The present disclosure relates to surgical access assemblies for minimally invasive surgery, including seals. More particularly, the present disclosure relates to seals for surgical access assemblies.
In order to facilitate minimally invasive surgery, a working space is created at a surgical site. An insufflation fluid, typically CO2, is introduced into the abdomen of the patient to create an inflated state called a pneumoperitoneum. Surgical access assemblies are utilized to allow the introduction of surgical instrumentation and endoscopes (or other visualization tools). These surgical access assemblies maintain the pressure for the pneumoperitoneum, as they have one or more seals that adapt to the surgical instrumentation. Typically, a “zero-seal” in the surgical access assembly seals the surgical access assembly in the absence of a surgical instrument in the surgical access assembly, and an instrument seal seals around a surgical instrument that has been inserted through the surgical access assembly.
The breadth of surgical instrumentation on the market today requires a robust seal capable adjusting to multiple sizes and withstanding multiple insertions of surgical instrumentation. Some of the instrumentation can include sharp edges that can tear or otherwise damage seals. Therefore, it would be beneficial to have a surgical access assembly with improved seal durability.
A surgical access assembly with improved seal durability is provided. The surgical access assembly includes an instrument valve housing including upper, lower, and inner housing sections and defining a cavity, and a valve assembly disposed within the cavity of the instrument valve housing. The valve assembly includes a guard assembly including a plurality of guard sections, a seal assembly disposed adjacent to the guard assembly, and a centering mechanism for maintaining the seal assembly and guard assembly centered within the cavity of the instrument valve. The seal assembly includes a plurality of seal sections and upper and lower support members. The plurality of seal sections are movable from an unfolded configuration to folded configuration in which the seal assembly forms an octagonal member defining an opening to facilitate sealed passage of a surgical instrument. The upper and lower support members are received on respective proximal and distal sides of the plurality of seal sections and compressed about the plurality of seal sections to sandwich the plurality of seal sections therebetween.
In embodiments, the upper and lower support members define an opening from about 0.30″ to about 0.45″. The upper and lower support members may measure from about 0.006″ to about 0.015″ in thickness. The plurality of seal sections may be formed of polyisoprene or liquid silicone rubber. Each seal section of the plurality of seal sections may be connected to an adjacent seal section of the plurality of seal sections by a connector portion. The connector portions may include living hinges. The upper support member may be connected to a seal section of the plurality of seal sections by a connector portion and the lower support member may be connected to another seal section of the plurality of seal sections by another connector portion.
In some embodiments, an inner edge of each seal section of the plurality of seal sections may define a V-shape. The V-shape may include an angle from about one hundred eighty degrees to about two hundred seventy-five degrees. The plurality of seal sections may include first, second, third, and fourth seal sections, each of the first, second, third, and fourth seal sections overlapping the adjacent second, third, fourth, and first seal sections.
The surgical access assembly may further include a retainer assembly including upper and lower retainer members. At least one of the upper or lower retainer members may include a plurality of pins receivable through the guard assembly and the seal assembly for retaining the guard and seal assemblies relative to each other. The centering mechanism may include a bellows. The upper and lower support members may include a hexagonal shape. The upper and lower support members may include an octagonal shape.
A valve assembly including a seal assembly with improved durability is provided. The valve assembly includes a guard assembly including a plurality of guard sections, a seal assembly disposed adjacent to the guard assembly, and a centering mechanism for maintaining the seal assembly and guard assembly centered within a cavity of an instrument valve. The seal assembly includes a plurality of seal sections and upper and lower support members. The plurality of seal sections are movable from an unfolded configuration to folded configuration in which the seal assembly forms an octagonal member defining an opening to facilitate sealed passage of a surgical instrument therethrough. The upper and lower support members are disposed on respective proximal and distal sides of the plurality of seal sections and compressed about the plurality of seal sections to sandwich the plurality of seal sections therebetween.
In embodiments, the valve assembly further includes a retainer assembly having upper and lower retainer members. At least one of the upper and lower retainer members may include a plurality of pins receivable through the guard assembly and the seal assembly for retaining the guard and seal assemblies relative to each other. The upper support member may be connected to a seal section of the plurality of seal sections by a connector portion and the lower support member is connected to another seal section of the plurality of seal sections by another connector portion.
A seal assembly with improved durability is provided. The seal assembly includes a plurality of seal sections movable from an unfolded configuration to folded configuration in which the seal assembly forms an octagonal member defining an opening to facilitate sealed passage of a surgical instrument, an upper support member disposed proximally of the plurality of seal sections, and a lower support member disposed distally of the plurality of seal sections. The upper and lower support members are compressed about the plurality of seal sections to sandwich the plurality of seal sections therebetween.
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 embodiments given below, serve to explain the principles of the disclosure, wherein:
Particular embodiments of the present surgical access assemblies are described hereinbelow with reference to the accompanying drawings; however, it is to be understood that the disclosed embodiments are merely exemplary of the disclosure and may be embodied in various forms. Well-known functions or constructions are not described in detail to avoid obscuring the present disclosure in unnecessary detail. Therefore, specific structural and functional details disclosed herein are not to be interpreted as limiting, but merely as a basis for the claims and as a representative basis for teaching one skilled in the art to variously employ the present disclosure in virtually any appropriately detailed structure. Like reference numerals refer to similar or identical elements throughout the description of the figures.
As used herein, the term “distal” refers to that portion of the instrument, or component thereof which is farther from the user while the term “proximal” refers to that portion of the instrument or component thereof which is closer to the user. As used herein, the term “about” means that the numerical value is approximate and small variations would not significantly affect the practice of the disclosed embodiments. Where a numerical limitation is used, unless indicated otherwise by the context, “about” means the numerical value can vary by ±10% and remain within the scope of the disclosed embodiments.
Surgical access assemblies are employed during minimally invasive surgery, e.g., laparoscopic surgery, and provide for the sealed access of surgical instruments into an insufflated body cavity, such as the abdominal cavity. The surgical access assembly of the present disclosure includes an instrument valve housing mounted on a cannula tube, and an obturator (not shown) inserted through the valve housing and cannula. The obturator can have a blunt distal end, or a bladed or non-bladed penetrating distal end and can be used to incise the abdominal wall so that the surgical access assembly can be introduced into the abdomen. The handle of the obturator can engage or selectively lock onto the instrument valve housing of the surgical access assembly.
Surgical access assemblies are employed to tunnel through an anatomical structure, e.g., the abdominal wall, either by making a new passage through the structure or by passing through an existing opening through the structure. Once the trocar assembly has tunneled through the anatomical structure, the trocar obturator is removed, leaving the cannula assembly in place. The instrument valve housing of the cannula includes valves that prevent the escape of insufflation fluids from the body cavity, while also allowing surgical instruments to be inserted into the body cavity.
In various embodiments, a bladeless optical trocar obturator may be provided that permits separation of tissue planes in a surgical procedure and visualization of body tissue fibers as they are being separated, thereby permitting a controlled traversal across a body wall. In other embodiments, the trocar obturator may be bladeless without being optical, e.g., without providing contemporaneous visualization thereof through the distal tip of an obturator. The bladeless obturator may be provided for the blunt dissection of the abdominal lining during a surgical procedure.
Various trocar obturators suitable for use with the cannulas of the present disclosure are known and include, for example, bladed, bladeless, blunt, optical, non-optical. For a detailed description of the structure and function of exemplary trocar assemblies, including exemplar trocar obturators and exemplar cannulas, please refer to commonly owned PCT Publication No. WO 2016/186905 (“the '905 publication”), the content of which is hereby incorporated by reference herein in its entirety.
With initial reference now to
With reference to
The cannula assembly 100 may also include features for the stabilization of the surgical access assembly. For example, the distal end of the cannula tube 104 may carry a balloon anchor or another expandable member that engages the abdomen from the interior side. For example, see U.S. Pat. No. 7,300,448, the entire disclosure of which is hereby incorporated by reference herein. A feature on the opposite side of the abdominal wall may be used to further stabilize the surgical access assembly, such as adhesive tabs or adjustable foam collars.
The upper, lower, and inner housing sections 112, 114, 116 of the instrument valve housing 110 define a longitudinal passage 111 for receipt of a surgical instrument (not shown). The valve assembly 120 is supported within the instrument valve housing 110 to provide sealed passage of the surgical instrument through the cannula assembly 100.
With particular reference to
With continued reference to
Although the centering mechanism 130 is shown having bellows 136, the valve assembly 120 may include alternative centering mechanisms. For example, the centering mechanism may include an annular base and a plurality of spokes extending from the base, as described in commonly owned U.S. Pat. App. Pub. No. 2015/0025477 (“the '477 publication”), the content of which is incorporated herein by reference in its entirety. It is envisioned that the centering mechanism may include multiple sets of spokes, as disclosed in the '477 publication.
Still referring to
With continued reference now to
The seal assembly 160 includes a multi-petal or section seal member 162, and upper and lower support members 164, 166. As shown, the multi-petal seal member 162 includes a six petal or sections forming a hexagonal body and defining an opening 161. Although shown including six (6) sections, it is envisioned that the seal assembly 160 may include any suitable number of sections, such as, for example, as few as four (4) sections, or as many as eight (8) sections. By forming the opening 161 of the multi-petal seal member 162 out of multiple petals instead of as a continuous solid opening through a single seal member, the likelihood of the multi-petal seal member 162 tearing during insertion, removal, and use of a surgical instrument therethrough is greatly reduced. Although shown having overlapping wing-shaped petals 162a, it is envisioned that the aspects of the present disclosure may be modified for use with seal members having petals of alternative configurations and arrangements. An exemplary multi-petal seal member is shown and described in U.S. patent application Ser. No. 16/272,068, filed Feb. 11, 2019, the content of which is incorporated herein in its entirety.
With particular reference to
The upper and lower support members 164, 166 may be formed of polyisoprene, liquid silicone rubber, or any other material with sufficient stretching properties. In embodiments, the upper and lower support members 164, 166 measure between 0.006″ and 0.015″ thick. As will be described in further detail below, the upper and lower support members 164, 166 form a sandwich around the multi-petal seal member 162 to lessen the impact of leak paths within the multi-petal seal member 162.
With particular reference to
Each of the multi-petal seal member 162, the upper support member 164, and the lower support member 166 defines a plurality of openings 161a, 163a, 165a, respectively, for receiving legs 186 extending from the upper retainer member 182 of the retainer assembly 180.
With continued reference to
The upper and lower retainer members 182, 184 of the retainer assembly 180 are configured to squeeze the upper and lower support members 164, 166 with the seal assembly 160 sandwiched between. In this manner, any leaks existing between the petals 162a of the multi-petal seal member 162 are reduced in size or eliminated.
The retainer assembly 180 (
The plurality of pins 186 of the upper retainer member 182 extend through the ring portion 142 of the guard assembly 140, through the openings 163a, 165a, 167a in the respective multi-petal seal member 162, and upper and lower support members 164, 166 of the seal assembly 160, through the inner annular ring 134 of the centering mechanism 130, and into the openings 185 in the lower retainer member 184.
During a surgical procedure utilizing cannula assembly 100, a surgical instrument (not shown) is introduced into the instrument valve housing 110 through the longitudinal passage 113 in the upper, lower, and inner housing sections 112, 114, 116. As described above, the distal end of the surgical instrument engages the guard assembly 140 causing flap portions of the guard assembly 140 to flex downward into contact with multi-petal seal member 162 of the seal assembly 160 to cause the central opening 163 of the multi-petal seal member 162 to open to accommodate passage of the surgical instrument through the seal assembly 160. By compressing the upper and lower support members 164, 166 of the seal assembly 160 about the multi-petal seal member 162 in a sandwich-like manner, leaks through the multi-petal seal member 162 are reduced and/or eliminated.
With reference now to
With particular reference to
The plurality of seal sections 262 of the seal assembly 260 includes first, second, third, and fourth sections 262a, 262b, 262c, 262d. Although shown with only four (4) sections, it is envisioned that the seal assembly 260 may include as many as eight (8) sections. The plurality of seal sections 262 and the upper and lower support members 264, 266 of seal assembly 260 may be formed of the same or different material. In embodiments, at least the plurality of seal sections 262 are formed of an elastic material, e.g., rubber, polyisoprenes, or silicone elastomers. In embodiments, the first, second, third, and fourth sections 262a, 262b, 262c, 262d may include one or more fabric layers.
Each of the first, second, third, and fourth sections 262a, 262b, 262c, 262d of the multi-petal seal member 262 of the seal assembly 260 and the upper and lower support members 264, 266 include an octagonal shape, although other shapes are envisioned. An inner edge 268a, 268b, 268c, 268d of the respective first, second, third, and fourth sections 262a, 262b, 262c, 262d of the seal assembly 260 may be straight (not shown), or, as shown, may define a V-shape or cut-away. In embodiments, the V-shape defines an angle between forty-five degrees (45°) and one-hundred eighty degrees (180°). In embodiments, the V-shape defines an angle of ninety degrees (90°). The V-shape of the inner edges 268a, 268b, 268c, 268d of the respective first, second, third, and fourth sections 262a, 262b, 262c, 262d of the seal assembly 260 facilitates reception of a surgical instrument (not shown) through the seal assembly 260. The first, second, third, and fourth sections 262a, 262b, 262c, 262d of the multi-petal seal member 262 may form a flat seal (as shown), or may form a conical seal.
With continued reference to
Each of the first, second, third, and fourth sections 262a, 262b, 262c, 262d and the upper and lower support members 264, 266 define a plurality of openings 265a, 265b, 265c, 265d along an outer perimeter of each section 262a, 262b, 262c, 262d, respectively, and a plurality of openings 265e, 265f along an outer perimeter of the respective upper and lower support members 244, 246. The plurality of openings 265a, 265b, 265c, 265d, 265e, 265f are configured to receive pins 186 (
The method of folding the seal assembly 260 will now be described with reference to
Turning to
With reference to
Referring to
With reference to
The seal assembly 260 is secured within the instrument valve housing 110 (
While various embodiments of the present disclosure have been shown and described herein, it will be obvious to those skilled in the art that these embodiments are provided by way of example only. Numerous variations, changes, and substitutions will now occur to those skilled in the art without departing from the present disclosure. Accordingly, it is intended that the invention be limited only by the spirit and scope of the appended claims.
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