Laparoscopic instrument and cannula assembly and related surgical method

• US 8,460,271 B2
• Filed: 05/13/2010
• Issued: 06/11/2013
• Est. Priority Date: 07/21/2004
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Piskun, Gregory, Konik, Anatoly, Rottenberg, Dan
• Primary Examiner(s): Sirmons, Kevin C
• Assistant Examiner(s): GILBERT, ANDREW M
• Application Number:
  US12/779,294
• Publication Number:
  US 20100222643A1
• Time in Patent Office: 1,125 Days
• Field of Search: 604/539, 604/523, 604/528, 604/533, 604174-175, 604/164.01, 604/164.04, 604/164.07, 604/164.09, 604/165.01, 604/165.02, 604/165.04, 606/108
• US Class Current: 604/513
• 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 17/2909 Handles
• 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 17/3421 Cannulas
• 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 2017/2904 curved, but rigid
• CPC Class Codes: A61B 2017/2905 flexible
• CPC Class Codes: A61B 2017/292 connection of actuating rod to handle, e.g. ball end in recess
• CPC Class Codes: A61B 2017/2929 with a head rotatable about the longitudinal axis of the shaft
• CPC Class Codes: A61B 2017/3419 Sealing means between cannula and body
• CPC Class Codes: A61B 2017/3445 used as instrument channel for multiple instruments catheters A61B2017/22072
• CPC Class Codes: A61B 2017/3447 Linked multiple cannulas
• CPC Class Codes: A61B 2017/3449 whereby the instrument channels merge into one single channel
• CPC Class Codes: A61B 2017/3466 for simultaneous sealing of multiple instruments
• CPC Class Codes: A61B 2017/347 Locking means, e.g. for locking instrument in cannula
• CPC Class Codes: A61B 2017/3492 against the outside of the body

Abstract

A laparoscopic port assembly includes a cannula unit including three cannulas each extending at an acute angle relative to a base. The cannulas are flexible for receiving respective angulated laparoscopic instruments. The cannula unit is rotatingly received in a port holder for rotation about a longitudinal axis of the holder, the holder being disposable in an opening in a patient'"'"'s skin.

Claims

1. A surgical method comprising:

forming an opening in a patient;

inserting a cannula holder through said opening;

securing said cannula holder directly to the soft tissues of said patient;

disposing a plurality of cannulas in said holder, said cannulas attached to a base member;

inserting said base member into said holder, said base member in rotatable engagement with said holder so that after inserting of said holder said cannulas traverse said holder and extend from outside the patient to inside the patient to enable positioning of distal ends of elongate medical instruments;

after inserting of said holder through said opening, inserting a plurality of elongate medical instruments through respective ones of said cannulas; and

rotating said cannulas and said instruments relative to said holder and jointly relative to said base member about a longitudinal axis of said holder perpendicular to the skin of said patient, the rotating including orienting said cannulas at angles relative to one another and to said base member in a relaxed or rest configuration of the holder,

wherein said cannulas are three in number and oriented at angles of 120°

with respect to each other.

2. The method defined in claim 1, wherein the disposing of said cannulas in said holder further includes attaching a locking member to said holder to maintain said base member in rotatable engagement with said holder.

3. A surgical method comprising:

inserting a cannula holder through an opening in a patient, a plurality of cannulas attached to said holder and to a base member to provide respective access paths to inside the patient;

after inserting of said holder through said opening, inserting a plurality of elongate medical instruments through respective ones of said cannulas; and

subsequently using at least two of said instruments in a crossed configuration while said instruments extend through respective ones of said cannulas,

the subsequently using including orienting said cannulas at angles relative to one another and to said base member wherein said plurality of cannulas are three in number and are oriented at angles of 120°

with respect to each other.

4. The method defined in claim 3, wherein said cannula holder includes an annular member, further comprising moving said cannulas and the inserted instruments relative to said annular member.

5. The method defined in claim 4, wherein the moving of said cannulas and the inserted instruments includes rotating said cannulas and said instruments jointly relative to said holder, about a longitudinal axis of said holder.

6. The method defined in claim 3, wherein at least one of said cannulas includes a flexible portion, further comprising bending said flexible portion of said one of said cannulas.

7. The method defined in claim 6, wherein one of said cannulas has a first configuration prior to insertion of one of said instruments through said one of said cannulas and has a different second configuration after insertion of one of said instruments through said one of said cannulas.

8. A surgical method comprising:

inserting an access port through an opening in a patient, said port having a panel or wall defining a closure surface and a plurality of cannulas;

providing a plurality of elongate medical instruments;

inserting said plurality of elongate medical instruments through said cannulas in the port so that said instruments traverse said closure surface and extend from outside the patient to inside the patient wherein said instruments are three in number and oriented at angles of 120°

with respect to each other; and

after the inserting of said instruments, using at least two of said instruments in a crossed configuration to perform a medical procedure inside the patient, the using of said instruments including manipulating handle ends of said instruments disposed outside the patient,

the using of said instruments including orienting said instruments at the angles with respect to each other and to said access port in a relaxed or rest configuration of the access port.