1. Technical Field
The present disclosure relates to an apparatus and method for accessing a body cavity. More particularly, the present disclosure relates to a surgical device including an access assembly in operative association with at least one pre-bent tube.
2. Background of Related Art
Today, many surgical procedures are performed through small incisions in the skin, as compared to the larger incisions typically required in traditional procedures, in an effort to reduce both trauma to the patient and recovery time. Generally, such procedures are referred to as “endoscopic,” unless performed on the patient's abdomen, in which case the procedure is referred to as “laparoscopic.” Throughout the present disclosure, the term “minimally invasive” should be understood to encompass both endoscopic and laparoscopic procedures.
During a typical minimally invasive procedure, surgical objects, such as surgical access devices, e.g., trocar and cannula assemblies, or endoscopes, are inserted into the patient's body through the incision in tissue. In general, prior to the introduction of the surgical object into the patient's body, insufflation gasses are used to enlarge the area surrounding the target surgical site to create a larger, more accessible work area. Accordingly, the maintenance of a substantially fluid-tight seal is desirable so as to prevent the escape of the insufflation gases and the deflation or collapse of the enlarged surgical site.
To this end, various valves and seals are used during the course of minimally invasive procedures and are widely known in the art. However, a continuing need exists for a seal anchor member that can be inserted directly into the incision in tissue and that can accommodate a variety of surgical objects while maintaining the integrity of an insufflated workspace.
Accordingly, an improved surgical apparatus is provided. The surgical apparatus includes an access port having a tubular member with a first ring secured at a proximal end and a second ring secured at a distal end. The surgical apparatus further includes an articulation structure having an outer tube and an inner tube and a control mechanism coupled to one end of the inner tube for advancing the inner tube through the outer tube. The outer tube includes at least one rigid section and at least one flexible section and the inner tube includes at least two pre-bent sections.
The inner tube is configured to slidably engage and advance through the outer tube. The inner tube and the outer tube are coaxial. The inner tube defines at least one channel for receiving at least one surgical instrument.
In another exemplary embodiment, the inner tube includes at least two channels. One of the at least two channels is used for smoke evacuation from a surgical site.
In another exemplary embodiment, at least one pre-bent section of the inner tube causes a like direction bend of the flexible section of the outer tube, when the at least one pre-bent section engages the flexible section. Additionally, at least one pre-bent section of the inner tube causes the flexible section of the outer tube to bend in any direction based on rotation of the control mechanism, when the at least one pre-bent section engages the flexible section.
The control mechanism is configured to rotate the inner tube 360° degrees.
In yet another exemplary embodiment, the outer tube has two rigid sections of substantially equal length separated by the flexible section. Additionally, the outer tube has two rigid sections separated by the flexible section, at least one of which is substantially equal in length to a length of the flexible section.
In another exemplary embodiment, an improved surgical apparatus is provided. The surgical apparatus includes an access port having a tubular member with a first ring secured at a proximal end and a second ring secured at a distal end and an instrument guide device including (i) an outer member having a proximal end and a distal end, the proximal and distal ends being rigid sections connected to each other via a flexible section and (ii) an inner member having at least two rigid bends and at least one channel extending therethrough. The inner member is adapted to be inserted through and slidably engage the outer member such that at least one rigid bend of the inner member engages the flexible section of the outer member.
Also provided is an articulation method. The method includes the steps of providing an access port having a tubular member with a first ring secured at a proximal end and a second ring secured at a distal end and providing an articulation mechanism including: an outer member having a proximal end and a distal end, the proximal and distal ends being rigid sections connected to each other via a flexible section and an inner member having at least two rigid bends and at least one channel extending therethrough. The inner member is adapted to be inserted through and slidably engage the outer member such that at least one rigid bend of the inner member engages the flexible section of the outer member.
The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments of the disclosure and, together with a general description of the disclosure given above, and the detailed description of the embodiment(s) given below, serve to explain the principles of the disclosure, wherein:
The access ports of the present disclosure, either alone or in combination with a cannula assembly, provide a substantially fluid-tight seal between a body cavity of a patient and the outside atmosphere. The access ports, or seal assemblies, of the present disclosure are configured to receive surgical instruments of varying diameter. Various surgical procedures contemplated include laparoscopic and arthroscopic surgical procedures.
The access ports of the present disclosure contemplate the introduction of various types of instrumentation adapted for insertion through a trocar and/or cannula assembly while maintaining a substantially fluid-tight interface about the instrument to help preserve the atmospheric integrity of a surgical procedure from gas and/or fluid leakage. Examples of instrumentation include, but are not limited to, clip appliers, graspers, dissectors, retractors, staplers, laser probes, photographic devices, endoscopes and laparoscopes, tubes, and the like. Such instruments will collectively be referred to as “instruments” or “instrumentation.”
Embodiments of the presently disclosed apparatus will now be described in detail with reference to the drawings, in which like reference numerals designate identical or corresponding elements in each of the several views. As used herein, the term “distal” refers to that portion of the tool, or component thereof which is further from the user while the term “proximal” refers to that portion of the tool or component thereof which is closer to the user. While the use of the access assembly is often described herein as engaging an incision, it should be recognized that this is merely exemplary and is not intended to limit the use of the assembly in any way, but rather it should be recognized that the present disclosure is intended to be useable in all instances in situations in which the access assembly engages an incision, a naturally occurring orifice, or any other suitable opening. The port is usable through an incision or through a naturally occurring orifice.
Referring to
Seal anchor member 100 is preferably formed from a suitable foam material having sufficient compliance to form a seal about one or more surgical objects, and also establish a sealing relation with the tissue, “T.”
Proximal end 102 of seal anchor member 100 defines a first diameter D1 and distal end 104 defines a second diameter D2. In one embodiment of seal anchor member 100, the respective first and second diameters D1, D2 of the proximal and distal ends 102, 104 are substantially equivalent, as seen in
Intermediate portion 106 defines a radial dimension “R” and extends longitudinally between proximal and distal ends 102, 104, respectively, to define an axial dimension or length “L.” The radial dimension “R” of intermediate portion 106 varies along the axial dimension, or length, “L” thereof. Accordingly, seal anchor member 100 defines a cross-sectional dimension that varies along its length “L,” which facilitates the anchoring of seal anchor member 100 within tissue “T,” as discussed in further detail below. However, an embodiment of seal anchor member 100 in which the radial dimension “R” remains substantially uniform along the axial dimension “L” thereof is also within the scope of the present disclosure.
The radial dimension “R” of intermediate portion 106 is appreciably less than the respective diameters D1, D2 of proximal and distal ends 102, 104 such that seal anchor member 100 defines an “hour-glass” shape or configuration to assist in anchoring seal anchor member 100 within tissue “T,” as discussed in further detail below. However, in an alternate embodiment, the radial dimension “R” of intermediate portion 106 may be substantially equivalent to the respective diameters D1, D2 of proximal and distal ends 102, 104. In cross section, intermediate portion 106 may exhibit any suitable configuration, e.g., substantially circular, oval or oblong.
Referring now to
Seal anchor member 100 may be formed of a biocompatible compressible material that facilitates the resilient, reciprocal transitioning of seal anchor member 100 between the expanded and compressed conditions thereof. In one embodiment, the compressible material is a “memory” foam. An external force may be applied to seal anchor member 100 to cause the seal anchor member 100 to assume the compressed condition. The external force may be directed inwardly and when seal anchor member 100 is subjected thereto, e.g., when seal anchor member 100 is squeezed, seal anchor member 100 undergoes an appreciable measure of deformation, thereby transitioning into the compressed condition.
Referring again to
Prior to the insertion of seal anchor member 100, positioning members 114 are deformed in conjunction with the respective proximal and distal ends 102, 104 of seal anchor member 100 to facilitate the advancement thereof through tissue tract 12 (
In use, the peritoneal cavity (not shown) is insufflated with a suitable biocompatible gas such as, e.g., CO2 gas, such that the cavity wall is raised and lifted away from the internal organs and tissue housed therein, providing greater access thereto. The insufflation may be performed with an insufflation needle or similar device, as is conventional in the art. Either prior or subsequent to insufflation, a tissue tract 12 is created in tissue “T,” the dimensions of which may be varied dependent upon the nature of the procedure.
Prior to the insertion of seal anchor member 100 within tissue tract 12, seal anchor member 100 is in its expanded condition in which the dimensions thereof prohibit the insertion of seal anchor member 100 into tissue tract 12. To facilitate insertion, the clinician transitions seal anchor member 100 into the compressed condition by applying a force “F” thereto, e.g., by squeezing seal anchor member 100. As best depicted in the surgical apparatus 400A of
After successfully anchoring seal anchor member 100 within the patient's tissue “T,” one or more surgical objects may be inserted through ports 108.
Additionally, one or more surgical objects are inserted through a tube configuration, including an outer tube and an inner tube, as described with reference to
Moreover, as seen in
Referring back to
In operation, when the inner tube 300 is in a retracted configuration (i.e., outside the outer tube 200), an instrument is also located in a straight configuration. After insertion of the instrument into the inner tube 300, the inner tube 300 may be pushed through the outer tube 200 by a control mechanism 350. When the inner tube 300 is extended therethrough, the pre-bent section 330 moves forward and makes a left turn of articulation (see surgical apparatus 400B of
When the inner tube 300 is retracted, the instrument straightens and may be removed from the outer tube 200. As such, the inner tube 300 may be easily inserted and removed to and from the outer tube 200 at any articulated positions. As a result, the motion of articulation may be determined by extending or retracting the inner tube 300 and by rotating the outer tube 200 for a 360° triangulation.
Therefore, in summary, the surgical apparatus may include an instrument guide device including (i) an outer member having a proximal end and a distal end, the proximal and distal ends being rigid sections connected to each other via a flexible section and (ii) an inner member having at least two rigid bends and at least one channel extending therethrough. The inner member is then adapted to be inserted through and slidably engage the outer member such that at least one rigid bend of the inner member engages the flexible section of the outer member. As such, at least one rigid bend of the inner member may cause a like direction bend of the flexible section of the outer member, when the at least one rigid bend engages the flexible section. Additionally, at least one rigid bend of the inner member may cause the flexible section of the outer member to bend in any direction based on rotation of a control mechanism, when the at least one rigid bend engages the flexible section. The inner member may also be connected to a control mechanism for controlling articulation of the inner member.
While several embodiments of the disclosure have been shown in the drawings, it is not intended that the disclosure be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. Therefore, the above description should not be construed as limiting, but merely as exemplifications of presently disclosed embodiments. Thus the scope of the embodiments should be determined by the appended claims and their legal equivalents, rather than by the examples given.
Persons skilled in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary embodiments. The features illustrated or described in connection with one exemplary embodiment may be combined with the features of other embodiments. Such modifications and variations are intended to be included within the scope of the present disclosure. As well, one skilled in the art will appreciate further features and advantages of the present disclosure based on the above-described embodiments. Accordingly, the present disclosure is not to be limited by what has been particularly shown and described, except as indicated by the appended claims.
This application claims the benefit of and priority to U.S. Provisional Patent Application No. 61/584,713, filed Jan. 9, 2012, the entire disclosure of which is incorporated by reference herein.
Number | Date | Country | |
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61584713 | Jan 2012 | US |