Trocar with floating septum seal

• US 5,385,553 A
• Filed: 06/15/1993
• Issued: 01/31/1995
• Est. Priority Date: 07/18/1991
• Status: Expired due to Term

• Current Assignee: Applied Medical Resources Corporation (Applied Medical Corporation)
• Original Assignee: Applied Medical Resources Corporation (Applied Medical Corporation)
• Inventors: Ritchart, Mark A., Gadberry, Donald L., Hart, Charles C.
• Primary Examiner(s): Hirsch, Paul J.
• Application Number:
  US08/077,005
• Time in Patent Office: 595 Days
• Field of Search: 604/167, 604/256
• US Class Current: 604/167.03
• 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 17/3498 Valves therefor, e.g. flapper valves, slide valves haemostasis valves A61M39/06; check valves A61M39/24
• CPC Class Codes: A61B 2017/3464 with means acting on inner surface of valve or seal for expanding or protecting, e.g. inner pivoting fingers
• CPC Class Codes: A61M 2039/0626 used with other surgical instruments, e.g. endoscope, trocar
• CPC Class Codes: A61M 2039/0633 the seal being a passive seal made of a resilient material with or without an opening
• CPC Class Codes: A61M 2039/0653 Perforated disc
• CPC Class Codes: A61M 2039/066 Septum-like element
• CPC Class Codes: A61M 2039/0666 Flap-valve
• CPC Class Codes: A61M 2039/0673 comprising means actively pressing on the device passing through the seal, e.g. inflatable seals, diaphragms, clamps
• CPC Class Codes: A61M 2039/0686 comprising more than one seal
• 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 trocar having a cannula and housing which define an access channel, is configured to receive a surgical instrument. A flexible valve disposed in the channel includes first portions which define an orifice through the valve and second portions which are disposed outwardly of the first portions. The second portions are provided with a greater flexibility so that when the instrument is inserted off-axis, the second portions of the valve will deform before the first portions causing the orifice to move without substantial deformation to the off-axis location. Alternatively, levers engaging the first portions of the valve can be pivotally mounted on a floating ring to move the substantially undeformed orifice to the off-axis location. An associated method includes the steps of deforming the second portions of the valve without substantially deforming the first portions of the valve to move the orifice into axial alignment with the instrument.

Claims

1. A trocar adapted to form an access channel across a body wall, and configured to receive a surgical instrument, the trocar comprising:

a cannula having an axis extending between a proximal end and a distal end of the trocar;

a seal housing disposed at the distal end of the cannula and forming with the cannula the access channel of the trocar;

a flexible valve disposed relative to the housing and across the access channel, the valve having elastomeric properties for forming a seal with the instrument when the instrument is disposed in the access channel;

first portions of the valve defining an orifice which is normally concentric with the axis of the cannula, the first portions being sized and configured to receive the instrument and form the seal with an outer surface of the instrument; and

second portions of the valve disposed circumferentially outwardly of the first portions of the valve for facilitating movement of the orifice from a first position generally concentric with the axis of the cannula to a second position generally removed from the axis of the cannula, in response to insertion of the instrument along a line removed from the axis of the cannula.

2. The trocar recited in claim 1 wherein:

the first portions of the valve have a first resiliency which tends to deform the orifice when the instrument is inserted off-axis;

the second portions of the valve have a second resiliency which tends to move the first portions of the valve off-axis in response to the instrument being inserted off-axis; and

the resiliency of the second portions of the valve being greater than the resiliency of the first portions of the valve so that the orifice tends to move off-axis without substantial deformation, in response to the instrument being inserted off-axis.

3. The trocar recited in claim 1 wherein the first portions of the valve have a first radial length to radial distance ratio;

the second portions of the valve have a second radial length to radial distance ratio; and

the second ratio is greater than the first ratio.

4. The trocar recited in claim 3 wherein the second portions of the valve have a bellows configuration.

5. A trocar adapted to form an access channel across a body wall, the channel being sized and configured to receive a surgical instrument having an outer surface and a first axis, the trocar comprising:

a cannula having a second axis extending between a proximal end and a distal end of the trocar;

a seal housing disposed at the distal end of the cannula and forming with the cannula the access channel of the trocar;

a flexible valve disposed relative to the housing and across the access channel, the valve having elastomeric properties for forming a seal with the instrument when the instrument is disposed in the access channel;

portions of the valve defining an orifice having a third axis which is normally aligned with the second axis of the cannula, the valve portions being sized and configured to receive the instrument and to form the seal with the outer surface of the instrument; and

means disposed circumferentially outwardly of the valve portion and responsive to the instrument being inserted with the first axis non-aligned with the second axis of the cannula, for moving the valve portions so that the third axis of the orifice is substantially aligned with the first axis of the instrument.

6. The trocar recited in claim 5 wherein the moving means comprises second portions of the valve disposed circumferentially outwardly of the first portions of the valve, the second portions having characteristics for aligning the third axis of the orifice with the second axis of the cannula without substantial deformation of the orifice.

7. The trocar recited in claim 6 further comprising:

means responsive to the first axis of the instrument being non-aligned with the second axis of the cannula, for moving the valve portions toward a position wherein the third axis of the orifice is aligned with the first axis of the instrument prior to contact between the instrument and the valve.

8. The trocar recited in claim 7 wherein portions of the housing define an annular recess and the trocar further comprises:

a lever mechanism disposed proximally of the valve and having a fourth axis generally aligned with the third axis of the orifice;

the lever mechanism being floatingly supported in the annular recess of the housing;

whereby

insertion of the instrument through the lever mechanism substantially aligns the fourth axis of the lever mechanism and the third axis of the orifice with the first axis of the instrument.

9. A method for forming a seal around an instrument introduced off-axis through an access device, includes the steps of:

providing a valve in the access device, the valve having an axis and including first portions defining an aperture sized and configured to receive the instrument, and second portions having a greater flexibility than the first portions;

inserting the instrument into the access device;

contacting the valve with the instrument at a location off-axis relative to the aperture;

pushing the instrument through the aperture to form the seal around the instrument; and

during the pushing step deforming the second portions of the valve, without substantially deforming the first portions of the valve to move the aperture into axial alignment with the instrument.

10. The method recited in claim 9 wherein the providing step includes the step of forming the second portions of the valve with an excess of material, and the deforming step includes the step of gathering the excess of material on the side of the instrument away from the aperture to displace the first portions of the valve into axial alignment with the instrument.

11. The method recited in claim 10 wherein the forming step includes the step of forming the second portions of the valve in a bellows configuration.

12. The method recited in claim 10 wherein the providing step includes the steps of:

forming the first portions of the valve with a first elastomeric material;

forming the second portions of the valve with a second elastomeric material having a greater elasticity than the first elastomeric material.

13. The method recited in claim 9 wherein the providing step includes the steps of:

providing the valve in the form of a septum with the first portions defining the aperture and the second portions extending outwardly of the first portions;

providing the first portions with a first thickness;

providing the second portions with a second thickness less than the first thickness in order to increase the flexibility of the second portions relative to the first portions.

14. A trocar adapted to form an access channel across a body wall and configured to receive a surgical instrument, the trocar comprising:

a cannula having an axis;

a housing disposed relative to the cannula and defining with the cannula the access channel of the trocar, the housing having an annular recess with a first diameter;

a ring disposed in the recess and having a second diameter;

a flexible valve disposed relative to the housing and across the access channel, the valve having an orifice and elastomeric properties for forming a seal with the instrument when the instrument is disposed in the access channel;

a plurality of levers connected to the ring and engaging the valve in proximity to the orifice;

the second diameter of the ring being less than the first diameter of the recess so that the ring and levers are free to float radially of the access of the cannula;

whereby

movement of the ring and levers cause the orifice to move without substantial deformation from the axis of the cannula.

15. The trocar recited in claim 14 wherein the levers engage the valve outward of the orifice.

16. The trocar recited in claim 15 wherein the levers are pivotally mounted on the ring.

17. The trocar recited in claim 14 wherein the annular recess is defined in a radial plane substantially perpendicular to the axis of the cannula.

18. An access device adapted to form an access channel across a body wall, and configured to receive a surgical instrument in the access channel, the access device comprising:

a cannula having an axis extending between a proximal end and a distal end of the device;

a seal housing disposed at the distal end of the cannula and forming with the cannula the access channel of the device;

a flexible valve disposed relative to the housing and across the access channel, the valve having elastomeric properties for forming a seal with the instrument when the instrument is disposed in the access channel;

portions of the valve defining an orifice which is sized and configured to receive the instrument and to form the seal with an outer surface of the instrument; and

means disposed circumferentially outwardly of the valve portions for supporting the valve portions within the seal housing, the supporting means being movable relative to the housing to permit the valve portions to float relative to the axis of the cannula.

19. The access device recited in claim 18 wherein:

the valve portions are free to float between a first position and a second position; and

the first position of the valve portions is a natural position where the valve portions are located in the absence of the instrument, and the second position is a stretched position where the valve portions are located in the presence of the instrument.

20. The access device recited in claim 19 wherein the natural position of the valve portions is disposed generally laterally of the stretched position of the valve portions.

21. The access device recited in claim 19 wherein:

the instrument has a first axis, the axis of the cannula comprises a second axis, and the orifice of the valve portions define a third axis;

the third axis of the orifice is aligned with the second axis of the cannula when the valve portions are in the first position.

22. The access device recited in claim 18 wherein the valve portions float generally in a plane transverse to the axis of the cannula.

23. An access device adapted to form an access channel across a body wall, and configured to receive a surgical instrument in the access channel, the access device comprising:

a cannula having an axis extending between a proximal end and a distal end of the device;

a seal housing disposed at the distal end of the cannula and forming with the cannula the access channel of the device;

a flexible valve disposed relative to the housing and across the access channel, the valve having elastomeric properties for forming a seal with the instrument when the instrument is disposed in the access channel;

portions of the valve defining an orifice which is sized and configured to receive the instrument and to form the seal with an outer surface of the instrument, the valve portions being located along a normal axis when the instrument is not present in the access channel; and

means for preventing deformation of the valve portions when the instrument is inserted through the valve along an axis displaced from the normal axis of the valve portions.

24. The access device recited in claim 23 wherein the means for preventing deformation of the valve portions includes means for mounting the valve portions relative to the housing and in a floating relationship with the housing to facilitate radial movement of the valve portions without substantial deformation of the valve portions.

25. The access device recited in claim 24 wherein the portions of the valve are first portions of the valve and the mounting means includes second portions of the valve having a fixed relationship with the valve housing and forming a seal with the valve housing across the access channel.