US20160338686A1 - Seal port with blood collector - Google Patents

Abstract

An access assembly for insertion through a single incision is provided. The access assembly includes a foam body having a proximal end and a distal end and a plurality of lumens extending through the foam body. Each of the lumens includes a sleeve extending the length of the body. The foam body has a central portion and a lower rim at a distal end of the central portion. The lower rim defines a circular recess, about the body, along a proximal side of the lower rim.

Description

CROSS REFERENCE TO RELATED APPLICATION
• This application is a continuation of U.S. patent application Ser. No. 13/031,352 filed Feb. 21, 2011, which claims the benefit of and priority to U.S. Provisional Application Ser. No. 61/355,379 filed on Jun. 16, 2010, and the disclosures of each of the above-identified applications are hereby incorporated by reference in their entirety.
BACKGROUND
• Technical Field
• The present disclosure relates to a flexible access assembly for use in single incision surgical procedures. More particularly, the present disclosure relates to a flexible access assembly having a mechanism for the removal of bodily fluids.
• Background of Related Art
• Today, many surgical procedures are performed through small incisions in the skin, as compared to the larger incisions typically required in traditional procedures, in an effort to reduce both trauma to the patient and recovery time. Generally, such procedures are referred to as “endoscopic”, unless performed on the patient's abdomen, in which case the procedure is referred to as “laparoscopic”. Throughout the present disclosure, the term “minimally invasive” should be understood to encompass both endoscopic and laparoscopic procedures.
• During a typical minimally invasive procedure, surgical objects, such as surgical access devices (e.g., trocar and cannula assemblies) or endoscopes, are inserted into the patient's body through the incision in tissue. In general, prior to the introduction of the surgical object into the patient's body, insufflation gases are used to enlarge the area surrounding the target surgical site to create a larger, more accessible work area. Accordingly, the maintenance of a substantially fluid-tight seal is desirable so as to prevent the escape of the insufflation gases and the deflation or collapse of the enlarged surgical site.
• To this end, various access devices with valves and seals are used during the course of minimally invasive procedures and are widely known in the art. However, a continuing need exists for surgical access devices that can facilitate the accessibility of an underlying tissue site with relative ease and with minor inconvenience for the surgeon.
SUMMARY
• Accordingly, an access assembly for insertion through a single incision is disclosed herein. The access assembly includes a body, e.g., a foam body, having a proximal end and a distal end and a plurality of lumens extending through the foam body, each of the lumens including a sleeve extending at least a portion of the length of the body. The foam body includes a central portion and a lower rim at a distal end of the central portion. The lower rim defines a circular recess, about the body, along a proximal side of the lower rim.
• The body has an upper rim at a proximal end of the central portion. Both the lower rim and an upper rim have a diameter greater than a diameter of the central portion. The access assembly may define four lumens. The sleeves are integrally formed with the body, or instead, the sleeves may be securely affixed with the body. The sleeves may be formed from one polymer and plastic. The sleeves may define a circular cross-section. The sleeves may include a braided material. The access assembly may further include one or more cannula assemblies inserted through the plurality of lumens. The body may include a Parylene coating. Various other coatings, e.g., hydrophilic, hydrophobic, bio-agents, anti-infection, analgesic, may also be employed.
DESCRIPTION OF THE DRAWINGS
• Various embodiments of the present disclosure are described hereinbelow with reference to the drawings, wherein:
• FIG. 1 is a perspective view of an embodiment of an access assembly according to the present disclosure;
• FIG. 2 is a top view of the access assembly ofFIG. 1;
• FIG. 3 is a cross-sectional side view of the access assembly ofFIGS. 1 and 2 taken along line3-3 ofFIG. 2;
• FIG. 4 is a perspective view of a tissue section having an incision therethrough with an underlying body organ shown in phantom;
• FIG. 5 is a perspective view of the access assembly ofFIG. 1 prepared for insertion through the incision in the tissue;
• FIG. 6 is a perspective view of the flexible access assembly ofFIG. 1 positioned through the incision in the tissue;
• FIG. 7 is a side view, partially shown in cross-section, of the access assembly ofFIG. 1, including a stopcock valve and a pair of cannula assemblies received therethrough;
• FIG. 8 is a perspective view of an alternative embodiment of an access assembly according to the present disclosure;
• FIG. 9 is a top view of the access assembly ofFIG. 10; and
• FIG. 10 is a cross-sectional side view of the access assembly ofFIGS. 9 and 10 taken along line10-10 ofFIG. 9.
• Other features of the present disclosure will become apparent from the following detailed description, taken in conjunction with the accompanying drawings, which illustrate, by way of example, the principles of the present disclosure.
DETAILED DESCRIPTION
• Embodiments of the presently disclosed access assembly 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.
• One type of minimal invasive surgery described herein is multiple instrument access through a single surgical port. This technique is a minimally invasive surgical procedure, which permits a surgeon to operate through a single entry point, typically the patient's navel. The disclosed procedure involves insufflating the body cavity with a housing member positioned within an opening in the patient's skin. Instruments including an endoscope and additional instruments such as graspers, staplers, forceps or the like may be introduced within the port to carry out the surgical procedure. The presently disclosed access port may be used with a surgically created incision, a naturally occurring opening such as the anus or the vagina, or in non-laparoscopic procedures.
• Referring toFIGS. 1-3, there is disclosed anaccess assembly10 for use in single incision surgery.Access assembly10 is flexible or compressible to allow it to be inserted through a single incision in the body of a patient such that after insertion it will expand and seal within the incision. Additionally, the flexible nature ofaccess assembly10 allows surgical instruments inserted therethrough to be manipulated about their axes and thus allow a higher degree of movement of the surgical instruments to orient them relative to the tissue being operated upon.
• Still referring toFIGS. 1-3,access assembly10 includes a flexible body orhousing12 defining a plurality oflumens16,18,20.Body12 may be formed of various materials such as, for example, silicone, thermoplastic elastomers (TPE), rubber, foam, gel, etc. In this manner,body12 ofaccess assembly10 may be compressed or squeezed and inserted through an incision in the body of a patient. In one embodiment,body12 includes TPE material that is infused with an inert gas, e.g. CO₂or nitrogen, to form a foam structure.Body12 may be coated with a lubricant, e.g. Parylene N or C, in order to create a lubricious surface finish on all external surfaces. Various other coatings, e.g., hydrophilic, hydrophobic, bio-agents, anti-infection, analgesic, may also be employed. In this manner, the coating facilitates insertion ofbody12 into an incision and insertion of cannula assemblies (FIG. 7) therethrough.
• With reference still toFIGS. 1-3,body12 defines a substantially hourglass shape when viewed from the side, including acentral portion22 having anupper rim24 located at aproximal end26 ofcentral portion22 and alower rim28 located at adistal end30 ofcentral portion22.Upper rim24 andlower rim28 aid in preventing movement ofaccess assembly10 longitudinally through the incision “I” (FIG. 4) in the patient. Thelower rim28 defines acircular recess40 along aproximal side41 of thelower rim28. Therecess40 encircles thebody12 to form a circular indentation completely about thebody12.
• Avertical lumen42 extends through thebody12 and connects with ahorizontal lumen44 to produce alongitudinal passageway43 that extends from theproximal end26 of thecentral portion22 to ahorizontal passageway45 that extends into therecess40. It is contemplated thatpassageway43 and/orpassageway45 may be coated with an anti-coagulant.
• As disclosed, therecess40 is defined by a semi-circular cross-section. However, it is contemplated that any cross-sectional shape may be used. It is also contemplated that thehorizontal lumen44 may intersect with therecess40 from any relative position, including along a bottom of therecess40. It is further contemplated that the cross-sectional shape may vary about a circumference of therecess40.
• Lumens16,18,20 extend throughbody12 and define longitudinal axes configured to receive a cannula assembly50 (FIG. 7), avalve assembly60 and/or other insufflation apparatus. As shown,lumens16,18,20 includesleeves16a,18a,20a, respectively, extending the length ofbody12.Sleeves16a,18a,20amay be integrally formed withbody12, or instead may be securely affixed tobody12 using adhesive, ultrasonic welding or other suitable means.Sleeves16a,18a,20aare formed of a plastic, polymer or other suitable material and are configured to prevent tearing ofbody12 as a cannula assembly or other apparatus is inserted therethrough.Sleeves16a,18a,20aare typically formed of a harder or less flexible material thanbody12 to resist stretching.Sleeves16a,18a,20amay also be coated with a lubricant to assist in insertion ofcannula assemblies50 and/orvalve assembly60.
• Referring now toFIGS. 4-7, the use ofaccess assembly10 in a single incision surgical procedure will now be described. Althoughaccess assembly10 will be described as relates to relates to a procedure for excising and removing a body organ, the aspects of the present disclosure may be modified for use in any closed procedure and should not be read as limited to the procedure herein described.
• Referring initially toFIG. 4, a single incision “I” is formed through a body tissue “T” and above a body organ, such as, for example, kidney “K”. Turning now toFIG. 5, once incision “I” has been formed through body tissue “T”,body12 ofaccess assembly10 is squeezed or compressed to reducebody12 to a relatively smaller diameter for insertion through incision “I”. As noted hereinabove,body12 is formed of a flexible material which allowsaccess assembly10 to be compressed. It should be recognized that thebody12 may be compressed into any suitable configuration prior to being inserted into an incision, not merely the configuration shown inFIG. 5. For example, in an embodiment, prior to insertion thebody12 is clamped at its distal end while the proximal end of thehousing12 remains essentially uncompressed, and the clamped distal end is inserted into the incision.
• Referring toFIG. 6, onceflexible access assembly10 has been inserted through incision “I”, pressure onbody12 is released, allowingbody12 to return towards its initial uncompressed state within incision “I”. Typically, the incision “I” is formed having a size that is smaller than the diameter of the initial uncompressed state of thehousing12. In this manner, when in place within the incision “I”, thehousing12 contacts and presses against the inner surface of the incision “I”, thereby retracting the opening and sealing with the incision “I”. Since incisions are often slit-shaped when formed, the portion of thehousing12 that is located within the incision may be somewhat oval-shaped (when viewed from above). As noted hereinabove,body12 includesupper rim24 andlower rim28 to prevent migration ofaccess assembly10 through incision “I” in body tissue “T”.
• Turning toFIG. 7, onceaccess assembly10 has been positioned above kidney “K”,cannula assemblies50 and/orvalve assembly60 may be inserted throughseal lumens16,18,20 to operate on kidney “K”.Cannula assembly50 includes ahousing52 configured to sealingly receive aninstrument5 and anelongated cannula52 configured to extend through one oflumens16,18,20.Housing52 may include aninsufflation port53. Although shown includingcannula assembly50, any cannula assembly capable of being received throughlumens16,18,20 may be used withaccess assembly10.Valve assembly60 is configured to be received through one oflumens16,18,20.Valve assembly60 may include a stopcock or other type ofvalve62 for selectively providing insufflation gas throughaccess assembly10. Although shown includingvalve assembly60, any valve assembly capable of sealed reception withinlumens16,18,20 may be used withaccess assembly10.
• Still referring toFIG. 7, once the body cavity has been properly insufflated, either throughvalve assembly60 orinsufflation port53 ofcannula assembly50, kidney “K” may be operated upon to excise it from the surrounding tissue. One or more surgical instruments, such as, for example, tissue graspers or surgical staplers, are inserted through and manipulated withincannula assemblies50 to complete the procedure. As shown,instrument5 may be inserted and retracted, in the direction of arrows “A”, through any ofseal lumens16,18,20 that have received acannula assembly50 therethrough. Due to the flexible nature ofaccess assembly10,cannula assembly50 may be flexed relative thereto. In this manner, onceinstrument5 is inserted throughcannula assembly50, aproximal end5aofinstrument5 may be manipulated in any direction, as indicated by arrows “B”. Thus,access assembly10 permits a surgeon to manipulate or orientinstrument5 at various locations relative to the tissue being operated upon.Cannula assemblies50 may also be flexed relative to each other. In this manner, a first instrument inserted through a first cannula assembly may be manipulated relative to a second instrument inserted through a second cannula assembly.
• With continued reference toFIG. 7, therecess40 functions to collectbodily fluids48 from the incision “I”. Avacuum source64 may be connected with thevertical lumen42, which is connected with therecess40 by thehorizontal lumen44. As a result, anybodily fluids48 that are collected within therecess40 can be removed. Thus,bodily fluids48 may be collected and dispensed with during a minimally invasive surgical procedure to aid in the prevention of contamination and visual impairment of the surgical work site.
• Upon completion of the procedure,cannula assemblies50 andvalve assembly60 are removed fromrespective lumens16,18,20.Access assembly10 is then compressed or squeezed such that it may be removed from incision “I”. Incision “I” is then closed in a conventional manner.
• Turning now toFIGS. 4-6, an alternative embodiment of an access assembly according to the present disclosure is shown generally asaccess assembly110.Access assembly110 is substantially similar toaccess assembly10 described hereinabove, and will only be described as relates to the differences therebetween.Access assembly110 includes abody112 defining a plurality oflumens116,118,120. Each oflumens116,118,120 includes asleeve116a,118a,120a, respectively. Each ofsleeves116a,118a,120ais formed of a braided mesh. As withsleeves16a,18a,20a, described hereinabove,sleeves116a,118a,120aare configured to prevent tearing ofbody112 as cannula assembly and other apparatus are inserted therethrough.
• It will be understood that various modifications may be made to the embodiments disclosed herein. For example, as noted hereinabove, the disclosed flexible access assembly may be provided with multiple lumens in excess of the disclosed three lumens. Additionally, the diameters or configuration of the disclosed lumens need not be identical but may be varied depending upon the contemplated surgical instruments to be utilized therethrough. 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 (17)

1-11. (canceled)

12. An access assembly for insertion through tissue, comprising:

a body formed of a flexible material, the body including a proximal end and a distal end having a distal rim, the body defining a fluid lumen extending between the proximal end and the distal rim, the fluid lumen including an opening on a proximal side of the distal rim, the distal rim defining a circular groove on the proximal side thereof, wherein the fluid lumen is in fluid communication with the circular groove such that the fluid lumen enables extraction of bodily fluids from the circular groove.

13. The access assembly according toclaim 12, wherein the body further defines a lumen extending therethrough, the lumen configured to receive a surgical instrument therethrough.

14. The access assembly according toclaim 13, wherein the body includes a sleeve disposed within the lumen.

15. The access assembly according toclaim 14, wherein the sleeve is integrally formed with the body.

16. The access assembly according toclaim 14, wherein the sleeve is formed of a braided mesh.

17. The access assembly according toclaim 12, wherein the body is formed of at least one of silicone, thermoplastic elastomer, rubber, foam, or gel.

18. The access assembly according toclaim 12, wherein the body further defines a passage extending between a distal end of the fluid lumen and the circular groove to provide fluid communication therebetween.

19. The access assembly according toclaim 12, wherein the body has a substantially hourglass shape.

20. The access assembly according toclaim 12, wherein the circular groove extends distally from the proximal side of the distal rim.

21. An access assembly for insertion through tissue, comprising:

a body including a proximal end and a distal end having a distal rim, the body defining:

a circular groove extending distally from a proximal side of the distal rim;

a fluid lumen extending between the proximal end and the distal rim; and

a passage extending between the circular groove and a distal portion of the fluid lumen such that the fluid lumen is in fluid communication with the circular groove.

22. The access assembly according toclaim 21, further comprising a vacuum source in fluid communication with the fluid lumen to extract bodily fluids from the circular groove.

23. The access assembly according toclaim 21, wherein at least one of the passage or the fluid lumen includes an anti-coagulant.

24. The access assembly according toclaim 21, wherein the body further defines a lumen configured to receive a surgical instrument therethrough.

25. The access assembly according toclaim 21, wherein the body further includes a sleeve.

26. The access assembly according toclaim 25, wherein the sleeve is formed of a braided mesh.

27. The access assembly according toclaim 21, wherein the body is formed of at least one of silicone, thermoplastic elastomer, rubber, foam, or gel.

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