US20120157782A1 - Hand access device - Google Patents

Abstract

A device for accessing a body cavity through an opening in tissue is provided. The access device includes a unitary compressible body configured to be received in an opening in tissue. The compressible body includes a central portion, an upper rim located on a proximal end of the body and a lower rim located on a distal end of the body. The central portion defines a slit configured to permit the passage of a hand therethrough in a sealing manner.

Description

CROSS REFERENCE TO RELATED APPLICATION
• The present application claims the benefit of and priority to U.S. Provisional Application Ser. No. 61/424,761 filed on Dec. 20, 2010, the entire contents of which are incorporated herein by reference.
BACKGROUND
• 1. Technical Field
• The present disclosure relates to access devices for use in surgical procedures. More particularly, the present disclosure relates to compressible access devices configured for sealed receipt of a hand therethrough.
• 2. Background of Related Art
• Access assemblies configured for reception through an opening or incision into a body cavity are known, as are methods of inserting the access assemblies therethrough. Traditional access assemblies include a rigid cannula that is received through the tissue of the body wall into the body cavity. Endoscopic, laparoscopic and other suitable instruments may then be directed through a housing located on the proximal end of the cannula to access the body cavity in a sealing manner.
• Compressible devices or assemblies configured for accessing a body cavity and permitting reception of instruments therethrough in a sealing manner are also known. Such compressible assemblies are composed of silicone, thermoplastic elastomers (TPE), rubber, foam, gel and other compressible materials and are configured to be compressed to facilitate insertion into an incision. Typically, such assemblies are deformed by a surgeon using his/her fingers or with the assistance of a grasping device, i.e., forceps. Compression of the assembly reduces the profile of the assembly, thereby facilitating reception of the assembly into the incision. Upon release of the compressive force, the previously compressed assembly returns to an uncompressed configuration. One or more endoscopic or laparoscopic devices may then be inserted through one or more lumens in the assembly to complete a procedure.
• Although advances have been made with regards to endoscopic and laparoscopic instrumentation, there is still no comparison to the dexterity and feel of one's hand. Being able to access a surgical site with a hand enables a surgeon to perform procedures that he/she would not otherwise be able to perform during a closed procedure. Thus, any procedure performed with hand access more closely resembles an open procedure, which a surgeon may be more comfortable performing.
• Therefore, it would be beneficial to have a compressible access device which provides hand access for a surgeon.
SUMMARY
• The present invention, in accordance with an embodiment thereof, relates to an access device comprising a unitary, compressible body configured to be received in an opening in tissue, the compressible body including a central portion, an upper rim located on a proximal end of the body and a lower rim located on a distal end of the body, wherein the central portion defines a slit configured to permit the passage of a hand therethrough in a sealing manner. The compressible body may define a substantially hour-glass shape. The upper and lower rims and the central portion may be substantially circular or substantially oval. The upper and lower rims may be substantially similar. The opening in the tissue may be an incision or a natural orifice. Each of the upper and lower rims may include a width of four inches (4″) and a depth of four inches (4″). Alternatively, each of the upper and lower rims may include a width of four inches (5″) and a depth of four inches (3″). The slit may include a length of at least two and one-half inches (2.5″). The compressible body may be composed of silicone, thermoplastic elastomers (TPE), rubber, foam and/or gel.
DESCRIPTION OF THE DRAWINGS
• Embodiments of a compressible access device are disclosed herein with reference to the drawings, wherein:
• FIG. 1 is a perspective view of an embodiment of an access device according to the present disclosure;
• FIG. 2 is a top view of the access device ofFIG. 1;
• FIG. 3 is a perspective view of the access device ofFIGS. 1 and 2, in a compressed condition prior to insertion through an incision;
• FIG. 4 is a perspective view of the access device ofFIGS. 1-3, selectively secured within an incision;
• FIG. 5 is a perspective view of an access device according to an alternative embodiment of the present disclosure; and
• FIG. 6 is a top view of the access device ofFIG. 5.
DETAILED DESCRIPTION
• Embodiments of the presently disclosed access device will now be described in detail with reference to the drawings wherein like numerals designate identical or corresponding elements in each of the several views. As is common in the art, the term “proximal” refers to that part or component closer to the user or operator, i.e. surgeon or physician, while the term “distal” refers to that part or component further away from the user. Although the access devices of the present disclosure will be described as relates to accessing an abdominal cavity through an incision in the abdominal wall, the access devices of the present disclosure may be modified for use in other closed procedures, i.e., laparoscopic, arthroscopic, endoscopic. Furthermore, the access devices of the present disclosure may be modified for use in accessing internal cavities through natural orifices, e.g., anus, vagina.
• Referring initially toFIG. 1, an access device according to an embodiment of the present disclosure is shown generally asaccess device100.Access device100 is configured for insertion through an opening in tissue, i.e., an incision, such that after insertion,access device100 creates a seal within the opening through which a surgeon may insert and manipulate his/her hand “H” (FIG. 4) and/or one or more surgical instruments (not shown) to complete a procedure.
• With reference toFIGS. 1 and 2,access device100 includes a substantially compressible and/orflexible body112.Body112 may be formed of various materials, such as, for example, silicone, thermoplastic elastomers (TPE), rubber, foam, gel, etc. In one embodiment,body112 includes a TPE material that is infused with an inert gas, e.g. CO₂or Nitrogen, to form a foam structure.Body112 may be coated with a lubricant, e.g. Parylene N or C, in order to create a lubricious outer surface. Various other coatings, e.g., hydrophilic, hydrophobic, bio-agents, anti-infection, analgesic, may also be employed to improve the characteristics ofaccess device100 or to adaptaccess device100 for a specific procedure.
• With reference still toFIGS. 1 and 2,body112 includes a substantially cylindricalcentral portion120, anupper rim122 located on aproximal end112a, and alower rim124 located at adistal end112b. In this manner,body112 defines a substantially hourglass shape when viewed from the side. Upper andlower rims122,124 are integrally formed withcentral portion120 and define substantially annular members.Central portion120 is configured to span the thickness of tissue “T”. Upper andlower rims122,124 aid in preventing movement ofaccess device100 longitudinally through incision “I” onceaccess device100 has been properly received therethrough. As the thickness of tissue depends on the body composition of the patient and the location through which the underlying cavity is being accessed, the length and size ofaccess device100, generally, andcentral portion120, specifically, may be modified to suit a given procedure. In this manner, an adult patient having fatty abdominal tissue requires an access device having a longercentral portion112 then an access assembly sized for an child.
• Still referring toFIGS. 1 and 2,body112 defines aslit115 extending longitudinally therethrough.Slit115 extends the length ofbody112 and provides a resealable opening through which a hand “H” of a surgeon may be passed. As shown, slit115 spans substantially the width ofcentral portion120.Body112 is configured such that hand “H” may be passed throughslit115 ofaccess device100 while maintaining an insufflation gas within a body cavity “C”. In this manner,body112 ofaccess device100 forms a seal about the hand and lower arm of the surgeon, to permit sealed passage of hand “H” therethrough.Body112 may include a coating aboutslit115 to prevent tearing and/or to facilitate reception of hand “H” therethrough.
• With reference still toFIGS. 1 and 2,body112 ofaccess assembly100 defines a substantially hourglass shape having a height “H”. Upper andlower rims122,124 each define substantially circular members having a width “W” and a depth “D”. As shown, each of upper andlower rims122,124 have similar sizes and shapes, however, it is envisioned thatrims122,124 may differ in size and/or shape.Slit115 defines a planar opening spanning a length “L” ofcentral portion120. The size ofaccess device100 is needed to be large enough to permit passage of hand “H” throughslit115 without tearing ofbody112, however,access device100 should not be so large as to create an unnecessarily large opening in tissue “T” of the patient that may be difficult to close and/or may leave a decidedly large scar. As the size of a hand “H” differs from surgeon to surgeon,access device100 may be provided in various sizes to accommodate the surgeon. In one embodiment, width “W” and depth “D” of first andsecond rims122,124 and height “H” ofbody112 each measure between three inches (3″) and five inches (5″), and preferably, four inches (4″). In the same embodiment, slit115 includes a length “L” of at least two and one-half inches (2.5″).
• The use ofaccess device100 will now be described with reference toFIGS. 3 and 4. The following discussion will include the use ofaccess device100 for accessing a body cavity “C” through an incision “I” in tissue “T”. As discussed above,access device100 may be used for accessing various cavities or lumen through other openings, including naturally occurring orifices, e.g., anus.
• Referring initially toFIG. 3, an incision “I” is created in tissue “T” through whichaccess device100 is to be inserted to access body cavity “C”.Body112 of access device is then compressed to reduce the profile ofaccess device100. This may be accomplished by hand or instead, through the use of an insertion mechanism (not shown). By reducing the profile ofaccess device100,access device100 may be more easily inserted through incision “I”.
• Turning toFIG. 4, once received through incision “I”,body112 ofaccess device100 is permitted to return to an initial, uncompressed condition. Decompression ofaccess device100 causesaccess device100 to expand within incision “I”, thereby effectively sealing body cavity “C”. Once sealed, body cavity “C” may be insufflated andaccess device100 operates in a manner similar to traditional access assemblies configured for use with surgical instruments.
• Removal ofaccess assembly100 from within incision “I” occurs in the reverse order of insertion.Body112 is once again compressed to reduce the profile ofaccess device100. Once compressed,access device100 may be readily withdrawn from incision “I”. Onceaccess assembly100 is removed from incision “I”, incision “I” is closed in a conventional manner, i.e., sutures, staples.
• Turning now toFIGS. 5 and 6, an access device according an alternative embodiment of the present disclosure is shown generally asaccess device200.Access device200 is substantially similar toaccess device100 described hereinabove, and will only be described as relates to the differences therebetween.Access device100 includes abody212 having acentral portion220, anupper rim222 located on a proximal end thereof and alower rim224 located on a distal end thereof.Body212 defines aslit215 extending longitudinally throughcentral portion220. Each of upper andlower rims222,224 andcentral portion220 define substantially oval members. The oval shape of upper andlower rims222,224 andcentral portion220 permits alonger slit215. In this manner,access device200 is configured to more readily accommodate passage of hand “H”. Upper andlower rims222,224 have a width “W₁” and a depth “D₁”.Body212 includes a height “H₁” and slit215 includes a length “L₁”. In one embodiment, upper andlower rims222,224 include a width “W₁” of about five inches (5″) and a depth “D₁” of about three inches (3″),body212 includes a height “H₁” of about three and one-half inches (3.5″) and slit215 includes a length “L₁” of about three inches (3″).
• It will be understood that various modifications may be made to the embodiments disclosed herein. For example, either or both of the upper and lower rims and the central portion may include selectively inflatable cavities configured to facilitate insertion and removal of the access device through an incision. Therefore, the above description should not be construed as limiting, but merely as exemplifications of particular embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.

Claims (13)

1. An access device comprising:

a unitary, compressible body configured to be received in an opening in tissue, the compressible body including a central portion, an upper rim located on a proximal end of the body and a lower rim located on a distal end of the body, wherein the central portion defines a slit configured to permit the passage of a hand therethrough in a sealing manner.

2. The access assembly ofclaim 1, wherein the compressible body defines a substantially hour-glass shape.

3. The access assembly ofclaim 1, wherein the upper and lower rims and the central portion are substantially circular.

4. The access assembly ofclaim 1, wherein the upper and lower rims and the central portion are substantially oval.

5. The access assembly ofclaim 1, wherein the upper and lower rims are substantially similar.

6. The access assembly ofclaim 1, wherein the opening in the tissue is an incision.

7. The access assembly ofclaim 1, wherein the opening in tissue is a natural orifice.

8. The access assembly ofclaim 1, wherein each of the upper and lower rims include a width of four inches (4″) and a depth of four inches (4″).

9. The access assembly ofclaim 1, wherein each of the upper and lower rims include a width of four inches (5″) and a depth of four inches (3″).

10. The access assembly ofclaim 1, wherein the slit includes a length of at least two and one-half inches (2.5″).

11. The access assemblyclaim 1, wherein the compressible body is composed of at least one of silicone, thermoplastic elastomers (TPE) and rubber.

12. The access assemblyclaim 1, wherein the compressible body is composed of foam.

13. The access assemblyclaim 1, wherein the compressible body is composed of gel.

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