Surgical access sheath

• US 5,290,249 A
• Filed: 09/17/1992
• Issued: 03/01/1994
• Est. Priority Date: 10/09/1990
• Status: Expired due to Term

• Current Assignee: Cook Medical Technologies, LLC (Cook Group Incorporated)
• Original Assignee: Vance Products Incorporated (Cook Group Incorporated)
• Inventors: Lyttle, John S., Pingleton, Edward D., Foster, Thomas L., Thomson, Paul G.
• Primary Examiner(s): Yasko, John D.
• Assistant Examiner(s): MENDEZ, MANUEL A
• Application Number:
  US07/947,095
• Time in Patent Office: 530 Days
• Field of Search: 606/198, 606/167, 606/184, 606/171, 604/104, 604/106, 604/264, 604/96, 604/98, 604/99, 604/105, 604/107, 604/164, 604/165, 604/198, 604/192, 604/153, 604/157, 604/105, 604/107, 604/174, 604/177
• US Class Current: 604/174
• CPC Class Codes: A61B 17/34 Trocars; Puncturing needles pointed biopsy instruments A61B10/0233; devices for piercing the ear-lobes A44C7/001; seals or hemostasis valves A61M39/06
• CPC Class Codes: A61B 2017/00986 Malecots, e.g. slotted tubes, of which the distal end is pulled to deflect side struts
• CPC Class Codes: A61B 2017/3486 Balloon
• CPC Class Codes: A61B 2090/036 abutting on tissue or skin
• CPC Class Codes: A61M 2025/0233 specifically adapted for attaching to a body wall by means which are on both sides of the wall, e.g. for attaching to an abdominal wall

Abstract

A surgical trocar access sheath having a laterally expandable retention mechanism for percutaneous insertion through a body cavity wall. The expandable retention mechanism is positioned about the distal end of the sheath for retaining the access sheath within the body cavity. The access sheath has an inner elongated member cannula and an outer elongated member tube having a slick surface for ready insertion through a puncture site. The laterally expandable retention mechanism includes a plurality of strips extending and formed longitudinally in the outer tube. The retention mechanism has an expanded state and a retracted state. In the expanded state, the longitudinal strips extend radially from the outer elongated member tube to engage the interior surface of the body cavity wall. The expandable retention mechanism is actuated by sliding an actuating mechanism hub attached to the distal end of the outer elongated member tube against another hub fixedly attached to the inner elongated member cannula. To insert or retract the access sheath through the cavity wall of a patient, the physician squeezes the actuating mechanism hub against the fixed hub to collapse the longitudinal strips against the surface of the inner elongated member cannula. Once inserted, the actuating mechanism is released to expand the retention mechanism.

Claims

1. A surgical access sheath comprising:

a first elongated member having a slick outer surface, a first distal end, a first proximal end, a first passageway extending longitudinally between said first ends, and a retention mechanism positioned about said first distal end and having a predetermined state;

a second elongated member positioned within said first passageway and having a second distal end attached about said first distal end, a second proximal end, and a second passageway extending longitudinally between said second ends, said retention mechanism assuming said predetermined state when said first and second proximal ends are urged longitudinally apart;

a proximal hub attached about said second proximal end of said second elongated member and having a longitudinal slot therein; and

a distal hub separate from said proximal hub, attached about said first proximal end of said first member, and having a projection extending therefrom and into said longitudinal slot of said proximal hub; and

spring means positioned between and contacting said proximal hub and said distal hub for urging said distal and proximal hubs longitudinally apart.

2. The access sheath of claim 1 wherein said retention mechanism includes a plurality of strips longitudinally positioned about said first distal end of said first elongated member.

3. The access sheath of claim 1 wherein said first member includes a tube and said retention mechanism includes a plurality of strips formed longitudinally in said tube about said first distal end.

4. The access sheath claim 1 wherein said first elongated member comprises a polytetrafluoroethylene material tube and said retention mechanism includes a plurality of strips formed longitudinally in said tube about said first distal end.

5. The access sheath of claim 1 further comprising a retention plate extending laterally from said first member and slidably engaging said first member.

6. The access sheath of claim 1 wherein said proximal hub includes a chamber and a side port extending laterally therefrom and communicating with said chamber.

7. The access sheath of claim 6 further comprising a seal positioned about a proximal end of said proximal hub and having an aperture therein communicating with said chamber.

8. The access sheath of claim 1 wherein said proximal hub includes a neck extending distally and wherein said distal hub has a chamber longitudinally positioned therein, said neck communicating with said chamber.

9. The access sheath of claim 8 wherein said spring is positioned within said chamber and engages said neck and said distal hub.

10. The access sheath of claim 9 wherein said neck includes said slot longitudinally positioned therein and wherein said projection extends into said chamber and said slot.

11. The access sheath of claim 1 further comprising a rod sized for extending through said second passageway of said second elongated member.

12. The access sheath of claim 11 wherein said rod includes a predetermined distal end shaped for puncturing a cavity wall of a patient.

13. The access sheath of claim 12 wherein said rod includes an end cap positioned about a proximal end thereof for pushing said access sheath through said cavity wall of said patient.

14. The access sheath of claim 1 further comprising a retainer cap attached to said first and second members about said distal ends thereof.

15. The access sheath of claim 14 wherein said retainer cap includes a beveled distal end.

16. A surgical access sheath comprising

a pliable material tube having a slick outer surface, a first distal end, a first proximal end, and a first passageway extending longitudinally between said first ends, said tube having a plurality of strips formed longitudinally therein about said first distal end and laterally expandable to an expanded state;

a rigid cannula positioned within said first passageway of said tube and having a second distal end attached about said first distal end of said first tube, a second proximal end, and a second passageway extending longitudinally between said second ends, said strips assuming said expanded state when said first and second proximal ends are urged longitudinally apart from each other;

a proximal hub attached about said second proximal end of said cannula and having a longitudinal slot therein;

a distal hub separate from said proximal hub, attached about said first proximal end of said tube, and having a projection extending therefrom and into said longitudinal slot of said proximal hub; and

spring means positioned between and contacting said proximal hub and said distal hub for urging said distal and proximal hubs longitudinally apart.

17. The surgical access sheath of claim 16 wherein said proximal hub includes a neck extending distally about said second proximal end of said cannula and wherein said distal hub has a chamber, said neck communicating with said chamber.

18. The access sheath of claim 17 wherein said spring means is positioned within said chamber and about said cannula and engages said neck and said second hub.

19. The access sheath of claim 18 wherein said neck includes a slot longitudinally positioned therein and wherein said distal hub further comprises a projection extending therefrom into said chamber and said slot.

20. A surgical access sheath comprising:

a flexible polytetrafluoroethylene material tube having a slick outer surface, a first distal end, a first proximal end, and a first passageway extending longitudinally between said first ends, said tube also having a plurality of strips formed longitudinally therein about said first distal end and laterally expandable to an expanded state;

a rigid stainless steel cannula positioned in said first passageway of said flexible tube and having a second distal end, a second proximal end, and a second passageway extending longitudinally between said second ends;

a retainer cap having a beveled distal end and attached to said distal ends of said tube and said cannula;

a first hub attached about said second proximal end of said cannula and having a first chamber communicating with said second passageway of said cannula, said hub including an access port extending laterally therefrom and communicating with said first chamber, said hub also including a flexible seal attached about a proximal end of said first chamber and having an aperture therein communicating with said first chamber, said first hub further having a neck extending distally about said second proximal end of said cannula, said neck having a slot longitudinally positioned therein;

a second hub attached about said first proximal end of said tube and positioned about said cannula, said second hub including a second chamber sized for receiving said neck of said first hub;

spring means positioned within said second chamber and around said cannula and contacting said neck and said second hub for urging said first and second hubs longitudinally apart and actuating said plurality of strips to said expanded state, said second hub further including a projection extending into said second chamber and said slot;

a trocar rod having a three-sided pointed distal end and an end cap positioned about a proximal end thereof, said rod extending through said aperture in said seal, said first chamber, and said second passageway of said cannula, said cap engaging said flexible seal and said hub for pushing said access sheath through a body cavity wall of a patient; and

a retention disk positioned around and extending laterally from said tube and slidably moveable along said tube for fixedly positioning said tube and said cannula with respect to said body cavity wall when said plurality of strips in said expanded state internally engage said body cavity wall.