Retraction of tissue for single port entry, robotically assisted medical procedures

• US 9,636,000 B2
• Filed: 08/05/2013
• Issued: 05/02/2017
• Est. Priority Date: 06/13/2006
• Status: Active Grant

• Current Assignee: Intuitive Surgical Operations, Inc. (Intuitive Surgical Holdings, LLC)
• Original Assignee: Intuitive Surgical Operations, Inc. (Intuitive Surgical Holdings, LLC)
• Inventors: Mohr, Catherine J.
• Primary Examiner(s): Merene, Jan Christopher
• Application Number:
  US13/958,977
• Publication Number:
  US 20130317306A1
• Time in Patent Office: 1,366 Days
• Field of Search: 600206, 600207
• CPC Class Codes: A61B 1/00082 Balloons
• CPC Class Codes: A61B 1/00087 Tools A61B17/00234 takes precedence
• CPC Class Codes: A61B 1/00193 adapted for stereoscopic vision
• CPC Class Codes: A61B 1/313 for introducing through surgical openings, e.g. laparoscopes
• CPC Class Codes: A61B 1/32 Devices for opening or enlarging the visual field, e.g. of a tube of the body dilators A61M29/00
• 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 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 34/70 Manipulators specially adapted for use in surgery
• CPC Class Codes: A61B 34/72 Micromanipulators
• CPC Class Codes: A61B 90/37 Surgical systems with images on a monitor during operation

Abstract

A single port entry surgical instrument has an elongated structure with lumens through which surgical tools and an image capturing device may be inserted and controllably extended out of its distal end for performing a medical procedure, a tubular-shaped balloon disposed around the elongated structure, and an expandable retractor disposed around the balloon so that when the balloon is inflated, the retractor expands and locks in an expanded configuration to retract extraneous tissue. The port entry may be secured using the expandable retractor or sealed using another inflatable balloon disposed around the proximal end of the elongated structure and centered in the port entry.

Claims

1. A method for securing an entry port through an anatomic structure for a surgical instrument before moving a tool guide forward towards a target tissue, wherein the surgical instrument includes the tool guide, a tubular-shaped balloon, and a retractor, wherein the tubular-shaped balloon is disposed around the tool guide so that the tool guide extends within a core formed in the tubular-shaped balloon, wherein the retractor is disposed around the tubular-shaped balloon in an unexpanded configuration while the tubular-shaped balloon is in a deflated condition in which an outer diameter of the tubular-shaped balloon is less than an inner diameter of the entry port, wherein the retractor is constructed so that the retractor is expanded and locks in an expanded configuration when the tubular-shaped balloon is in an inflated condition that causes an outer diameter of the retractor to be pressed against and held in place by an inner wall of the entry port, and wherein the retractor is constructed so that the retractor remains locked without external support when the tubular-shaped balloon is deflated and no longer contacts an inner surface of the retractor, the method comprising:

manipulating a tool inserted in the tool guide to cut a hole through the anatomic structure so as to form the entry port prior to disposing the retractor within the entry port;

securing the entry port through the anatomic structure by;

positioning the surgical instrument so that the retractor in its unexpanded configuration is disposed within the entry port;

expanding the tubular-shaped balloon so that the retractor is expanded to and locked in its expanded configuration so that the outer diameter of the retractor is pressed against and held in place by the inner wall of the entry port; and

deflating the tubular-shaped balloon so that the tubular-shaped balloon no longer contacts the inner surface of the retractor while the retractor remains locked in its expanded configuration without external support to secure the entry port; and

moving the tool guide forward towards the target tissue while the retractor, which is locked in its expanded configuration, is securing the entry port, wherein the target tissue is disposed so that the surgical instrument had not passed by or through the target tissue prior to positioning the surgical instrument so that the retractor in its unexpanded configuration is disposed within the entry port.

2. A method for securing an entry port through an anatomic structure for a surgical instrument before moving a tool guide forward towards a target tissue, wherein the surgical instrument includes the tool guide, a tubular-shaped balloon, and a retractor, wherein the tubular-shaped balloon is disposed around the tool guide so that the tool guide extends within a core formed in the tubular-shaped balloon, wherein the retractor is disposed around the tubular-shaped balloon in an unexpanded configuration while the tubular-shaped balloon is in a deflated condition in which an outer diameter of the tubular-shaped balloon is less than an inner diameter of the entry port, wherein the retractor is constructed so that the retractor is expanded and locks in an expanded configuration when the tubular-shaped balloon is in an inflated condition that causes an outer diameter of the retractor to be pressed against and held in place by an inner wall of the entry port, and wherein the retractor is constructed so that the retractor remains locked without external support when the tubular-shaped balloon is deflated and no longer contacts an inner surface of the retractor, the method comprising:

securing the entry port through the anatomic structure by;

positioning the surgical instrument so that the retractor in its unexpanded configuration is disposed within the entry port;

expanding the tubular-shaped balloon so that the retractor is expanded to and locked in its expanded configuration so that the outer diameter of the retractor is pressed against and held in place by the inner wall of the entry port; and

deflating the tubular-shaped balloon so that the tubular-shaped balloon no longer contacts the inner surface of the retractor while the retractor remains locked in its expanded configuration without external support to secure the entry port;

moving the tool guide forward towards the target tissue while the retractor, which is locked in its expanded configuration, is securing the entry port, wherein the target tissue is disposed so that the surgical instrument had not passed by or through the target tissue prior to positioning the surgical instrument so that the retractor in its unexpanded configuration is disposed within the entry port;

performing a medical procedure on the target tissue using a tool inserted in the tool guide;

moving the tool guide and the tool back towards the entry port after performing the medical procedure; and

manipulating the tool to interact with an element of the retractor so as to collapse the retractor from its expanded configuration.

3. The method of claim 2, wherein manipulating the tool to interact with the retractor so as to collapse the retractor from its expanded configuration, comprises:

grasping and manipulating the element of the retractor by using an end effector of the tool, so that the manipulated element causes the retractor to collapse from its expanded configuration back to a non-expanded configuration.