Surgical access device

• US 5,082,005 A
• Filed: 12/18/1990
• Issued: 01/21/1992
• Est. Priority Date: 12/18/1990
• Status: Expired due to Fees

• Current Assignee: New England Deaconess Hospital
• Original Assignee: New England Deaconess Hospital
• Inventors: Kaldany, Antoine
• Primary Examiner(s): Hirsch, Paul J.
• Application Number:
  US07/629,148
• Time in Patent Office: 399 Days
• Field of Search: 128/849, 128/850, 128/853, 128/854, 604/93, 604/175
• US Class Current: 128/850
• CPC Class Codes: A61M 13/003 Blowing gases other than for carrying powders, e.g. for inflating, dilating or rinsing
• CPC Class Codes: A61M 2039/0223 having means for anchoring the subcutaneous access site
• CPC Class Codes: A61M 2210/10 Trunk
• CPC Class Codes: A61M 2210/1017 Peritoneal cavity
• CPC Class Codes: A61M 2230/005 Parameter used as control input for the apparatus
• CPC Class Codes: A61M 39/0208 Subcutaneous access sites for injecting or removing fluids transcutaneous access sites A61M39/0247; implantable infusion devices A61M5/14276
• CPC Class Codes: A61M 39/0247 Semi-permanent or permanent transcutaneous or percutaneous access sites to the inside of the body peritoneal dialysis catheters A61M1/285; tracheostomy devices A61M16/0465; measuring pressure within the body A61B5/03; colostomy devices A61F5/445; gastrotomy feeding tubes A61J15/0015; means for fixing a feeding tube outside of the body A61J15/0053

Abstract

A surgical access device for subcutaneous implantation in a patient adjacent a bodily cavity. The device comprises a resilient biocompatible plate, a slit through the plate and a skirt which extends internally from the edge of the slit. The device has attachment points for securing the device subcutaneously to muscle or other tissue. The slit through the plate opens in response to an appropriate force to provide access to the bodily cavity through the skirt.

Claims

1. A surgical access device for sub-cutaneous implantation in a patient in a space adjacent a bodily cavity for providing convenient access to an incision made in said cavity, comprising:

a) a resilient plate extending in a first plane;

b) attachment points for securing the plate subcutaneously;

c) an access in the plate formed by a deformable slit extending through the plate and

d) a skirt extending from the slit in a direction transverse the first plane a sufficient distance, such that when the plate is implanted, the skirt extends between the incision sub-cutaneously for preventing closure of the incision.

2. A surgical access device according to claim 1, wherein the plate contains an air inlet for the introduction of air into the bodily cavity.

3. A surgical access device of claim 1, wherein the plate is composed of a biocompatible metal.

4. A surgical access device of claim 2, wherein the attachment points are suture holes.

5. A surgical access device of claim 3, wherein the suture holes are positioned around the periphery of the device, around the periphery of the slit, and around the periphery of the air inlet.

6. A surgical access device of claim 1, wherein the plate is reinforced by a border of material thicker than the plate.

7. A surgical access device of claim 1, wherein the plate is rectangular and the slit extends transverse the longitudinal axis.

8. A surgical access device of claim 1, wherein the slit has smooth opposed lips.

9. A surgical access device for sub-cutaneous implantation in a patient in a space adjacent the abdominal cavity for providing convenient access to an abdominal incision, comprising:

a) a planar bio-compatible plate extending in a plane;

b) an access in the plate formed by a slit through the plate, the slit having first and second opposed edges;

c) suture holes in the plate for securing the plate subcutaneously, the suture holes located around the periphery of the plate and around the periphery of the slit; and

d) a skirt protruding from the surface of the plate at the access in a direction transverse the plane of the plate for insertion between the incision sub-cutaneously to prevent complete closure of said incision and prevent buildup of tissue adhesions.

18. The device of claim 9 including a valve formed in the plate for applying air into the cavity.

19. The device of claim 18 including an oval adapter plate for covering the slit when opened, While allowing tool access to the cavity without substantial loss of air.

10. A method for repeated surgical access to an incision made in a bodily cavity of a patient, comprising:

a) implanting a surgical access device adjacent the bodily cavity in the patient, the device comprising a resilient plate extending in a first plane with an access slit through the plate and a skirt extending from the slit in a plane transverse the plane of the plate and extending between the incision sub-cutaneously to prevent closure of the incision;

b) subjecting the plate to a force which opens the access slit and opening the skirt to access the cavity;

c) removing the force to close the access slit; and

d) repeating steps b) and c) as necessary for repeated access to the cavity.

11. The method of claim 10, wherein the slit is oriented transverse to the longitudinal axis of the plate and the plate is subjected to opposing forces in a direction coincident with the axis of the slit.

12. The method of claim 10, wherein the plate is implanted by suturing the periphery of the plate to muscle tissue and suturing the periphery of the access slit around the incision formed in the bodily cavity.

13. A method for repeated non-traumatic surgical access to a bodily cavity of a patient, comprising:

a) implanting a surgical access device beneath the skin in the muscle wall adjacent the bodily cavity wall in the patient, the device comprising;

i) a resilient plate;

ii) attachment points for securing the plate subcutaneously;

iii) an access formed by an opening in the surface of the plate; and

iv) a skirt protruding from the surface of the plate toward the bodily cavity;

the skirt being inserted into the body subcutaneously through an incision made in the wall of the cavity; and

the implanting comprising securing the periphery of the plate to the muscle wall and the periphery of the access to the cavity wall; and

b) opening the access to perform a surgical procedure.

14. A method for repeated non-traumatic surgical access to the abdominal cavity of a patient through an incision, comprising:

a) implanting a surgical access device in a space adjacent the incision in the abdominal cavity of a patient between the skin tissue and the peritoneum, the device comprising a plate with a reinforced border and an access lit, the slit being oriented in a direction transverse to the longitudinal axis of the plate with a skirt protruding from the surface of the plate and extending between the incision sub-cutaneously into the abdominal cavity, said implanting including the steps of;

(i) securing the border to muscle wall tissue;

(ii) inserting the skirt through the incision formed in the peritoneum to prevent closure and adhesion of said incision; and

(iii) securing the periphery of the slit to the periphery of the opening in the peritoneum.

15. The method of claim 14 including the steps of:

b) subjecting the plate to force which opens the access slit;

c) removing the force to close the access slit; and

d) repeating steps b) and c) as necessary for repeated access to the cavity.

16. The method of claim 14 including the step of providing inward flow of fluid in the peritoneum through a valve formed in the plate.

17. The method of claim 16 including covering the access slit with an oval shaped adapter plate when the slit is opened, said adapter plate having an opening to permit a tool to be inserted therethrough without substantial loss of fluid.