Split hoop wound retractor

• US 7,815,567 B2
• Filed: 10/12/2006
• Issued: 10/19/2010
• Est. Priority Date: 10/14/2005
• Status: Active Grant

• Current Assignee: Applied Medical Resources Corporation (Applied Medical Corporation)
• Original Assignee: Applied Medical Resources Corporation (Applied Medical Corporation)
• Inventors: Johnson, Gary M, Brustad, John R., Albrecht, Jeremy J, Hart, Charles C
• Primary Examiner(s): Robert; Eduardo C
• Assistant Examiner(s): NEGRELLI, CHRISTINA L
• Application Number:
  US11/548,765
• Publication Number:
  US 20070149859A1
• Time in Patent Office: 1,468 Days
• Field of Search: 600206-208, 600/201, 600/203, 600/21, 600/22, 600/215, 600/225, 600/231, 606/108
• US Class Current: 600/208
• CPC Class Codes: A61B 17/02 for holding wounds open; Tractors specula A61B1/32 ; drainage appliances for wounds A61M27/00
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0293 with ring member to support retractor elements
• 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 17/3431 being collapsible, e.g. made of thin flexible material A61B17/3423 takes precedence
• CPC Class Codes: A61B 17/3439 with means for changing the inner diameter of the cannula, e.g. expandable A61B17/3423, A61B17/3431 take precedence; catheters A61M25/0662
• 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 17/3496 Protecting sleeves or inner probes; Retractable tips for protecting body piercing guide needles A61M25/0612
• 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 2017/00477 Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61B 2017/00526 Methods of manufacturing
• CPC Class Codes: A61B 2017/0225 flexible, e.g. fabrics, meshes, or membranes
• CPC Class Codes: A61B 2017/0287 with elastic retracting members connectable to a frame, e.g. hooked elastic wires
• CPC Class Codes: A61B 2017/3419 Sealing means between cannula and body
• CPC Class Codes: A61B 2017/347 Locking means, e.g. for locking instrument in cannula
• CPC Class Codes: A61B 2050/005 with a lid or cover
• CPC Class Codes: A61B 2050/0051 closable by rotation
• CPC Class Codes: A61B 90/40 Apparatus fixed or close to patients specially adapted for providing an aseptic surgical environment

Abstract

An incrementally adjustable wound retractor, which provides access to a body cavity, includes an inner ring having a diameter greater than the desired diameter of the wound incision, an outer ring having an annular axis and a diameter greater than the desired diameter of the wound incision, and a flexible sleeve disposed in a generally cylindrical form between the inner and outer rings. The outer ring includes first and second circular tubes spaced apart axially with each including a lumen having a rigid, noncompliant split hoop placed therein. The outer ring may be rolled over itself and around the annular axis to retract the sleeve with sufficient force to stretch the incision to the desired diameter. A gel cap seal may be coupled to the outer ring outside of the biological body to seal the opening produced by the wound retractor between the body cavity and outside the body cavity.

Claims

1. A surgical access device, comprising:

a wound retractor for retracting an opening in a biological body wall, the wound retractor having,

an outer ring having an annular axis and adapted for juxtaposition with an outer surface of the biological body wall,

an inner ring adapted for juxtaposition with an inner surface of the biological body wall, and

a sleeve coupling the outer ring to the inner ring, the sleeve being adapted to traverse the opening in the body wall,

wherein the outer ring has a neutral state and a transitional state,

in the neutral state, the outer ring is substantially noncompliant, and

in the transitional state, the outer ring rolls over itself around the annular axis to roll the sleeve around the outer ring to retract and seal the opening in the body wall; and

a gel cap adapted for being coupled to the substantially noncompliant outer ring of the wound retractor, the gel cap having,

a cap ring adapted to be coupled to the outer ring of the wound retractor, the cap ring comprising a proximal portion, a distal portion, and a plurality of apertures extending through a wall at the proximal portion of the cap ring, and,

a gel pad, wherein portions of the gel pad extend through the plurality of apertures, thereby mechanically coupling the gel pad to the cap ring through the plurality of apertures, the gel pad being made of a gel material, the gel pad including an access portion for providing a passage from external the body to a body cavity, the passage forming an instrument seal in the presence of an instrument inserted therethrough and a zero seal in the absence of an instrument inserted therethrough.

2. The surgical access device of claim 1, the outer ring of the wound retractor having a lumen, and further comprising:

a substantially noncompliant hoop positioned in the lumen of the outer ring of the wound retractor.

3. The surgical access device of claim 2, the outer ring of the wound retractor having two lumens, and further comprising:

a substantially noncompliant hoop positioned in each of the two lumens of the outer ring of the wound retractor.

4. The surgical access device of claim 1, the sleeve including a material that is flexible and impermeable to fluids and bacteria.

5. The surgical access device of claim 1, the inner ring being made of materials having sufficient hardness to retain the shape of the inner ring after insertion of the inner ring into a body cavity.

6. The surgical access device of claim 1, the outer ring being made of materials that allow the outer ring to be turned around its annular axis.

7. The surgical access device of claim 1, the cap ring of the gel cap comprising:

a cylindrical ring having a plurality of lips at the distal end of the cap ring, each of the lips curving radially inward from the wall of the cap ring and extending around a portion of the circumference of the cap ring,

wherein the lips are configured to receive the outer ring of the wound retractor such that the outer ring is positioned between the lips and the gel pad.

8. The surgical access device of claim 1, wherein the distal portion of the cap ring is adapted to receive the outer ring of the wound retractor such that the outer ring of the wound retractor embeds into the gel pad and displaces the gel, thereby forming a seal between the gel pad and the outer ring and sleeve of the wound retractor.

9. The surgical access device of claim 1, the access portion of the gel pad including a plurality of intersecting dead-end slits.

10. The surgical access device of claim 7, the distal end of the cap ring including three lips, the three lips being equally spaced about the circumference of the cap ring.

11. The surgical access device of claim 7, the distal end of the cap ring including more than three lips, the more than three lips being equally spaced about the circumference of the cap ring.

12. The surgical access device of claim 7, the distal end of the cap ring including two lips, the two lips being diametrically opposed about the circumference of the cap ring and each of the two lips extending a sufficient distance around the circumference of the cap ring to facilitate adequate coupling of the gel cap to the outer ring of the wound retractor.

13. The surgical access device of claim 1 wherein the gel pad covers and seals the entire opening in the cap ring.

14. The surgical access device of claim 1, wherein the gel pad is adapted to cover the entire wound opening.

15. A surgical access device suitable for laparoscopic access to a body cavity through a body wall, the surgical access device comprising:

a proximal end, a distal end, and a longitudinal axis;

a body wall retractor comprising a deformable inner ring, an outer ring comprising an annular axis, and a tubular sleeve extending from the inner ring to the outer ring, wherein

the longitudinal axis extends through the inner ring, the outer ring, and the tubular sleeve,

the inner ring is insertable into a body cavity through an opening in a body wall, and

the outer ring has a neutral state in which the outer ring is substantially non-compliant, and a transitional state in which the outer ring is rotated around the annular axis, thereby adjusting a length of the tubular sleeve wrapped around the outer ring, and

a cap engagable with the outer ring.

16. The surgical access device of claim 15, wherein the outer ring comprises at least one lumen.

17. The surgical access device of claim 16, further comprising a substantially noncompliant hoop disposed in the at least one lumen.

18. The surgical access device of claim 15, wherein the outer ring comprises an elliptical cross-section.

19. The surgical access device of claim 15, wherein the cap is releasably engagable with the outer ring.

20. The surgical access device of claim 15, wherein the cap comprises an instrument access portion.

21. The surgical access device of claim 15, wherein the cap comprises an annular cap ring and a gel pad, wherein at least a portion of the gel pad is disposed within the annular cap ring;

and the cap ring is engagable with the outer ring.

22. The surgical access device of claim 21, wherein the gel pad comprises an elastomeric gel.