SURGICAL ACCESS APPARATUS AND METHOD

• US 20120184821A1
• Filed: 03/15/2012
• Published: 07/19/2012
• Est. Priority Date: 10/19/2000
• Status: Active Grant

• Current Assignee: Applied Medical Resources Corporation (Applied Medical Corporation)
• Original Assignee: Applied Medical Resources Corporation (Applied Medical Corporation)
• Inventors: Ewers, Richard C., Brustad, John R., Pingleton, Edward D., Hilal, Nabil, Dulak, Gary R., Adlparvar, Payam, Bowes, Robert R.
• Granted Patent: US 8,496,581 B2
• Time in Patent Office: Days
• US Class Current: 600/208
• 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 17/3474 Insufflating needles, e.g. Veress needles
• CPC Class Codes: A61B 17/3498 Valves therefor, e.g. flapper valves, slide valves haemostasis valves A61M39/06; check valves A61M39/24
• CPC Class Codes: A61B 2017/00265 Hand assisted surgery, i.e. minimally invasive surgery with at least part of an assisting hand inside the body
• CPC Class Codes: A61B 2017/00526 Methods of manufacturing
• 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 catheters A61B2017/22072
• CPC Class Codes: A61B 2017/3492 against the outside of the body
• CPC Class Codes: A61M 13/003 Blowing gases other than for carrying powders, e.g. for inflating, dilating or rinsing

Abstract

A device comprises an access port adapted to permit access of at least one surgical instrument into a patient. The access port comprises a proximal portion, a distal portion, and an intermediate portion monolithically formed of a flexible material. At least one opening extends through the access port. The proximal portion comprises a proximal flange. The distal portion comprises a distal flange. The intermediate portion comprises an outer surface and at least one inner surface. The access port is adapted to form a perimeter seal when the proximal flange is disposed exteriorly and the distal flange is disposed interiorly. The access port is adapted to form a seal with the at least one surgical instrument positioned through the access port. The intermediate portion conforms to the surface of the surgical instrument positioned through the at least one opening and forms the seal between the inner surface and the surgical instrument.

Claims

1. A device adapted to provide sealed access for an instrument across a body wall and into a body cavity, comprising:

an access port adapted to permit access of at least one surgical instrument through an incision in an abdominal wall of a patient and into an abdominal cavity, wherein the access port comprises a proximal portion, a distal portion, and an intermediate portion between the proximal portion and the distal portion, wherein the proximal portion, the distal portion, and the intermediate portion are monolithically formed of a flexible material, wherein at least one opening extends through the access port between the proximal portion and the distal portion,

wherein the proximal portion comprises a proximal flange having a proximal flange diameter, and wherein the proximal portion comprises a proximal surface wherein at least a portion of the proximal surface comprises a concave portion defining a cavity,

wherein the distal portion comprises a distal flange having a distal flange diameter,

wherein the intermediate portion comprises an outer surface and at least one inner surface, the outer surface has a diameter that is less than the proximal and distal flange diameters, the inner surface at least partially defines the at least one opening, and

wherein the access port is adapted to be disposed within the abdominal wall in an operative position, wherein disposition of the access port within the abdominal wall maintains the access port in the operative position and forms a perimeter seal between the outer surface and the abdominal wall when the intermediate portion is disposed across the incision and positioned within the incision with the proximal flange disposed exteriorly of the abdominal wall and the distal flange disposed interiorly of the abdominal wall, and wherein the access port is adapted to form a seal with the at least one surgical instrument positioned through the access port, wherein the intermediate portion conforms to the surface of the surgical instrument positioned through the at least one opening and forms the seal between the inner surface and the surgical instrument.

2. The device of claim 1, wherein the at least one opening accommodates a wide range of instrument sizes.

3. The device of claim 1, wherein the access port comprises a plurality of openings.

4. The device of claim 1, wherein the access port is adapted to maintain a sealing relationship with a plurality of instruments positioned through the access port while accommodating relative movement between the plurality of instruments.

5. The device of claim 1, wherein the proximal flange diameter is equal to the distal flange diameter.

6. The device of claim 1, wherein the flexible material comprises a thermoplastic elastomer.

7. The device of claim 1, wherein the flexible material comprises a triblock copolymer.

8. The device of claim 1, wherein the flexible material comprises a foam material.

9. A device adapted to provide sealed access for an instrument into a body cavity, comprising:

an access port adapted to permit access of at least one surgical instrument through an incision in an abdominal wall of a patient and into an abdominal cavity, wherein the access port comprises a proximal portion, a distal portion, and an intermediate portion between the proximal portion and the distal portion, wherein the proximal portion, the distal portion, and the intermediate portion are monolithically formed of a flexible material, wherein at least one opening extends through the access port between the proximal portion and the distal portion,

wherein the proximal portion comprises a proximal flange having a proximal flange diameter,

wherein the distal portion comprises a distal flange having a distal flange diameter,

wherein the intermediate portion comprises an outer surface and at least one inner surface, the outer surface has a diameter that is less than the proximal and distal flange diameters, the inner surface at least partially defines the at least one opening, wherein the flexible material of the intermediate portion extends between the outer surface and the at least one inner surface, wherein the flexible material comprises a thermoplastic elastomer, and

wherein disposition of the access port within the abdominal wall without inflation of the access port maintains the access port in an operative position with the intermediate portion exerting a force on the incision forming a seal between the flexible material and the abdominal wall when positioned within the incision with the proximal flange disposed exteriorly of the abdominal wall and the distal flange disposed interiorly of the abdominal wall, and wherein the access port is adapted to form a seal with the surgical instrument positioned through the access port, wherein the flexible material conforms to the surface of the surgical instrument positioned through the at least one opening and forms the seal within the intermediate portion between the proximal flange and the distal flange.

10. The device of claim 9, wherein the flexible material comprises a triblock copolymer.

11. The device of claim 10, wherein the flexible material comprises Styrene-Ethylene/Butylene-Styrene.

12. The device of claim 10, wherein the flexible material comprises an oil.

13. The device of claim 12, wherein the flexible material comprises a foam material.

14. The device of claim 13, further comprising a trocar configured for placement through the at least one opening.

15. The device of claim 14, wherein the proximal portion comprises an arcuate proximal surface defining a lead-in cavity.

16. The device of claim 14, wherein the at least one opening is configured to self seal in the absence of any instrument extending through the at least one opening.

17. The device of claim 14, wherein the proximal portion comprises a proximal surface having a proximal surface area, and the distal portion comprises a distal surface having a distal surface area equal to the proximal surface area

18. A method adapted to provide sealed access for an instrument into a body cavity of a patient, comprising:

providing an access port adapted to permit access of at least one surgical instrument through an opening in a patient and into a body cavity, wherein the access port comprises a proximal portion, a distal portion, and an intermediate portion between the proximal portion and the distal portion, wherein the proximal portion, the distal portion, and the intermediate portion are monolithically formed of a flexible material, wherein at least one channel extends through the access port between the proximal portion and the distal portion, wherein the proximal portion comprises a proximal flange having a proximal flange diameter, wherein the distal portion comprises a distal flange having a distal flange diameter, wherein the intermediate portion comprises an outer surface and at least one inner surface, the outer surface has a diameter that is less than the proximal and distal flange diameters, the inner surface at least partially defines the at least one channel, wherein the flexible material surrounds the at least one channel and extends between the outer surface and the inner surface, and providing at least one surgical instrument,

positioning the access port within an opening in the patient, wherein the intermediate portion is disposed across the opening and positioned within the opening with the proximal flange disposed exteriorly of the opening and the distal flange disposed interiorly of the opening, wherein disposition of the intermediate portion within the opening forms a seal between the access port and the opening, and

positioning the surgical instrument through the channel of the access port, wherein the intermediate portion conforms to the surface of the surgical instrument and forms a seal with the surgical instrument within the channel between the proximal flange and the distal flange.

19. The method of claim 18, wherein the proximal portion comprises a proximal surface wherein at least a portion of the proximal surface comprises a concave portion.

20. The method of claim 19, wherein the flexible material comprises a thermoplastic elastomer.