DEVICES, SYSTEMS, AND METHODS FOR PROVIDING SURGICAL ACCESS AND FACILITATING CLOSURE OF SURGICAL ACCESS OPENINGS

• US 20150038793A1
• Filed: 07/29/2014
• Published: 02/05/2015
• Est. Priority Date: 08/02/2013
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: PRIOR, SCOTT J., MALKOWSKI, JAROSLAW T., HENDERSHOT, JOHN D. III, HORTON, KENNETH W., TOKARZ, CHRISTOPHER A., TEBBE, GREGORY F., BERRY, DANNY R.
• Granted Patent: US 10,258,324 B2
• Time in Patent Office: Days
• US Class Current: 600/204
• CPC Class Codes: A61B 17/0057 Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009
• CPC Class Codes: A61B 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• CPC Class Codes: A61B 17/0483 Hand-held instruments for holding sutures A61B17/0469 takes precedence; other holders for needles or sutures A61B17/06061; surgical forceps A61B17/28; surgical pincettes A61B17/30
• 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 17/3462 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 17/3468 for implanting or removing devices, e.g. prostheses, implants, seeds, wires devices for implanting seeds A61M37/0069
• CPC Class Codes: A61B 2017/00349 Needle-like instruments having hook or barb-like gripping means, e.g. for grasping suture or tissue A61B17/06066 takes precedence
• CPC Class Codes: A61B 2017/00637 for sealing trocar wounds through abdominal wall
• CPC Class Codes: A61B 2017/00663 the implement being a suture
• CPC Class Codes: A61B 2017/00907 for light
• CPC Class Codes: A61B 2017/3405 using mechanical guide means
• CPC Class Codes: A61B 2017/3411 with a plurality of holes, e.g. holes in matrix arrangement
• CPC Class Codes: A61B 2017/3441 with distal sealing means
• CPC Class Codes: A61B 2017/3445 used as instrument channel for multiple instruments
• CPC Class Codes: A61B 2017/3454 Details of tips
• CPC Class Codes: A61B 2017/347 Locking means, e.g. for locking instrument in cannula
• CPC Class Codes: A61B 2090/036 abutting on tissue or skin
• CPC Class Codes: A61B 2090/08021 of the patient or his organs
• CPC Class Codes: A61B 2090/701 for flexible tubular instruments, e.g. endoscopes
• CPC Class Codes: A61B 90/361 Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61B 90/70 : Cleaning devices specially adapted for surgical instruments
• CPC Class Codes: A61M 13/00 : Insufflators for therapeutic or disinfectant purposes , i.e. devices for blowing a gas, powder or vapour into the body hand-held units in which gas flow is produced by muscular energy at the moment of use B05B11/062
• CPC Class Codes: A61M 19/00 : Local anaesthesia syringes therefor A61M5/00; Hypothermia A61M5/42 takes precedence; cooling blood in a bypass of the arterial system A61M1/36
• CPC Class Codes: A61M 5/329 : characterised by features of the needle shaft

Abstract

A surgical system includes a cannula and a guide member. The cannula is configured for positioning within an opening in tissue. The cannula includes a base and an elongated tubular member extending distally from the base. The elongated tubular member includes an annular wall defining a longitudinal passageway and defines at least one slot extending through the annular wall. The guide member includes a guide housing configured for releasably engaging the guide member with the cannula and an elongated guide shaft configured for insertion into the elongated tubular member of the cannula. The guide member defines at least one lumen extending therethrough and is configured such that, upon engagement of the guide member with the cannula, the at least one lumen is aligned with the at least one slot of the cannula to define a guide passageway through the guide member and cannula.

Claims

1. A surgical system, comprising:

a cannula configured for positioning within an opening in tissue, the cannula including an elongated portion having a base and an elongated tubular member extending distally from the base, the elongated tubular member including an annular wall defining a longitudinal passageway that provides access to an internal surgical site through the opening in tissue, the elongated tubular member defining at least one slot extending through the annular wall, the at least one slot disposed in communication with the longitudinal passageway; and

a guide member including a guide housing configured for releasably engaging the guide member with the cannula and an elongated guide shaft configured for insertion into the elongated tubular member of the cannula, the guide member defining at least one lumen extending therethrough and configured such that, upon engagement of the guide member with the cannula, the at least one lumen is aligned with the at least one slot of the cannula to define a guide passageway through the guide member and cannula.

2. The surgical system according to claim 1, wherein the at least one lumen extends through the guide member between at least one aperture defined through the guide housing and at least one slot defined through the elongated guide shaft, the at least one slot of the elongated guide shaft and the at least one slot of the cannula aligned with one another upon engagement of the guide member with the cannula.

3. The surgical system according to claim 1, wherein the at least one lumen defines a path with a constant radius of curvature.

4. The surgical system according to claim 1, wherein the at least one lumen defines a path with a varying radius of curvature.

5. The surgical system according to claim 1, wherein the at least one lumen extends through the guide member between proximal and distal slots defined through the elongated guide shaft, and wherein the elongated tubular member of the cannula defines at least two slots extending through the annular wall, each of the proximal and distal slots are aligned with one of the slots of the cannula upon engagement of the guide member with the cannula.

6. The surgical system according to claim 1, further including at least one sealing member disposed about at least a portion of the cannula, the at least one sealing member sealing the at least one slot.

7. The surgical system according to claim 1, wherein the cannula includes a housing releasably engagable with the base of the elongated portion.

8. The surgical system according to claim 7, wherein the guide housing is configured to releasably engage the housing of the cannula and wherein the elongated guide shaft is configured for insertion through the housing of the cannula and into the elongated tubular member of the cannula.

9. The surgical system according to claim 1, wherein the guide housing includes at least one engagement tab configured for releasable engagement within a corresponding aperture defined through the cannula to releasably engage and align the guide member relative to the cannula.

10. The surgical system according to claim 1, wherein the guide housing includes threading configured for releasable engagement with corresponding threading of the cannula to releasably engage and align the guide member relative to the cannula.

11. The surgical system according to claim 1, wherein the elongated guide shaft includes a suture retention and positioning member disposed at a distal end thereof, wherein, when the guide member is engaged with the cannula, the suture retention and positioning member presents a portion of suture within the internal surgical site to facilitate grasping of the portion of suture.

12. The surgical system according to claim 1, further including a suture passer, the suture passer configured for insertion through the guide passageway, tissue surrounding the cannula, and into the internal surgical site to at least one of deposit a portion of suture within the internal surgical site and retrieve a portion of suture from the internal surgical site.

13. The surgical system according to claim 1, further comprising an obturator including an obturator housing and an elongated obturator member, the obturator housing configured to releasably engage the cannula and the elongated obturator member configured for insertion into the elongated tubular member of the cannula, the obturator configured to facilitate insertion and positioning of the cannula within the opening in tissue when the obturator is engaged therewith.

14. The surgical system according to claim 1, wherein the elongated guide shaft of the guide member includes an obturator feature disposed at a distal end thereof to facilitate insertion and positioning of the cannula within the opening in tissue when the guide member is engaged therewith.

15. The surgical system according to claim 1, wherein the guide member includes an outer sleeve, an inner shaft, and a cap, at least two of the outer sleeve, the inner shaft, or the cap engagable with one another to form the guide member.

16. The surgical system according to claim 15, wherein the inner shaft defines at least one channel that cooperates with an interior surface of the outer sleeve to define the at least one lumen of the guide member.

17. The surgical system according to claim 1, wherein the guide member is formed from a plurality of components, at least two of the components engaged to one another via a snap-fit engagement or a bayonet coupling.

18. The surgical system according to claim 1, wherein the elongated guide shaft includes a resiliently compressible cleaning member disposed thereabout towards a distal end thereof, the resiliently compressible cleaning member configured to clean an inner surface of the annular wall of the cannula upon translation of the guide member through the longitudinal passageway of the cannula.

19. A surgical kit, comprising:

a cannula configured for positioning within an opening in tissue, the cannula defining a longitudinal passageway that provides access to an internal surgical site through the opening in tissue, the cannula defining at least one slot extending through an annular wall thereof, the at least one slot disposed in communication with the longitudinal passageway;

an obturator releasably engagable with the cannula, the obturator configured to facilitate insertion and positioning of the cannula within the opening in tissue when the obturator is engaged therewith;

a guide member configured for releasably engaging the cannula, the guide member defining at least one lumen extending therethrough and configured such that, upon engagement of the guide member with the cannula, the at least one lumen is aligned with the at least one slot of the cannula to define a guide passageway through the guide member and cannula; and

a suture passer, the suture passer configured for insertion through the guide passageway, tissue surrounding the cannula, and into the internal surgical site to at least one of deposit a portion of suture within the internal surgical site and retrieve a portion of suture from the internal surgical site.

20. A surgical kit, comprising:

a cannula configured for positioning within an opening in tissue, the cannula defining a longitudinal passageway that provides access to an internal surgical site through the opening in tissue, the cannula defining at least one slot extending through an annular wall thereof, the at least one slot disposed in communication with the longitudinal passageway;

a guide member configured for releasably engaging the cannula, the guide member configured to facilitate insertion and positioning of the cannula within the opening in tissue when engaged therewith, the guide member defining at least one lumen extending therethrough and configured such that, upon engagement of the guide member with the cannula, the at least one lumen is aligned with the at least one slot of the cannula to define a guide passageway through the guide member and cannula; and

a suture passer, the suture passer configured for insertion through the guide passageway, tissue surrounding the cannula, and into the internal surgical site to at least one of deposit a portion of suture within the internal surgical site and retrieve a portion of suture from the internal surgical site.

21. A surgical kit, comprising:

a cannula configured for positioning within an opening in tissue, the cannula defining a longitudinal passageway that provides access to an internal surgical site through the opening in tissue, the cannula defining at least one slot extending through an annular wall thereof, the at least one slot disposed in communication with the longitudinal passageway;

a guide member configured for releasably engaging the cannula, the guide member configured to facilitate insertion and positioning of the cannula within the opening in tissue when engaged therewith, the guide member defining at least one lumen extending therethrough and configured such that, upon engagement of the guide member with the cannula, the at least one lumen is aligned with the at least one slot of the cannula to define a guide passageway through the guide member and cannula; and

a syringe assembly having a needle extending distally therefrom, the needle configured for insertion through the guide passageway and into tissue surrounding the cannula for delivering at least one fluid to tissue surrounding the cannula.

22. The surgical kit according to claim 21, wherein the needle defines a rigid, curved configuration such that, upon insertion through the guide passageway, the needle enters tissue surrounding the cannula and is advanced therethrough to a pre-determined location.

23. The surgical kit according to claim 21, wherein the at least one fluid is an anesthetic.