Endoluminal and transluminal surgical methods and devices

• US 9,155,557 B2
• Filed: 04/17/2008
• Issued: 10/13/2015
• Est. Priority Date: 04/17/2007
• Status: Active Grant

• Current Assignee: Surgiquest, Inc. (Jefferies Financial Group, Inc.)
• Original Assignee: Surgiquest, Inc. (Jefferies Financial Group, Inc.)
• Inventors: Azarbarzin, Kurt, Jones, Daniel B., Stearns, Ralph, Nolan, Timothy J.
• Primary Examiner(s): HENDERSON, RYAN N
• Application Number:
  US12/148,234
• Publication Number:
  US 20080262302A1
• Time in Patent Office: 2,735 Days
• Field of Search: 600121-125, 600154-159, 600/104, 600/106, 600114-116, 604/26, 604 43- 45, 604506-517, 606139-151
• US Class Current: 1/1
• CPC Class Codes: A61B 1/00052 positioned at proximal end of the endoscope body
• CPC Class Codes: A61B 1/018 for receiving instruments
• CPC Class Codes: A61B 1/042 characterised by a proximal camera, e.g. a CCD camera
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/22031 Gripping instruments, e.g. forceps, for removing or smashing calculi A61B17/221 takes precedence
• 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 17/3431 being collapsible, e.g. made of thin flexible material A61B17/3423 takes precedence
• CPC Class Codes: A61B 17/3474 Insufflating needles, e.g. Veress needles
• CPC Class Codes: A61B 2017/00278 Transorgan operations, e.g. transgastric
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00398 using powered actuators, e.g. stepper motors, solenoids
• CPC Class Codes: A61B 2017/00544 pneumatically
• CPC Class Codes: A61B 2017/00867 shape memory effect
• CPC Class Codes: A61B 2017/00907 for light
• CPC Class Codes: A61B 2090/3614 using optical fibre
• CPC Class Codes: A61B 90/361 Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61B 90/37 Surgical systems with images on a monitor during operation
• CPC Class Codes: A61B 90/40 Apparatus fixed or close to patients specially adapted for providing an aseptic surgical environment

Abstract

An access device adapted and configured to be inserted through a natural biological orifice, and related surgical methods are provided. The access device includes a body, a nozzle means and means for delivering a pressurized flow of fluid to the nozzle means. The body is configured and dimensioned to be inserted through a natural bodily orifice and has proximal and distal end portions and defines at least one lumen therethrough to accommodate passage of one or more surgical instruments. The nozzle means is operatively associated with the body for directing pressurized fluid into the lumen to develop a pressure differential in an area within a region within the lumen to form a fluid seal around the one or more surgical instruments passing therethrough.

Claims

1. An access device adapted and configured to be inserted into a natural lumen of a patient'"'"'s body through a natural orifice to gain access to a surgical site in a body cavity through a wall of the natural lumen, the access device comprising:

a) a proximal housing portion;

b) an elongated flexible body portion extending distally from the proximal housing portion, the flexible body portion dimensioned and configured for transluminal access to the surgical site and having a tubular wall defining a central lumen to accommodate passage of surgical instruments to the surgical site, wherein a distal end portion of the flexible body portion has a longitudinal slit formed therein extending proximally from a distal end of the body portion to gain access to the wall of the natural lumen, wherein the tubular wall forming the longitudinal slit includes laterally opposed side grasping elements configured for actuated movement between open, closed and grasping positions to engage the wall of the natural lumen, and wherein control elements are arranged within the tubular wall adjacent to the longitudinal slit to effect actuated movement of the grasping elements;

c) a nozzle formed within the tubular wall of the flexible body portion around a circumference of the central lumen for directing pressurized fluid into the central lumen to develop a pressure differential between pressure at the surgical site and pressure outside of the surgical site, the pressure differential forming a barrier to egress of pressurized fluid from the surgical site through the central lumen of the flexible body portion, while forming a fluid seal around surgical instruments passing through the central lumen of the flexible body portion to the surgical site; and

d) a fluid inlet in the proximal housing portion in communication with the nozzle.

2. The access device of claim 1, further comprising at least one manipulating element for controlling a curvature of the flexible body portion of the access device.

3. The access device of claim 1, further comprising an image sensor arranged in the distal end portion of the body portion of the access device, adapted and configured to capture images of a region distal to the distal end portion of the access device.

4. The access device of claim 3, further comprising a light source arranged in the distal end portion of the body portion of the access device, adapted and configured to illuminate a region distal to the distal end portion of the body portion of the access device.

5. The access device of claim 1, further comprising one or more working channels provided in the wall of the body portion of the access device.

6. The access device of claim 5, wherein one of said working channels is configured and adapted to provide irrigation to the surgical site.

7. The access device of claim 5, wherein one of said working channels is configured and adapted to provide drainage from the surgical site.

8. The access device of claim 5, wherein one of said working channels is configured and adapted to allow a surgical instrument to pass therethrough.

9. The access device of claim 1, further comprising a guide element adapted and configured to guide surgical instruments in the lumen of the body portion of the access device.

10. The access device of claim 1, further comprising a pressure sense channel arranged in the wall of the body portion of the access device configured and adapted to be in fluid communication with the surgical site.

11. The access device of claim 1, further comprising at least one control element arranged within the flexible body portion, adapted and configured to effect a change in curvature of the flexible body portion.

12. The access device of claim 1, further comprising a pressure sensing channel formed in the wall of the body portion for communicating with the surgical site.

13. An access device as recited in claim 1, wherein the opposed side grasping elements are undulating grasping elements.

14. An access device as recited in claim 13, wherein the opposed side grasping elements are straight grasping elements.

15. An access device as recited in claim 1, wherein the control elements include ribs arranged in the tubular wall of the distal end portion of the flexible body portion and formed from a shape memory alloy.

16. An access device as recited in claim 15, wherein the control elements include one or more control wires in the tubular wall of the distal end portion of the flexible body portion.

17. An access device as recited in claim 15, wherein the ribs formed from a shape memory alloy have a first shape at a first temperature and a second shape at a second temperature.

18. An access device as recited in claim 17, wherein resistive heating of the ribs through application of a voltage thereto causes the ribs to change from the first shape to the second shape.

19. An access device as recited in claim 17, wherein the first shape of the ribs corresponds to the grasping elements being in a closed position, and the second shape of the ribs corresponds to the grasping elements being in an open position.