Laparoscopic access port for surgical instruments or the hand

• US 6,319,246 B1
• Filed: 11/30/1999
• Issued: 11/20/2001
• Est. Priority Date: 10/07/1994
• Status: Expired due to Term

• Current Assignee: General Surgical Innovations Incorporated (Johnson Controls International plc)
• Original Assignee: General Surgical Innovations Incorporated (Johnson Controls International plc)
• Inventors: Scott, James Stephen, Hermann, George D., Mollenauer, Kenneth H., Jervis, James E., Howell, Thomas A., Young, Roderick A., de la Torre, Roger A.
• Primary Examiner(s): Dawson, Glenn K.
• Application Number:
  US09/451,570
• Time in Patent Office: 721 Days
• Field of Search: 66/1, 661/85, 662/00, 662/13, 604/19, 604/22, 604/164.01, 604/167.01, 604/171, 604/264, 604/523, 604/533, 604/534, 604/539
• US Class Current: 606/1
• 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 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 2017/3419 Sealing means between cannula and body
• CPC Class Codes: A61B 2017/3449 whereby the instrument channels merge into one single channel
• CPC Class Codes: A61B 2017/349 Trocar with thread on outside
• CPC Class Codes: A61B 2017/3492 against the outside of the body
• CPC Class Codes: A61B 46/10 specially adapted for instruments, e.g. microscopes

Abstract

A flexible, fluid-tight envelope provides access for a hand and surgical instruments through a body tissue incision while maintaining insufflation pressure or a pneumoperitoneum within the body. The envelope is transparent and has an interior volume with opposite proximal and distal ends. A first opening in the envelope at the proximal end adjoins the incision in the body tissue and is secured and sealed to the body tissue. The second opening at the envelope distal end is provided with a closure member that seals closed the second opening on itself or around the forearm of a surgeon or a surgical instrument inserted into the interior volume of the envelope.

Claims

1. A surgical apparatus for providing access to a body cavity of a patient through an incision, the apparatus comprising:

a first member having a portion configured for attachment to the patient and a first coupling disposed proximate the portion, the first member defining a passageway for accessing the body cavity through the incision; and

a second member including a second coupling configured for releasable attachment to the first coupling and a flexible portion having an interior in fluid communication with the passageway when the first and second couplings are releasably attached, wherein the first and second couplings are sufficient when releasably attached to secure the first member to the second member and wherein the flexible portion is configured to be inverted and passed through the passageway.

2. The surgical apparatus of claim 1, wherein the first and second couplings form a seal when releasably attached.

3. The surgical apparatus of claim 2, wherein the seal is sufficient to maintain insufflation pressure within the body cavity.

4. The surgical apparatus of claim 1, wherein one of the first and second couplings has an annular groove, and at least a portion of the other of the first and second couplings is dimensioned to engage the groove.

5. The surgical apparatus of claim 1, wherein the length of the flexible portion is greater than the distance from the first coupling to the portion of the first member.

6. A surgical apparatus for providing access to a body cavity of a patient through an incision, the apparatus comprising:

a first member having a portion configured for attachment to the patient and a first coupling in substantially vertical registration with the portion, the first member defining a passageway for accessing the body cavity through the incision; and

a second member including a second coupling configured for releasable attachment to the first coupling and a flexible portion having an interior in fluid communication with the passageway when the first and second couplings are releasably attached, wherein the first and second couplings form a seal when releasably attached and wherein the flexible portion is configured to be inverted and passed through the passageway.

7. The surgical apparatus of claim 6, wherein the seal is sufficient to maintain insufflation pressure within the body cavity.

8. The surgical apparatus of claim 7, wherein the first and second couplings are sufficient when releasably attached to secure the first member to the second member.

9. The surgical apparatus of claim 6, wherein the passageway extends through the vertically registered portion and first coupling of the first member, and wherein the passageway lies along a generally straight axis.

10. The surgical apparatus of claim 6, wherein the flexible portion is an elongated sleeve.

11. The apparatus of claim 6, wherein

one of the first and second couplings has a groove and the other of the first and second couplings has a mating portion dimensioned to releasably and sealingly engage the groove.

12. The apparatus of claim 11, wherein at least one of the groove and the mating portion is deformable and resilient.

13. The apparatus of claim 12, wherein the groove circumscribes the one of the first and second couplings.

14. The apparatus of claim 13, wherein the groove is an annular groove.

15. The apparatus of claim 11, wherein the mating portion includes a rim.

16. The apparatus of claim 11, wherein the mating portion is a flange.

17. The apparatus of claim 16, wherein the flange projects radially outward.

18. The apparatus of claim 11, wherein the first coupling has the groove.

19. The apparatus of claim 18, wherein the groove is in the interior of the first coupling.

20. The apparatus of claim 19, wherein the second coupling has a radially outward projecting flange configured to engage the groove.

21. The apparatus of claim 11, wherein

the first coupling has a first lip, and

the second coupling has a second lip configured to releasably engage the first lip.

22. The apparatus of claim 21, wherein the second lip projects radially outward.

23. The apparatus of claim 21, wherein the first lip is defined by a groove.

24. The apparatus of claim 21, wherein the second lip is defined by a flange.

25. The apparatus of claim 6, wherein at least a portion of the first coupling is dimensioned to be inserted into the incision.

26. The apparatus of claim 25, wherein

the first member has axially opposite proximal and distal ends, wherein the first coupling is at the distal end and the proximal end has an annular rim that is insertable through the incision to underlie the tissue with the first member projecting through the incision to secure and seal the first member to body tissue surrounding the incision.

27. The apparatus of claim 26, further comprising a panel having a hole therethrough that is positionable over the incision with the first member projecting through the hole to thereby further secure and seal the first member to the body tissue.

28. The apparatus of claim 6, wherein at least one of the first and second members is flexible and can be clamped closed to seal access to the passageway.

29. A surgical apparatus for providing access to a body cavity through an incision while maintaining insufflation pressure within the body, the apparatus comprising:

a first portion including a first lip and defining a passageway for communicating with the body cavity, the first portion being adapted to sealingly engage against the body to prevent insufflation gases from escaping between the body and the first portion;

a second portion including a second lip configured to releasably engage the first lip of the first portion, the first and second lips being sufficient when releasably engaged to seal the first portion to the second portion; and

a flexible, fluid-tight member secured to the second portion, the interior of the member being in fluid communication with the passageway when the first lip is releasably connected to the second lip, wherein the flexible member is configured to be inverted and passed through the passageway.

30. The surgical apparatus of claim 29, wherein the seal is sufficient to prevent insufflation gases from escaping between the first and second portions.

31. The apparatus of claim 29, wherein the first portion is configured to be inserted into the incision.

32. A surgical apparatus for providing access to a body cavity of a patient through an incision while maintaining insufflation pressure within the body, the apparatus comprising:

a patient portion having the following features;

a patient attachment piece,

a coupling, and

a substantially straight, open-ended passageway between the patient attachment piece and the coupling; and

a physician portion having the following features;

a mating coupling that can be releasably attached to the coupling of the patient portion,

a flexible sleeve connected at one end to the mating coupling, wherein the sleeve can be inverted and passed through the passageway when the couplings are attached, and

wherein the couplings and the patient portion are the sole mechanism for attaching the physician portion to the patient.