Systems for the prevention of surgical site infections

• US 9,393,005 B2
• Filed: 01/08/2013
• Issued: 07/19/2016
• Est. Priority Date: 01/10/2012
• Status: Active Grant

• Current Assignee: Board of Trustees of the Leland Stanford Junior University (Stanford University)
• Original Assignee: Board of Trustees of the Leland Stanford Junior University (Stanford University)
• Inventors: Suh, Insoo, Coe, Jonathan, Gnanashanmugam, Swaminadhan, Koehler, Jeremy, Welton, Mark
• Primary Examiner(s): Truong, Kevin T
• Assistant Examiner(s): Ku, Si Ming
• Application Number:
  US13/736,888
• Publication Number:
  US 20130178710A1
• Time in Patent Office: 1,288 Days
• Field of Search: 600201-208
• 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 17/0293 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 17/3462 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 2017/00539 hydraulically
• CPC Class Codes: A61B 2017/00544 pneumatically
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/0225 flexible, e.g. fabrics, meshes, or membranes
• CPC Class Codes: A61B 2017/3437 with means for removing or absorbing fluid, e.g. wicks or absorbent pads
• CPC Class Codes: A61B 2017/3492 against the outside of the body
• CPC Class Codes: A61B 2217/005 with suction drainage system
• CPC Class Codes: A61B 2217/007 with irrigation system

Abstract

A surgical access system facilitates access to a surgical site within a patient'"'"'s body through an incision in the body. Surgical access systems can have at least one retention member and a fluid transportation member configured to deliver fluid to a surgical site or to remove fluid from a surgical site. In some embodiments, a surgical access device irrigates a surgical site to reduce surgical site infections and removes fluid from the surgical site to increase a physician'"'"'s visibility into the surgical site.

Claims

1. A surgical access system adapted to facilitate access to a surgical site within a body of a patient through an incision in the body, the surgical access system comprising:

a first retention member;

a second retention member coupled to the first retention member by a connector, wherein the first retention member and the second retention member are configured to expand the incision to provide access to the surgical site, wherein the connector comprises two or more fluidically independent chambers, wherein at least a first chamber is configured to allow the application of suction;

a fluid delivery member fluidly coupled to the connector;

a first group of perforations in a second chamber of the connector, wherein the first group of perforations is in fluid communication with the fluid delivery member to allow a fluid to irrigate the surgical site; and

a second group of perforations in the first chamber of the connector which allow the fluid to be removed from the surgical site after the fluid has irrigated the surgical site.

2. The surgical access system of claim 1, further comprising a fluid removal member coupled with at least one of the first retention member, the second retention member, and the connector.

3. The surgical access system of claim 1, wherein the connector is a pliable membrane.

4. The surgical access system of claim 1, wherein the first group of perforations is above the second group of perforations and fluid is removed by the connector above the first retention member.

5. The surgical access system of claim 1, wherein the one or more chambers are oriented in a direction substantially perpendicular to, parallel to, or oblique to a longitudinal axis of the surgical access system.

6. The surgical access system of claim 1, wherein the first group of perforations are evenly spaced, clustered, in a sinusoidal pattern, in a zig zag pattern, or in a straight line in the second chamber and the second group of perforations are evenly spaced, clustered, in a sinusoidal pattern, in a zig zag pattern, or in a straight line in the first chamber.

7. A surgical access system adapted to facilitate access to a surgical site within a body of a patient through an incision in the body, the surgical access system comprising:

a first retention member configured for placement within the body at or near the surgical site;

a second retention member configured for placement outside the body;

a pliable membrane extending between the first retention member and the second retention member, wherein the pliable membrane comprises two or more fluidically independent chambers, wherein at least a first chamber is configured to allow the application of suction;

a fluid delivery member coupled with the pliable membrane for introducing a fluid into the pliable membrane;

a first group of perforations in a second chamber of the pliable membrane, wherein the first group of perforations is in fluid communication with the pliable membrane to allow the fluid to irrigate the surgical site; and

a second group of perforations in the first chamber of the pliable membrane which allow the fluid to be removed from the surgical site after the fluid has irrigated the surgical site.

8. The surgical access system of claim 7, further comprising a fluid removal member coupled with at least one of the first retention member and the pliable membrane.

9. The surgical access system of claim 8, wherein the fluid removal member comprises an outlet conduit coupled to a medical suction device.

10. The surgical access system of claim 7, wherein the pliable membrane comprises a circumferential fluid dispersion member.

11. The surgical access system of claim 7, wherein the pliable membrane comprises a fluid-permeable tube.

12. The surgical access system of claim 7, wherein the fluid comprises a therapeutic or diagnostic agent.

13. The surgical access system of claim 7, further comprising a flow regulator in fluid communication with the fluid delivery member.

14. The surgical access system of claim 7, wherein the first retention member and the second retention member are circular.

15. The surgical access system of claim 7, wherein the first group of perforations is above the second group of perforations and fluid is removed by the pliable membrane above the first retention member.

16. The surgical access system of claim 7, wherein the one or more chambers are oriented in a direction substantially perpendicular to, parallel to, or oblique to a longitudinal axis of the surgical access system.

17. The surgical access system of claim 7, wherein the first group of perforations are evenly spaced, clustered, in a sinusoidal pattern, in a zig zag pattern, or in a straight line in the second chamber and the second group of perforations are evenly spaced, clustered, in a sinusoidal pattern, in a zig zag pattern, or in a straight line in the first chamber.

18. A surgical access system adapted to facilitate access to a surgical site within a body of a patient through an incision in the body, the surgical access system comprising:

a first retention ring;

a second retention ring;

a pliable membrane extending between the first retention ring and the second retention ring, wherein the pliable membrane comprises an inner wall and an outer wall, wherein the pliable membrane comprises a space between at least a portion of the inner wall and the outer wall, wherein the space is configured to enable a fluid to pass through at least a portion of the pliable membrane, wherein the pliable membrane comprises two or more fluidically independent chambers, wherein at least a first chamber is configured to allow the application of suction;

a fluid delivery member coupled with the pliable membrane for introducing the fluid into the pliable membrane, wherein the fluid delivery member is in fluid communication with the space;

a first group of perforations in a second chamber of the pliable membrane, wherein the first group of perforations is in fluid communication with the space to allow the fluid to irrigate the surgical site; and

a second group of perforations in the first chamber of the pliable membrane which allow the fluid to be removed from the surgical site after the fluid has irrigated the surgical site.

19. The surgical access system of claim 18, further comprising a fluid removal member in fluid communication with the pliable membrane.

20. The surgical access system of claim 19, wherein the fluid removal member comprises an outlet conduit coupled to a medical suction device.

21. The surgical access system of claim 18, wherein the pliable membrane comprises a tubular membrane, wherein the tubular membrane comprises an upper portion and a lower portion, wherein the lower portion is closer than the upper portion to the first retention ring, wherein a first fluid conduit member is in fluid communication with the upper portion, and a second fluid conduit member is in fluid communication with the lower portion.

22. The surgical access system of claim 21, wherein the upper portion comprises the first fluidically independent chamber and the lower portion comprises the second fluidically independent chamber.

23. The surgical access system of claim 21, wherein the first fluid conduit member comprises a fluid delivery member and the second fluid conduit member comprises a fluid removal member.

24. The surgical access system of claim 18, wherein the pliable membrane comprises one or more joined locations at which the inner wall and the outer wall are coupled to each other, wherein the one or more joined locations are configured to prevent separation of the inner wall from the outer wall.

25. The surgical access system of claim 18, wherein the first group of perforations is above the second group of perforations and fluid is removed by the pliable membrane above the first retention ring.

26. The surgical access system of claim 18, wherein the one or more chambers are oriented in a direction substantially perpendicular to, parallel to, or oblique to a longitudinal axis of the surgical access system.

27. The surgical access system of claim 18, wherein the first group of perforations are evenly spaced, clustered, in a sinusoidal pattern, in a zig zag pattern, or in a straight line in the second chamber and the second group of perforations are evenly spaced, clustered, in a sinusoidal pattern, in a zig zag pattern, or in a straight line in the first chamber.