Apparatus for inserting a surgical device at least partially through a wound opening

• US 8,465,494 B2
• Filed: 02/06/2006
• Issued: 06/18/2013
• Est. Priority Date: 12/01/1998
• Status: Active Grant

• Current Assignee: Atropos Limited
• Original Assignee: Atropos Limited
• Inventors: Butler, John, Vaugh, Trevor, Bonadio, Frank, Deegan, Catherine, MacNally, Shane J.
• Primary Examiner(s): BOLES, SAMEH RAAFAT
• Application Number:
  US11/347,803
• Publication Number:
  US 20060247499A1
• Time in Patent Office: 2,689 Days
• Field of Search: 600/201, 600/203, 600/208, 600/204, 606/95, 606/99
• US Class Current: 606/99
• 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 17/06109 Big needles, either gripped by hand or connectable to a handle
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/32093 for skin incisions
• CPC Class Codes: A61B 17/3415 for introducing tubes or catheters, e.g. gastrostomy tubes, drain catheters A61B17/3417 takes precedence; body piercing catheter guide needles A61M25/06
• 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 17/3421 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 17/3431 being collapsible, e.g. made of thin flexible material A61B17/3423 takes precedence
• CPC Class Codes: A61B 17/3468 for implanting or removing devices, e.g. prostheses, implants, seeds, wires devices for implanting seeds A61M37/0069
• CPC Class Codes: A61B 17/3476 Powered trocars, e.g. electrosurgical cutting, lasers, powered knives
• 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 18/04 by heating by applying electromagnetic radiation A61B18/18; hyperthermia using electric or magnetic fields, radiation or ultrasound A61N
• CPC Class Codes: A61B 18/1487 Trocar-like, i.e. devices producing an enlarged transcutaneous opening
• CPC Class Codes: A61B 2017/00353 one mechanical instrument performing multiple functions, e.g. cutting and grasping channel for multiple instruments A61B2017/3445; instrument channel A61B2017/22072; replaceable heads A61B2017/2931; suction A61M1/00
• CPC Class Codes: A61B 2017/00473 Distal part, e.g. tip or head A61B2017/00464 takes precedence
• CPC Class Codes: A61B 2017/0225 flexible, e.g. fabrics, meshes, or membranes
• CPC Class Codes: A61B 2017/06042 located close to needle tip
• CPC Class Codes: A61B 2017/320044 Blunt dissectors blunt suture needles A61B2017/06085
• CPC Class Codes: A61B 2017/3443 : with means for adjusting the length of a cannula
• CPC Class Codes: A61B 2017/3484 : Anchoring means, e.g. spreading-out umbrella-like structure
• CPC Class Codes: A61B 2017/3492 : against the outside of the body
• CPC Class Codes: A61B 2090/036 : abutting on tissue or skin
• CPC Class Codes: A61B 2090/08021 : of the patient or his organs
• CPC Class Codes: A61B 34/70 : Manipulators specially adapted for use in surgery

Abstract

An apparatus (650) for inserting a distal ring (9) of a wound retractor device (2) through a wound opening comprises a bladeless tip (641) for creating the wound opening by forcing tissue apart, and a conveying device (5) for conveying the distal ring (9) through the wound opening. The conveying device (5) comprises a hook element (6) for engaging the distal ring (9) to convey the distal ring (9) through the wound opening, and a receiver housing (651) for receiving a seal (652) and a proximal ring (653) of the wound retractor device (2) to hold the seal (652) and the proximal ring (653) externally of the wound opening, and thus maintain a sleeve portion of the wound retractor device (2) in tension, during conveying of the distal ring (9) through the wound opening.

Claims

1. An apparatus for inserting a wound protector having a distal ring portion and a sleeve portion, at least partially through a tissue opening, the apparatus comprising:

a housing including;

an interior surface defining a chamber, the chamber being configured to receive at least a portion of the wound protector, wherein the interior surface of the housing is configured to compress at least a portion of the distal ring portion, at least one opening into the chamber, the at least one opening into the chamber being configured to allow passage of at least a portion of the wound protector, and a housing including a cross section, the cross-section having a maximum transverse dimension that is greater than a maximum dimension normal to the maximum transverse dimension, and a blunt distal tip, wherein the cross-section being maintained during entire removal of the portion of the wound protector from the housing.

2. An apparatus as claimed in claim 1 wherein the at least one opening is provided at the distal end portion of the housing.

3. An apparatus as claimed in claim 1 wherein the at least one opening opens at an angle with respect to a longitudinal axis of the housing.

4. An apparatus as claimed in claim 1 wherein the at least one opening is configured to receive a portion of the wound protector extending out of the chamber.

5. An apparatus as claimed in claim 4 wherein the at least one opening is provided along at least a portion of a sidewall of the housing.

6. An apparatus as claimed in claim 4 wherein the at least one opening faces laterally with respect to a longitudinal axis of the housing.

7. An apparatus as claimed in claim 1 further including an ejector element configured to assist ejection of at least a portion of the wound protector from the chamber.

8. An apparatus as claimed in claim 7 wherein the ejector element includes a plunger.

9. An apparatus as claimed in claim 8 wherein the plunger is configured to move with respect to the housing to engage at least a portion of the wound protector.

10. An apparatus as claimed in claim 1 wherein the distal end portion is configured to convey the wound protector arranged concentrically with respect to a longitudinal axis of the distal end portion.

11. An apparatus as claimed in claim 1 wherein the maximum transverse dimension is between 3 mm and 35 mm.

12. An apparatus as claimed in claim 11 wherein the maximum transverse dimension is between 5 mm and 12 mm.

13. An apparatus as claimed in claim 1 wherein the apparatus is configured to penetrate the tissue opening and convey at least a portion of the wound protector into the tissue opening in a single step.

14. An apparatus as claimed in claim 1 wherein the at least one opening includes a first opening in the distal end portion of the housing and a second opening in a sidewall of the housing.

15. An apparatus as claimed in claim 1 wherein the at least one opening includes a slot configured to receive the sleeve portion of the wound protector.

16. The apparatus as claimed in claim 1 wherein the at least one opening includes a slot having a width that expands toward a distal end portion of the slot.

17. A surgical assembly comprising:

a surgical device including;

a tissue opening engaging sleeve, and

a ring coupled to the tissue opening engaging sleeve; and

an apparatus configured to assist with inserting at least a portion of the surgical device into a tissue opening, the apparatus including a housing configured to receive at least a portion of the surgical device and convey at least a portion of the surgical device into the tissue opening, wherein the housing includes a ring engaging portion configured to exert a compressive force on the ring,

wherein the housing further includes a distal end portion with a maximum transverse dimension of between 3 mm and 35 mm and a substantially oval cross-section, the substantially oval cross-section extending from the distal end portion to a proximal end portion of the housing.

18. An assembly as claimed in claim 17 wherein the surgical device is configured to retract the tissue opening with the tissue opening engaging sleeve.

19. An assembly as claimed in claim 18 wherein the ring is configured for location distally of the tissue opening to retain the surgical device in position retracting the tissue opening.

20. The surgical assembly as claimed in claim 17 wherein the housing includes at least one opening.

21. The surgical assembly as claimed in claim 20 wherein the at least one opening includes an opening in the distal end portion.

22. The surgical assembly as claimed in claim 21 wherein the opening in the distal end portion is configured to receive the ring.

23. The surgical assembly as claimed in claim 20 wherein the at least one opening includes an opening in a sidewall of the housing.

24. The surgical assembly as claimed in claim 23 wherein the opening in the sidewall is configured to receive a portion of the tissue opening engaging sleeve.

25. The apparatus as claimed in claim 20 wherein the at least one opening includes a slot having a width that expands toward a distal end portion of the slot.

26. The surgical assembly as claimed in claim 17 wherein the apparatus further includes an ejector element configured to assist ejection of at least a portion of the surgical device from the housing.

27. The surgical assembly as claimed in claim 26 wherein the ejector element includes a plunger movable relative to the housing.

28. The surgical assembly as claimed in claim 27 wherein the plunger is configured to push the ring from the housing.

29. The surgical assembly as claimed in claim 17 wherein the housing includes a substantially blunt tip.

30. An apparatus for inserting a surgical device including a ring portion and a sleeve portion at least partially through a tissue opening, the apparatus comprising:

a housing including a sidewall portion and a slot in the sidewall portion, the slot being configured to receive at least a portion of the sleeve portion, wherein the housing is configured to exert a compressive force on the ring portion of the surgical device,

a housing distal end portion including a substantially oval cross section, the cross-section having a maximum transverse dimension that is greater than a maximum dimension normal to the maximum transverse dimension, and

an ejector element movable relative to the housing, the ejector element being configured to assist removal of the surgical device from the housing the oval cross-section being maintained during the entire removal of the surgical device from the housing.

31. The apparatus as claimed in claim 30 wherein the housing includes a chamber configured to receive the ring portion of the surgical device.

32. The apparatus as claimed in claim 30 wherein the housing includes an opening in the distal end portion of the housing.

33. The apparatus as claimed in claim 32 wherein the slot and the opening in the distal end portion are contiguous.

34. The apparatus as claimed in claim 33 wherein the opening in the distal end portion is configured to allow passage of the ring portion of the surgical device.

35. The apparatus as claimed in claim 30 wherein the housing includes a substantially blunt tip portion.

36. The apparatus as claimed in claim 30 wherein the ejector element includes a plunger, the plunger being slidable relative to the housing.

37. The apparatus as claimed in claim 36 wherein the plunger includes a distal end portion configured to engage the surgical device.

38. The apparatus as claimed in claim 30 wherein the housing includes a rounded distal tip.

39. The apparatus as claimed in claim 30 wherein a width of the slot expands toward a distal end portion of the slot.