Patent Application
20240374285
The subject disclosure is directed to endoscopic surgery, and more particularly, to a surgical gas delivery system for gas sealed insufflation and recirculation having trocars compatible for use with surgical robots.
Laparoscopic or “minimally invasive” surgical techniques are becoming commonplace in the performance of procedures such as cholecystectomies, appendectomies, hernia repair and nephrectomies. Benefits of such procedures include reduced trauma to the patient, reduced opportunity for infection, and decreased recovery time. Such procedures within the abdominal (peritoneal) cavity are typically performed through a device known as a trocar or cannula, which facilitates the introduction of laparoscopic instruments into the abdominal cavity of a patient.
Additionally, such procedures commonly involve filling or “insufflating” the abdominal cavity with a pressurized fluid, such as carbon dioxide, to create an operating space, which is referred to as a pneumoperitoneum. The insufflation can be carried out by a surgical access device, such as a trocar, equipped to deliver insufflation fluid, or by a separate insufflation device, such as an insufflation (veress) needle. Introduction of surgical instruments into the pneumoperitoneum without a substantial loss of insufflation gas is desirable, in order to maintain the pneumoperitoneum.
During typical laparoscopic procedures, a surgeon makes three to four small incisions, usually no larger than about twelve millimeters each, which are typically made with the surgical access devices themselves, often using a separate inserter or obturator placed therein. Following insertion, the obturator is removed, and the trocar allows access for instruments to be inserted into the abdominal cavity. Typical trocars provide a pathway to insufflate the cavity, so that a surgeon has an open interior space in which to work.
The trocar must also provide a way to maintain the pressure within the cavity by sealing between the trocar and the surgical instrument being used, while still allowing at least a minimum amount of freedom of movement for the surgical instruments. Such instruments can include, for example, scissors, grasping instruments, and occluding instruments, cauterizing units, cameras, light sources and other surgical instruments. Sealing elements or mechanisms are typically provided on trocars to prevent the escape of insufflation gas from the abdominal cavity. These sealing mechanisms often comprise a duckbill-type valve made of a relatively pliable material, to seal around an outer surface of surgical instruments passing through the trocar.
SurgiQuest, Inc., a wholly owned subsidiary of ConMed Corporation has developed unique gas sealed surgical access devices that permit ready access to an insufflated surgical cavity without the need for conventional mechanical valve seals, as described, for example, in U.S. Pat. No. 7,854,724 and U.S. Pat. No. 8,795,223. These access devices are constructed from several nested components including an inner tubular body portion and a coaxial outer tubular body portion. The inner tubular body portion defines a gas sealed central lumen for introducing conventional laparoscopic or endoscopic surgical instruments to the surgical cavity of a patient and the outer tubular body portion defines an annular lumen surrounding the inner tubular body portion for delivering insufflation gas to the surgical cavity of the patient and for facilitating periodic sensing of abdominal pressure.
Surgical robotics manufacturers are exploring various configurations and approaches to implementing robotic-assisted surgery, whereby surgical robots are able to interact with trocars, to insert, manipulate, and/or remove the trocars during a procedure. Currently, there remains a need in the art for trocars, gas sealed trocars, and access ports compatible with surgical robots. The present disclosure provides a solution for this need.
In accordance with at least one aspect of this disclosure, an access port for performing an endoscopic surgical procedure in a surgical cavity of a patient includes a proximal housing portion. The proximal housing portion includes a central lumen providing instrument access to the surgical cavity, wherein the proximal housing portion defined an interior plenum. An engagement housing is operatively associated with a proximal end of the proximal housing portion and having a circumferential engagement area formed therein that is adapted and configured to releasably accept a grasping member of a surgical robot. A seal is housed within the interior plenum, wherein the engagement housing is proximal relative to the interior plenum and to the seal. An elongated tubular body portion extends from the proximal housing portion in a distal direction, in communication with the central lumen.
In embodiments, the engagement area can have an engagement surface defining a shape that is configured to receive the grasping member of the surgical robot with a surface of the grasping member flush with the engagement surface within the engagement housing. In certain embodiments, the engagement housing includes a protrusion such that the circumferential engagement area extends only partially circumferentially around the engagement housing, where the engagement housing has a generally c-shaped profile in cross-section. In certain such embodiments, the engagement housing can be configured to accept a corresponding c-shaped grasping member of the surgical robot, or the engagement housing can be shaped to correspond to any shape of the grasping member of the surgical robot.
In certain embodiments, the engagement housing is formed integral with the proximal housing portion, where the engagement housing is defined in a cover configured to attach to the proximal housing portion and form a fixed relationship with the proximal housing portion. In certain embodiments, the engagement housing is defined in a cover configured to attach to the proximal housing portion and is configured to rotate relative to the proximal housing portion. In certain such embodiments, the proximal housing portion can further include a stopper configured to prohibit rotation of the engagement housing relative to the proximal housing portion beyond the stopper. In embodiments, the stopper can be a detent.
The engagement housing further includes an attachment feature configured to engage a proximal end of an obturator passing through the central lumen. In embodiments, the proximal housing portion further includes a sound dampener disposed in the central lumen, where the sound dampener can include foam material configured to dampen air sounds in the central lumen.
In certain embodiments, the seal can include a ring jet assembly that is adapted and configured to accelerate pressurized gas delivered into the proximal housing portion to form a gaseous seal within a region of the tubular body portion so as to maintain a stable pressure in the surgical cavity. In certain embodiments, the seal can include a mechanical seal that is adapted and configured to prevent egress of insufflation gas from the surgical cavity.
In embodiments, the engagement housing is defined in a cover configured to attach to the proximal housing portion, the cover having one or more castellations extending distally therefrom configured to engage one or more detents in the proximal housing portion around the central lumen to retain the cover to the proximal housing portion.
In accordance with at least one aspect of this disclosure, a gas sealed access port for performing an endoscopic surgical procedure in a surgical cavity of a patient includes a proximal housing. The proximal housing portion includes a central lumen providing gas sealed access to the surgical cavity, an inlet path for communicating with a source of pressurized gas, a tapered neck portion and an interior cavity accommodating a seal including an annular jet assembly for receiving pressurized gas from the inlet path to generate a gaseous seal within the tapered neck portion to maintain a stable pressure within the surgical cavity. An engagement housing is operatively associated with a proximal end of the proximal housing portion and having a circumferential engagement area formed therein that is adapted and configured to releasably accept a grasping member of a surgical robot. An elongated tubular body extends distally from the tapered neck portion of the proximal housing in communication with the central lumen. The engagement housing can be the same or similar to that as described above.
In accordance with at least one aspect of this disclosure, an engagement housing for an access port for performing an endoscopic surgical procedure in a surgical cavity of a patient can include a cover configured to seat within a proximal housing of the access port. In embodiments, the cover can define an engagement area disposed at least partially circumferentially around an outer periphery of the cover configured to releasably accept a grasping member of a surgical robot. The cover can also include one or more castellations extending distally therefrom configured to engage one or more detents in the proximal housing of the access port to retain the cover to the proximal housing.
These and other features of the embodiments of the subject disclosure will become more readily apparent to those skilled in the art from the following detailed description taken in conjunction with the drawings.
So that those skilled in the art to which the subject disclosure appertains will readily understand how to make and use the devices and methods of the subject disclosure without undue experimentation, embodiments thereof will be described in detail herein below with reference to certain figures, wherein:
Reference will now be made to the drawings wherein like reference numerals identify similar structural features or aspects of the subject disclosure. For purposes of explanation and illustration, and not limitation, an illustrative view of an embodiment of an access port in accordance with the disclosure is shown in
Today the surgical robotics market is faced with a number of newcomers that are exploring various configurations and approaches to robotic-assisted surgery. Certain sealed trocars and access ports, for example as provided in commonly assigned U.S. Pat. No. 8,795,223 issued Aug. 5, 2014, U.S. Pat. No. 10,905,463, issued Feb. 2, 2021, U.S. Pat. No. 11,399,866, issued Aug. 2, 2022, and U.S. Pat. No. 11,039,857 issued Jun. 22, 2021, which are incorporated herein by reference in their entirety, have the ability to maintain a stable pneumoperitoneum, constant smoke evacuation and easy instrument insertion and withdrawal. Surgical robotics manufacturers would benefit from access ports having the benefits and functionality as those described and incorporated herein, that are compatible with said robotics, without modification by an end user. Embodiments of access ports as described herein will allow for the different configurations of surgical robots to work effectively with said access ports.
In accordance with at least one aspect of this disclosure, as shown in
Referring now to
In certain embodiments, the engagement housing 200 includes a protrusion 220 such that the circumferential engagement area 218 extends only partially circumferentially around the engagement housing 200. In this case, the engagement housing 200 and engagement area 218 can have a generally c-shaped profile in cross-section. In certain such embodiments then, the engagement housing 200 can be configured to accept a corresponding c-shaped grasping member of the surgical robot, though it is possible the engagement housing 200 can be shaped to correspond to any shape of any grasping member of a given surgical robot.
In certain embodiments, the protrusion 218 can act as leading edge for the engagement housing 200 when accepting the grasping member of the surgical robot, where the protrusion 220 can be oriented so as to prevent interference from a tube set during actuation of the access port 100. In certain embodiments, such as shown in
In certain embodiments, such as shown in
In embodiments, such as shown in
In certain embodiments, as shown in
In certain embodiments, such as shown in
In accordance with at least one aspect of this disclosure, a gas sealed access port 100 can be as described in commonly assigned U.S. Pat. No. 8,795,223 issued Aug. 5, 2014, U.S. Pat. No. 10,905,463, issued Feb. 2, 2021. For example, the proximal housing portion of the gas sealed access port can include a central lumen providing gas sealed access to the surgical cavity, an inlet path for communicating with a source of pressurized gas, a tapered neck portion and an interior cavity accommodating an annular jet assembly for receiving pressurized gas from the inlet path to generate a gaseous seal within the tapered neck portion to maintain a stable pressure within the surgical cavity. An elongated tubular body extends from the tapered neck portion of the proximal housing in communication with the central lumen. An engagement housing, the same or similar to that as shown and described herein can be associated with the proximal housing portion.
In accordance with at least one aspect of this disclosure, an engagement housing 200 for an access port 100 for performing an endoscopic surgical procedure in a surgical cavity of a patient can include a cover 222, 322, 422, 522 configured to seat within a proximal housing of the access port. In embodiments, the cover can define an engagement area 218 disposed at least partially circumferentially around an outer periphery of the cover configured to releasably accept a grasping member of a surgical robot. The cover can also include one or more castellations 228, 328 extending distally therefrom configured to engage one or more detents in the proximal housing of the access port to retain the cover to the proximal housing. In embodiments, the engagement area may be generic, configured to accept any grasping member of any surgical robot (e.g., as shown in
With reference now to
Embodiments, surgical robotics manufactures that do not manufacture their own cannulas or access ports utilize the access ports as described herein. Typical surgical robot grasping members are not designed to accommodate certain access ports. However systems and methods as shown and described herein can ensure the compatibility with most of the surgical robots.
Those having ordinary skill in the art understand that any numerical values disclosed herein can be exact values or can be values within a range. Further, any terms of approximation (e.g., “about”, “approximately”, “around”) used in this disclosure can mean the stated value within a range. For example, in certain embodiments, the range can be within (plus or minus) 20%, or within 10%, or within 5%, or within 2%, or within any other suitable percentage or number as appreciated by those having ordinary skill in the art (e.g., for known tolerance limits or error ranges).
The articles “a”, “an”, and “the” as used herein and in the appended claims are used herein to refer to one or to more than one (i.e., to at least one) of the grammatical object of the article unless the context clearly indicates otherwise. By way of example, “an element” means one element or more than one element.
The phrase “and/or,” as used herein in the specification and in the claims, should be understood to mean “either or both” of the elements so conjoined, i.e., elements that are conjunctively present in some cases and disjunctively present in other cases. Multiple elements listed with “and/or” should be construed in the same fashion, i.e., “one or more” of the elements so conjoined. Other elements may optionally be present other than the elements specifically identified by the “and/or” clause, whether related or unrelated to those elements specifically identified. Thus, as a non-limiting example, a reference to “A and/or B”, when used in conjunction with open-ended language such as “comprising” can refer, in one embodiment, to A only (optionally including elements other than B); in another embodiment, to B only (optionally including elements other than A); in yet another embodiment, to both A and B (optionally including other elements); etc.
As used herein in the specification and in the claims, “or” should be understood to have the same meaning as “and/or” as defined above. For example, when separating items in a list, “or” or “and/or” shall be interpreted as being inclusive, i.e., the inclusion of at least one, but also including more than one, of a number or list of elements, and, optionally, additional unlisted items. Only terms clearly indicated to the contrary, such as “only one of” or “exactly one of,” or, when used in the claims, “consisting of,” will refer to the inclusion of exactly one element of a number or list of elements. In general, the term “or” as used herein shall only be interpreted as indicating exclusive alternatives (i.e., “one or the other but not both”) when preceded by terms of exclusivity, such as “either,” “one of,” “only one of,” or “exactly one of.”
Any suitable combination(s) of any disclosed embodiments and/or any suitable portion(s) thereof are contemplated herein as appreciated by those having ordinary skill in the art in view of this disclosure.
The embodiments of the present disclosure, as described above and shown in the drawings, provide for improvement in the art to which they pertain. While the apparatus and methods of the subject disclosure have been shown and described, those skilled in the art will readily appreciate that changes and/or modifications may be made thereto without departing from the scope of the subject disclosure.
This application claims benefit of priority to U.S. Provisional Patent Application No. 63/279,621 filed Nov. 15, 2021, the content of which is incorporated by reference herein in its entirety.
| Filing Document | Filing Date | Country | Kind |
|---|---|---|---|
| PCT/US2022/049726 | 11/11/2022 | WO |
| Number | Date | Country | |
|---|---|---|---|
| 63279621 | Nov 2021 | US |
