Access device for endoscopic surgery

• US 5,514,133 A
• Filed: 08/26/1994
• Issued: 05/07/1996
• Est. Priority Date: 08/26/1994
• Status: Expired due to Term

• Current Assignee: Tyco Healthcare Group LP (Medtronic Plc)
• Original Assignee: Robert Golub, Roberto Cantu Jr, Stein H. David
• Inventors: Stein, H. David, Cantu, Roberto Jr., Golub, Robert
• Primary Examiner(s): Pellegrino, Stephen C.
• Assistant Examiner(s): PEFFLEY, MICHAEL F
• Application Number:
  US08/296,942
• Time in Patent Office: 620 Days
• Field of Search: 606/1, 606/2, 606/3, 604/174, 604/175, 604/167, 604/178, 604/177, 604/256, 604/337, 604/338
• US Class Current: 606/1
• 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 17/3423 Access ports, e.g. toroid shape introducers for instruments or hands access sites for liquids A61M39/0247
• CPC Class Codes: A61B 2017/3419 Sealing means between cannula and body
• CPC Class Codes: A61B 2017/3482 inside

Abstract

An endoscopic surgical apparatus is provided for enabling the surgeon to access directly the surgical site during an endoscopic procedure. The apparatus includes an opening extending longitudinally through the apparatus and being configured and dimensioned to receive a hand therethrough. A first plate engages against the outer surface of the abdominal wall. A second plate is spaced from the first plate and is movable between a first position and a second position wherein the second plate is in close cooperative alignment with the inner surface of the abdominal wall. An adjustment member is mounted to the second plate and actuates movement of the second plate between its first position and its second position. A first sealing member inhibits the flow of gas through said opening and is formed by a pair of overlapping seals. A flexible sleeve extends between the first and second plates and adjusts in length to accommodate various thicknesses of the abdominal wall. The sleeve also creates an access port for the passage of objects through the abdominal wall.

Claims

1. A surgical apparatus comprising:

a first plate having an abdominal wall engaging surface for engaging the outer surface of the abdominal wall;

a second plate cooperating with said first plate and adapted to receive the abdominal wall therebetween, said second plate being movable between a first position distal to the abdominal wall and a second position which engages the inner surface of the abdominal wall such that the abdominal wall is positionable between said first and second plates;

a sleeve having an adjustable length and extending from said first plate for providing access through the abdominal wall, said sleeve and said first and second plates defining an opening extending longitudinally through said apparatus and adapted and configured for receiving a hand therethrough, said sleeve further having a collapsible bellows for facilitating the adjustment in length of the sleeve;

a sealing member for inhibiting the escape of insufflation gas through said opening during a surgical procedure;

an adjustment member fixedly extending from said lower plate to said upper plate such that movement of said adjustment member in a direction toward said first plate correspondingly moves said second plate from said first to said second position; and

an anchor for receiving said adjustment member and maintaining the position thereof.

2. A surgical apparatus as recited in claim 1, wherein said sealing member comprises a first seal and a second seal which cooperate such that any insufflation gas which escapes through said first seal is prevented by said second seal from escaping through said opening.

3. A surgical apparatus as recited in claim 1 wherein said opening has a diameter between about 50 mm and 100 mm and extends in length from said upper plate to said lower plate.

4. A surgical apparatus as recited in claim 3 wherein a top surface of said second plate and a bottom surface of said first plate further comprise a non-slip surface between the first and second plates and the abdominal wall positioned therebetween.

5. A device for use during an endoscopic surgical procedure, comprising:

a first plate for engaging the outer surface of the abdominal wall;

a second plate spaced from said first plate and having a surface for engaging the inner surface of the abdominal wall, said second plate is movable between a first position wherein the second plate is spaced from the abdominal wall and a second position wherein said second plate is engaging the inner surface of the abdominal wall;

a sleeve for providing access through the abdominal wall extending between said first and second plates and defining therethrough an opening extending longitudinally from a proximal to a distal end of said device and being sized and configured to receive a hand therethrough, said sleeve further having a collapsible bellows for facilitating the adjustment in length of the sleeve; and

an adjustment member extending from said second plate to said first plate for moving said second plate, such that movement of said adjustment member correspondingly moves said second plate from said first to said second positions.

6. A device as claimed in claim 5 further comprising a first seal member which at least partially closes said opening to inhibit the escape of insufflation gas through said opening during a surgical procedure.

7. A device as claimed in claim 6 wherein said first seal member is a pair of cooperating and at least partially overlapping seals extending from said first plate.

8. A device as claimed in claim 5 wherein said adjustment member is fixedly attached to said second plate and moving said adjustment member correspondingly moves said second plate to bring said second plate into close cooperative alignment with said first plate, such that said first and second plates are secured to the abdominal wall.

9. A device as claimed in claim 5 further comprising an anchoring member secured to said first plate for receiving and retaining said adjustment member in a fixed position.

10. A device as claimed in claim 5 further comprising a second seal member extending from said first plate for further inhibiting the escape of insufflation gas through said opening during a surgical procedure by at least partially closing said opening.

11. A device as claimed in claim 10 wherein second plate abdominal wall engaging surface has projections thereon for enhancing engagement with the wall.

12. A surgical access port for providing a substantially gas-tight access opening to an abdominal cavity through the abdominal wall, comprising:

an outer member for positioning outside the abdominal cavity and defining a passageway to the abdominal cavity;

an inner member adapted to be inserted through an incision in the abdominal wall for positioning inside the abdominal cavity, said inner member and outer members defining a passageway to the abdominal cavity, said inner member movable between a first position in which said inner member is adjustable relative to the abdominal wall and a second position wherein said inner member is engaged against the abdominal wall which is secured between the inner and outer members;

a flexible, expansible sleeve extending between the inner and outer members to define a gas-tight passage between the inner and outer member openings, said sleeve movable between a first position which corresponds to said inner member first position and a second position which corresponds to said inner member second position and the engagement of the inner member against the abdominal wall secured between inner and outer members, wherein the flexibility of the sleeve permits the movement between said first and second positions and adjustment of the inner member relative to the outer member and abdominal wall;

a sealing element disposed in said passage, said element adapted to receive, with an at least substantially gas-tight seal, a surgeon'"'"'s hand passing through said passage, and being adjustable to form at least a substantially gas-tight seal when the surgeons hand is withdrawn and inserted.

13. The access port according to claim 12, further comprising at least one securing member extending between said inner and outer members such that movement of said at least one securing member causes corresponding movement of said inner member to draw together and securing said inner and outer members against the abdominal wall.

14. The access port according to claim 13, wherein said securing member comprises an elongated flexible member mounted to said inner member for positioning said inner member relative to the abdominal wall.

15. The access port according to claim 12, wherein said sealing element comprises a distal, split seal for sealing said passage in the absence of an object inserted therethrough and a proximal expandable annular seal for sealing around the object inserted therethrough.

16. The access port according to claim 12, wherein said inner member includes hinge means for folding the inner member substantially in half in one direction to facilitate insertion through the incision.