SURGICAL ACCESS ASSEMBLY AND METHOD OF USING SAME

• US 20120071748A1
• Filed: 10/24/2011
• Published: 03/22/2012
• Est. Priority Date: 10/28/2004
• Status: Active Grant

• Current Assignee: NICO Corporation
• Original Assignee: NICO Corporation
• Inventors: Mark, Joseph L., Kassam, Amin, Dougherty, Brian C., LaMar, Chad
• Granted Patent: US 9,770,261 B2
• Time in Patent Office: Days
• US Class Current: 600/411
• CPC Class Codes: A61B 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• CPC Class Codes: A61B 17/3205 Excision instruments
• CPC Class Codes: A61B 17/3417 Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating syringe needles A61M5/32; dilators A61M29/00
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 2017/320064 with tissue or sample retaining means
• CPC Class Codes: A61B 2017/3456 blunt
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2090/062 penetration depth
• CPC Class Codes: A61B 2090/0807 Indication means
• CPC Class Codes: A61B 2090/0811 for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument
• CPC Class Codes: A61B 2090/103 Cranial plugs for access to brain
• CPC Class Codes: A61B 2090/309 using white LEDs
• CPC Class Codes: A61B 2090/3614 using optical fibre
• CPC Class Codes: A61B 5/0066 Optical coherence imaging
• CPC Class Codes: A61B 5/0071 by measuring fluorescence emission
• CPC Class Codes: A61B 5/055 involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
• CPC Class Codes: A61B 5/061 Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body A61B1/00158 takes precedence
• CPC Class Codes: A61B 6/12 Arrangements for detecting or locating foreign bodies
• CPC Class Codes: A61B 8/0808 for diagnosis of the brain
• CPC Class Codes: A61B 8/0841 for locating instruments
• CPC Class Codes: A61B 8/12 : in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• CPC Class Codes: A61B 90/361 : Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61M 2039/0626 : used with other surgical instruments, e.g. endoscope, trocar
• CPC Class Codes: A61M 39/06 : Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof

Abstract

A surgical access assembly is disclosed. The surgical access assembly comprises an outer sheath and an obturator. The outer sheath is defined by an open distal end and an open proximal end and includes a hollow body portion therebetween. The obturator is defined by a distal end and a proximal end and the distal end further comprises a tapered distal tip member that terminates in a closed radiused distal tip. The obturator is configured to be received within the outer sheath such that the tapered distal tip member protrudes from the open distal end of the outer sheath when the obturator is in an introducing configuration.

Claims

1. A surgical access assembly, comprising

an outer sheath defined by an open distal end and an open proximal end and including a hollow body portion therebetween;

an obturator defined by a distal end and a proximal end, wherein the distal end further comprises a tapered distal tip member that terminates in a closed radiused distal tip;

wherein the obturator is configured to be received within the outer sheath such that the tapered distal tip member protrudes from the open distal end of the outer sheath when the obturator is in an introducing configuration.

2. The surgical access assembly of claim 1, wherein the distal end of the outer sheath further comprises a radiused rim.

3. The surgical access assembly of claim 1, further comprising a grip portion secured to the open proximal end of the outer sheath.

4. The surgical access assembly of claim 3, wherein an outer surface of the grip portion is textured.

5. The surgical access assembly of claim 3, further comprises at least one small opening formed therethrough.

6. The surgical access assembly of claim 5, further comprising a plurality of small openings spaced equi-distantly about the grip portion.

7. The surgical access assembly of claim 3, further comprising a locating member extending from a periphery of the grip portion.

8. The surgical access assembly of claim 1, wherein the body portion of the outer sheath is transparent.

9. The surgical access assembly of claim 8, wherein the body portion further comprises at least one reference indicator that is configured to visually indicate a predetermined location on outer sheath.

10. The surgical access assembly of claim 9, wherein a plurality of indicators are provided, the indicators spaced apart equi-distance from one another about the circumference of the body portion.

11. The surgical access assembly of claim 9, wherein the reference indicator is a longitudinal indicator that extends from the proximal end to the distal end.

12. The surgical access assembly of claim 9, wherein the reference indicator is printed onto one of the internal and external surface of the body portion with an imageable visible ink.

13. The surgical access assembly of claim 9 wherein the reference indicator etched onto one of the internal and external surface of the body portion.

14. The surgical access assembly of claim 10, wherein the plurality of the indicators are one of a series of spaced apart small holes and non-through divots.

15. The surgical access assembly of claim 1, wherein the obturator further comprises a body portion extending between the distal end and the proximal end, and further comprising a handle portion fixedly connected to the proximal end, wherein the handle portion further comprises a first stop member and a grip member.

16. The surgical access assembly of claim 15, further comprising a locking member that is operatively connected to the handle portion.

17. The surgical access assembly of claim 16, further comprising an engagement opening that is in communication with a receiving aperture that receives the locking member, wherein the engagement opening is in communication with a channel that receives a retaining member that is configured to retain the locking member to the handle portion.

18. The surgical access assembly of claim 1, wherein the obturator further comprises a body portion extending between the distal end and the proximal end, and wherein the body portion further comprises at least one void area.

19. The surgical access assembly of claim 1, wherein the body portion further comprises at least one compensating protuberance on an outer surface of the body portion.

20. The surgical access assembly of claim 1, wherein the body portion further comprises a channel segment disposed therein, the channel segment configured to receive a navigation member.

21. The surgical access assembly of claim 20, wherein the channel segment terminates in depression that aligns with a proximal edge of the tapered distal tip member.

22. The surgical access assembly of claim 1, wherein the obturator further comprises at least one viewing window disposed in the tapered distal tip member, the viewing window in communication with a channel that is configured to receive a viewing member to permit visualization of tissue.

23. The surgical access assembly of claim 1, further comprising an illuminating ring that operatively connects to a portion of the outer sheath, wherein the illuminating ring comprises a top surface, a wall member and at least one light element carried by the illuminating ring, wherein an access opening is formed through the top surface of the illuminating ring.

24. The surgical access assembly of claim 23, wherein the light element is a plurality of LED lights.

25. The surgical access assembly of claim 23, wherein a plurality of light elements are provided and the light elements are spaced equi-distantly about the access opening.

26. The surgical access assembly of claim 23, wherein the wall of the illuminating ring further comprises a wall opening that is configured to receive a locating element to selectively secure the illuminating ring to the outer sheath.

27. The surgical access assembly of claim 1, further comprising a navigating member that operatively connects to one of the obturator and outer sheath.

28. The surgical access assembly of claim 27, wherein the navigation member is one of an ultrasound probe and an array.

29. The surgical access assembly of claim 27, wherein the navigation member is an imaging device is positioned within obturator.

30. A method of using a surgical access assembly, comprising:

identifying an area of interest within a body;

assembling a outer sheath over an obturator in an insertion configuration such that a distal tapered tip protrudes from an open distal end of the outer sheath;

advancing the assembled outer sheath and obturator to the area of interest until the distal tapered tip is positioned adjacent the area of interest;

decanting the outer sheath such that the distal end of the outer sheath is moved toward the tapered distal tip; and

removing the obturator from the outer sheath and leaving the outer sheath in place to provide access to the area of interest.

31. The method of claim 30, wherein identifying the area of interest further comprises imaging the body to determine the location of eloquent structures to identify a trajectory for inserting the surgical access assembly.

32. The method of claim 31, wherein the imaging may be performed by one of CT-Angiography, MRI, diffusion tensor imaging and diffuse tensor tractography.

33. The method of claim 31, further comprising inputting data obtained from imaging into a navigational system.

34. The method of claim 30, further comprising operatively connecting a navigation member to one of the obturator and outer sheath.

35. The method of claim 30, wherein the obturator further comprises an indicator and wherein decanting further comprises moving the outer sheath toward the distal end of the tapered distal tip until the proximal end of the outer sheath is aligned with the indicator.

36. The method of claim 30, further comprising securing the outer sheath in place.

37. The method of claim 36, wherein a proximal end of the outer sheath is provided with a plurality of holes that cooperates with a securing element to secure the outer sheath in place once obturator is removed.

38. The method of claim 36, wherein a securing element operatively secures the outer sheath such that outer sheath is permitted a limited range of motion while positioned within the body.

39. The method of claim 30, further comprising attaching an illuminating ring to the outer sheath after the obturator has been removed.

40. The method of claim 30, wherein a surgical device is inserted into the outer sheath and tissue is resected by the surgical device.

41. The method of claim 40, wherein at least one additional surgical instrument is inserted into the outer sheath with the surgical device.

42. The method of claim 40, further comprising repositioning the outer sheath, while the outer sheath is loosely secured to the body.

43. The method of claim 42, wherein repositioning is performed by operatively engaging a portion of the outer sheath with a manipulation tool such that the manipulation tool may move the outer sheath laterally.

44. The method of claim 40, further comprising removing the surgical device and delivering a therapy to the area of interest.

45. The method of claim 44, further comprising removing the outer sheath from the body prior to delivering a therapy to the area of interest.

46. The method of claim 44, further comprising irrigating the area of interest prior to delivery therapy.

47. The method of claim 30, wherein advancing the assembled outer sheath and obturator to the area of interest comprises atraumatically dilating tissue to the area of interest.

48. The method of claim 44, further comprising implanting a delivery device at area of interest, whereby the delivery device is configured to pass a therapeutic agent from a reservoir within the delivery device.