 17, wherein folding the plurality of folding walls further comprises applying tension to at least one cable coupled to the distal end of the cannula.

20. The method of claim 17, wherein folding the plurality of folding walls further comprises removing an obturator from the cannula to allow a plurality of springs to contract radially against an outer surface of the cannula.