Methods and devices for providing access into a body cavity

• US 9,351,717 B2
• Filed: 12/16/2014
• Issued: 05/31/2016
• Est. Priority Date: 03/06/2009
• Status: Active Grant

• Current Assignee: Cilag Gmbh International (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Widenhouse, Christopher W., Shelton, Frederick E. IV
• Primary Examiner(s): Philogene, Pedro
• Assistant Examiner(s): SUMMITT, LYNNSY M
• Application Number:
  US14/571,457
• Publication Number:
  US 20150099938A1
• Time in Patent Office: 532 Days
• US Class Current: 1/1
• 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 17/3423 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 2017/00862 elastic or resilient
• 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
• 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 2017/3464 with means acting on inner surface of valve or seal for expanding or protecting, e.g. inner pivoting fingers
• CPC Class Codes: A61B 2017/3466 for simultaneous sealing of multiple instruments

Abstract

Methods and devices are provided for providing surgical access into a body cavity. In one embodiment, a surgical access device is provided that includes a housing coupled to a retractor. The housing can be have one or more movable sealing ports for receiving surgical instruments. Each movable sealing port can include one or more sealing elements therein for sealing the port and/or forming a seal around a surgical instrument disposed therethrough. Each movable sealing port can be rotatable relative to the housing and each sealing element can be rotatable relative to the housing along a predetermined orbital path.

Claims

1. A surgical device, comprising:

a distal retractor configured to be positioned in an opening formed in tissue to provide a pathway through the tissue;

a proximal lock ring configured to releasably mate to the retractor; and

a base configured to releasably mate to the lock ring and configured to be captured between the retractor and the lock ring when the lock ring is releasably mated to the retractor, the base being configured to rotate 360°

about a central point of the base relative to the lock ring and the retractor when the lock ring is releasably mated to the retractor, the base including a first sealing port comprises a first sealing element configured to form a seal around a first surgical instrument advanced therethrough, the base including a second sealing port configured to form a seal around a second surgical instrument advanced therethrough, the first sealing port being configured to rotate 360°

about a central point of the first sealing port relative to the lock ring, the retractor, and the second sealing port, the central point of the first sealing port being laterally offset from the central point of the base, the second sealing port being configured to rotate 360°

about a central point of the second sealing port relative to the lock ring, the retractor, and the first sealing port, and the central point of the second sealing port being laterally offset from the central point of the base and being laterally offset from the central point of the first sealing port, and wherein the first sealing element of the first sealing port is laterally movable in a plane parallel to a plane defined by the base such that a distance between the first sealing element of the first sealing port and the central point of the base is adjustable.

2. The device of claim 1, wherein the first sealing element is laterally offset from the central point of the first sealing port, and the second sealing port has a second sealing element positioned therein, the second sealing element being laterally offset from the central point of the second sealing port.

3. The device of claim 1, wherein the first sealing element is configured to orbit 360°

around the central point of the first sealing port when the first sealing port rotates 360°

about the central point of the first sealing port relative to the lock ring, the retractor, and the second sealing port, and the second sealing port has a second sealing element positioned therein that is configured to orbit 360°

around the central point of the second sealing port when the second sealing port rotates 360°

about the central point of the second sealing port relative to the lock ring, the retractor, and the first sealing port.

4. The device of claim 1, wherein the base includes a proximal base member and a distal base member coupled to the proximal base member, the first sealing port and the second sealing port each being movably sandwiched between the proximal base member and the distal base member.

5. The device of claim 4, wherein the proximal and distal base members coupled together define first and second openings extending therethrough, the first sealing port being rotatably seated in the first opening, and the second sealing port being rotatably seated in the second opening.

6. The device of claim 1, wherein the base includes a circumferential lip, and the lock ring includes an interior sidewall configured to movably engage the circumferential lip when the base is captured between the retractor and the lock ring.

7. The device of claim 6, further comprising a resilient spring configured to be captured between a proximal surface of the retractor and a distal surface of the base when the base is captured between the retractor and the lock ring.

8. The device of claim 1, further comprising a resilient spring configured to form a seal between the base and the retractor when the base is captured between the retractor and the lock ring.

9. A surgical device, comprising:

a distal retractor configured to be positioned in an opening formed in tissue to provide a pathway through the tissue; and

a proximal base configured to releasably mate to the distal retractor and rotate 360°

relative to the distal retractor when releasably mated thereto, the proximal base including;

a first base portion having first and second holes formed therethrough,

a second base portion having third and fourth holes formed therethrough, the first hole being aligned with the third hole to define a first opening extending through the proximal base, and the second hole being aligned with the fourth hole to define a second opening extending through the proximal base,

a first sealing port captured between the first and second base portions, the first sealing port including a first sealing element configured to form a seal around a first surgical instrument inserted therethrough, and

a second sealing port captured between the first and second base portions, the second sealing port including a second sealing element configured to form a seal around a second surgical instrument inserted therethrough, the first sealing port being configured to rotate 360°

within the first opening relative to the proximal base and the second sealing port, and the second sealing port being configured to rotate 360°

within the second opening relative to the proximal base and the first sealing port;

wherein the first sealing element is laterally offset from a central longitudinal axis of the first sealing port about which the first sealing port is configured to rotate 360°

within the first opening relative to the proximal base and the second sealing port, and the second sealing element is laterally offset from a central longitudinal axis of the second sealing port about which the second sealing port is configured to rotate 360°

within the second opening relative to the proximal base and the first sealing port.

10. The device of claim 9, wherein the proximal base is rotatable 360°

relative to the distal retractor about a central longitudinal axis of the proximal base that is laterally offset from the central longitudinal axis of the first sealing port and that is laterally offset from the central longitudinal axis of the second sealing port.

11. The device of claim 9, further comprising a lock ring configured to releasably mate to the distal retractor so as to movably capture the proximal base between the lock ring and the distal retractor.

12. The device of claim 11, wherein the proximal base is rotatable 360°

relative to the distal retractor and the lock ring when the proximal base and the lock ring are releasably mated to the retractor.

13. The device of claim 11, wherein the lock ring includes an engagement and release mechanism configured to releasably engage a complementary engagement and release mechanism of the distal retractor to releasably mate the lock ring and the distal retractor together.

14. A surgical method, comprising:

positioning a retractor in an opening formed in tissue;

rotating a base sandwiched between a lock ring and the retractor 360°

about a central point of the base relative to the lock ring and the retractor, the base including a first sealing port including a first sealing element configured to form a seal around a first surgical instrument advanced therethrough, and the base including a second sealing port including a second sealing element configured to form a seal around a second surgical instrument advanced therethrough;

rotating the first sealing port 360°

about a central point of the first sealing port relative to the lock ring, the retractor, and the second sealing port, the rotation of the first sealing port causing the first sealing element to orbit 360°

in a first path around the central point of the first sealing port; and

rotating the second sealing port 360°

about a central point of the second sealing port relative to the lock ring, the retractor, and the first sealing port, the rotation of the second sealing port causing the second sealing element to orbit 360°

in a second path, which is different than the first path, around the central point of the second sealing port.

15. The method of claim 14, wherein the first and second paths do not intersect.

16. The method of claim 14, wherein the central point of the base, the central point of the first sealing port, and the central point of the second sealing port are each laterally offset from one another.

17. The method of claim 14, further comprising releasably attaching the lock ring to the retractor so as to sandwich the base between the lock ring and the retractor.

18. A surgical device, comprising:

a distal retractor configured to be positioned in an opening formed in tissue to provide a pathway through the tissue;

a proximal lock ring configured to releasably mate to the retractor;

a base configured to be captured between the retractor and the lock ring when the lock ring is releasably mated to the retractor, the base being configured to rotate 360°

about a central point of the base relative to the lock ring and the retractor when the lock ring is releasably mated to the retractor, the base including a first sealing port configured to form a seal around a first surgical instrument advanced therethrough, the base including a second sealing port configured to form a seal around a second surgical instrument advanced therethrough, the first sealing port being configured to rotate 360°

about a central point of the first sealing port relative to the lock ring, the retractor, and the second sealing port, the central point of the first sealing port being laterally offset from the central point of the base, the second sealing port being configured to rotate 360°

about a central point of the second sealing port relative to the lock ring, the retractor, and the first sealing port, and the central point of the second sealing port being laterally offset from the central point of the base and being laterally offset from the central point of the first sealing port; and

a resilient spring configured to form a seal between the base and the retractor when the base is captured between the retractor and the lock ring.