Surgical instrument support and method of using the same

• US 5,658,272 A
• Filed: 02/21/1995
• Issued: 08/19/1997
• Est. Priority Date: 09/15/1992
• Status: Expired due to Fees

• Current Assignee: Harrith M. Hasson
• Original Assignee: Harrith M. Hasson
• Inventors: Hasson, Harrith M.
• Primary Examiner(s): DAWSON, GLENN K
• Application Number:
  US08/392,272
• Time in Patent Office: 910 Days
• Field of Search: 606/1, 606/108, 606/130, 606/185, 604/116, 604/164, 604/264, 128/749
• US Class Current: 606/1
• CPC Class Codes: A61B 17/3403 Needle locating or guiding means guides for suture needles A61B17/0482; guiding or tracking by nuclear magnetic resonance G01R33/285
• 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 2017/3486 Balloon
• CPC Class Codes: A61B 2017/3492 against the outside of the body
• 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 support for a surgical instrument, having a base that defines a seat with a concave surface and a flat surface facing in a first direction for placement against tissue and a connector having a convex surface to abut to and move universally relative to the concave base surface. A sleeve with a passage through which a surgical instrument can be directed is attached to the connector such that the sleeve follows universal movement of the connector relative to the base. Cooperating structure on the connector and base maintains the connector and base in an operative position in which the convex surface on the connector resides adjacent to the plane of the flat base surface and does not project significantly in the first direction beyond the flat base surface.

Claims

1. A surgical instrument support comprising:

a base having a flat surface facing in a first direction for placement against a tissue,

said base defining a seat with a concave surface,

there being one piece defining at least a portion of each of the flat and concave base surfaces;

connector having a convex surface to abut to and move universally relative to the concave base surface;

sleeve defining a passage through which a surgical instrument can be directed;

means for connecting the connector to the sleeve so that the sleeve follows universal movement of the connector relative to the base; and

first means cooperating between the connector and base for maintaining the connector and base in an operative position in which the convex surface on the connector resides adjacent to a plane within which the flat base surface resides and does not project significantly in the first direction beyond the flat base surface,

said flat base surface defining the furthestmost extension of the support in the first direction,

whereby the flat base surface can be pressed sealingly against a tissue through which an incision is to be made to allow a surgical instrument to be directed through the sleeve passage into an incision around which the flat base surface seals,

wherein the first cooperating means comprises means for snap fitting the connector and sleeve into the operative position.

2. A surgical instrument support comprising:

a base having a flat surface facing in a first direction for placement against a tissue,

said base defining a seat with a concave surface,

there being one piece defining at least a portion of each of the flat and concave base surfaces;

a connector having a convex surface to abut to and move universally relative to the concave base surface;

a sleeve defining a passage through which a surgical instrument can be directed;

means for connecting the connector to the sleeve so that the sleeve follows universal movement of the connector relative to the base; and

first means cooperating between the connector and base for maintaining the connector and base in an operative position in which the convex surface on the connector resides adjacent to a plane within which the flat base surface resides and does not project significantly in the first direction beyond the flat base surface,

said flat base surface defining the furthestmost extension of the support in the first direction,

whereby the flat base surface can be pressed sealingly against a tissue through which an incision is to be made to allow a surgical instrument to be directed through the sleeve passage into an incision around which the flat base surface seals,

wherein the sleeve has an axial extent and an outer surface, there being second means on the sleeve selectively positionable between a) a first position wherein the second means defines an axially facing shoulder that projects radially beyond the outer surface of the sleeve and b) a second position wherein the second means does not project significantly radially beyond the outer surface of the sleeve, and third means cooperating between the sleeve and at least one of the connector and base for selectively mounting the sleeve and base in first and second different relative positions, with the shoulder of the second means being spaced axially from the flat base surface a first distance with the base and sleeve in said first relative position and the connector and sleeve in an operative relationship and the second means being spaced axially from the flat base surface a second distance with the base and sleeve in said second relative position and the connector and sleeve in an operative relationship.

3. The surgical instrument support according to claim 2 wherein the third means includes fourth means for releasably fixing the relative position of the connector and sleeve and fifth means for releasably fixing the relative positions of the connector and base.

4. The surgical instrument support according to claim 3 wherein at least one of the fourth and fifth means comprises a set screw that is extendable in a line transversely to a line perpendicular to the plane of the flat base surface.

5. The surgical instrument support according to claim 2 wherein the second means comprises a bladder that is selectively inflatable and deflatable to be placed in its first and second positions, respectively.

6. A surgical instrument support comprising:

base having a flat surface facing in a first direction for placement against a tissue,

said base defining a seat with a concave surface,

there being one piece defining at least a portion of each of the flat and concave base surfaces;

a connector having a convex surface to abut to and move universally relative to the concave base surface;

a sleeve defining a passage through which a surgical instrument can be directed;

means for connecting the connector to the sleeve so that the sleeve follows universal movement of the connector relative to the base; and

first means cooperating between the connector and base for maintaining the connector and base in an operative position in which the convex surface on the connector resides adjacent to a plane within which the flat base surface resides and does not project significantly in the first direction beyond the flat base surface,

said flat base surface defining the furthestmost extension of the support in the first direction,

whereby the flat base surface can be pressed sealingly against a tissue through which an incision is to be made to allow a surgical instrument to be directed through the sleeve passage into an incision around which the flat base surface seals,

wherein said convex surface is part of a spherical outer surface on the connector and a line tangent to said spherical outer surface at a right angle to the plane within which the flat base surface resides intercepts the flat base surface

wherein each of the connector and flat base surface has a diameter and the diameter of the flat base surface is at least two times the diameter of the connector.

7. A support for a surgical instrument, said support comprising:

a base having a substantially flat surface facing in a first direction for placement against a tissue;

a connector having a spherical outer surface and a through bore; and

first means cooperating between the base and connector for snap fitting the base and connector together in an operative position in which the connector is universally movable relative to the base and the spherical outer surface of the connector resides adjacent to a plane within which the flat base surface resides and does not project significantly in the first direction beyond the flat base surface.

8. A support for a surgical instrument, said support comprising:

a base having a substantially flat surface facing in a first direction for placement against a tissue;

a connector having a spherical outer surface and a through bore;

first means cooperating between the base and connector for snap fitting the base and connector together in an operative position in which the connector is universally movable relative to the base and the spherical outer surface of the connector resides adjacent to the plane of the flat base surface and does not project significantly in the first direction beyond the flat base surface; and

second means cooperating between the base and connector for fixing the base and connector selectively in a plurality of different positions.

9. The surgical instrument support according to claim 8 wherein the second means comprises a set screw.

10. A support for a surgical instrument, said support comprising:

a base having a substantially flat surface facing in a first direction for placement against a tissue;

a connector having a spherical outer surface and a through bore;

first means cooperating between the base and connector for snap fitting the base and connector together in an operative position in which the connector is universally movable relative to the base and the spherical outer surface of the connector resides adjacent to a plane within which the flat base surface resides and does not project significantly in the first direction beyond the flat base surface; and

second means mounted to at least one of the base and connector for defining a first shoulder facing the flat base surface to captively hold a tissue between the first shoulder and the flat base surface.

11. The surgical instrument support according to claim 10 wherein the second means comprises a sleeve with a flexible bladder thereon that defines said first shoulder.

12. A support for a surgical instrument, said support comprising:

a base having a substantially flat surface fitting in a first direction for placement against a tissue;

a connector having a spherical outer surface and a through bore;

first means cooperating between the base and connector for snap fitting the base and connector together in an operative position in which the connector is universally movable relative to the base and the spherical outer surface of the connector resides adjacent to a plane within which the flat base surface resides and does not project significantly in the first direction beyond the flat base surface,

wherein the flat base surface has one of a square and rectangular shape as viewed at a right angle to the plane of the flat base surface.

13. A method of defining a passageway through a tissue to accommodate a surgical instrument, said method comprising the steps of:

making an incision in the tissue;

placing a base with an opening therethrough against the tissue so that the incision is exposed at the base opening;

directing a sleeve through the base opening and tissue so that a portion of the sleeve is in a cavity bounded by the tissue;

defining a first shoulder on the portion of the sleeve in the cavity;

drawing the sleeve out of the incision to bear the shoulder on the sleeve portion against the tissue;

providing a connector on the sleeve and sliding the connector along the sleeve to bear the connector against the base at a location adjacent to the tissue and thereby bring the first shoulder and base firmly against the tissue to captively hold the tissue; and

fixing the connector relative to the sleeve.

14. The method of defining a passageway through a tissue according to claim 13 including the step of fixing at least one of the connector and sleeve to the base.

15. A method of defining a passageway through a tissue to accommodate a surgical instrument, said method comprising the steps of:

making an incision in the tissue;

placing a base with an opening therethrough against the tissue so that the incision is exposed at the base opening;

directing a sleeve through the base opening and tissue so that a portion of the sleeve is in a cavity bounded by the tissue;

defining a first shoulder on the portion of the sleeve in the cavity;

drawing the sleeve out of the incision to bear the first shoulder on the sleeve portion against the tissue;

providing a connector on the sleeve and sliding the connector along the sleeve to bear the connector against the tissue to thereby firmly hold the tissue between the connector and first shoulder; and

guiding pivoting movement of the connector on the base.

16. The method of defining a passageway through a tissue according to claim 15 including the step of fixing the connector, sleeve, and base, each relative to the other.

17. A support for a surgical instrument, said support comprising:

a base having a flat surface facing in a first direction for placement against a tissue,

said base defining a seat with a concave surface;

a connector having a convex surface to abut to and move universally relative to the concave base surface;

a sleeve defining a passage through which a surgical instrument can be directed;

means for connecting the connector to the sleeve so that the sleeve follows universal movement of the connector relative to the base; and

first means cooperating between the connector and base for maintaining the connector and base in an operative position in which the convex surface on the connector resides adjacent to a plane within which the flat base surface resides and does not project significantly in the first direction beyond the flat base surface, said first cooperating means comprising means for snap fitting the connector and sleeve into the operative position.

18. A support for a surgical instrument, said support comprising:

a base having a flat surface facing in a first direction for placement against a tissue,

said base defining a seat with a concave surface;

a connector having a convex surface to abut to and move universally relative to the concave base surface;

a sleeve defining a passage through which a surgical instrument can be directed;

means for connecting the connector to the sleeve so that the sleeve follows universal movement of the connector relative to the base; and

first means cooperating between the connector and base for releasably fixedly maintaining the connector and base in an operative position in which the convex surface on the connector resides adjacent to a plane within which the flat base surface resides and does not project significantly in the first direction beyond the flat base surface,

said first cooperating means comprising means for snap fitting the connector and sleeve into the operative position.