1. Technical Field
The present disclosure relates to surgical devices and, more particularly, to a surgical access assembly for use during minimally invasive surgical procedures.
2. Background of the Related Art
Minimally invasive surgical procedures, which include both endoscopic and laparoscopic procedures, permit surgery to be performed on organs, vessels, or the like that are far removed from an opening in the skin. Such procedures are typically performed through a surgical access assembly employing one or more narrow tubes or cannulas inserted percutaneously into the patient.
To better access the underlying organs, etc., typically, the surgical area is insufflated using one or more biocompatible gases. The insufflation gases lift tissue away from the target site such that that a larger, more accessible workspace is created. Accordingly, it is of substantial importance to maintain the integrity of the insufflated environment so as to provide continued access to the surgical site through the duration of the procedure. To this end, surgical access assemblies generally include a seal assembly, which includes a seal or valve member.
Surgical seals generally define an aperture that is dimensioned to receive any surgical instrumentation that might be used during the course of the procedure, and are generally formed of a material that is capable of resilient deformation. The seal's aperture typically defines a diameter that is substantially smaller than that of any surgical instrument to be inserted therethrough such that the aperture is forcibly enlarged by the instrument, and the resilient nature of the material comprising the seal allows it to stretch in order to accommodate the surgical instrument. This stretching creates a force that is applied to the instrument and results in the formation of a substantially fluid tight seal therewith, substantially preventing the escape of insufflation gases through the cannula of the access assembly. Consequently, however, it is often necessary for a clinician to apply significant pressure in an effort to move the surgical instrument longitudinally through the seal.
While it is known in the art that lubricating either the surgical instrument or the seal member may reduce the force necessary to move the surgical instrument longitudinally distally during the course of a procedure, there exists a continuing need for surgical assemblies and seal members that incorporate lubricous elements.
In one aspect of the present disclosure, a surgical access apparatus is disclosed that includes a housing with a seal member disposed therein. The seal member includes at least one reservoir adapted to accommodate a fluid and having at least one egress such that the fluid may be discharged from the at least one reservoir. The at least one egress is configured and dimensioned to communicate the at least one fluid externally of the seal member.
In one embodiment, the at least one reservoir includes a plurality of reservoirs that may be substantially arcuate in configuration and concentrically disposed within the seal member.
The seal member may be at least partially formed from a deformable material such that the seal member may transition from a first condition, in which the fluid is retained within the at least one reservoir, to a second condition, in which the fluid is discharged from the at least one reservoir. In the first condition, the at least one reservoir defines a fluid retaining capacity that is decreased as the seal member transitions from the first condition to the second condition, thereby causing the expulsion of fluid from the at least one reservoir.
In one embodiment, the seal member includes a veneer member secured to the periphery thereof for facilitating the retention of the fluid within the at least one reservoir. The veneer member is adapted to be penetrated by a surgical instrument upon its insertion into the housing.
In another aspect of the present disclosure, a surgical access apparatus is disclosed which comprises a housing having at least one vessel associated therewith, a cannula sleeve extending from the housing, and a seal member disposed within the housing and defining an aperture therethrough. The at least one vessel is defined by a plurality of walls that describe an interior space that is configured and dimensioned to retain a fluid. The at least one vessel includes at least one egress that is configured and dimensioned for fluid communication such that the fluid may be dispensed from the at least one vessel.
The at least one vessel may be mounted to an inner wall of the housing and may be engagable with a surgical instrument upon its insertion into the surgical access apparatus such that the fluid retained within the at least one vessel may be discharged therefrom through the at least one egress.
In one embodiment, the housing defines at least one channel therein that is configured and dimensioned to communicate a gas. The channel is disposed distally of the at least one egress such that the fluid may be drawn out of the at least one vessel upon the communication of the gas.
In another embodiment, the surgical access apparatus includes at least one pump member operatively associated with the at least one vessel.
In yet another embodiment, the surgical access apparatus further includes a latch member operatively associated with the at least one pump member and disposed on the inner wall of the housing. The latch member is movable from a first position to a second position upon the insertion of a surgical instrument into the housing such that the at least one pump member may be activated.
The seal member may be movable from a first position to a second position upon the insertion of a surgical instrument into the aperture thereof. In the first position, the seal member substantially abuts the at least one egress, and in the second position, the at least one egress is at least partially exposed.
The surgical access apparatus may further include a biasing member disposed within the at least one vessel that facilitates dispensation of the fluid retained therein.
In an alternate embodiment, the at least one vessel also includes at least one ingress disposed distally of the at least one egress, and the cannula sleeve defines a channel therethrough. In this embodiment, the at least one ingress in fluid communication with the interior space defined by the plurality of walls of the at least one vessel through a channel defined in the cannula sleeve.
In still another embodiment, the surgical access apparatus further includes a one-way valve disposed within the channel adjacent the at least one ingress. The one-way valve is configured and dimensioned such that the fluid retained within the at least one reservoir is substantially prevented from exiting the channel through the at least one ingress.
In another aspect of the present disclosure, a surgical access apparatus is disclosed that includes a housing having at least one reservoir disposed therein that is adapted to retain a fluid, a seal member disposed within the housing, and a wick member in fluid communication with the at least one reservoir, wherein the wick member is at least partially disposed within the housing and proximally of the seal member.
In yet another aspect of the present disclosure, a surgical access apparatus is disclosed which includes a housing having a seal member and a bladder member disposed therein. The bladder member defines an internal cavity that is adapted to retain a fluid therein that is exuded from the bladder member upon the puncture thereof by a surgical instrument.
In a final aspect of the present disclosure, a surgical access apparatus is disclosed that includes a housing having a seal member disposed therein and a grommet member associated therewith. The grommet member is adapted for penetration by a needle member that is configured and dimensioned to communicate a fluid therethrough. The grommet member is oriented such that the fluid may be communicated through the needle member and about the seal member.
These and other features of the valve disclosed herein will become more readily apparent to those skilled in the art from the following detailed description of various embodiments of the present disclosure.
Various embodiments of the present disclosure are described hereinbelow with references to the drawings, wherein:
In the drawings and in the description which follows, in which like reference numerals identify similar or identical elements, the term “proximal” will refer to the end of the apparatus which is closest to the clinician, while the term “distal” will refer to the end which is furthest from the clinician, as is traditional and known in the art.
Throughout the present disclosure, the term “seal” or “seal member” should be understood as referring to any seal or valve member, formed of any suitable biocompatible material that is at least semi-resilient in nature and capable of deformation, which may be used in connection with any surgical portal or access assembly, apparatus, or device.
In each of the embodiments described hereinbelow, the term “fluid” should be understood as referring to any biocompatible substance or fluid that is at least semi-lubricous in nature. In addition, it should be understood that the “fluid” may refer to either a single substance or fluid, or to a combination of a plurality of substances or fluids, which may or may not have medicinal or therapeutic characteristics.
Referring now to the drawings, in which like reference numerals identify identical or substantially similar parts throughout the several views,
Throughout the present disclosure and in the figures, the surgical apparatus will be depicted as including elements that are typically associated with a cannula assembly, e.g. housing 110 and sleeve 130. It should be understood, however, that the principles of the present disclosure are applicable to any surgical access or portal apparatus or device suitable for the intended purpose of facilitating access to a patient's internal cavities, organs, tissues, or during the course of a minimally invasive procedure.
Each apparatus disclosed herein is adapted for use with an obturator assembly (not shown). The obturator assembly may include an obturator, trocar, or similar penetrating device having a tip that may be blunt, or incisive, appreciably transparent or opaque, retractable or fixed, or any other such variation, either currently known or later devised. The obturator assembly is typically utilized to penetrate tissue such that sleeve 130 of apparatus 100 may be percutaneously introduced into a patient. Subsequently, the obturator assembly is removed from the apparatus 100 to permit the introduction of one or more surgical instruments through passage 132 in sleeve 130.
Each apparatus disclosed herein may be formed, either in whole or in part, of any suitable medical grade material, such as stainless steel, polymeric materials, or the like that may be partially or completely transparent or opaque. Generally, sleeve 130 will have a diameter within the range of about 4.5 mm to about 15 mm, although a sleeve having a substantially larger, or smaller, diameter is within the scope of the present disclosure.
As seen in
Referring now to
Aperture 124A of seal member 120A is configured and dimensioned to receive a surgical instrument “I” defining a longitudinal axis “A”. Prior to insertion, seal member 120A is in a first, or initial, condition (
As seen in
Upon the introduction of instrument “I” to seal member 120B, seal member 120B transitions from the first condition (
Referring now to
Upon the introduction of instrument “I”, seal member 120C transitions from a first condition (
Referring now to
Referring in particular to
Prior to the introduction of a surgical instrument thereto, seal member 120 is in a first, or initial, condition (
The communication of fluid “F” from vessel 210 through egress 216 is facilitated not only by the gravitational force acting upon fluid “F”, but by the biasing force “FB” exerted upon fluid “F” by biasing member 218. In the first condition, biasing force “FB” endeavors to expel fluid “F” from vessel 210. However, biasing force “FB” is insufficient in magnitude to displace seal member 120 distally, and thereby expose egress 216 and permit the communication of fluid “F” therethrough. Accordingly, in the first position, biasing force “FB” acts only to pressurize fluid “F”. In the second condition, however, as seal member x is displaced distally by instrument “I” and egress 216 is exposed, the flow of fluid “F” therethrough is no longer obstructed, as discussed above, and biasing force “FB”, or the potential energy stored in spring 222, is free to advance pusher element 220 such that fluid “F” is forced from vessel 210.
As seen in
As seen in
In this embodiment, when seal member 120 is in the first condition (
Referring to
In this embodiment, prior to the transition of seal member 120 from the first condition (
As seal member 120 transitions from the first condition to the second condition upon the introduction of instrument “I”, seal member 120 is deflected distally at angle θ formed with transverse axis “B”, such that fluid “F” is communicated inwardly, across outer wall 122 of seal member 120, ultimately contacting, and thereby lubricating instrument “I”, as discussed above with respect to the embodiments of
As seen in
With respect to
When seal member 120 is in the first condition (
Referring now to
Latch member 282 is disposed proximally of seal member 120 on an inner wall 284 of housing 110 at any location that facilitates the engagement of latch member 282 and surgical instrument “I” upon the insertion thereof into housing 110, as discussed in further detail below. Latch member 282 is configured and dimensioned for movement between a first position (
Latch member 282 is operatively associated with a biasing mechanism (not shown), e.g. a spring, that maintains latch member 282 in the first position. Upon the displacement of latch member 282 by instrument “I”, a biasing force is created in the biasing mechanism (not shown) that is directed radially inward, thereby returning the latch member 282 to the first position upon the removal of instrument “I”.
In the second position, latch member 282 is configured and dimensioned to activate pump 280. Latch member 282 may activate pump 280 in any suitable manner, including but not limited to, completing an electrical circuit when in the second position such that energy may be delivered to pump 280 from a suitable energy source (not shown), such as a battery or a generator. The activation of pump 280 causes the continuous discharge of fluid “F” from vessel 210D through egress 216D and onto outer wall 122 of seal member 120, and perhaps instrument “I”. As instrument “I” is advanced distally, instrument “I” deflects seal member 120 in a distal direction at angle θ formed with transverse axis “B”. Thereafter, fluid “F” is communicated inwardly, across outer wall 122 of seal member 120, thereby facilitating the lubrication of instrument “I” and seal member 120, as discussed above with respect to each of the previous embodiments.
Upon the removal of instrument “I”, the biasing force created by the biasing member (not shown) and exerted upon latch member 282 displaces latch member 282 radially inward, thereby returning latch member 282 to the first position, deactivating pump 280, and arresting the communication of fluid “F” from reservoir.
Referring now to
In the first condition, vessels 210E are configured such that they define a first angle θ1 formed with axis “B”. Angle θ1 may be any angle that substantially prevents the discharge of fluid “F” from vessels 210E under the influence of the force of gravity and may include an angle of 0°, as seen in
As instrument “I” is advanced distally, instrument “I” engages and deflects seal member 120 in a distal direction. Thereafter, fluid “F” is communicated inwardly, across outer wall 122 of seal member 120, thereby facilitating the lubrication of instrument “I” and seal member 120, as discussed above with respect to each of the aforedescribed embodiments.
Referring now to
In this aspect of the present disclosure, housing 110 includes at least one reservoir 320 disposed therein that is in fluid communication with wick member 310. Reservoir 320 may be formed of individual structural elements, or may be simply defined by a recess or cavity formed within housing 110.
Wick member 310 is any member that may be used to communicate or draw fluid “F” from reservoir 320 through capillary action, and accordingly, wick member 310 may be composed of any material suitable for that intended purpose including, but not limited to, natural fibers, such as cotton, or synthetic materials. Additionally, the material comprising wick member 310 may have characteristics that make wick member 310 at least semi-resilient, such that wick member 310 may deform upon the introduction of instrument “I”, as discussed in further detail below.
Wick member 310 is disposed within housing 110 such that wick member 310 is located proximally of seal member 120, and wick member 310 is at least partially disposed within the at least one reservoir 320 such that at least a portion of wick member 310 is disposed within fluid “F”. It is contemplated that wick member 310 may be integrally formed with housing 110, or that wick member 310 may be releasably formed therewith, thereby facilitating the replacement of wick member 310 when necessary.
Prior to the introduction of instrument “I”, wick member 310 is at least partially sodden with fluid “F”, as seen in
As instrument “I” is advanced distally, instrument “I” penetrates wick member 310, thereby creating an opening, or a hole, 312 therein that substantially approximates the diameter “DI” of instrument “I”. The present disclosure contemplates that the opening 312 may be sufficiently dimensioned such that a seal is at least partially formed with instrument “I”. The continued engagement of instrument “I” with wick member 310 resiliently enlarges the opening 312 in wick member 310 and ensures the substantially continuous application of fluid “F” to instrument “I”. In an alternate embodiment of wick member 310, wick member 310 may define a pre-formed aperture (not shown) therein that is configured and dimensioned to receive instrument “I”, thereby obviating the need for puncture.
With respect to
Bladder member 410 is disposed proximally of seal member 120, and in one embodiment, bladder member 410 may sit directly atop seal member 120. Bladder member 410 includes an outer wall 412 that defines an internal cavity 414 adapted to retain fluid “F”. Bladder member 410 may be formed of any suitable material that is adapted for puncture by a surgical instrument “I”, and may be either integrally formed with or releasably disposed within housing 110, thereby facilitating the replacement thereof.
Upon the introduction of surgical instrument “I” to bladder member 410, instrument “I” punctures outer wall 412, thereby releasing the fluid “F” retained therein. As instrument “I” is advanced distally through bladder member 410, fluid “F” is applied to instrument “I”. The proximal location of bladder member 410 in relation to seal member 120 ensures that fluid “F” is applied to instrument “I” prior to the insertion of instrument “I” into seal member 120, thereby facilitating the lubrication of instrument “I” and the longitudinal manipulation thereof within seal member 120, as discussed above with respect to each of the previous embodiments.
As seen in
Grommet member 510 is disposed proximally of seal member 120 within housing 110 and is adapted for the insertion and removal of a needle member 520. Grommet member 510 may be formed of any material suitable for this purpose, including but not limited to, polymeric materials. In one embodiment, grommet member 510 may define a pre-formed opening or passage (not shown) therethrough that is configured and dimensioned to receive needle member 520. As depicted, needle member 520 includes a needle element 522 defining a channel 524 therethrough, a reservoir 526 having fluid “F” disposed therein, and a plunger element 528 disposed within reservoir 526 and coupled to a pusher 530. It is contemplated that needle member 520 may be any member suitable for the intended purpose of retain and dispensing fluid “F”.
Upon the introduction of a surgical instrument “I” into housing 110, needle member 520 is inserted through grommet member 510. Subsequently, pusher 530 is advanced such that plunger element 528 may dispense fluid “F” through channel 524 in needle element 522. Fluid “F” may be dispensed upon either or both of outer wall 122 or aperture 124 of seal member 120. Alternatively, fluid “F” may be applied directly to instrument “I”. The proximal location of grommet member 510 in relation to seal member 120 ensures that fluid “F” is applied to instrument “I”, either directly or through contact with seal member 120, prior to the insertion of instrument “I”, thereby facilitating the lubrication of instrument “I” and the longitudinal manipulation thereof within seal member 120, as discussed above with respect to each of the aforementioned embodiments.
In each of the embodiments disclosed herein, it is contemplated that the surgical instrument “I” may itself be lubricated prior to its introduction to any of the aforedescribed housings, either manually by a clinician, or through the employ of a self-lubricating system associated with the instrument.
Although the illustrative embodiments of the present disclosure have been described herein with reference to the accompanying drawings, the above description, disclosure, and figures should not be construed as limiting, but merely as exemplifications of particular embodiments. It is to be understood, therefore, that the disclosure is not limited to those precise embodiments, and that various other changes and modifications may be effected therein by one skilled in the art without departing from the scope or spirit of the disclosure.
This application claims the benefit of and priority to U.S. Provisional Application Ser. No. 60/980,521 filed on Oct. 17, 2007, entitled “ACCESS ASSEMBLY WITH SEAL LUBRICANT MECHANISM”, the entire contents of which are hereby incorporated herein by reference.
Number | Date | Country | |
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60980521 | Oct 2007 | US |