US20040267096A1 - Hand access port device - Google Patents
Hand access port device Download PDFInfo
- Publication number
- US20040267096A1 US20040267096A1 US10/902,756 US90275604A US2004267096A1 US 20040267096 A1 US20040267096 A1 US 20040267096A1 US 90275604 A US90275604 A US 90275604A US 2004267096 A1 US2004267096 A1 US 2004267096A1
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- US
- United States
- Prior art keywords
- sleeve
- patient
- access port
- access
- ring
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
Links
- 238000007789 sealing Methods 0.000 claims abstract description 110
- 239000000463 material Substances 0.000 claims abstract description 30
- 230000002093 peripheral effect Effects 0.000 claims abstract description 3
- 239000000853 adhesive Substances 0.000 claims description 16
- 230000001070 adhesive effect Effects 0.000 claims description 16
- 238000001356 surgical procedure Methods 0.000 claims description 16
- 238000003780 insertion Methods 0.000 claims description 12
- 230000037431 insertion Effects 0.000 claims description 12
- 238000002324 minimally invasive surgery Methods 0.000 claims description 7
- 210000001015 abdomen Anatomy 0.000 claims description 6
- 210000003815 abdominal wall Anatomy 0.000 claims description 5
- 238000004513 sizing Methods 0.000 claims description 3
- 230000014759 maintenance of location Effects 0.000 claims description 2
- 208000005646 Pneumoperitoneum Diseases 0.000 abstract description 8
- 208000014674 injury Diseases 0.000 description 6
- 230000002265 prevention Effects 0.000 description 6
- 230000008733 trauma Effects 0.000 description 6
- 210000003414 extremity Anatomy 0.000 description 4
- 238000000034 method Methods 0.000 description 4
- 210000000707 wrist Anatomy 0.000 description 4
- 230000006835 compression Effects 0.000 description 2
- 238000007906 compression Methods 0.000 description 2
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- 239000007788 liquid Substances 0.000 description 2
- 239000012858 resilient material Substances 0.000 description 2
- 239000004698 Polyethylene Substances 0.000 description 1
- 208000027418 Wounds and injury Diseases 0.000 description 1
- 210000000683 abdominal cavity Anatomy 0.000 description 1
- 230000004913 activation Effects 0.000 description 1
- 230000002411 adverse Effects 0.000 description 1
- 230000004075 alteration Effects 0.000 description 1
- 239000000560 biocompatible material Substances 0.000 description 1
- 239000006260 foam Substances 0.000 description 1
- 210000000245 forearm Anatomy 0.000 description 1
- 210000004247 hand Anatomy 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 210000000056 organ Anatomy 0.000 description 1
- 210000003200 peritoneal cavity Anatomy 0.000 description 1
- 229920003023 plastic Polymers 0.000 description 1
- 239000004033 plastic Substances 0.000 description 1
- -1 polyethylene Polymers 0.000 description 1
- 229920000573 polyethylene Polymers 0.000 description 1
- 230000002980 postoperative effect Effects 0.000 description 1
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Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
- A61B17/3423—Access ports, e.g. toroid shape introducers for instruments or hands
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/40—Apparatus fixed or close to patients specially adapted for providing an aseptic surgical environment
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00265—Hand assisted surgery, i.e. minimally invasive surgery with at least part of an assisting hand inside the body
Definitions
- the present invention relates to an improved hand access port, which enables hand access during laproscopic surgery while retaining pneumoperitoneum.
- Minimally invasive surgery is surgery carried out by causing a minimum amount of trauma by incision in a patient's body. This type of surgery almost invariably involves deliberately introducing gas into a patient's peritoneal cavity to cause pneumoperitoneum.
- a lower annular edge of the outer sleeve is sealingly secured, for example by adhesive, either to wrapping material applied to the patient or directly to the patient's skin.
- the exit opening sealing feature includes a pair of arcuate bands positioned to bring the opposing faces of the sleeve into contact to form an initial seal.
- the arcuate bands are passed through the incision into the abdomen. During pressurization, the arcuate bands also function to prevent the tendency of the inner sleeve to invert under pressure since the bands cannot pass back through the incision.
- the entry opening sealing feature includes an inflatable chamber formed between the sleeves to cause the walls of the inner sleeve to contact and form an entrance seal.
- the arcuate bands of the exit opening sealing means tend to shift outwardly from the abdomen through the incision thereby adversely affecting the seal.
- the inner walls may not effectively contact and seal around the entire outer annular surface of the wrist/arm. As a result, an excessive amount of gas is leaked from the patient's body cavity.
- improvements in sealing the lower edge of the outer sleeve to prevent leakage would be advantageous.
- FIG. 1 Another known sleeve is shown in PCT Patent Application No. PCT/IE94/00045 entitled “Apparatus for use in surgery”.
- the access port sleeve shown is used to create a controlled pressurized environment within the sleeve while allowing a surgeon's arm to pass through the sleeve.
- gas is pumped into the body cavity around the surgery site and the sleeve prevents gas escaping while allowing the surgeon to operate using minimally invasive surgery techniques.
- the application shows a sleeve having a flange at a distal end provided with adhesive for adhering the device to a patient's body or alternatively a mounting ring to surround the incision in a patient's body.
- the device described suffers from the principle disadvantage that in use, the sleeve protrudes upwardly from the patient and may interfere with the surgical team's activities. Additionally, the sleeve must be sealed against the surgeon's upper forearm by clamping the device to the arm sufficiently tightly to avoid gas leak around the area of the seal. This presents the surgeon with a problem both in sealing the sleeve and in subsequent mobility.
- a further problem associated with the use of sleeves of the kind described is that a phenomenon known as “tenting” may occur. “Tenting” means that when the sleeve is adhered to the patient's skin or to a surgical drape and gas is induced into the patients abdominal cavity, there is a tendency for the sleeve to fill with gas and to pull away from the patient.
- a still further problem associated with the use of such sleeves is that repeated insertion of surgical devices or the surgeons hand can cause unacceptably high trauma levels around the incision. This is particularly problematic when a surgeon attempts to remove an intact specimen or a hard organ.
- It is yet another object of the present invention is to provide an access port device, which effectively prevents inadvertent retraction of a sleeve of the device from a body cavity.
- Yet another object of the present invention is to provide an access port device capable of creating a gas tight seal between the access port device and patient's body.
- Still another object of the present invention is to provide an access port device capable of effectively minimizing gas leakage from a body cavity through the space between the access port device and the patient's body.
- a further object of the present invention is to provide an access port device, which creates an effective seal without the use of adhesive.
- an access port device for use in surgery comprising a first sleeve of flexible material including a proximal end and a distal end, a securing device attached to the distal end of the first sleeve to secure the access port device externally to the patient and a second sleeve of flexible material attached to the proximal end of the first sleeve.
- the second sleeve includes an entry opening adjacent the proximal end of the first sleeve and an exit opening positioned a spaced distance from the entry opening.
- An inflatable chamber is formed between the first and second sleeves.
- the access port device further includes a third sleeve of flexible material attached to at least one of the first and second sleeves wherein the third sleeve includes an annular elastic band positioned between the entry and the exit openings of the second sleeve to sealingly engage a surgeon's arm extending through the third sleeve.
- the third sleeve is preferably formed of a sufficient length to be positioned adjacent the exit opening and extends along a substantial portion of the second sleeve.
- the third sleeve may be attached to the second sleeve at a first attachment location adjacent the entry opening, and at a second attachment location a spaced distance along the second sleeve from the first attachment location.
- the elastic band is preferably positioned at a distal end of the third sleeve.
- the access port may include an elongated exit opening seal mounted on the second sleeve at the exit opening.
- the exit opening seal is positioned along an exit opening seal plane extending through the entry opening, and the exit opening of the second sleeve.
- a second sleeve retraction prevention device may be included for preventing inadvertent retraction of the second sleeve from an incision in a patient's body.
- the second sleeve retraction prevention device includes at least one transverse wing extending transverse to the exit opening seal plane.
- the at least one transverse wing includes at least one first wing positioned on a first side of the exit opening and at least one second wing positioned on a second side of the exit opening.
- Each of the at least one first wings and the at least one second wings may include a pair of wings.
- the wings may be integrally formed on the elongated exit opening seal.
- the elongated exit opening seal may include a pair of opposed bands biased together while the transverse wing may be integrally formed on at least one band of the opposed bands.
- the first pair of wings may be located at a first end of the pair of opposed bands while the second pair of wings is located at a second end of the pair of opposed bands.
- One wing of each pair of wings extends from the bands in a first transverse direction while the other wing extends from the other band in a second transverse direction opposite to the first direction.
- the access port device of the present invention comprises a sleeve of flexible material including a proximal end and a distal end, and forming an access opening positionable in an incision in a patient's body.
- the device further includes an outer annular sealing device attached to the proximal end of the sleeve to secure the access port device externally to a patient and an inner annular sealing device attached to the distal end of the sleeve to secure the access port device internally to the patient.
- the access port device includes an access component removably connected to the outer annular sealing device and including a flexible ring removably engaging the outer annular sealing device.
- the access component may include an access sleeve of flexible material, which may include an integral glove for receiving a surgeon's hand.
- the access sleeve and glove have a length sufficient to extend from the flexible ring through the access opening.
- the outer annular scaling device may include an annular groove for receiving the flexible ring and the groove may be formed in an outer peripheral surface of the outer annular sealing device.
- An inflatable chamber may be formed between the sleeve and the access sleeve.
- the outer annular sealing device may include a flexible annular extension extending radially inwardly from the outer annular scaling device wherein the annular extension includes an inner annular biasing surface facing outwardly from the patient's body.
- the annular extension may include a circumferentially unsupported annular floating edge.
- the device may further include a gas chamber positioned adjacent the inner annular biasing surface to collect gas leaking between the sleeve and the patient's body.
- the flexible annular extension is generally flat.
- the outer annular sealing device may include an upper annular overhang positioned opposite and spaced from the flexible annular extension so that the gas chamber is positioned between the upper annular overhang and the flexible annular extension.
- the outer annular sealing, device may further include an outer biasing surface facing the inflatable chamber.
- the present invention provides an access port device comprising a first sleeve of flexible material including a proximal end and a distal end and forming an access opening positionable in an incision in a patient's body.
- the access port device also includes a leakage-minimizing feature for minimizing gas leakage from between the first sleeve and the patient's body.
- the leakage minimizing feature includes an outer annular sealing device attached to the proximal end of the first sleeve, an inner annular sealing device attached to the distal end of the first sleeve for abutting and sealingly engaging an inner surface of a body cavity of the patient, and a seal force applying device for causing leakage gas between the first sleeve and the patient's body to apply a sealing force against the outer annular sealing device to bias the outer annular sealing device toward the patient.
- the access port device may further include a second sleeve of flexible material positioned adjacent the first sleeve and an inflatable chamber formed between the first and second sleeves.
- the sealing force applying device may further include the flexible annular extension and the inner biasing surface.
- the sealing force applying device may further include sizing the first sleeve to fit closely to the patient's cavity wall to cause a sealing force to bias the outer annular sealing device into scaling engagement with the patient's skin.
- the sealing force applying device may further include the annular overhang, gas chamber and outer biasing surfaces mentioned hereinabove.
- the present invention also provides an access port device for use in surgery which comprises a sleeve of flexible material, a non adhesive outer annular sealing device attached to a proximal end of the sleeve and adapted to create a non adhesive, substantially gas tight seal adjacent the patient's body to prevent gas flow from the patient's body and an inner annular sealing device attached to the distal end of the sleeve to secure the access port device internally to the patient.
- the access component is sealingly mounted on the outer annular sealing device and extendable into the access opening.
- the access component may be removably mounted on the outer annular sealing device, which may, in turn, include the flexible annular extension.
- a surgical device for use in minimally invasive surgery of the type using an inflated body cavity accessible to a surgeon through an incision, the device being formed to define a sleeve access port for insertion into the incision and having:—
- mounting means for locating and securing the device in position on a patient
- sealing means to prevent substantial leakage of gas from the body cavity
- a retractor to limit contact between the sleeve and the incision when in use.
- the retractor is provided as a deformable tube.
- the tube has at opposing ends a proximal ring and a distal ring.
- the proximal and distal rings are formed for substantially airtight engagement with the sleeve and with the patient's abdomen.
- the or each ring incorporates an adhesive portion for fixing the ring in position.
- the distal ring is formed for substantially airtight engagement with the sleeve and with the patient's internal abdominal wall.
- engagement between the proximal ring and sleeve is provided by a skirt carried on the sleeve and having a rim formed for releasable engagement to the ring.
- the ring and skirt are integrally formed.
- the skirt has an integrally formed glove or pocket for receiving a surgeons hand or surgical instrument.
- the skirt has a recessed or undercut receiver formed for engagement with a ring or a surgeons glove.
- the proximal ring incorporates a flexible gas retaining ring extending down from the proximal ring and formed for engagement against a patients skin when in position to define a gas retention chamber.
- the gas retaining ring is inflatably movable between an insertion position and an in use position.
- the gas retaining ring is provided by a collapsible bellows ring.
- the device incorporates a retractor-positioning device.
- the retractor-positioning device has means for releaseably engaging the proximal ring and the distal ring.
- the means for engaging the proximal ring and the distal ring are movable between a retracted position and a locating position.
- the means for engaging the proximal ring and the distal ring are telescopically movable.
- the proximal ring supports a flexible web, said web in turn defining a hole for receiving the sleeve.
- the device incorporates a collapsible support scaffold, the scaffold being formed for supporting the device in an operative state and collapsible to provide a surgeon free access to the incision.
- FIG. 1 is a perspective view of a first embodiment of the access port device of the present invention
- FIG. 2 is a perspective view of the bottom of the first embodiment of FIG. 1;
- FIG. 3 is a plan view of the opposed bands of the exit opening seal
- FIG. 4 is a perspective view of one of the bands of the exit opening seal
- FIG. 5 is a cross sectional side view of the access port of the first embodiment as applied to a patient prior to access during, surgery;
- FIG. 6 is a cross sectional side view similar to FIG. 5 during use with access by a surgeon's arm;
- FIG. 7 is a cross sectional view of a second embodiment of the present invention in use.
- FIG. 8 is a cross sectional view of a third embodiment of the present invention including a seal force applying feature
- FIG. 9 is a cross sectional view of the device of FIG. 8 during use but without showing an access component attached;
- FIG. 10 is a sectional view of a surgical device in accordance with the invention in position on a patient;
- FIG. 11 is front view of a sleeve forming part of the invention.
- FIG. 12 is a perspective view of a retractor forming part of the invention.
- FIG. 13 is a front view of a retractor-positioning device forming part of the invention.
- FIG. 14 is a sectional view of another embodiment of a surgical device in accordance with the invention in position on a patient;
- FIG. 15 is a sectional view of the device of FIG. 14 with a surgeon's hand inserted;
- FIG. 16 is a sectional view of a further embodiment of a surgical device in accordance with the invention in position on a patient;
- FIG. 17 is a sectional view of the device of FIG. 16 with a surgeons hand inserted;
- FIG. 18 is a sectional view of another surgical device in accordance with the invention in position on a patient;
- FIG. 19 is a sectional view of a further surgical device in accordance with the invention in position on a patient;
- FIG. 20 is a top view of the surgical device of FIG. 19;
- FIG. 21 is a sectional view of another surgical device in accordance with the invention in an insertion position on a patient.
- FIG. 22 is a sectional view of the surgical device of FIG. 21 in an operating position on a patient.
- Access port device 10 for permitting access to a patient's body cavity during surgery while maintaining body cavity pressure.
- Access port device 10 generally includes a first sleeve 12 of flexible material including a proximal end 14 and a distal end 16 , a securing device 18 attached to the distal end 16 of first sleeve 12 , a second sleeve 20 attached to proximal end 14 of first sleeve 12 and a third sleeve 22 of flexible material attached to at least one of the first sleeve 12 and second sleeve 20 .
- this arrangement can be effectively and sealingly attached to a patient's body surrounding an incision to permit the insertion of a hand into a patient's body cavity while simply and effectively maintaining pneumoperitoneum as desired throughout a laproscopic surgery procedure.
- both first sleeve 12 and second sleeve 20 extend annularly with second sleeve 20 positioned inside first sleeve 12 .
- Second sleeve 20 is preferably integrally formed at proximal end 14 of first sleeve 12 , i.e. second sleeve 20 is an integral extension of first sleeve 12 turned inwardly onto itself.
- Securing device 18 includes a flange 24 extending transversely from distal end 16 for connection to either the patient's skin or wrapping material covering the patient's skin.
- the flange 24 includes an adhesive, such as a solid or a liquid adhesive, for adhering to the wrapping material or skin to securely and sealingly affix the access port device 10 to the patient.
- Both first sleeve 12 and second sleeve 20 may each be formed from opposing sheets of flexible material fused together along opposite edges 26 and 28 , respectively, with edges 26 being positioned outwardly from edges 28 .
- an inflatable chamber 30 (FIG. 5) is positioned between first sleeve 12 and second sleeve 20 for receiving pressurized gas via an inlet valve 32 (FIG. 1).
- Inlet valve 32 is provided on first sleeve 12 so that inflatable chamber 30 can be inflated prior to the insertion of a surgeon's hand into the device as shown in FIG. 5.
- the gas pressure in inflatable chamber 30 is maintained by gas flowing from the body cavity of the patient during pneumoperitoneum. Thus, after the inflation of chamber 30 through valve 32 , valve 32 is closed.
- the second sleeve 20 forms an entry opening 34 positioned adjacent the proximal end 14 of first sleeve 12 and an exit opening 36 positioned a spaced distance from entry opening 34 .
- Second sleeve 20 has a length sufficient to extend through first sleeve 12 and through an incision 2 formed in a patient's body 4 so as to be positioned in the patient's body cavity when access port device 10 is applied to the patient as shown in FIG. 5.
- Access port device 10 further includes an elongated exit opening seal 38 mounted on second sleeve 20 and extending across exit opening 36 .
- Elongated exit opening seal 38 is positioned along an exit opening seal plane, indicated at 40 , which extends through entry opening 34 and exit opening 36 of second sleeve 20 .
- Elongated exit opening seal 38 includes a pair of resilient opposed bands 42 as clearly shown in FIGS. 2, 3 and 5 . Each band 42 is positioned in a respective elongated cuff 44 formed in the distal end of second sleeve 20 .
- Bands 42 are formed of a resilient flexible material, i.e. plastic, which permits the bands to be flexed outwardly to create an exit opening for receiving a surgeon's hand and/or an instrument.
- Each of the bands 42 may also include a cushioning strip made from, for example, foam, to provide more comfort to the surgeon's hand/wrist during use.
- the bands 42 are biased together bringing the opposing faces of second sleeve 20 into mutual contact and hence forming an exit opening seal.
- the geometry of bands 42 is such that, when presented at right angles to the incision 2 , it is possible for the bands to pass through the incision.
- bands 42 align themselves nominally parallel to the abdominal wall as shown in FIG. 5.
- elongated exit opening seal 38 functions to form an initial seal preventing the escape of gas from the body cavity to the atmosphere via the exit opening, 36 of second sleeve 20 .
- Access port device 10 also includes a second sleeve retraction prevention feature, indicated generally at 46 , for preventing inadvertent retraction of second sleeve 20 from incision 2 .
- a second sleeve retraction prevention feature 46 for preventing inadvertent retraction of second sleeve 20 from incision 2 .
- second sleeve retraction feature 46 includes at least one transverse wing 48 extending from the distal end of second sleeve 20 transverse to exit opening seal plane 40 (FIG. 5).
- second sleeve retraction prevention feature 46 includes a transverse wing 48 formed at each end of each of the opposed bands 42 as clearly shown in FIG. 3.
- Transverse wings 48 are integrally formed on opposed bands 42 and extend transversely generally parallel to the under surface of the patient's body defining the body cavity. The transverse wings 48 extend through respective slits formed in the cuff 44 of second sleeve 20 thereby securing bands 42 within cuff 44 .
- transverse wings 48 will prevent inadvertent movement of elongated exit opening seal 38 through incision 2 by abutting the under surface of the patient's body forming the body cavity as shown in FIG. 6. Even prior to insertion of a surgeon's arm into the access port device 10 , when insulflation pressure causes movement of exit opening seal 38 toward incision 2 , transverse wings 48 will abut the incision and prevent exit opening seal 38 from passing through incision 2 . As a result, second sleeve retraction prevention feature 46 creates a more reliable and effectively usable access port device, which can be easily and simply utilized without subsequent repositioning of second sleeve 20 after initial setup.
- access port device 10 of the present invention also includes the third sleeve 22 positioned within, and attached to, second sleeve 20 .
- third sleeve 22 extends from entry opening 34 of second sleeve 20 to a location adjacent exit opening 36 .
- Third sleeve 22 is attached to, or integrally formed on, second sleeve 20 at a first attachment 50 adjacent entry opening 34 .
- First attachment 50 extends annularly to prevent gas from escaping from the space between second sleeve 20 and third sleeve 22 .
- Third sleeve 22 is also attached to second sleeve 20 at a second attachment 52 located a spaced distance from first attachment 50 along third sleeve 22 .
- Second attachment 52 occurs at a point close to a distal end of third sleeve 22 so as to maintain the distal end in the inner space of second sleeve 20 .
- second attachment 52 may be in the form of two separate weld lines positioned on opposite sides of third sleeve 22 .
- An inflatable gas chamber 60 is formed between second sleeve 20 and third sleeve 22 , which captures gas leaking by elongated exit opening seal 38 .
- chambers 30 and 60 create an entry opening seal 62 by forcing the opposing surfaces of third sleeve 22 into abutment prior to use as shown in FIG. 5.
- exit opening seal 38 and entry opening seal 62 effectively minimizes gas leakage through access port device 10 so as to retain pneumoperitoneum.
- third sleeve 22 includes an annular elastic band 54 for sealingly engaging a surgeon's hand, wrist or arm positioned in third sleeve 22 as shown in FIG. 6.
- annular elastic band 54 is positioned at the distal end of third sleeve 22 .
- Annular elastic band 54 is sized and designed with sufficient elasticity so as to permit insertion of hands and arms of varying sizes while ensuring a substantially gas tight seal between elastic band 54 and the arm. It will be understood that the size and elasticity of the access port and elastic band 54 can be varied to accommodate, for instance only one finger rather than the entire hand and arm of the surgeon.
- the size and elasticity of the access port and elastic band 54 may be designed to accommodate instruments of various sizes while still substantially preventing leakage from the patient's body cavity through the access port device 10 .
- the various sleeves of access port device 10 may be manufactured from any flexible, gas impermeable, sterilizable, biocompatible material, for instance polyethylene.
- FIG. 7 discloses a second embodiment of the present invention directed to an access port device 100 including a first sleeve of flexible material 102 having a proximal end 104 for positioning external to a patient and a distal end 106 for positioning in a patient's body cavity.
- Access port device 100 includes an outer annular sealing device 110 attached to proximal end 104 of first sleeve 102 and an inner annular sealing device 112 attached to distal end 106 of first sleeve 102 .
- Both outer and inner annular sealing devices 110 and 112 are sized and shaped to extend in an annular fashion around a given incision and, therefore, may be provided in a variety of sizes depending on the length of the incision.
- Outer annular sealing device 110 includes a biasing surface 114 facing, outwardly away from the patient's body 4 .
- Proximal end 104 of first sleeve 102 is sealingly attached to biasing surface 114 around the entire circumference of outer annular sealing device 110 .
- the distal end 106 of first sleeve 102 is sealingly attached to inner annular scaling device 112 in any conventional manner creating a secure sealed connection.
- Inner annular sealing device 112 may be a ring formed of any flexible, resilient material.
- Biasing surface 114 is preferably formed on a flexible annular extension 116 of outer annular sealing device 1 10 .
- Access port device 100 also includes an access component 1 18 sealingly engaging outer annular sealing device 110 and extendable into the access opening formed by first sleeve 102 .
- access component 1 18 includes a flexible ring 120 designed for removable mounting in an annular groove 122 formed in outer annular sealing device 1 10 .
- Flexible ring 120 is preferably formed of an elastic, resilient material to permit the ring to be stretched and moved into groove 122 and, if desired, expanded for removal from groove 122 .
- access component 118 also includes a sleeve of flexible material 124 extending from flexible ring 120 and having a length sufficient to extend through the access opening formed by first sleeve 102 and inner annular sealing device 112 as shown in FIG. 7.
- the sleeve of flexible material 124 may include an integrated glove to form a sleeved glove 126 for receiving a surgeon's hand/arm. As shown in FIG.
- an inflatable chamber 128 is formed between first sleeve 102 and the sleeve of flexible material 124 for containing gas flowing through the gap between sleeved glove 126 and first sleeve 102 thereby retaining pneumoperitoneum.
- the first sleeve 102 is sized to permit inner annular sealing device 112 to be effectively positioned underneath the patient's cavity wall 4 and outer annular sealing device 1 10 to be positioned on the outer surface of the patient while first sleeve 102 fits closely to the patient's cavity wall.
- inner annular sealing device 1 10 is biased tightly against the inner surface of the patient's body cavity wall 4 while first sleeve 102 exerts a downward force on outer annular sealing device 110 .
- biasing surface 1 14 faces outwardly away from the patient's body cavity wall 4 , gas pressure in the inflatable chamber creates gas pressure sealing forces acting on biasing surface 1 14 which tends to bias outer annular sealing device 1 10 against the patient.
- the present access port device 100 creates an effective seal for minimizing gas leakage from the patient's body cavity through the space between access port device 100 and the patient's body cavity wall 4 .
- FIGS. 8 and 9 disclose a preferred embodiment of an access port device indicated generally at 150 , which is similar to the access port device disclosed in the embodiment of FIG. 7 except for a modified outer annular sealing device 152 , which creates a more effective seal against a patient's body in many applications.
- access port device 150 may include an access component (not shown), such as the sleeved glove 126 of the previous embodiment, which can be sealingly mounted in annular groove 154 of outer annular sealing device 152 .
- access port device 150 includes an inner annular sealing device or ring 156 and flexible sleeve 158 forming an access opening, 160 similar to the embodiment of FIG. 7.
- access port device 150 includes a leakage minimizing device 153 for minimizing gas-leakage from between sleeve 158 and the patient's body, which includes a sealing force applying feature 159 including outer annular sealing device 152 and a leakage gas chamber 162 for receiving leakage gas leaking between access port device 150 and the patient.
- outer annular sealing device 152 includes a flexible annular extension 164 having a generally flat shape and extending radially inwardly to form a circumferentially unsupported annular floating edge 166 .
- Flexible annular extension 164 also includes an inner biasing surface 168 facing outwardly from the patient and exposed to gas in the gas chamber 162 .
- the outer annular sealing device 152 further includes an overhang 170 , which in part forms gas chamber 162 and includes an outer biasing surface 172 .
- the sleeve 158 is sealingly attached to outer biasing surface 172 . Therefore, gas chamber 162 is formed between flexible annular extension 164 and overhang 170 .
- overhang 170 may be designed with a sufficient length so as to abut the patient's skin when placed on the patient as shown in FIG. 9.
- the sealing force applying feature 159 effectively minimizes leakage between access port device 150 and the patient's body in the following manner.
- inner annular sealing device 156 lies tight against the inner surface of the patient's body cavity, i.e. abdomen.
- the flexible sleeve 158 is sized, as discussed hereinabove with respect to the embodiment of FIG. 7, so as to exert a downward force on outer annular sealing device 152 causing compression of flexible annular extension 164 against the patient's skin or an intermediate material.
- annular groove 7 may then be attached to annular groove 154 by stretching flexible ring 120 around outer annular sealing device 152 so as to position ring 120 in groove 154 .
- the access component is in the form of sleeved glove 126
- the surgeon would place the glove on his hand by inserting his arm into the sleeved glove prior to mounting the access component on outer annular sealing device 152 .
- flexible ring 120 would then be placed in annular groove 154 while the surgeon's arm is extended through access opening 160 .
- the overall length of the sleeve glove 126 may be adjusted by rolling or unrolling the flexible ring 120 to thereby take-up or release the flexible material from ring 120 .
- This leakage gas will be trapped in gas chamber 162 .
- Gas pressure induced biasing forces are then generated on inner biasing surface 168 so as to bias flexible annular extension 164 into sealing abutment against the patient's skin thereby creating an enhanced seal between flexible annular extension 164 and the patient.
- the greater the gas pressure in gas chamber 162 the greater the sealing force between flexible annular extension 164 and the patient's skin.
- the surgeon's hand may simply be pulled outwardly and removed from sleeved glove 126 or the flexible ring 120 may be first released from outer annular sealing devices 110 , 152 .
- the seal created between outer annular sealing device 110 due to the effect of leakage minimizing device 153 is sufficient to avoid the use of adhesive between device 153 and the patient, thereby creating a non adhesive sealed access port. If an adhesive is used, which is more likely in the embodiment of FIG. 7, a liquid adhesive may be applied.
- FIGS. 10 to 13 there is illustrated a surgical device according to the invention, indicated generally by the reference numeral 2001 .
- the surgical device 2001 is formed for use in minimally invasive surgery of the type using an inflated body cavity indicated generally by the reference numeral 2002 .
- the cavity 2002 is accessible to a surgeon through an access port, defined by a sleeve 2004 , which passes through an incision in a patient's abdominal wall 2003 .
- the sleeve 2004 is connected to a retractor indicated generally by the reference numeral 2005 which atraumatically retracts the incision.
- the retractor 2005 is pressed against the incision to protect it from contact as a surgeon introduces or withdraws a hand, surgical device or body tissue.
- the retractor 2005 is inserted using a retractor-positioning device indicated generally as 2006 , which will be described in more detail below.
- sealing means is provided for the device 2001 by the sleeve 2004 , which is in this case of the type known and marketed by Medtech Ltd., as an INTROMIT R sleeve.
- the sleeve 2004 has an entrance opening 2041 .
- a flexible elongate inner sleeve 2042 extends downwardly from the opening 2041 and terminates away from the opening with a taut valve 2043 .
- a feathered valve 2044 is also suspended from the opening inside the inner sleeve 2042 .
- the sleeve 2004 also has a skirt 2045 extending downwardly from the opening 2041 outside the inner sleeve 2042 .
- the skirt 2045 has a flexible rim 2046 for connection in an airtight manner to the retractor 2005 .
- the retractor 2005 as shown in FIG. 12 has a proximal ring 2051 for receiving the flexible rim 2046 and a distal ring 2052 connected to the proximal ring 2051 with a flexible incision engaging retractor wall 2053 .
- the proximal ring 2051 and the distal ring 2052 are positioned on the patient using the retractor-positioning device 6 as shown in FIG. 13.
- the retractor-positioning device 2006 has means for engaging the proximal ring 2051 provided by a pair of oppositely directed telescopic arms 2061 carried on an introduction shaft 2063 .
- the shaft 2063 also carries means for engaging the distal ring provided in this case by pivotally moveable distal arms 2063 .
- an incision is made in the abdominal wall 2003 .
- the distal ring 2052 and the proximal ring 2051 are engaged on the respective arms 2062 , 2061 with the arms 2062 , 2061 in a retracted position (not shown) having the arms 2062 , 2061 close to the shaft 2063 .
- the proximal ring 2051 is then positioned on the patient by telescopically extending the arms 2061 .
- the distal arms 2062 and portion of the shaft 2063 are then passed through the incision into the cavity 2000 .
- the distal ring 2052 is moved into position when in the cavity 2002 by pivoting the oppositely directed arms 2062 away from the shaft 2063 so that the ring 2052 surrounds the incision.
- the ring 2051 is disengaged from the arms 2061 causing it to open against the abdomen wall.
- the arms 2062 are disengaged from the ring 2052 by pulling upward.
- the flexible rim 2046 is then deformed by the surgeon to engage on and around the proximal ring 2051 in an airtight manner.
- the body cavity is then inflated and when inflated the flexible elongate inner sleeve 2042 is allowed to extend downwardly from the opening 2041 with the taut valve 2043 inserted into the body cavity.
- the feathered valve 2044 is also suspended from the opening 2041 inside the inner sleeve 2042 and above the incision.
- the gas pressure within the cavity inflates the skirt 2045 .
- the seal of the rim 2046 and the ring 2051 prevents air pressure from escaping.
- the surgeon can then operate on the patient and the constant and controlled distance between the sleeve and the retractor prevents unnecessary contact with the incision thereby reducing overall patient trauma and providing the surgeon with a greater range of movement unencumbered by the incision wall.
- FIGS. 14 and 15 there is illustrated another surgical device according to the invention, indicated generally by the reference numeral 2100 in which parts similar to those described in FIGS. 10 to 13 are identified by the same reference numerals generally.
- the device has an extended proximal ring 2151 .
- the proximal ring 2151 supports a highly flexible web 2152 which in turn defines an opening through which a sleeve 2153 passes.
- the sleeve 2153 is terminated in a taut valve 2043 above the incision.
- the operation of this device is similar to that described above. It will be appreciated that the retractor may also be manually positioned on the operating site.
- the taut valve is housed above the incision thereby allowing a surgeon greater visibility as well as eliminating the need to insert any valves within the body cavity. Additionally, the valve will not travel with the surgeon's wrist during insertion and as a low sealing force is required, the surgeon suffers little compression on the arm during insertion.
- FIGS. 16 and 17 there is illustrated a further surgical device according to the invention, indicated generally by the reference numeral 700 in which parts similar to those described in FIGS. 10 to 15 are identified by the same reference numerals generally.
- the skirt 2045 is supported by a collapsible scaffold structure 701 .
- the scaffold structure 701 is in turn carried on the proximal ring 2051 .
- the skirt 2045 is supported by the structure 701 (See FIG. 16).
- the structure collapses (See FIG. 17) to provide free access and good operating site visibility for the surgeon.
- FIG. 18 illustrates another a surgical device according to the invention, indicated generally by the reference numeral 1200 .
- a taut valve 1201 is formed from an elasticised portion of a tapered sleeve 1204 .
- Oppositely directed connecting limbs 1202 extend outwardly from the valve 1201 and attach to a proximal ring 1203 .
- the limbs 1202 stretch the sleeve 1204 causing the sleeve 1204 to narrow the taut valve 1201 and seal.
- the limbs 1202 are deflected to allow access.
- the limbs re-establish the seal as before.
- FIGS. 19 and 20 there is illustrated another surgical device according to the invention, indicated generally by the reference numeral 1300 in which parts similar to those described in FIGS. 10 to 18 are identified by the same reference numerals generally.
- the sleeve 2004 extends downwardly from an oval semi-rigid proximal ring 1301 .
- the ring 1301 in turn is carried on an inflatable ring 1302 , which is formed for inflation by an inflator 1303 .
- the device is positioned on a patient and the ring 1302 is inflated.
- the degree of retraction required is controlled by the pressure in the ring 1302 as greater pressure will force the sleeve 2004 against the incision.
- the inflation of the ring 1302 draws the sleeve 2004 against the incision and prevents loss of pneumoperitoneum.
- FIGS. 21 and 22 illustrate another surgical device according to the invention indicated as 1500 , which is similar in operation to the embodiment shown in FIGS. 19 and 20.
- ring 1302 is replaced with a compressible bellows ring 1501 .
- the bellows ring 1501 has a one-way valve 1502 .
- the compressed bellows ring 1501 is positioned on a patient.
- the ring is drawn up to allow air to inflate the bellows ring 1501 through the valve 1502 .
- This inflation retracts the incision to the required degree and the valve 1502 prevents the air from escaping and the incision from closing.
- the incision can be released only by activation of the valve 1502 by the surgeon.
Abstract
An access port device is provided which enables hand access to a patient's body cavity while retaining pneumoperitoneum by minimizing gas leakage through the access port device. The access port device comprises a sleeve of flexible material including a proximal end and a distal end, and forming an access opening positionable in an incision in a patient's body, an outer annular sealing device attached to the proximal end of the sleeve to secure the access port device externally to a patient, an inner annular sealing device attached to the distal end of the sleeve to secure the access port device internally to the patient, and an access component removably connected to the outer annular sealing device, the access component including a flexible ring removably engaging the outer annular sealing device. The access component may include a sleeved glove, an access sleeve of flexible material, the access sleeve including an integral glove for receiving a surgeon's hand, and the access sleeve and glove having a length sufficient to extend from the flexible ring through the access opening. In another aspect, the outer annular sealing device includes an annular groove for receiving the flexible ring. The annular groove may be formed in an outer peripheral surface of the outer annular sealing device. The access component may further include an access sleeve of flexible material positioned adjacent to the sleeve, the device further including an inflatable chamber formed between the sleeve and the access sleeve.
Description
- The present invention relates to an improved hand access port, which enables hand access during laproscopic surgery while retaining pneumoperitoneum.
- Minimally invasive surgery is surgery carried out by causing a minimum amount of trauma by incision in a patient's body. This type of surgery almost invariably involves deliberately introducing gas into a patient's peritoneal cavity to cause pneumoperitoneum.
- Accordingly, surgical sleeves have been developed to prevent gas from escaping from the patient's body cavity while allowing the surgeon to operate using minimally invasive surgery techniques. These sleeves create a controlled pressurized environment within the sleeve while allowing the surgeon's arm to ass through the sleeve. For example, U.S. Pat. Nos. 5,803,921 and 5,899,208 both disclose an access port device having an inner sleeve, an outer sleeve, an exit opening sealing feature for preventing substantial leakage of gas from the patient's body in the region of an exit opening and an entry opening sealing, feature substantially preventing gas leakage around the surgeon's arm at the entry opening. A lower annular edge of the outer sleeve is sealingly secured, for example by adhesive, either to wrapping material applied to the patient or directly to the patient's skin. The exit opening sealing feature includes a pair of arcuate bands positioned to bring the opposing faces of the sleeve into contact to form an initial seal. The arcuate bands are passed through the incision into the abdomen. During pressurization, the arcuate bands also function to prevent the tendency of the inner sleeve to invert under pressure since the bands cannot pass back through the incision. The entry opening sealing feature includes an inflatable chamber formed between the sleeves to cause the walls of the inner sleeve to contact and form an entrance seal.
- Although the devices disclosed in the '921 and '208 patents operate effectively in many applications, improvements are desirable. For example, in the certain applications, the arcuate bands of the exit opening sealing means tend to shift outwardly from the abdomen through the incision thereby adversely affecting the seal. Also, when a surgeon extends a hand through the entrance seal formed by the inner walls of the sleeve, the inner walls may not effectively contact and seal around the entire outer annular surface of the wrist/arm. As a result, an excessive amount of gas is leaked from the patient's body cavity. In addition, improvements in sealing the lower edge of the outer sleeve to prevent leakage would be advantageous.
- Another known sleeve is shown in PCT Patent Application No. PCT/IE94/00045 entitled “Apparatus for use in surgery”. The access port sleeve shown is used to create a controlled pressurized environment within the sleeve while allowing a surgeon's arm to pass through the sleeve. During surgery, gas is pumped into the body cavity around the surgery site and the sleeve prevents gas escaping while allowing the surgeon to operate using minimally invasive surgery techniques. The application shows a sleeve having a flange at a distal end provided with adhesive for adhering the device to a patient's body or alternatively a mounting ring to surround the incision in a patient's body. While providing a suitable apparatus for performing such surgery the device described suffers from the principle disadvantage that in use, the sleeve protrudes upwardly from the patient and may interfere with the surgical team's activities. Additionally, the sleeve must be sealed against the surgeon's upper forearm by clamping the device to the arm sufficiently tightly to avoid gas leak around the area of the seal. This presents the surgeon with a problem both in sealing the sleeve and in subsequent mobility.
- A further problem associated with the use of sleeves of the kind described is that a phenomenon known as “tenting” may occur. “Tenting” means that when the sleeve is adhered to the patient's skin or to a surgical drape and gas is induced into the patients abdominal cavity, there is a tendency for the sleeve to fill with gas and to pull away from the patient. A still further problem associated with the use of such sleeves is that repeated insertion of surgical devices or the surgeons hand can cause unacceptably high trauma levels around the incision. This is particularly problematic when a surgeon attempts to remove an intact specimen or a hard organ.
- Therefore, there is a need for an improved access port device for more effectively preventing gas from escaping from the patient's body while allowing the surgeon to effectively operate using minimally invasive surgery techniques.
- Therefore, it is an object of the present invention to overcome the disadvantages of the prior art and to provide an access port device capable of permitting effective surgery while permitting body cavity pressure to be easily maintained.
- It is another object of the present invention to provide an access port device capable of minimizing leakage of gas from the body cavity between the access port device and a surgeon's hand/arm in a simple manner without limiting the movement of the hand.
- It is yet another object of the present invention is to provide an access port device, which effectively prevents inadvertent retraction of a sleeve of the device from a body cavity.
- Yet another object of the present invention is to provide an access port device capable of creating a gas tight seal between the access port device and patient's body.
- Still another object of the present invention is to provide an access port device capable of effectively minimizing gas leakage from a body cavity through the space between the access port device and the patient's body.
- A further object of the present invention is to provide an access port device, which creates an effective seal without the use of adhesive.
- These and other objects of the present invention are achieved by providing an access port device for use in surgery, comprising a first sleeve of flexible material including a proximal end and a distal end, a securing device attached to the distal end of the first sleeve to secure the access port device externally to the patient and a second sleeve of flexible material attached to the proximal end of the first sleeve. The second sleeve includes an entry opening adjacent the proximal end of the first sleeve and an exit opening positioned a spaced distance from the entry opening. An inflatable chamber is formed between the first and second sleeves. The access port device further includes a third sleeve of flexible material attached to at least one of the first and second sleeves wherein the third sleeve includes an annular elastic band positioned between the entry and the exit openings of the second sleeve to sealingly engage a surgeon's arm extending through the third sleeve. The third sleeve is preferably formed of a sufficient length to be positioned adjacent the exit opening and extends along a substantial portion of the second sleeve. Also, the third sleeve may be attached to the second sleeve at a first attachment location adjacent the entry opening, and at a second attachment location a spaced distance along the second sleeve from the first attachment location. The elastic band is preferably positioned at a distal end of the third sleeve.
- The access port may include an elongated exit opening seal mounted on the second sleeve at the exit opening. The exit opening seal is positioned along an exit opening seal plane extending through the entry opening, and the exit opening of the second sleeve. A second sleeve retraction prevention device may be included for preventing inadvertent retraction of the second sleeve from an incision in a patient's body. The second sleeve retraction prevention device includes at least one transverse wing extending transverse to the exit opening seal plane. The at least one transverse wing includes at least one first wing positioned on a first side of the exit opening and at least one second wing positioned on a second side of the exit opening. Each of the at least one first wings and the at least one second wings may include a pair of wings. The wings may be integrally formed on the elongated exit opening seal. The elongated exit opening seal may include a pair of opposed bands biased together while the transverse wing may be integrally formed on at least one band of the opposed bands. The first pair of wings may be located at a first end of the pair of opposed bands while the second pair of wings is located at a second end of the pair of opposed bands. One wing of each pair of wings extends from the bands in a first transverse direction while the other wing extends from the other band in a second transverse direction opposite to the first direction.
- In another embodiment, the access port device of the present invention comprises a sleeve of flexible material including a proximal end and a distal end, and forming an access opening positionable in an incision in a patient's body. The device further includes an outer annular sealing device attached to the proximal end of the sleeve to secure the access port device externally to a patient and an inner annular sealing device attached to the distal end of the sleeve to secure the access port device internally to the patient. Moreover, the access port device includes an access component removably connected to the outer annular sealing device and including a flexible ring removably engaging the outer annular sealing device. The access component may include an access sleeve of flexible material, which may include an integral glove for receiving a surgeon's hand. The access sleeve and glove have a length sufficient to extend from the flexible ring through the access opening. The outer annular scaling device may include an annular groove for receiving the flexible ring and the groove may be formed in an outer peripheral surface of the outer annular sealing device. An inflatable chamber may be formed between the sleeve and the access sleeve. The outer annular sealing device may include a flexible annular extension extending radially inwardly from the outer annular scaling device wherein the annular extension includes an inner annular biasing surface facing outwardly from the patient's body. The annular extension may include a circumferentially unsupported annular floating edge. The device may further include a gas chamber positioned adjacent the inner annular biasing surface to collect gas leaking between the sleeve and the patient's body. Preferably, the flexible annular extension is generally flat. The outer annular sealing device may include an upper annular overhang positioned opposite and spaced from the flexible annular extension so that the gas chamber is positioned between the upper annular overhang and the flexible annular extension. The outer annular sealing, device may further include an outer biasing surface facing the inflatable chamber.
- Thus, the present invention provides an access port device comprising a first sleeve of flexible material including a proximal end and a distal end and forming an access opening positionable in an incision in a patient's body. The access port device also includes a leakage-minimizing feature for minimizing gas leakage from between the first sleeve and the patient's body. The leakage minimizing feature includes an outer annular sealing device attached to the proximal end of the first sleeve, an inner annular sealing device attached to the distal end of the first sleeve for abutting and sealingly engaging an inner surface of a body cavity of the patient, and a seal force applying device for causing leakage gas between the first sleeve and the patient's body to apply a sealing force against the outer annular sealing device to bias the outer annular sealing device toward the patient. The access port device may further include a second sleeve of flexible material positioned adjacent the first sleeve and an inflatable chamber formed between the first and second sleeves. The sealing force applying device may further include the flexible annular extension and the inner biasing surface. The sealing force applying device may further include sizing the first sleeve to fit closely to the patient's cavity wall to cause a sealing force to bias the outer annular sealing device into scaling engagement with the patient's skin. The sealing force applying device may further include the annular overhang, gas chamber and outer biasing surfaces mentioned hereinabove.
- The present invention also provides an access port device for use in surgery which comprises a sleeve of flexible material, a non adhesive outer annular sealing device attached to a proximal end of the sleeve and adapted to create a non adhesive, substantially gas tight seal adjacent the patient's body to prevent gas flow from the patient's body and an inner annular sealing device attached to the distal end of the sleeve to secure the access port device internally to the patient. In this case, the access component is sealingly mounted on the outer annular sealing device and extendable into the access opening. The access component may be removably mounted on the outer annular sealing device, which may, in turn, include the flexible annular extension.
- According to one aspect of the invention there is provided a surgical device for use in minimally invasive surgery of the type using an inflated body cavity accessible to a surgeon through an incision, the device being formed to define a sleeve access port for insertion into the incision and having:—
- mounting means for locating and securing the device in position on a patient;
- sealing means to prevent substantial leakage of gas from the body cavity; and
- a retractor to limit contact between the sleeve and the incision when in use.
- Thus, contact with the incision is limited thereby reducing patient trauma and greatly improving the ease with which instruments or a surgeon's hand may be inserted.
- In one arrangement, the retractor is provided as a deformable tube.
- Preferably, the tube has at opposing ends a proximal ring and a distal ring.
- Preferably, the proximal and distal rings are formed for substantially airtight engagement with the sleeve and with the patient's abdomen.
- In one arrangement the or each ring incorporates an adhesive portion for fixing the ring in position.
- Preferably, the distal ring is formed for substantially airtight engagement with the sleeve and with the patient's internal abdominal wall.
- Ideally engagement between the proximal ring and sleeve is provided by a skirt carried on the sleeve and having a rim formed for releasable engagement to the ring.
- In one arrangement the ring and skirt are integrally formed.
- In one arrangement the skirt has an integrally formed glove or pocket for receiving a surgeons hand or surgical instrument.
- In one arrangement the skirt has a recessed or undercut receiver formed for engagement with a ring or a surgeons glove.
- In a preferred embodiment, the proximal ring incorporates a flexible gas retaining ring extending down from the proximal ring and formed for engagement against a patients skin when in position to define a gas retention chamber.
- Preferably, the gas retaining ring is inflatably movable between an insertion position and an in use position.
- In one arrangement, the gas retaining ring is provided by a collapsible bellows ring.
- In a particularly preferred embodiment, the device incorporates a retractor-positioning device.
- Ideally, the retractor-positioning device has means for releaseably engaging the proximal ring and the distal ring.
- Preferably, the means for engaging the proximal ring and the distal ring are movable between a retracted position and a locating position.
- Ideally, the means for engaging the proximal ring and the distal ring are telescopically movable.
- According to another aspect of the invention the proximal ring supports a flexible web, said web in turn defining a hole for receiving the sleeve.
- According to a further aspect of the invention the device incorporates a collapsible support scaffold, the scaffold being formed for supporting the device in an operative state and collapsible to provide a surgeon free access to the incision.
- The invention will now be described more particularly with reference to the accompanying drawings, which show, by way of example only, some embodiments of a surgical device in accordance with the invention, in which:—
- FIG. 1 is a perspective view of a first embodiment of the access port device of the present invention;
- FIG. 2 is a perspective view of the bottom of the first embodiment of FIG. 1;
- FIG. 3 is a plan view of the opposed bands of the exit opening seal;
- FIG. 4 is a perspective view of one of the bands of the exit opening seal;
- FIG. 5 is a cross sectional side view of the access port of the first embodiment as applied to a patient prior to access during, surgery;
- FIG. 6 is a cross sectional side view similar to FIG. 5 during use with access by a surgeon's arm;
- FIG. 7 is a cross sectional view of a second embodiment of the present invention in use;
- FIG. 8 is a cross sectional view of a third embodiment of the present invention including a seal force applying feature;
- FIG. 9 is a cross sectional view of the device of FIG. 8 during use but without showing an access component attached;
- FIG. 10 is a sectional view of a surgical device in accordance with the invention in position on a patient;
- FIG. 11 is front view of a sleeve forming part of the invention;
- FIG. 12 is a perspective view of a retractor forming part of the invention;
- FIG. 13 is a front view of a retractor-positioning device forming part of the invention;
- FIG. 14 is a sectional view of another embodiment of a surgical device in accordance with the invention in position on a patient;
- FIG. 15 is a sectional view of the device of FIG. 14 with a surgeon's hand inserted;
- FIG. 16 is a sectional view of a further embodiment of a surgical device in accordance with the invention in position on a patient;
- FIG. 17 is a sectional view of the device of FIG. 16 with a surgeons hand inserted;
- FIG. 18 is a sectional view of another surgical device in accordance with the invention in position on a patient;
- FIG. 19 is a sectional view of a further surgical device in accordance with the invention in position on a patient;
- FIG. 20 is a top view of the surgical device of FIG. 19;
- FIG. 21 is a sectional view of another surgical device in accordance with the invention in an insertion position on a patient; and
- FIG. 22 is a sectional view of the surgical device of FIG. 21 in an operating position on a patient.
- Referring to FIGS. 1-6, there is shown a first embodiment of the access port device of the present invention, indicated generally at10, for permitting access to a patient's body cavity during surgery while maintaining body cavity pressure.
Access port device 10 generally includes afirst sleeve 12 of flexible material including aproximal end 14 and adistal end 16, a securingdevice 18 attached to thedistal end 16 offirst sleeve 12, asecond sleeve 20 attached toproximal end 14 offirst sleeve 12 and athird sleeve 22 of flexible material attached to at least one of thefirst sleeve 12 andsecond sleeve 20. As described hereinbelow, this arrangement can be effectively and sealingly attached to a patient's body surrounding an incision to permit the insertion of a hand into a patient's body cavity while simply and effectively maintaining pneumoperitoneum as desired throughout a laproscopic surgery procedure. - Referring to FIGS. 1 and 5, both
first sleeve 12 andsecond sleeve 20, extend annularly withsecond sleeve 20 positioned insidefirst sleeve 12.Second sleeve 20 is preferably integrally formed atproximal end 14 offirst sleeve 12, i.e.second sleeve 20 is an integral extension offirst sleeve 12 turned inwardly onto itself. Securingdevice 18 includes aflange 24 extending transversely fromdistal end 16 for connection to either the patient's skin or wrapping material covering the patient's skin. Preferably, theflange 24 includes an adhesive, such as a solid or a liquid adhesive, for adhering to the wrapping material or skin to securely and sealingly affix theaccess port device 10 to the patient. Bothfirst sleeve 12 andsecond sleeve 20 may each be formed from opposing sheets of flexible material fused together alongopposite edges edges 26 being positioned outwardly from edges 28. As shown in FIG. 5, an inflatable chamber 30 (FIG. 5) is positioned betweenfirst sleeve 12 andsecond sleeve 20 for receiving pressurized gas via an inlet valve 32 (FIG. 1).Inlet valve 32 is provided onfirst sleeve 12 so thatinflatable chamber 30 can be inflated prior to the insertion of a surgeon's hand into the device as shown in FIG. 5. The gas pressure ininflatable chamber 30 is maintained by gas flowing from the body cavity of the patient during pneumoperitoneum. Thus, after the inflation ofchamber 30 throughvalve 32,valve 32 is closed. - Referring to FIG. 5, the
second sleeve 20 forms anentry opening 34 positioned adjacent theproximal end 14 offirst sleeve 12 and anexit opening 36 positioned a spaced distance fromentry opening 34.Second sleeve 20 has a length sufficient to extend throughfirst sleeve 12 and through an incision 2 formed in a patient's body 4 so as to be positioned in the patient's body cavity whenaccess port device 10 is applied to the patient as shown in FIG. 5.Access port device 10 further includes an elongatedexit opening seal 38 mounted onsecond sleeve 20 and extending acrossexit opening 36. Elongatedexit opening seal 38 is positioned along an exit opening seal plane, indicated at 40, which extends through entry opening 34 and exit opening 36 ofsecond sleeve 20. Elongatedexit opening seal 38 includes a pair of resilientopposed bands 42 as clearly shown in FIGS. 2, 3 and 5. Eachband 42 is positioned in a respectiveelongated cuff 44 formed in the distal end ofsecond sleeve 20.Bands 42 are formed of a resilient flexible material, i.e. plastic, which permits the bands to be flexed outwardly to create an exit opening for receiving a surgeon's hand and/or an instrument. Each of thebands 42 may also include a cushioning strip made from, for example, foam, to provide more comfort to the surgeon's hand/wrist during use. In the relaxed state, thebands 42 are biased together bringing the opposing faces ofsecond sleeve 20 into mutual contact and hence forming an exit opening seal. The geometry ofbands 42 is such that, when presented at right angles to the incision 2, it is possible for the bands to pass through the incision. Once in position within the patient's body cavity,bands 42 align themselves nominally parallel to the abdominal wall as shown in FIG. 5. Thus, elongatedexit opening seal 38 functions to form an initial seal preventing the escape of gas from the body cavity to the atmosphere via the exit opening, 36 ofsecond sleeve 20. -
Access port device 10 also includes a second sleeve retraction prevention feature, indicated generally at 46, for preventing inadvertent retraction ofsecond sleeve 20 from incision 2. It has been found that during use of conventional access port devices, the insulflation pressure in the patient's body cavity acts to undesirably invert the inner sleeve and move the inner sleeve outwardly through the incision. Second sleeveretraction prevention feature 46 of the present invention effectively prevents elongatedexit opening seal 38, and thus the distal end ofsecond sleeve 20, from passing outwardly through incision 2 under the force of the insulflation pressure. As shown in FIGS. 2-5, secondsleeve retraction feature 46 includes at least onetransverse wing 48 extending from the distal end ofsecond sleeve 20 transverse to exit opening seal plane 40 (FIG. 5). Specifically, in the preferred embodiment, second sleeveretraction prevention feature 46 includes atransverse wing 48 formed at each end of each of theopposed bands 42 as clearly shown in FIG. 3.Transverse wings 48 are integrally formed onopposed bands 42 and extend transversely generally parallel to the under surface of the patient's body defining the body cavity. Thetransverse wings 48 extend through respective slits formed in thecuff 44 ofsecond sleeve 20 thereby securingbands 42 withincuff 44. During use, once the distal end ofsecond sleeve 20 has been inserted through incision 2 into the patient's body cavity,transverse wings 48 will prevent inadvertent movement of elongatedexit opening seal 38 through incision 2 by abutting the under surface of the patient's body forming the body cavity as shown in FIG. 6. Even prior to insertion of a surgeon's arm into theaccess port device 10, when insulflation pressure causes movement ofexit opening seal 38 toward incision 2,transverse wings 48 will abut the incision and preventexit opening seal 38 from passing through incision 2. As a result, second sleeveretraction prevention feature 46 creates a more reliable and effectively usable access port device, which can be easily and simply utilized without subsequent repositioning ofsecond sleeve 20 after initial setup. - Importantly,
access port device 10 of the present invention also includes thethird sleeve 22 positioned within, and attached to,second sleeve 20. In the preferred embodiment,third sleeve 22 extends from entry opening 34 ofsecond sleeve 20 to a locationadjacent exit opening 36.Third sleeve 22 is attached to, or integrally formed on,second sleeve 20 at afirst attachment 50adjacent entry opening 34.First attachment 50 extends annularly to prevent gas from escaping from the space betweensecond sleeve 20 andthird sleeve 22.Third sleeve 22 is also attached tosecond sleeve 20 at asecond attachment 52 located a spaced distance fromfirst attachment 50 alongthird sleeve 22.Second attachment 52 occurs at a point close to a distal end ofthird sleeve 22 so as to maintain the distal end in the inner space ofsecond sleeve 20. For example,second attachment 52 may be in the form of two separate weld lines positioned on opposite sides ofthird sleeve 22. Aninflatable gas chamber 60 is formed betweensecond sleeve 20 andthird sleeve 22, which captures gas leaking by elongatedexit opening seal 38. The inflation ofchambers entry opening seal 62 by forcing the opposing surfaces ofthird sleeve 22 into abutment prior to use as shown in FIG. 5. Thus the combination ofexit opening seal 38 andentry opening seal 62 effectively minimizes gas leakage throughaccess port device 10 so as to retain pneumoperitoneum. - Importantly,
third sleeve 22 includes an annularelastic band 54 for sealingly engaging a surgeon's hand, wrist or arm positioned inthird sleeve 22 as shown in FIG. 6. In the preferred embodiment, annularelastic band 54 is positioned at the distal end ofthird sleeve 22. Annularelastic band 54 is sized and designed with sufficient elasticity so as to permit insertion of hands and arms of varying sizes while ensuring a substantially gas tight seal betweenelastic band 54 and the arm. It will be understood that the size and elasticity of the access port andelastic band 54 can be varied to accommodate, for instance only one finger rather than the entire hand and arm of the surgeon. Also, the size and elasticity of the access port andelastic band 54 may be designed to accommodate instruments of various sizes while still substantially preventing leakage from the patient's body cavity through theaccess port device 10. It should be noted that the various sleeves ofaccess port device 10 may be manufactured from any flexible, gas impermeable, sterilizable, biocompatible material, for instance polyethylene. - Reference is now made to FIG. 7 which discloses a second embodiment of the present invention directed to an
access port device 100 including a first sleeve offlexible material 102 having aproximal end 104 for positioning external to a patient and adistal end 106 for positioning in a patient's body cavity.Access port device 100 includes an outerannular sealing device 110 attached toproximal end 104 offirst sleeve 102 and an innerannular sealing device 112 attached todistal end 106 offirst sleeve 102. Both outer and innerannular sealing devices annular sealing device 110 includes a biasingsurface 114 facing, outwardly away from the patient's body 4.Proximal end 104 offirst sleeve 102 is sealingly attached to biasingsurface 114 around the entire circumference of outerannular sealing device 110. Likewise, thedistal end 106 offirst sleeve 102 is sealingly attached to innerannular scaling device 112 in any conventional manner creating a secure sealed connection. Innerannular sealing device 112 may be a ring formed of any flexible, resilient material.Biasing surface 114 is preferably formed on a flexibleannular extension 116 of outer annular sealing device 1 10. -
Access port device 100 also includes an access component 1 18 sealingly engaging outerannular sealing device 110 and extendable into the access opening formed byfirst sleeve 102. Preferably, access component 1 18 includes aflexible ring 120 designed for removable mounting in anannular groove 122 formed in outer annular sealing device 1 10.Flexible ring 120 is preferably formed of an elastic, resilient material to permit the ring to be stretched and moved intogroove 122 and, if desired, expanded for removal fromgroove 122. Of course,flexible ring 120 is designed with a circumference and sized relative to the size of outer annular sealing device 1 10 such that stretching of the ring is required for engagingannular groove 122 so that the ring is biased into sealing engagement with outerannular sealing device 110 inannular groove 122. In the present embodiment,access component 118 also includes a sleeve offlexible material 124 extending fromflexible ring 120 and having a length sufficient to extend through the access opening formed byfirst sleeve 102 and innerannular sealing device 112 as shown in FIG. 7. In the embodiment shown, the sleeve offlexible material 124 may include an integrated glove to form asleeved glove 126 for receiving a surgeon's hand/arm. As shown in FIG. 7, aninflatable chamber 128 is formed betweenfirst sleeve 102 and the sleeve offlexible material 124 for containing gas flowing through the gap betweensleeved glove 126 andfirst sleeve 102 thereby retaining pneumoperitoneum. - The
first sleeve 102 is sized to permit innerannular sealing device 112 to be effectively positioned underneath the patient's cavity wall 4 and outer annular sealing device 1 10 to be positioned on the outer surface of the patient whilefirst sleeve 102 fits closely to the patient's cavity wall. As a result, inner annular sealing device 1 10 is biased tightly against the inner surface of the patient's body cavity wall 4 whilefirst sleeve 102 exerts a downward force on outerannular sealing device 110. In addition, since biasing surface 1 14 faces outwardly away from the patient's body cavity wall 4, gas pressure in the inflatable chamber creates gas pressure sealing forces acting on biasing surface 1 14 which tends to bias outer annular sealing device 1 10 against the patient. Consequently, an effective seal is achieved between outer annular sealing device 1 10 and the patient's body. Therefore, by sizingfirst sleeve 102 appropriately and utilizing biasing surface 1 14, the presentaccess port device 100 creates an effective seal for minimizing gas leakage from the patient's body cavity through the space betweenaccess port device 100 and the patient's body cavity wall 4. - FIGS. 8 and 9 disclose a preferred embodiment of an access port device indicated generally at150, which is similar to the access port device disclosed in the embodiment of FIG. 7 except for a modified outer
annular sealing device 152, which creates a more effective seal against a patient's body in many applications. Similar to the embodiment of FIG. 7,access port device 150 may include an access component (not shown), such as thesleeved glove 126 of the previous embodiment, which can be sealingly mounted inannular groove 154 of outerannular sealing device 152. Also,access port device 150 includes an inner annular sealing device orring 156 andflexible sleeve 158 forming an access opening, 160 similar to the embodiment of FIG. 7. However, in the present embodiment,access port device 150 includes aleakage minimizing device 153 for minimizing gas-leakage from betweensleeve 158 and the patient's body, which includes a sealingforce applying feature 159 including outerannular sealing device 152 and aleakage gas chamber 162 for receiving leakage gas leaking betweenaccess port device 150 and the patient. In addition, outerannular sealing device 152 includes a flexibleannular extension 164 having a generally flat shape and extending radially inwardly to form a circumferentially unsupported annular floatingedge 166. Flexibleannular extension 164 also includes aninner biasing surface 168 facing outwardly from the patient and exposed to gas in thegas chamber 162. The outerannular sealing device 152 further includes anoverhang 170, which in part formsgas chamber 162 and includes anouter biasing surface 172. Thesleeve 158 is sealingly attached toouter biasing surface 172. Therefore,gas chamber 162 is formed between flexibleannular extension 164 andoverhang 170. It should be noted thatoverhang 170 may be designed with a sufficient length so as to abut the patient's skin when placed on the patient as shown in FIG. 9. - When applied to a patient's body as shown in FIG. 9, the sealing
force applying feature 159 effectively minimizes leakage betweenaccess port device 150 and the patient's body in the following manner. When the device is attached to the patient, innerannular sealing device 156 lies tight against the inner surface of the patient's body cavity, i.e. abdomen. Theflexible sleeve 158 is sized, as discussed hereinabove with respect to the embodiment of FIG. 7, so as to exert a downward force on outerannular sealing device 152 causing compression of flexibleannular extension 164 against the patient's skin or an intermediate material. The access component of FIG. 7 may then be attached toannular groove 154 by stretchingflexible ring 120 around outerannular sealing device 152 so as to positionring 120 ingroove 154. If the access component is in the form ofsleeved glove 126, the surgeon would place the glove on his hand by inserting his arm into the sleeved glove prior to mounting the access component on outerannular sealing device 152. After placing the glove on his hand,flexible ring 120 would then be placed inannular groove 154 while the surgeon's arm is extended through access opening 160. Also, before attaching thesleeve glove 126 to outerannular sealing device 152, the overall length of thesleeve glove 126 may be adjusted by rolling or unrolling theflexible ring 120 to thereby take-up or release the flexible material fromring 120. - During use, with the patient's body cavity deliberately pressurized by introducing gas as shown in FIG. 9, any leakage gas from the patient's body cavity, leaking between inner
annular sealing device 156 and the patient, will flow in the space betweensleeve 158 and the patient towardgas chamber 162. This leakage gas will be trapped ingas chamber 162. Gas pressure induced biasing forces are then generated oninner biasing surface 168 so as to bias flexibleannular extension 164 into sealing abutment against the patient's skin thereby creating an enhanced seal between flexibleannular extension 164 and the patient. The greater the gas pressure ingas chamber 162, the greater the sealing force between flexibleannular extension 164 and the patient's skin. As a result, increased leakage intogas chamber 162 not only maintains but tends to enhance the seal between outerannular sealing device 152 and the patient's skin. In the event flexibleannular extension 164 lifts away from the patient's skin, innerannular sealing device 156 will remain in contact with the patient's skin thereby maintaining a seal. Also, the gas pressure in the inflatable chamber formed betweensleeve 158 and the access component imparts gas pressure induced forces onouter biasing surface 172 tending tobias overhang 170 into abutment with the patient's skin thereby further assisting in sealing against leakage. When it is desired to remove thesleeved glove 126, the surgeon's hand may simply be pulled outwardly and removed fromsleeved glove 126 or theflexible ring 120 may be first released from outerannular sealing devices annular sealing device 110 due to the effect ofleakage minimizing device 153 is sufficient to avoid the use of adhesive betweendevice 153 and the patient, thereby creating a non adhesive sealed access port. If an adhesive is used, which is more likely in the embodiment of FIG. 7, a liquid adhesive may be applied. - Referring to FIGS.10 to 13 there is illustrated a surgical device according to the invention, indicated generally by the
reference numeral 2001. Thesurgical device 2001 is formed for use in minimally invasive surgery of the type using an inflated body cavity indicated generally by thereference numeral 2002. Thecavity 2002 is accessible to a surgeon through an access port, defined by asleeve 2004, which passes through an incision in a patient'sabdominal wall 2003. Thesleeve 2004 is connected to a retractor indicated generally by thereference numeral 2005 which atraumatically retracts the incision. Theretractor 2005 is pressed against the incision to protect it from contact as a surgeon introduces or withdraws a hand, surgical device or body tissue. Theretractor 2005 is inserted using a retractor-positioning device indicated generally as 2006, which will be described in more detail below. - Referring now to FIG. 11, sealing means is provided for the
device 2001 by thesleeve 2004, which is in this case of the type known and marketed by Medtech Ltd., as an INTROMIT R sleeve. Thesleeve 2004 has anentrance opening 2041. A flexible elongateinner sleeve 2042 extends downwardly from theopening 2041 and terminates away from the opening with ataut valve 2043. Afeathered valve 2044 is also suspended from the opening inside theinner sleeve 2042. Thesleeve 2004 also has askirt 2045 extending downwardly from theopening 2041 outside theinner sleeve 2042. Theskirt 2045 has aflexible rim 2046 for connection in an airtight manner to theretractor 2005. - The
retractor 2005 as shown in FIG. 12 has aproximal ring 2051 for receiving theflexible rim 2046 and adistal ring 2052 connected to theproximal ring 2051 with a flexible incision engagingretractor wall 2053. Theproximal ring 2051 and thedistal ring 2052 are positioned on the patient using the retractor-positioning device 6 as shown in FIG. 13. The retractor-positioning device 2006 has means for engaging theproximal ring 2051 provided by a pair of oppositely directedtelescopic arms 2061 carried on anintroduction shaft 2063. Theshaft 2063 also carries means for engaging the distal ring provided in this case by pivotally moveabledistal arms 2063. - In use, an incision is made in the
abdominal wall 2003. Thedistal ring 2052 and theproximal ring 2051 are engaged on therespective arms arms arms shaft 2063. Theproximal ring 2051 is then positioned on the patient by telescopically extending thearms 2061. Thedistal arms 2062 and portion of theshaft 2063 are then passed through the incision into the cavity 2000. Thedistal ring 2052 is moved into position when in thecavity 2002 by pivoting the oppositely directedarms 2062 away from theshaft 2063 so that thering 2052 surrounds the incision. Thering 2051 is disengaged from thearms 2061 causing it to open against the abdomen wall. Thearms 2062 are disengaged from thering 2052 by pulling upward. By positioning the retractor in this way a variety of incision depths can be accommodated. - When the
retractor 2005 has been positioned on the patient theflexible rim 2046 is then deformed by the surgeon to engage on and around theproximal ring 2051 in an airtight manner. The body cavity is then inflated and when inflated the flexible elongateinner sleeve 2042 is allowed to extend downwardly from theopening 2041 with thetaut valve 2043 inserted into the body cavity. Thefeathered valve 2044 is also suspended from theopening 2041 inside theinner sleeve 2042 and above the incision. The gas pressure within the cavity inflates theskirt 2045. The seal of therim 2046 and thering 2051 prevents air pressure from escaping. The surgeon can then operate on the patient and the constant and controlled distance between the sleeve and the retractor prevents unnecessary contact with the incision thereby reducing overall patient trauma and providing the surgeon with a greater range of movement unencumbered by the incision wall. - Referring now to FIGS. 14 and 15 there is illustrated another surgical device according to the invention, indicated generally by the
reference numeral 2100 in which parts similar to those described in FIGS. 10 to 13 are identified by the same reference numerals generally. In this embodiment, the device has an extendedproximal ring 2151. Theproximal ring 2151 supports a highlyflexible web 2152 which in turn defines an opening through which asleeve 2153 passes. Thesleeve 2153 is terminated in ataut valve 2043 above the incision. The operation of this device is similar to that described above. It will be appreciated that the retractor may also be manually positioned on the operating site. By providing the device in this way the taut valve is housed above the incision thereby allowing a surgeon greater visibility as well as eliminating the need to insert any valves within the body cavity. Additionally, the valve will not travel with the surgeon's wrist during insertion and as a low sealing force is required, the surgeon suffers little compression on the arm during insertion. - Referring now to FIGS. 16 and 17 there is illustrated a further surgical device according to the invention, indicated generally by the reference numeral700 in which parts similar to those described in FIGS. 10 to 15 are identified by the same reference numerals generally. In this embodiment the
skirt 2045 is supported by acollapsible scaffold structure 701. Thescaffold structure 701 is in turn carried on theproximal ring 2051. - In use, when the
device 701 has been positioned on a patient theskirt 2045 is supported by the structure 701 (See FIG. 16). As a surgeon inserts a hand or instrument into thesleeve 2004 the structure collapses (See FIG. 17) to provide free access and good operating site visibility for the surgeon. - FIG. 18 illustrates another a surgical device according to the invention, indicated generally by the
reference numeral 1200. In this embodiment ataut valve 1201 is formed from an elasticised portion of atapered sleeve 1204. Oppositely directed connecting limbs 1202 extend outwardly from thevalve 1201 and attach to aproximal ring 1203. In use, the limbs 1202 stretch thesleeve 1204 causing thesleeve 1204 to narrow thetaut valve 1201 and seal. When a surgeon inserts a hand or surgical instrument the limbs 1202 are deflected to allow access. When the hand or instrument is removed, the limbs re-establish the seal as before. - Referring now to FIGS. 19 and 20 there is illustrated another surgical device according to the invention, indicated generally by the
reference numeral 1300 in which parts similar to those described in FIGS. 10 to 18 are identified by the same reference numerals generally. In this embodiment, thesleeve 2004 extends downwardly from an oval semi-rigidproximal ring 1301. Thering 1301 in turn is carried on aninflatable ring 1302, which is formed for inflation by aninflator 1303. In use, the device is positioned on a patient and thering 1302 is inflated. The degree of retraction required is controlled by the pressure in thering 1302 as greater pressure will force thesleeve 2004 against the incision. As the proximal, distal and inflatable rings are oval even pressure is applied at all points during retraction greatly reducing patient trauma. The inflation of thering 1302 draws thesleeve 2004 against the incision and prevents loss of pneumoperitoneum. - FIGS. 21 and 22 illustrate another surgical device according to the invention indicated as1500, which is similar in operation to the embodiment shown in FIGS. 19 and 20. In this
embodiment ring 1302 is replaced with a compressible bellowsring 1501. The bellows ring 1501 has a one-way valve 1502. In use, the compressed bellows ring 1501 is positioned on a patient. The ring is drawn up to allow air to inflate the bellows ring 1501 through thevalve 1502. This inflation retracts the incision to the required degree and thevalve 1502 prevents the air from escaping and the incision from closing. The incision can be released only by activation of thevalve 1502 by the surgeon. - Thus, by the relatively simple expedient of providing an integrated wound or incision retractor in the access port, trauma is reduced thereby greatly easing patient suffering and accelerating postoperative recovery. Additionally, the invention provides a greater range of movement to the surgeon allowing the device to be used in a wider variety of surgical applications.
- It will of course be understood that the invention is not limited to the specific details described herein, which are given by way of example only, and that various modifications and alterations are possible within the scope of the apended claims.
Claims (51)
1-13. (Cancelled without prejudice).
14. An access port device for use in surgery, comprising:
a sleeve of flexible material including a proximal end and a distal end, and forming an access opening positionable in an incision in a patient's body;
an outer annular sealing device attached to said proximal end of said sleeve to secure the access port device externally to a patient;
an inner annular sealing device attached to said distal end of said sleeve to secure the access port device internally to the patient;
an access component removable connected to said outer annular sealing device, said access component including a flexible ring removable engaging said outer annular sealing device.
15. An access port device as claimed in claim 14 , wherein said access component includes a sleeved glove.
16. An access port device as claimed in claim 14 , wherein said access component includes an access sleeve of flexible material, said access sleeve including an integral glove for receiving a surgeon's hand, said access sleeve and glove having a length sufficient to extend from said flexible ring through said access opening.
17. An access port device as claimed in any of claims 14 to 16 , wherein said outer annular sealing device includes an annular groove for receiving said flexible ring.
18. An access port device as claimed in claim 17 , wherein said annular groove is formed in an outer peripheral surface of said outer annular sealing device.
19. An access port device as claimed in claim 14 , wherein said access component further includes an access sleeve of flexible material positioned adjacent to said sleeve, the device further including an inflatable chamber formed between said sleeve and said access sleeve.
20. An access port device as claimed in claim 19 , wherein said outer annular sealing device further includes a flexible annular extension extending radially inwardly from said outer annular device, said annular extension including a inner annular biasing surface facing outwardly from the patient's body.
21. An access port device as claimed in claim 20 , wherein said annular extension includes a circumferentially unsupported annular floating edge.
22. An access port device as claimed in claim 20 or claim 21 , further including a gas chamber positioned adjacent said inner annular biasing surface to collect gas leaking between said sleeve and the patient's body.
23. An access port device as claimed in claim 20 , wherein said flexible annular extension is generally flat.
24. An access port device as claimed in claim 22 , wherein said outer annular sealing device includes an upper annular overhang positioned opposite and spaced from said flexible annular extension, said gas chamber being positioned between said upper annular overhang and said flexible annular extension.
25. An access port device as claimed in claim 20 , said outer annular sealing device further including an outer biasing surface facing said inflatable chamber to cause gas pressure in said inflatable chamber to apply a gas pressure sealing force against said outer biasing surface to bias said outer annular sealing device into abutment with the patient's outer surface.
26. An access port device for use in surgery, comprising:
a first sleeve of flexible material including a proximal end and a distal end, and forming an access opening positionable in an incision in a patient's body; and
a leakage minimizing means for minimizing gas leakage from between said first sleeve and the patient's body, said leakage minimizing means including an outer annular sealing device attached to said proximal end of said first sleeve, an inner annular sealing device attached to said distal end of said first sleeve for abutting and sealingly engaging an inner surface of a body cavity of the patient, and a sealing force applying means for causing leakage gas between said first sleeve and the patient's body to apply a sealing force against said outer annular sealing device to bias said outer annular sealing device toward the patient.
27. An access port device as claimed in claim 26 , further including a second sleeve of flexible material positioned adjacent to said first sleeve and an inflatable chamber formed between said first sleeve and said second sleeve.
28. An access port device as claimed in claim 27 , wherein said sealing force applying means includes a flexible annular extension extending radially inwardly from said outer annular sealing device and an inner biasing surface facing outwardly away from the patient's body.
29. An access port device as claimed in claim 28 , wherein said annular extension includes a circumferentially unsupported annular floating edge.
30. An access port device as claimed in any of claims 26 to 29 wherein said sealing force applying means further includes a leakage gas chamber means positioned adjacent said outer annular sealing device for collecting gas leakage between said first sleeve and the patient's body.
31. An access port device as claimed in claim 28 , wherein said sealing force applying means further includes a gas chamber positioned adjacent said inner biasing surface to collect gas leaking between said first sleeve and the patient's body.
32. An access port device as claimed in claim 31 , wherein said flexible annular extension is generally flat.
33. An access port device as claimed in claim 32 , wherein said outer annular ring includes an upper annular overhang positioned opposite and spaced from said flexible annular extension, said gas chamber being positioned between said upper annular overhang and said flexible annular extension.
34. An access port device as claimed in claim 26 , wherein said leakage minimizing means includes sizing said first sleeve to fit closely to the patient's cavity wall to cause a sealing force to bias said outer annular sealing device into sealing engagement with the patient's skin.
35. An access port device as claimed in claim 33 , wherein sealing force applying means further includes an outer biasing surface formed on said overhang and adapted to receive gas pressure biasing forces tending to bias said overhang into abutment with the patient's outer surface.
36. An access port device for use in surgery, comprising:
a sleeve of flexible material including a proximal end and a distal end, and forming an access opening positionable in an incision in a patient's body;
a non adhesive outer annular sealing device attached to said proximal end of said sleeve and adapted to create a non adhesive, substantially gas-tight seal adjacent the patient's body to prevent gas flow from the patient's body;
an inner annular scaling device attached to said distal end of said sleeve to secure the access port device internally to the patient; and
an access component sealingly mounted on said outer annular sealing device and extendable into said access opening.
37. An access port device as claimed in claim 36 , wherein said access component is removably mounted on said outer annular sealing device.
38. The access port device of claim 37 , wherein said non adhesive outer annular sealing device includes a flexible annular extension extending radially inwardly and an inner biasing surface formed on said flexible annular extension and facing outwardly away from the patient's body.
39. An access port device as claimed in claim 38 , wherein said annular extension includes a circumferentially unsupported annular floating edge.
40. An access port device as claimed in claim 38 , further including a gas chamber positioned adjacent said inner biasing surface to collect gas leaking between said sleeve and the patient's body.
41. An access port device as claimed in claim 37 , wherein said flexible annular extension is generally flat.
42. (Cancelled without prejudice).
43. A surgical device for use in minimally invasive surgery of the type using an inflated body cavity accessible to a surgeon through an incision, the device being formed to define a sleeve access port for insertion into the incision and having:
mounting means for locating and securing the device in position on a patient;
sealing means to prevent substantial leakage of gas from the body cavity; and
a retractor to limit contact between the sleeve and the incision when in use.
44. A surgical device as claimed in claim 43 wherein the retractor is provided as a deformed tube.
45. A surgical device as claimed in claim 44 wherein the tube has at opposing ends a proximal ring and a distal ring.
46. A surgical device as claimed in claim 45 wherein the proximal and distal rings are formed for substantially airtight engagement with the sleeve and with the patient's abdomen.
47. A surgical device as claimed in claim 46 wherein the ring incorporates an adhesive portion for fixing the ring in position.
48. A surgical device as claimed in any of claims 45 to 47 wherein the distal ring is formed for substantially airtight engagement with the sleeve and with the patient's internal abdominal wall.
49. A surgical device as claimed in claim 45 wherein engagement between the proximal ring and sleeve is provided by a skirt carried on the sleeve and having a rim formed for releasable engagement to the ring.
50. A surgical device as claimed in claim 49 wherein the ring and skirt are integrally formed.
51. A surgical device as claimed in claim 49 or 50 wherein the skirt has an integrally formed glove for receiving a surgeon's hand.
52. A surgical device as claimed in claim 49 wherein the skirt has an integrally formed pocket for receiving a surgical instrument.
53. A surgical device as claimed in claim 49 wherein the skirt has a recessed receiver formed for engagement with a ring.
54. A surgical device as claimed in claim 49 wherein the skirt has a recessed receiver formed for engagement with a surgeon's glove.
55. A surgical device as claimed in claim 45 wherein the proximal ring incorporates a flexible gas retaining ring extending down from the proximal ring and formed for engagement against a patient's skin when in position to define a gas retention chamber.
56. A surgical device as claimed in claim 55 wherein the gas retaining ring is inflatably movable between an insertion position and an in use position.
57. A surgical device as claimed in claim 55 or 56 wherein the gas retaining ring is provided by a collapsible bellows ring.
58. A surgical device as claimed in claim 45 wherein the device incorporates a retractor-positioning device.
59. A surgical device as claimed in claim 45 wherein the retractor-positioning device has means for releaseably engaging the proximal ring and the distal ring.
60. A surgical device as claimed in claim 58 wherein the means for engaging the proximal ring and the distal ring are movable between a retracted position and a locating position.
61. A surgical device as claimed in claim 58 or claim 59 wherein the means for engaging the proximal ring and the distal ring are telescopically movable.
62. A surgical device as claimed in claim 45 wherein the proximal ring supports a flexible web, said web in turn defining a hole for receiving the sleeve.
63. A surgical device as claimed in wherein the device incorporates a collapsible support scaffold, the scaffold being formed for supporting the device in an operative state and collapsible to provide a surgeon free access to the incision.
Priority Applications (1)
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IE19990795A IE990795A1 (en) | 1999-07-30 | 1999-09-24 | Hand Access Port Device |
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Cited By (94)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20050059865A1 (en) * | 2003-09-17 | 2005-03-17 | Applied Medical Resources Corporation | Surgical instrument access device |
US20080021359A1 (en) * | 2006-07-18 | 2008-01-24 | Beckman Andrew T | Roll-up wound protector with asymmetic ring |
WO2008076798A1 (en) * | 2006-12-15 | 2008-06-26 | Ethicon Endo-Surgery, Inc | Resiliently supported seal cap for hand assisted laparoscopic surgical procedures |
US20090093683A1 (en) * | 2007-10-05 | 2009-04-09 | Tyco Healthcare Group Lp | Surgical portal kit for use in single incision surgery |
US7650887B2 (en) | 2002-06-05 | 2010-01-26 | Applied Medical Resources Corporation | Wound retractor |
US20100100043A1 (en) * | 2007-10-05 | 2010-04-22 | Racenet Danyel J | Flexible Access Device For Use In Surgical Procedure |
US7704207B2 (en) | 2005-10-14 | 2010-04-27 | Applied Medical Resources Corporation | Circular surgical retractor |
US20100113882A1 (en) * | 2008-10-30 | 2010-05-06 | Widenhouse Christopher W | Surgical access port with multilayered tortuous path seal |
US7749161B2 (en) | 2006-12-01 | 2010-07-06 | Ethicon Endo-Surgery, Inc. | Hand assisted laparoscopic device |
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US20110054258A1 (en) * | 2009-08-31 | 2011-03-03 | O'keefe Jonathan B | Foam port introducer |
US7951076B2 (en) | 2003-02-25 | 2011-05-31 | Applied Medical Resources Corporation | Surgical access system |
US20110201892A1 (en) * | 2010-02-12 | 2011-08-18 | Fiona Middlemiss Haig | Expandable thoracic access port |
US8016755B2 (en) | 2000-10-19 | 2011-09-13 | Applied Medical Resources Corporation | Surgical access apparatus and method |
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US20110319719A1 (en) * | 2010-02-12 | 2011-12-29 | O'prey Cormac | Thoracic access port |
US8109873B2 (en) | 2007-05-11 | 2012-02-07 | Applied Medical Resources Corporation | Surgical retractor with gel pad |
US8142354B1 (en) | 2007-10-30 | 2012-03-27 | Ethicon Endo-Surgery, Inc. | Laminated surgical access port |
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US8257251B2 (en) | 2009-04-08 | 2012-09-04 | Ethicon Endo-Surgery, Inc. | Methods and devices for providing access into a body cavity |
US8262568B2 (en) | 2008-10-13 | 2012-09-11 | Applied Medical Resources Corporation | Single port access system |
US8273017B1 (en) | 2007-10-30 | 2012-09-25 | Ethicon Endo-Surgery, Inc. | Surgical access port with ring actuated latching mechanism |
US8317690B2 (en) | 2009-03-31 | 2012-11-27 | Covidien Lp | Foam port and introducer assembly |
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US8480683B2 (en) | 2009-11-24 | 2013-07-09 | Covidien Lp | Foam introduction system including modified port geometry |
US8550992B2 (en) | 2010-12-20 | 2013-10-08 | Covidien Lp | Two-part access assembly |
US8668641B2 (en) | 2011-03-30 | 2014-03-11 | Covidien, LP | Surgical access assembly with sleeve and adjustable fastener |
US8703034B2 (en) | 2001-08-14 | 2014-04-22 | Applied Medical Resources Corporation | Method of making a tack-free gel |
US8740904B2 (en) | 2009-11-24 | 2014-06-03 | Covidien Lp | Seal anchor introducer including biasing member |
US8753267B2 (en) | 2011-01-24 | 2014-06-17 | Covidien Lp | Access assembly insertion device |
US8758236B2 (en) | 2011-05-10 | 2014-06-24 | Applied Medical Resources Corporation | Wound retractor |
US8795161B2 (en) | 2008-06-25 | 2014-08-05 | Covidien Lp | Button port |
USD712033S1 (en) | 2007-10-05 | 2014-08-26 | Covidien Lp | Seal anchor for use in surgical procedures |
US20140276437A1 (en) * | 2013-03-15 | 2014-09-18 | Applied Medical Resources Corporation | Trocar surgical seal |
US8845529B2 (en) | 2011-12-29 | 2014-09-30 | Covidien Lp | Surgical access assembly and method of use therefor |
US8932212B2 (en) | 2009-10-01 | 2015-01-13 | Covidien Lp | Seal anchor with non-parallel lumens |
US8968188B2 (en) | 2010-11-24 | 2015-03-03 | Covidien Lp | Expandable segmented and sectioned access assembly |
US9028403B2 (en) | 2012-01-19 | 2015-05-12 | Covidien Lp | Access port having rollable proximal end |
US9084594B2 (en) | 2012-01-10 | 2015-07-21 | The Board Of Trustees Of The Lealand Stanford Junior University | Methods for the prevention of surgical site infections |
USD738500S1 (en) | 2008-10-02 | 2015-09-08 | Covidien Lp | Seal anchor for use in surgical procedures |
US20150351795A1 (en) * | 2012-03-26 | 2015-12-10 | Covidien Lp | Surgical access assembly and method of use therefor |
US20160008081A1 (en) * | 2013-01-14 | 2016-01-14 | Kirk Promotion Ltd | Surgical assisting device |
US9271639B2 (en) | 2012-02-29 | 2016-03-01 | Covidien Lp | Surgical introducer and access port assembly |
US9289200B2 (en) | 2010-10-01 | 2016-03-22 | Applied Medical Resources Corporation | Natural orifice surgery system |
US9289115B2 (en) | 2010-10-01 | 2016-03-22 | Applied Medical Resources Corporation | Natural orifice surgery system |
US9451980B2 (en) | 2010-12-20 | 2016-09-27 | Covidien Lp | Hand access device |
US20170112484A1 (en) * | 2013-01-17 | 2017-04-27 | Abbott Cardiovascular Systems, Inc. | Access device for accessing tissue |
US9642608B2 (en) | 2014-07-18 | 2017-05-09 | Applied Medical Resources Corporation | Gels having permanent tack free coatings and method of manufacture |
US9707011B2 (en) | 2014-11-12 | 2017-07-18 | Covidien Lp | Attachments for use with a surgical access device |
US9717522B2 (en) | 2009-08-31 | 2017-08-01 | Applied Medical Resources Corporation | Multi-functional surgical access system |
US9949730B2 (en) | 2014-11-25 | 2018-04-24 | Applied Medical Resources Corporation | Circumferential wound retraction with support and guidance structures |
US9955960B2 (en) | 2011-02-26 | 2018-05-01 | Abbott Cardiovascular Systems, Inc. | Hinged tissue support device |
US9974564B2 (en) | 2013-03-14 | 2018-05-22 | Prescient Surgical, Inc. | Methods and devices for the prevention of incisional surgical site infections |
US10064649B2 (en) | 2014-07-07 | 2018-09-04 | Covidien Lp | Pleated seal for surgical hand or instrument access |
US10172641B2 (en) | 2014-08-15 | 2019-01-08 | Applied Medical Resources Corporation | Natural orifice surgery system |
US10327751B2 (en) | 2013-03-20 | 2019-06-25 | Prescient Surgical, Inc. | Methods and apparatus for reducing the risk of surgical site infections |
US10368908B2 (en) | 2015-09-15 | 2019-08-06 | Applied Medical Resources Corporation | Surgical robotic access system |
US10575840B2 (en) | 2015-10-07 | 2020-03-03 | Applied Medical Resources Corporation | Wound retractor with multi-segment outer ring |
US10674896B2 (en) | 2016-09-12 | 2020-06-09 | Applied Medical Resources Corporation | Surgical robotic access system for irregularly shaped robotic actuators and associated robotic surgical instruments |
US10675056B2 (en) | 2017-09-07 | 2020-06-09 | Covidien Lp | Access apparatus with integrated fluid connector and control valve |
US10792071B2 (en) | 2019-02-11 | 2020-10-06 | Covidien Lp | Seals for surgical access assemblies |
US10828065B2 (en) | 2017-08-28 | 2020-11-10 | Covidien Lp | Surgical access system |
US10932767B2 (en) | 2018-12-07 | 2021-03-02 | Covidien Lp | Surgical access assembly and method of use therefor |
US11000313B2 (en) | 2019-04-25 | 2021-05-11 | Covidien Lp | Seals for surgical access devices |
US11160543B2 (en) | 2020-02-13 | 2021-11-02 | Covidien Lp | Magnetic suture tab for free standing specimen bag |
US11160682B2 (en) | 2017-06-19 | 2021-11-02 | Covidien Lp | Method and apparatus for accessing matter disposed within an internal body vessel |
US11166748B2 (en) | 2019-02-11 | 2021-11-09 | Covidien Lp | Seal assemblies for surgical access assemblies |
US11259841B2 (en) | 2019-06-21 | 2022-03-01 | Covidien Lp | Seal assemblies for surgical access assemblies |
US11259840B2 (en) | 2019-06-21 | 2022-03-01 | Covidien Lp | Valve assemblies for surgical access assemblies |
US11357542B2 (en) | 2019-06-21 | 2022-06-14 | Covidien Lp | Valve assembly and retainer for surgical access assembly |
US20220218391A1 (en) * | 2021-01-11 | 2022-07-14 | Covidien Lp | Cannula assembly including a suction cup seal |
US11389193B2 (en) | 2018-10-02 | 2022-07-19 | Covidien Lp | Surgical access device with fascial closure system |
US11399865B2 (en) | 2019-08-02 | 2022-08-02 | Covidien Lp | Seal assemblies for surgical access assemblies |
US11413068B2 (en) | 2019-05-09 | 2022-08-16 | Covidien Lp | Seal assemblies for surgical access assemblies |
US11413065B2 (en) | 2019-06-28 | 2022-08-16 | Covidien Lp | Seal assemblies for surgical access assemblies |
US11432843B2 (en) | 2019-09-09 | 2022-09-06 | Covidien Lp | Centering mechanisms for a surgical access assembly |
US11446058B2 (en) | 2020-03-27 | 2022-09-20 | Covidien Lp | Fixture device for folding a seal member |
US11457949B2 (en) | 2018-10-12 | 2022-10-04 | Covidien Lp | Surgical access device and seal guard for use therewith |
US11464540B2 (en) | 2020-01-17 | 2022-10-11 | Covidien Lp | Surgical access device with fixation mechanism |
US11471142B2 (en) | 2013-03-15 | 2022-10-18 | Applied Medical Resources Corporation | Mechanical gel surgical access device |
US11523842B2 (en) | 2019-09-09 | 2022-12-13 | Covidien Lp | Reusable surgical port with disposable seal assembly |
US11529170B2 (en) | 2020-04-29 | 2022-12-20 | Covidien Lp | Expandable surgical access port |
US11541218B2 (en) | 2020-03-20 | 2023-01-03 | Covidien Lp | Seal assembly for a surgical access assembly and method of manufacturing the same |
US11576701B2 (en) | 2020-03-05 | 2023-02-14 | Covidien Lp | Surgical access assembly having a pump |
US11596439B2 (en) | 2017-11-07 | 2023-03-07 | Prescient Surgical, Inc. | Methods and apparatus for prevention of surgical site infection |
US11622790B2 (en) | 2020-05-21 | 2023-04-11 | Covidien Lp | Obturators for surgical access assemblies and methods of assembly thereof |
US11642153B2 (en) | 2020-03-19 | 2023-05-09 | Covidien Lp | Instrument seal for surgical access assembly |
US11717321B2 (en) | 2020-04-24 | 2023-08-08 | Covidien Lp | Access assembly with retention mechanism |
US11751908B2 (en) | 2020-06-19 | 2023-09-12 | Covidien Lp | Seal assembly for surgical access assemblies |
US11812991B2 (en) | 2019-10-18 | 2023-11-14 | Covidien Lp | Seal assemblies for surgical access assemblies |
Families Citing this family (102)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US7537564B2 (en) | 1998-12-01 | 2009-05-26 | Atropos Limited | Wound retractor device |
US7195590B2 (en) | 1998-12-01 | 2007-03-27 | Atropos Limited | Surgical device |
US7559893B2 (en) | 1998-12-01 | 2009-07-14 | Atropos Limited | Wound retractor device |
IL143214A0 (en) | 1998-12-01 | 2002-04-21 | Atropos Ltd | Laparoscopic sealed access device |
IES990218A2 (en) | 1999-03-18 | 2000-11-15 | Gaya Ltd | A surgical device |
IES990220A2 (en) | 1999-03-18 | 2000-11-15 | Gaya Ltd | A surgical device |
IE990795A1 (en) * | 1999-07-30 | 2001-03-07 | Gaya Ltd | Hand Access Port Device |
JP4385112B2 (en) | 1999-10-14 | 2009-12-16 | アトロポス・リミテッド | Wound retractor |
EP1441636B1 (en) * | 2001-10-20 | 2012-01-11 | Applied Medical Resources Corporation | Sealed surgical access device |
US7052454B2 (en) * | 2001-10-20 | 2006-05-30 | Applied Medical Resources Corporation | Sealed surgical access device |
DE20205341U1 (en) * | 2002-04-06 | 2002-08-08 | Merope Merete Healthcare Gmbh | Self-opening protective bag for surgical instruments and apparatus |
JP2004016239A (en) * | 2002-06-12 | 2004-01-22 | Fujitsu Ltd | Crossword puzzle device and crossword puzzle program |
US9271753B2 (en) | 2002-08-08 | 2016-03-01 | Atropos Limited | Surgical device |
ATE364355T1 (en) | 2002-09-19 | 2007-07-15 | Atropos Ltd | SURGICAL WOUND RETRACTOR |
MXPA05003554A (en) * | 2002-10-04 | 2005-09-30 | Atropos Ltd | A wound retractor device. |
CN100384382C (en) * | 2002-10-04 | 2008-04-30 | 阿特波斯有限公司 | Wound retractor device |
JP4460576B2 (en) | 2003-04-25 | 2010-05-12 | タイコ ヘルスケア グループ リミテッド パートナーシップ | Surgical hand access device |
WO2005009257A2 (en) * | 2003-07-30 | 2005-02-03 | Atropos Limited | Cannula with instrument seal |
AU2005231843B2 (en) | 2004-04-05 | 2010-09-16 | Covidien Lp | Surgical hand access apparatus |
EP2407091B1 (en) | 2004-04-05 | 2013-08-28 | Covidien LP | Surgical hand access apparatus |
AU2005293216A1 (en) | 2004-10-11 | 2006-04-20 | Atropos Limited | An instrument access device |
US20060149137A1 (en) * | 2005-01-05 | 2006-07-06 | Applied Medical Resources Corporation | Easily placeable and removable wound retractor |
US7766824B2 (en) | 2005-03-31 | 2010-08-03 | Tyco Healthcare Group Lp | Surgical hand access apparatus |
US20060247500A1 (en) | 2005-04-08 | 2006-11-02 | Voegele James W | Surgical access device |
JP2009501045A (en) | 2005-07-15 | 2009-01-15 | アトロポス・リミテッド | Wound retractor |
US20100081883A1 (en) * | 2008-09-30 | 2010-04-01 | Ethicon Endo-Surgery, Inc. | Methods and devices for performing gastroplasties using a multiple port access device |
US8821391B2 (en) * | 2009-03-06 | 2014-09-02 | Ethicon Endo-Surgery, Inc. | Methods and devices for providing access into a body cavity |
US20100081864A1 (en) * | 2008-09-30 | 2010-04-01 | Ethicon Endo-Surgery, Inc. | Methods and devices for performing gastrectomies and gastroplasties |
US8961406B2 (en) | 2009-03-06 | 2015-02-24 | Ethicon Endo-Surgery, Inc. | Surgical access devices and methods providing seal movement in predefined movement regions |
US8485970B2 (en) | 2008-09-30 | 2013-07-16 | Ethicon Endo-Surgery, Inc. | Surgical access device |
US8579807B2 (en) * | 2008-04-28 | 2013-11-12 | Ethicon Endo-Surgery, Inc. | Absorbing fluids in a surgical access device |
US8251900B2 (en) * | 2009-03-06 | 2012-08-28 | Ethicon Endo-Surgery, Inc. | Surgical access devices and methods providing seal movement in predefined paths |
US8206294B2 (en) * | 2008-09-30 | 2012-06-26 | Ethicon Endo-Surgery, Inc. | Surgical access device with flexible seal channel |
US8357085B2 (en) | 2009-03-31 | 2013-01-22 | Ethicon Endo-Surgery, Inc. | Devices and methods for providing access into a body cavity |
US8926506B2 (en) | 2009-03-06 | 2015-01-06 | Ethicon Endo-Surgery, Inc. | Methods and devices for providing access into a body cavity |
US8430811B2 (en) | 2008-09-30 | 2013-04-30 | Ethicon Endo-Surgery, Inc. | Multiple port surgical access device |
US9005116B2 (en) | 2006-04-05 | 2015-04-14 | Ethicon Endo-Surgery, Inc. | Access device |
US8690831B2 (en) | 2008-04-25 | 2014-04-08 | Ethicon Endo-Surgery, Inc. | Gas jet fluid removal in a trocar |
US8425410B2 (en) | 2008-09-30 | 2013-04-23 | Ethicon Endo-Surgery, Inc. | Surgical access device with protective element |
US20080011307A1 (en) * | 2006-07-12 | 2008-01-17 | Beckman Andrew T | Hand assisted laparoscopic device |
US20080021360A1 (en) * | 2006-07-18 | 2008-01-24 | Fihe Carrie I | Roll-up wound protector |
US8663271B2 (en) * | 2006-08-04 | 2014-03-04 | Northgate Technologies, Inc. | In-dwelling port for access into a body |
US7922656B2 (en) | 2007-04-04 | 2011-04-12 | Ethicon Endo-Surgery, Inc. | Hand assisted laparoscopic seal assembly with detachable attachment ring |
US8657740B2 (en) | 2007-06-05 | 2014-02-25 | Atropos Limited | Instrument access device |
WO2008149332A1 (en) | 2007-06-05 | 2008-12-11 | Atropos Limited | An instrument access device |
CN100488467C (en) * | 2007-06-14 | 2009-05-20 | 河北医科大学第二医院 | Dynamic negative-pressure thoracotomy operating cabin of simulating pectoral cavity |
US8100929B2 (en) | 2007-06-29 | 2012-01-24 | Ethicon Endo-Surgery, Inc. | Duckbill seal with fluid drainage feature |
US8465515B2 (en) | 2007-08-29 | 2013-06-18 | Ethicon Endo-Surgery, Inc. | Tissue retractors |
US8308755B2 (en) | 2007-09-24 | 2012-11-13 | Ethicon Endo-Surgery, Inc. | Elliptical retractor |
US8517931B2 (en) | 2007-11-26 | 2013-08-27 | Ethicon Endo-Surgery, Inc. | Tissue retractors |
US8128559B2 (en) | 2007-11-26 | 2012-03-06 | Ethicon Endo-Surgery, Inc. | Tissue retractors |
US7976501B2 (en) | 2007-12-07 | 2011-07-12 | Ethicon Endo-Surgery, Inc. | Trocar seal with reduced contact area |
US11235111B2 (en) | 2008-04-28 | 2022-02-01 | Ethicon Llc | Surgical access device |
US9358041B2 (en) | 2008-04-28 | 2016-06-07 | Ethicon Endo-Surgery, Llc | Wicking fluid management in a surgical access device |
US8870747B2 (en) | 2008-04-28 | 2014-10-28 | Ethicon Endo-Surgery, Inc. | Scraping fluid removal in a surgical access device |
USD700326S1 (en) | 2008-04-28 | 2014-02-25 | Ethicon Endo-Surgery, Inc. | Trocar housing |
US8568362B2 (en) * | 2008-04-28 | 2013-10-29 | Ethicon Endo-Surgery, Inc. | Surgical access device with sorbents |
US8273060B2 (en) | 2008-04-28 | 2012-09-25 | Ethicon Endo-Surgery, Inc. | Fluid removal in a surgical access device |
US8636686B2 (en) | 2008-04-28 | 2014-01-28 | Ethicon Endo-Surgery, Inc. | Surgical access device |
US7981092B2 (en) | 2008-05-08 | 2011-07-19 | Ethicon Endo-Surgery, Inc. | Vibratory trocar |
US8328761B2 (en) * | 2008-09-30 | 2012-12-11 | Ethicon Endo-Surgery, Inc. | Variable surgical access device |
WO2011044448A2 (en) | 2009-10-10 | 2011-04-14 | Surgiquest, Incorporated | Low-profile surgical access devices with anchoring |
US8375955B2 (en) | 2009-02-06 | 2013-02-19 | Atropos Limited | Surgical procedure |
US9737334B2 (en) | 2009-03-06 | 2017-08-22 | Ethicon Llc | Methods and devices for accessing a body cavity |
US8353824B2 (en) * | 2009-03-31 | 2013-01-15 | Ethicon Endo-Surgery, Inc. | Access method with insert |
US8945163B2 (en) | 2009-04-01 | 2015-02-03 | Ethicon Endo-Surgery, Inc. | Methods and devices for cutting and fastening tissue |
US8419635B2 (en) * | 2009-04-08 | 2013-04-16 | Ethicon Endo-Surgery, Inc. | Surgical access device having removable and replaceable components |
US8137267B2 (en) * | 2009-04-08 | 2012-03-20 | Ethicon Endo-Surgery, Inc. | Retractor with flexible sleeve |
US20100261972A1 (en) * | 2009-04-08 | 2010-10-14 | Ethicon Endo-Surgery, Inc. | Surgical Access Device with One Time Seal |
US20100280327A1 (en) * | 2009-05-04 | 2010-11-04 | Ethicon Endo-Surgery, Inc. | Methods and devices for providing access through tissue to a surgical site |
US8241209B2 (en) | 2009-06-05 | 2012-08-14 | Ethicon Endo-Surgery, Inc. | Active seal components |
US8361109B2 (en) | 2009-06-05 | 2013-01-29 | Ethicon Endo-Surgery, Inc. | Multi-planar obturator with foldable retractor |
US8475490B2 (en) | 2009-06-05 | 2013-07-02 | Ethicon Endo-Surgery, Inc. | Methods and devices for providing access through tissue to a surgical site |
US8465422B2 (en) | 2009-06-05 | 2013-06-18 | Ethicon Endo-Surgery, Inc. | Retractor with integrated wound closure |
US8795163B2 (en) | 2009-06-05 | 2014-08-05 | Ethicon Endo-Surgery, Inc. | Interlocking seal components |
US8033995B2 (en) * | 2009-06-05 | 2011-10-11 | Ethicon Endo-Surgery, Inc. | Inflatable retractor with insufflation and method |
US9078695B2 (en) | 2009-06-05 | 2015-07-14 | Ethicon Endo-Surgery, Inc. | Methods and devices for accessing a body cavity using a surgical access device with modular seal components |
US20110028794A1 (en) * | 2009-07-30 | 2011-02-03 | Ethicon Endo-Surgery, Inc. | Methods and devices for providing access into a body cavity |
WO2011033495A1 (en) | 2009-09-17 | 2011-03-24 | Atropos Limited | An instrument access device |
US9474540B2 (en) | 2009-10-08 | 2016-10-25 | Ethicon-Endo-Surgery, Inc. | Laparoscopic device with compound angulation |
US8562592B2 (en) | 2010-05-07 | 2013-10-22 | Ethicon Endo-Surgery, Inc. | Compound angle laparoscopic methods and devices |
US9226760B2 (en) | 2010-05-07 | 2016-01-05 | Ethicon Endo-Surgery, Inc. | Laparoscopic devices with flexible actuation mechanisms |
US8460337B2 (en) | 2010-06-09 | 2013-06-11 | Ethicon Endo-Surgery, Inc. | Selectable handle biasing |
US10292617B2 (en) | 2010-09-30 | 2019-05-21 | Aspect Imaging Ltd. | Automated tuning and frequency matching with motor movement of RF coil in a magnetic resonance laboratory animal handling system |
US8864659B2 (en) | 2010-11-23 | 2014-10-21 | Covidien Lp | Seal anchor for use in surgical procedures |
US8696557B2 (en) | 2010-12-21 | 2014-04-15 | Covidien Lp | Access assembly including inflatable seal member |
US9022928B2 (en) | 2011-03-18 | 2015-05-05 | Covidien Lp | Wound protector including balloon within incision |
US9033873B2 (en) | 2011-03-23 | 2015-05-19 | Covidien Lp | Surgical retractor including rotatable knobs |
US9119666B2 (en) | 2011-03-25 | 2015-09-01 | Covidien Lp | Access port with integrated flexible sleeve |
US9078696B2 (en) | 2011-05-02 | 2015-07-14 | Covidien Lp | Surgical retractor including polygonal rolling structure |
US8764645B2 (en) | 2012-03-26 | 2014-07-01 | Covidien Lp | Surgical access device and wound protector |
US9474545B1 (en) * | 2013-03-15 | 2016-10-25 | H. Charles Kim | Apparatus and method for selectively arrestable manuary access to sufflated body cavity |
US9662115B2 (en) * | 2013-08-26 | 2017-05-30 | Covidien Lp | EEA abdominal access device |
GB2518859B (en) * | 2013-10-02 | 2018-12-12 | Salts Healthcare Ltd | Wound management device |
US9572595B1 (en) | 2014-03-05 | 2017-02-21 | Northgate Technologies Inc. | In-dwelling port for access into a body |
CN104473667B (en) * | 2014-12-26 | 2017-09-29 | 佛山市第一人民医院 | Long oversleeve type hand-actuated accelerator, clutch and brake |
AU2016253021B2 (en) * | 2015-04-23 | 2021-02-11 | Applied Medical Resources Corporation | Systems and methods for tissue removal |
GB201520065D0 (en) * | 2015-11-13 | 2015-12-30 | Univ Oslo Hf | Patient isolator |
US10952772B2 (en) | 2016-07-04 | 2021-03-23 | Atropos Limited | Access device |
CN109549702B (en) * | 2019-01-15 | 2023-08-15 | 广东省妇幼保健院 | Access channel of single-port laparoscope and manufacturing method |
CN110025341B (en) * | 2019-04-10 | 2020-05-12 | 汕头大学医学院第一附属医院 | Disposable incision retractor with net-like supporting structure and traction device thereof |
RU2743201C1 (en) * | 2020-05-18 | 2021-02-16 | Федеральное государственное бюджетное образовательное учреждение дополнительного профессионального образования "Российская медицинская академия непрерывного профессионального образования" Министерства здравоохранения Российской Федерации (ФГБОУ ДПО РМАНПО Минздрава России) | Method of conversion of laparoscopic tubovariectomy with purulent tuboovarian formation |
Citations (53)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US1810466A (en) * | 1928-05-25 | 1931-06-16 | Deutsch Josef | Device for giving access to cavities of the animal and human body |
US2305289A (en) * | 1939-06-17 | 1942-12-15 | Coburg Hermann | Surgical appliance |
US2835253A (en) * | 1956-08-14 | 1958-05-20 | Florence W Borgeson | Surgical appliance |
US3111943A (en) * | 1961-08-02 | 1963-11-26 | John R Orndorff | Aseptic surgical wound protector |
US3244169A (en) * | 1964-02-17 | 1966-04-05 | Surgical Devices | Viscera pouch |
US3332417A (en) * | 1965-04-22 | 1967-07-25 | Parke Davis & Co | Adjustable wound protector |
US3347226A (en) * | 1964-12-11 | 1967-10-17 | Harold W Harrower | Adjustable wound edge protector |
US3347227A (en) * | 1964-12-11 | 1967-10-17 | Harold W Harrower | Wound edge protector |
US3397692A (en) * | 1966-02-24 | 1968-08-20 | Parke Davis & Co | Protector for incised wounds |
US3416520A (en) * | 1966-11-22 | 1968-12-17 | Parke Davis & Co | Surgical drape |
US3523534A (en) * | 1967-04-05 | 1970-08-11 | Hollister Inc | Closure for drainage pouch |
US3841332A (en) * | 1973-11-19 | 1974-10-15 | D Treacle | Enterostomy drainage appliance |
US3850172A (en) * | 1972-06-05 | 1974-11-26 | J Cazalis | Gas-tight enclosures for surgical operations |
US4024872A (en) * | 1976-06-01 | 1977-05-24 | Muldoon James P | Colostomy device and method |
US4188945A (en) * | 1977-08-26 | 1980-02-19 | Triplus Sjukvardsprodukter Ab | Surgical cloth |
US4367728A (en) * | 1979-09-07 | 1983-01-11 | Mutke Hans G | Isolation apparatus |
US4550713A (en) * | 1983-03-10 | 1985-11-05 | Hyman Frederic E Dr | Method and apparatus for opposing deformity, displacement, and expulsion of the ocular tissues during open eye surgery |
US4553537A (en) * | 1983-06-09 | 1985-11-19 | Max Rosenberg | Surgical barrier |
US4777943A (en) * | 1984-11-10 | 1988-10-18 | Malliner Laboratories Inc. | Use of transparent membranes made of hydrogel polymers as a cover for various organs during surgery |
US4863438A (en) * | 1985-11-29 | 1989-09-05 | Applied Medical Technology, Inc. | Low profile gastrostomy device |
US4903710A (en) * | 1987-01-06 | 1990-02-27 | Jessamine John G | Surgical isolation drapes |
US4926882A (en) * | 1988-09-06 | 1990-05-22 | Lawrence Sharon K | Transparent shielding device for use with autopsy saw |
US4991593A (en) * | 1989-06-13 | 1991-02-12 | Minnesota Scientific, Inc. | Flexible bag for storing body organs |
US4998538A (en) * | 1989-08-25 | 1991-03-12 | Charowsky Deborah A | Medical drape for laser surgery |
US5037379A (en) * | 1990-06-22 | 1991-08-06 | Vance Products Incorporated | Surgical tissue bag and method for percutaneously debulking tissue |
US5178162A (en) * | 1992-04-14 | 1993-01-12 | Bose William J | Splash and spill resistant extremity irrigation and debridement surgical drape |
US5299582A (en) * | 1991-09-16 | 1994-04-05 | Little Rapids Corporation | Surgical isolation apparatus |
US5316541A (en) * | 1993-01-19 | 1994-05-31 | Fischer William B | Enclosure for surgical procedures |
US5399208A (en) * | 1989-12-19 | 1995-03-21 | Nippon Paint Co., Ltd. | Method for phosphating metal surface with zinc phosphate |
US5514133A (en) * | 1994-08-26 | 1996-05-07 | Golub; Robert | Access device for endoscopic surgery |
US5522791A (en) * | 1994-08-31 | 1996-06-04 | Leyva; Horacio A. | Apparatus for retracting an incision and inflating an abdominal cavity |
US5524644A (en) * | 1995-06-09 | 1996-06-11 | Medical Creative Technologies, Inc. | Incrementally adjustable incision liner and retractor |
US5562677A (en) * | 1992-06-30 | 1996-10-08 | Ethicon, Inc. | Obturator for justing a flexible trocar tube |
US5636645A (en) * | 1995-02-28 | 1997-06-10 | Ou; Honzen | Method and surgical glove for performing laparoscopic-assisted mini laparotomy |
US5640977A (en) * | 1994-04-08 | 1997-06-24 | Medical Creative Technologies, Inc. | Apparatus and method for use in surgery |
US5653705A (en) * | 1994-10-07 | 1997-08-05 | General Surgical Innovations, Inc. | Laparoscopic access port for surgical instruments or the hand |
US5672168A (en) * | 1994-10-07 | 1997-09-30 | De La Torre; Roger A. | Laparoscopic access port for surgical instruments or the hand |
US5728103A (en) * | 1996-08-23 | 1998-03-17 | Applied Medical Technology, Inc. | Implantable subcutaneous access device and method of using same |
US5792119A (en) * | 1992-10-27 | 1998-08-11 | Marx; Karl-Heinz | Tubular implant to be used for percutaneously feeding a patient |
US5803923A (en) * | 1994-09-15 | 1998-09-08 | Jugvir I. Singh-Derewa | Presbyopia correction using a protected space pattern, methods and apparatus |
US5810721A (en) * | 1996-03-04 | 1998-09-22 | Heartport, Inc. | Soft tissue retractor and method for providing surgical access |
US5813409A (en) * | 1994-09-02 | 1998-09-29 | Medical Creative Technologies, Inc. | Surgical apparatus |
US5841298A (en) * | 1996-04-25 | 1998-11-24 | Industrial Technology Research Institute | Locally asynchronous, pipeline-able logic circuits for true-single-phase synchronous logic circuit |
US5853395A (en) * | 1997-02-18 | 1998-12-29 | Dexterity, Inc. | Extracorporeal pneumoperitoneum enclosure and method of use |
US5906577A (en) * | 1997-04-30 | 1999-05-25 | University Of Massachusetts | Device, surgical access port, and method of retracting an incision into an opening and providing a channel through the incision |
US6033428A (en) * | 1999-01-26 | 2000-03-07 | Sardella; William V. | Laparoscopic surgery device |
US6149642A (en) * | 1998-01-16 | 2000-11-21 | Medical Creative Technologies Inc. | Surgical instrument and method for use in hand-assisted laparoscopy |
US6254534B1 (en) * | 1999-10-14 | 2001-07-03 | Atropos Limited | Retractor |
US20040015185A1 (en) * | 2000-10-19 | 2004-01-22 | Ewers Richard C. | Surgical access apparatus and method |
US6823426B2 (en) * | 2001-12-20 | 2004-11-23 | Intel Corporation | System and method of data replacement in cache ways |
US20050020884A1 (en) * | 2003-02-25 | 2005-01-27 | Hart Charles C. | Surgical access system |
US6908430B2 (en) * | 1999-07-30 | 2005-06-21 | Applied Medical Resources Corporation | Hand access port device |
US6945932B1 (en) * | 1999-03-18 | 2005-09-20 | Gaya Limited | Surgical access device |
Family Cites Families (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JP3556670B2 (en) | 1993-09-06 | 2004-08-18 | アトロポス・リミテッド | Equipment used for surgery |
ATE164303T1 (en) * | 1994-02-18 | 1998-04-15 | Gaya Ltd | SURGICAL DEVICE |
US5899208A (en) | 1995-05-08 | 1999-05-04 | Gaya Limited | Hand access port |
JPH1199156A (en) * | 1997-07-29 | 1999-04-13 | Olympus Optical Co Ltd | Access device for surgical treatment |
IL143214A0 (en) * | 1998-12-01 | 2002-04-21 | Atropos Ltd | Laparoscopic sealed access device |
-
1999
- 1999-09-24 IE IE19990795A patent/IE990795A1/en not_active Application Discontinuation
-
2000
- 2000-07-28 EP EP06010229A patent/EP1698293A2/en not_active Withdrawn
- 2000-07-28 EP EP04002888A patent/EP1415610B1/en not_active Expired - Lifetime
- 2000-07-28 EP EP06010228A patent/EP1698292A2/en not_active Withdrawn
- 2000-07-28 CA CA002380993A patent/CA2380993A1/en not_active Abandoned
- 2000-07-28 JP JP2002592698A patent/JP2004520920A/en active Pending
- 2000-07-28 DE DE60011911T patent/DE60011911T2/en not_active Expired - Fee Related
- 2000-07-28 EP EP04002889A patent/EP1415611B1/en not_active Expired - Lifetime
- 2000-07-28 DE DE60033450T patent/DE60033450T2/en not_active Expired - Fee Related
- 2000-07-28 DE DE60026382T patent/DE60026382T2/en not_active Expired - Fee Related
- 2000-07-28 EP EP00948222A patent/EP1207795B1/en not_active Expired - Lifetime
- 2000-07-28 WO PCT/IE2000/000092 patent/WO2001008581A2/en active IP Right Grant
-
2002
- 2002-01-18 US US10/052,297 patent/US6908430B2/en not_active Expired - Fee Related
-
2004
- 2004-07-29 US US10/902,756 patent/US20040267096A1/en not_active Abandoned
Patent Citations (56)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US1810466A (en) * | 1928-05-25 | 1931-06-16 | Deutsch Josef | Device for giving access to cavities of the animal and human body |
US2305289A (en) * | 1939-06-17 | 1942-12-15 | Coburg Hermann | Surgical appliance |
US2835253A (en) * | 1956-08-14 | 1958-05-20 | Florence W Borgeson | Surgical appliance |
US3111943A (en) * | 1961-08-02 | 1963-11-26 | John R Orndorff | Aseptic surgical wound protector |
US3244169A (en) * | 1964-02-17 | 1966-04-05 | Surgical Devices | Viscera pouch |
US3347226A (en) * | 1964-12-11 | 1967-10-17 | Harold W Harrower | Adjustable wound edge protector |
US3347227A (en) * | 1964-12-11 | 1967-10-17 | Harold W Harrower | Wound edge protector |
US3332417A (en) * | 1965-04-22 | 1967-07-25 | Parke Davis & Co | Adjustable wound protector |
US3397692A (en) * | 1966-02-24 | 1968-08-20 | Parke Davis & Co | Protector for incised wounds |
US3416520A (en) * | 1966-11-22 | 1968-12-17 | Parke Davis & Co | Surgical drape |
US3523534A (en) * | 1967-04-05 | 1970-08-11 | Hollister Inc | Closure for drainage pouch |
US3850172A (en) * | 1972-06-05 | 1974-11-26 | J Cazalis | Gas-tight enclosures for surgical operations |
US3841332A (en) * | 1973-11-19 | 1974-10-15 | D Treacle | Enterostomy drainage appliance |
US4024872A (en) * | 1976-06-01 | 1977-05-24 | Muldoon James P | Colostomy device and method |
US4188945A (en) * | 1977-08-26 | 1980-02-19 | Triplus Sjukvardsprodukter Ab | Surgical cloth |
US4367728A (en) * | 1979-09-07 | 1983-01-11 | Mutke Hans G | Isolation apparatus |
US4550713A (en) * | 1983-03-10 | 1985-11-05 | Hyman Frederic E Dr | Method and apparatus for opposing deformity, displacement, and expulsion of the ocular tissues during open eye surgery |
US4553537A (en) * | 1983-06-09 | 1985-11-19 | Max Rosenberg | Surgical barrier |
US4777943A (en) * | 1984-11-10 | 1988-10-18 | Malliner Laboratories Inc. | Use of transparent membranes made of hydrogel polymers as a cover for various organs during surgery |
US4863438A (en) * | 1985-11-29 | 1989-09-05 | Applied Medical Technology, Inc. | Low profile gastrostomy device |
US4863438B1 (en) * | 1985-11-29 | 1992-01-28 | Applied Med Tech Inc | |
US4903710A (en) * | 1987-01-06 | 1990-02-27 | Jessamine John G | Surgical isolation drapes |
US4926882A (en) * | 1988-09-06 | 1990-05-22 | Lawrence Sharon K | Transparent shielding device for use with autopsy saw |
US4991593A (en) * | 1989-06-13 | 1991-02-12 | Minnesota Scientific, Inc. | Flexible bag for storing body organs |
US4998538A (en) * | 1989-08-25 | 1991-03-12 | Charowsky Deborah A | Medical drape for laser surgery |
US5399208A (en) * | 1989-12-19 | 1995-03-21 | Nippon Paint Co., Ltd. | Method for phosphating metal surface with zinc phosphate |
US5037379A (en) * | 1990-06-22 | 1991-08-06 | Vance Products Incorporated | Surgical tissue bag and method for percutaneously debulking tissue |
US5299582A (en) * | 1991-09-16 | 1994-04-05 | Little Rapids Corporation | Surgical isolation apparatus |
US5178162A (en) * | 1992-04-14 | 1993-01-12 | Bose William J | Splash and spill resistant extremity irrigation and debridement surgical drape |
US5562677A (en) * | 1992-06-30 | 1996-10-08 | Ethicon, Inc. | Obturator for justing a flexible trocar tube |
US5792119A (en) * | 1992-10-27 | 1998-08-11 | Marx; Karl-Heinz | Tubular implant to be used for percutaneously feeding a patient |
US5316541A (en) * | 1993-01-19 | 1994-05-31 | Fischer William B | Enclosure for surgical procedures |
US5640977A (en) * | 1994-04-08 | 1997-06-24 | Medical Creative Technologies, Inc. | Apparatus and method for use in surgery |
US5514133A (en) * | 1994-08-26 | 1996-05-07 | Golub; Robert | Access device for endoscopic surgery |
US5522791A (en) * | 1994-08-31 | 1996-06-04 | Leyva; Horacio A. | Apparatus for retracting an incision and inflating an abdominal cavity |
US5813409A (en) * | 1994-09-02 | 1998-09-29 | Medical Creative Technologies, Inc. | Surgical apparatus |
US5803923A (en) * | 1994-09-15 | 1998-09-08 | Jugvir I. Singh-Derewa | Presbyopia correction using a protected space pattern, methods and apparatus |
US5672168A (en) * | 1994-10-07 | 1997-09-30 | De La Torre; Roger A. | Laparoscopic access port for surgical instruments or the hand |
US5653705A (en) * | 1994-10-07 | 1997-08-05 | General Surgical Innovations, Inc. | Laparoscopic access port for surgical instruments or the hand |
US5636645A (en) * | 1995-02-28 | 1997-06-10 | Ou; Honzen | Method and surgical glove for performing laparoscopic-assisted mini laparotomy |
US5524644A (en) * | 1995-06-09 | 1996-06-11 | Medical Creative Technologies, Inc. | Incrementally adjustable incision liner and retractor |
US5810721A (en) * | 1996-03-04 | 1998-09-22 | Heartport, Inc. | Soft tissue retractor and method for providing surgical access |
US5841298A (en) * | 1996-04-25 | 1998-11-24 | Industrial Technology Research Institute | Locally asynchronous, pipeline-able logic circuits for true-single-phase synchronous logic circuit |
US5728103A (en) * | 1996-08-23 | 1998-03-17 | Applied Medical Technology, Inc. | Implantable subcutaneous access device and method of using same |
US5853395A (en) * | 1997-02-18 | 1998-12-29 | Dexterity, Inc. | Extracorporeal pneumoperitoneum enclosure and method of use |
US5906577A (en) * | 1997-04-30 | 1999-05-25 | University Of Massachusetts | Device, surgical access port, and method of retracting an incision into an opening and providing a channel through the incision |
US6142936A (en) * | 1997-04-30 | 2000-11-07 | University Of Massachusetts | Surgical access port and method for accessing a patient's body cavity |
US6149642A (en) * | 1998-01-16 | 2000-11-21 | Medical Creative Technologies Inc. | Surgical instrument and method for use in hand-assisted laparoscopy |
US6033428A (en) * | 1999-01-26 | 2000-03-07 | Sardella; William V. | Laparoscopic surgery device |
US6945932B1 (en) * | 1999-03-18 | 2005-09-20 | Gaya Limited | Surgical access device |
US6908430B2 (en) * | 1999-07-30 | 2005-06-21 | Applied Medical Resources Corporation | Hand access port device |
US6254534B1 (en) * | 1999-10-14 | 2001-07-03 | Atropos Limited | Retractor |
US6582364B2 (en) * | 1999-10-14 | 2003-06-24 | Atropos Limited | Retractor and method for use |
US20040015185A1 (en) * | 2000-10-19 | 2004-01-22 | Ewers Richard C. | Surgical access apparatus and method |
US6823426B2 (en) * | 2001-12-20 | 2004-11-23 | Intel Corporation | System and method of data replacement in cache ways |
US20050020884A1 (en) * | 2003-02-25 | 2005-01-27 | Hart Charles C. | Surgical access system |
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US20080021359A1 (en) * | 2006-07-18 | 2008-01-24 | Beckman Andrew T | Roll-up wound protector with asymmetic ring |
US8231527B2 (en) | 2006-07-18 | 2012-07-31 | Ethicon Endo-Surgery, Inc. | Roll-up wound protector with asymmetric ring |
US7749161B2 (en) | 2006-12-01 | 2010-07-06 | Ethicon Endo-Surgery, Inc. | Hand assisted laparoscopic device |
US8197404B2 (en) | 2006-12-15 | 2012-06-12 | Ethicon Endo-Surgery, Inc. | Handoscopy interwoven layered seal laparoscopic disk |
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US7819800B2 (en) | 2006-12-15 | 2010-10-26 | Ethicon Endo-Surgery, Inc. | Fully automated iris seal for hand assisted laparoscopic surgical procedures |
WO2008076798A1 (en) * | 2006-12-15 | 2008-06-26 | Ethicon Endo-Surgery, Inc | Resiliently supported seal cap for hand assisted laparoscopic surgical procedures |
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US8109873B2 (en) | 2007-05-11 | 2012-02-07 | Applied Medical Resources Corporation | Surgical retractor with gel pad |
US8961410B2 (en) | 2007-05-11 | 2015-02-24 | Applied Medical Resources Corporation | Surgical retractor with gel pad |
USD712033S1 (en) | 2007-10-05 | 2014-08-26 | Covidien Lp | Seal anchor for use in surgical procedures |
US20100100043A1 (en) * | 2007-10-05 | 2010-04-22 | Racenet Danyel J | Flexible Access Device For Use In Surgical Procedure |
USD712034S1 (en) | 2007-10-05 | 2014-08-26 | Covidien Lp | Seal anchor for use in surgical procedures |
US20090093683A1 (en) * | 2007-10-05 | 2009-04-09 | Tyco Healthcare Group Lp | Surgical portal kit for use in single incision surgery |
USD736921S1 (en) | 2007-10-05 | 2015-08-18 | Covidien Lp | Seal anchor for use in surgical procedures |
US9113951B2 (en) | 2007-10-05 | 2015-08-25 | Covidien Lp | Seal anchor for use in surgical procedures |
US8273017B1 (en) | 2007-10-30 | 2012-09-25 | Ethicon Endo-Surgery, Inc. | Surgical access port with ring actuated latching mechanism |
US8142354B1 (en) | 2007-10-30 | 2012-03-27 | Ethicon Endo-Surgery, Inc. | Laminated surgical access port |
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US8795161B2 (en) | 2008-06-25 | 2014-08-05 | Covidien Lp | Button port |
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US8317690B2 (en) | 2009-03-31 | 2012-11-27 | Covidien Lp | Foam port and introducer assembly |
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US20110054258A1 (en) * | 2009-08-31 | 2011-03-03 | O'keefe Jonathan B | Foam port introducer |
US9717522B2 (en) | 2009-08-31 | 2017-08-01 | Applied Medical Resources Corporation | Multi-functional surgical access system |
US8932212B2 (en) | 2009-10-01 | 2015-01-13 | Covidien Lp | Seal anchor with non-parallel lumens |
US10532168B2 (en) | 2009-10-01 | 2020-01-14 | Covidien Lp | Seal anchor with non-parallel lumens |
US9017250B2 (en) | 2009-10-01 | 2015-04-28 | Covidien Lp | Seal anchor with non-parallel lumens |
US8932213B2 (en) | 2009-10-01 | 2015-01-13 | Covidien Lp | Seal anchor with non-parallel lumens |
US9744317B2 (en) | 2009-10-01 | 2017-08-29 | Covidien Lp | Seal anchor with non-parallel lumens |
US8795289B2 (en) | 2009-11-24 | 2014-08-05 | Covidien Lp | Foam introduction system including modified port geometry |
US8740904B2 (en) | 2009-11-24 | 2014-06-03 | Covidien Lp | Seal anchor introducer including biasing member |
US9566054B2 (en) | 2009-11-24 | 2017-02-14 | Covidien Lp | Foam introduction system including modified port geometry |
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US8968188B2 (en) | 2010-11-24 | 2015-03-03 | Covidien Lp | Expandable segmented and sectioned access assembly |
US8550992B2 (en) | 2010-12-20 | 2013-10-08 | Covidien Lp | Two-part access assembly |
US9486197B2 (en) | 2010-12-20 | 2016-11-08 | Covidien Lp | Two-part access assembly |
US9451980B2 (en) | 2010-12-20 | 2016-09-27 | Covidien Lp | Hand access device |
US8753267B2 (en) | 2011-01-24 | 2014-06-17 | Covidien Lp | Access assembly insertion device |
US9017251B2 (en) | 2011-01-24 | 2015-04-28 | Covidien Lp | Access assembly insertion device |
US9955960B2 (en) | 2011-02-26 | 2018-05-01 | Abbott Cardiovascular Systems, Inc. | Hinged tissue support device |
US8668641B2 (en) | 2011-03-30 | 2014-03-11 | Covidien, LP | Surgical access assembly with sleeve and adjustable fastener |
US9314233B2 (en) | 2011-03-30 | 2016-04-19 | Covidien Lp | Surgical access assembly with sleeve and adjustable fastener |
US9307975B2 (en) | 2011-05-10 | 2016-04-12 | Applied Medical Resources Corporation | Wound retractor |
US9241697B2 (en) | 2011-05-10 | 2016-01-26 | Applied Medical Resources Corporation | Wound retractor |
US9192366B2 (en) | 2011-05-10 | 2015-11-24 | Applied Medical Resources Corporation | Wound retractor |
US8758236B2 (en) | 2011-05-10 | 2014-06-24 | Applied Medical Resources Corporation | Wound retractor |
US9144422B2 (en) | 2011-12-29 | 2015-09-29 | Covidien Lp | Surgical access assembly and method of use therefor |
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US9084594B2 (en) | 2012-01-10 | 2015-07-21 | The Board Of Trustees Of The Lealand Stanford Junior University | Methods for the prevention of surgical site infections |
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US20170112484A1 (en) * | 2013-01-17 | 2017-04-27 | Abbott Cardiovascular Systems, Inc. | Access device for accessing tissue |
US10143460B2 (en) * | 2013-01-17 | 2018-12-04 | Abbott Cardiovascular Systems, Inc. | Access device for accessing tissue |
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US9949730B2 (en) | 2014-11-25 | 2018-04-24 | Applied Medical Resources Corporation | Circumferential wound retraction with support and guidance structures |
US10368908B2 (en) | 2015-09-15 | 2019-08-06 | Applied Medical Resources Corporation | Surgical robotic access system |
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US11382658B2 (en) | 2015-09-15 | 2022-07-12 | Applied Medical Resources Corporation | Surgical robotic access system |
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US10575840B2 (en) | 2015-10-07 | 2020-03-03 | Applied Medical Resources Corporation | Wound retractor with multi-segment outer ring |
US11627867B2 (en) | 2016-09-12 | 2023-04-18 | Applied Medical Resources Corporation | Surgical robotic access system for irregularly shaped robotic actuators and associated robotic surgical instruments |
US10674896B2 (en) | 2016-09-12 | 2020-06-09 | Applied Medical Resources Corporation | Surgical robotic access system for irregularly shaped robotic actuators and associated robotic surgical instruments |
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US20220218391A1 (en) * | 2021-01-11 | 2022-07-14 | Covidien Lp | Cannula assembly including a suction cup seal |
Also Published As
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EP1207795B1 (en) | 2004-06-30 |
DE60011911T2 (en) | 2005-07-07 |
EP1698292A2 (en) | 2006-09-06 |
EP1415610A2 (en) | 2004-05-06 |
EP1698293A2 (en) | 2006-09-06 |
EP1415611B1 (en) | 2007-02-14 |
DE60011911D1 (en) | 2004-08-05 |
IE990795A1 (en) | 2001-03-07 |
DE60033450T2 (en) | 2007-11-29 |
WO2001008581A8 (en) | 2002-06-20 |
EP1415611A2 (en) | 2004-05-06 |
CA2380993A1 (en) | 2001-02-08 |
US6908430B2 (en) | 2005-06-21 |
EP1415611A3 (en) | 2004-11-03 |
US20020068923A1 (en) | 2002-06-06 |
EP1207795A2 (en) | 2002-05-29 |
DE60033450D1 (en) | 2007-03-29 |
DE60026382T2 (en) | 2006-12-14 |
WO2001008581A2 (en) | 2001-02-08 |
WO2001008581A3 (en) | 2001-06-07 |
EP1415610A3 (en) | 2004-11-03 |
DE60026382D1 (en) | 2006-04-27 |
JP2004520920A (en) | 2004-07-15 |
EP1415610B1 (en) | 2006-03-01 |
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