Search Images Maps Play YouTube News Gmail Drive More »
Sign in
Screen reader users: click this link for accessible mode. Accessible mode has the same essential features but works better with your reader.

Patents

  1. Advanced Patent Search
Publication numberUS20090204081 A1
Publication typeApplication
Application numberUS 12/030,590
Publication date13 Aug 2009
Filing date13 Feb 2008
Priority date13 Feb 2008
Also published asEP2090258A1, EP2090258B1, EP2462884A1, EP2462884B1, US9161747, US20130303858, US20150374407
Publication number030590, 12030590, US 2009/0204081 A1, US 2009/204081 A1, US 20090204081 A1, US 20090204081A1, US 2009204081 A1, US 2009204081A1, US-A1-20090204081, US-A1-2009204081, US2009/0204081A1, US2009/204081A1, US20090204081 A1, US20090204081A1, US2009204081 A1, US2009204081A1
InventorsGregory R. Whittaker, Gary McAlister, Jason Hamilton
Original AssigneeDepuy Mitek, Inc.
Export CitationBiBTeX, EndNote, RefMan
External Links: USPTO, USPTO Assignment, Espacenet
Compression expanded cannula
US 20090204081 A1
Abstract
Various methods and devices are provided for accessing an interior surgical site using an access portal which can be inserted and removed with minimal tissue damage and which can form a seal with tissue while inserted. Generally, a device is provided having a rigid elongate surgical access member with a lumen extending therethrough that is configured to receive a surgical tool. The device can also include a flexible sleeve having a lumen extending therethrough that is configured to receive the elongate surgical access member. A substantially rigid collar is provided disposed adjacent to a proximal end of the flexible sleeve and having a lumen extending therethrough that is configured to receive the elongate surgical access member. In an exemplary embodiment, the collar is movable relative to the elongate surgical access member to selectively configure the flexible sleeve in a relaxed condition in which the flexible sleeve has a relatively smooth outer tissue-contacting surface and a compressed condition in which the flexible sleeve has a plurality of protrusions formed on the outer tissue-contacting surface that are configured to create a seal between the outer tissue-contacting surface and tissue.
Images(12)
Previous page
Next page
Claims(23)
1. A surgical access device, comprising:
an elongate surgical access member having a lumen extending therethrough that is configured to receive a surgical tool;
a flexible sleeve member having a lumen extending therethrough that is configured to receive the elongate surgical access member; and
a substantially rigid collar member disposed adjacent to a proximal end of the flexible sleeve and having a lumen extending therethrough that is configured to receive the elongate surgical access member, the collar member being movable relative to the elongate surgical access member to selectively configure the flexible sleeve in a relaxed condition in which the flexible sleeve has a relatively smooth outer surface and a compressed condition in which the flexible sleeve has a plurality of protrusions formed on the outer surface that are configured to create a seal between the outer surface and tissue,
wherein the flexible sleeve is normally in the relaxed condition and is configured to receive a compressive force to be configured in the compressed condition.
2. The device of claim 1, wherein the plurality of protrusions are configured to increase an outer diameter of the flexible sleeve in the compressed condition.
3. The device of claim 1, wherein the plurality of protrusions are one of threads and ribs.
4. The device of claim 1, wherein the collar member includes threads formed on an interior surface thereof which are configured to mate to corresponding threads formed on an exterior surface of the elongate surgical access member.
5. The device of claim 4, wherein the collar member is configured to rotate via the mated threads and move in a distal direction to move the flexible sleeve distally into the compressed condition.
6. The device of claim 1, wherein the device further comprises at least one camming member in communication with the rigid collar member.
7. The device of claim 6, wherein the at least one camming member is rotatable to configure the flexible sleeve in a compressed condition.
8. The device of claim 1, wherein the elongate surgical access member comprises a cage member coupled between the rigid collar member and a distal ring.
9. The device of claim 8, wherein the rigid collar member is effective to move the cage member proximally to configure the flexible sleeve in a compressed condition.
10. A surgical access device, comprising:
a body defining a central longitudinal axis; and
a deformable surgical access member configured to be in communication with the body, the deformable surgical access member defining an outer tissue-contacting surface,
wherein the deformable surgical access member is configured to receive a compressive force to effect an increase in an outer diameter thereof to configure the outer tissue-contacting surface in a condition effective to form a seal with tissue.
11. The device of claim 10, wherein the outer tissue-contacting surface contains threads configured to form a seal with tissue when a compressive force is applied to the deformable surgical access member.
12. The device of claim 10, wherein the deformable surgical access member is disposed between a substantially rigid band disposed adjacent to a proximal end of the deformable surgical access member and a substantially rigid distal ring.
13. The device of claim 12, wherein the substantially rigid band includes threads formed on an interior surface thereof and configured to mate with corresponding threads formed on an exterior surface of the body.
14. The device of claim 13, wherein the substantially rigid band is configured to rotate via the mated threads to move the substantially rigid band distally and cause the outer tissue-contacting surface of the deformable surgical access member to form a seal with tissue.
15. The device of 13, wherein the body comprises a cage member, and the substantially rigid band is configured to rotate via the mated threads to move the cage member proximally to cause the outer tissue-contacting surface of the deformable surgical access member to form a seal with tissue.
16. A method for providing instrument access within a patient, comprising:
providing a cannula assembly including an elongate surgical access member with a bore formed therethrough configured to receive a surgical tool;
inserting the cannula assembly into an incision in a patient in an insertion condition in which the flexible sleeve has a relatively smooth exterior surface; and
applying a compressive force to the flexible sleeve to move the flexible sleeve from the insertion condition to a compressed condition in which the exterior surface of the flexible sleeve includes surface features which extend radially outward from the elongate surgical access member to form a seal with tissue.
17. The method of claim 16, wherein an outer diameter of the flexible sleeve is greater in the compressed condition than in the insertion condition.
18. The method of claim 16, further comprising inserting at least one surgical tool through the bore in the member to effect a surgical procedure.
19. The method of claim 16, wherein the compressive force is applied by sliding a member distally relative to the elongate surgical access member.
20. The method of claim 16, wherein the compressive force is applied by rotating a threaded member along complimentary threads on the elongate surgical access member.
21. The method of claim 16, wherein the compressive force is applied by rotating at least one camming member.
22. The method of claim 16, wherein the compressive force is applied by withdrawing a surgical tool from the elongate surgical access member and the flexible sleeve.
23. The method of claim 22, wherein the compressed condition is the natural state of the flexible sleeve 114.
Description
    FIELD
  • [0001]
    The present invention generally relates to methods and devices for providing access portals through which surgical instruments can be inserted. More particularly, the invention relates to devices which can be inserted into and removed from a patient with minimal tissue damage.
  • BACKGROUND
  • [0002]
    Arthroscopic, or more generally, minimally invasive surgical procedures rely on obtaining percutaneous access to an internal surgical site using small-diameter openings to gain access to the desired surgical site. In many cases, access tubes are placed through the opening to allow a variety of elongated instruments to be passed through the access tubes to gain access to an internal surgical work site without the need for large incisions. As a result, patient trauma and recovery time are typically reduced.
  • [0003]
    Very often, these access tubes, which are often called cannulas, must be left in an incision for an extended period of time, without significant movement, as instruments are inserted and removed. This typically requires rigid surface features on the exterior of the cannula, such as corrugations or threads, to engage the tissue surrounding the cannula. These rigid surface features, however, can cause tissue damage as the cannula is inserted and usually do not result in the most secure fit once in place due to tissue trauma surrounding the cannula. The cannula can also be difficult to remove once inserted due to the rigid surface features, possibly leading to further tissue damage during removal.
  • [0004]
    Accordingly, there is a need for improved devices and methods that provide access portals which can be inserted into and removed from an incision with minimal tissue damage and can effectively engage tissue while within the incision.
  • SUMMARY OF THE INVENTION
  • [0005]
    The present invention generally provides access portals through which surgical procedures can be performed and that can be inserted and removed with minimal tissue damage to form a seal with tissue while inserted. In one embodiment, a surgical access device is provided having an elongate surgical access member with a lumen extending therethrough that is configured to receive a surgical tool. The surgical access device can also include a flexible sleeve having a lumen extending therethrough that is configured to receive the elongate surgical access member. A substantially rigid collar member can be disposed adjacent to a proximal end of the flexible sleeve having a lumen extending therethrough that is configured to receive the elongate surgical access member. In an exemplary embodiment, the collar member is movable relative to the elongate surgical access member to selectively configure the flexible sleeve in a relaxed condition in which the flexible sleeve has a relatively smooth outer tissue-contacting surface and a compressed condition in which the flexible sleeve has a plurality of protrusions formed on the outer tissue-contacting surface that are configured to create a seal between the outer tissue-contacting surface and tissue. The flexible sleeve is normally in the relaxed condition and is configured to receive a compressive force to be configured in the compressed condition.
  • [0006]
    In an exemplary embodiment, the plurality of protrusions are configured to increase an outer diameter of the flexible sleeve in the compressed condition and can be threads and/or ribs. In addition, the collar member can include threads formed on an interior surface thereof which are configured to mate to corresponding threads formed on an exterior surface of the elongate surgical access member. In one exemplary embodiment, the collar member is configured to rotate via the mated threads and to move the flexible sleeve distally into the compressed condition. The surgical access device can further include at least one camming member in communication with the rigid collar member where the camming member is rotatable to configure the flexible sleeve in a compressed condition. In another exemplary embodiment, the elongate surgical access member can be a cage member coupled between the rigid collar member and a distal ring, where the rigid collar member is effective to move the cage member proximally to configure the flexible sleeve in a compressed condition.
  • [0007]
    In a further embodiment, a surgical access device is provided having a body defining a central longitudinal axis and a deformable surgical access member configured to be in communication with the body. The deformable surgical access member can define an outer tissue-contacting surface such that the deformable surgical access member is configured to receive a compressive force to effect an increase in an outer diameter thereof to configure the outer tissue-contacting surface in a condition effective to form a seal with tissue. In one exemplary embodiment, the outer tissue-contacting surface can contain threads configured to form a seal with tissue when a compressive force is applied to the deformable surgical access member.
  • [0008]
    In an embodiment, the deformable surgical access member is disposed between a substantially rigid band disposed adjacent to a proximal end of the deformable surgical access member and a substantially rigid distal ring. The substantially rigid band can include threads formed on an interior surface thereof which are configured to mate with corresponding threads formed on an exterior surface of the body. The substantially rigid band can be configured to rotate via the mated threads to move the substantially rigid band distally and to cause the outer tissue-contacting surface of the deformable surgical access member to form a seal with tissue. In another embodiment, the elongate surgical access member can be a cage member and the substantially rigid band can be configured to rotate via the mated threads to move the cage member proximally to cause the outer tissue-contacting surface of the deformable surgical access member to form a seal with tissue.
  • [0009]
    Methods are also provided relating to instrument access within a patient and include providing a cannula assembly having a elongate surgical access member with a bore formed therethrough configured to receive a surgical tool. The method can also include inserting the cannula assembly into an incision in a patient in an insertion condition in which the flexible sleeve has a relatively smooth exterior surface and applying a compressive force to the flexible sleeve to move the flexible sleeve from the insertion condition to a compressed condition in which the exterior surface of the flexible sleeve includes surface features which extend radially outward from the elongate surgical access member to form a seal with tissue. In an embodiment, an outer diameter of the flexible sleeve is greater in the compressed condition than in the insertion condition.
  • [0010]
    The method can further include inserting at least one surgical tool through the bore in the elongate surgical access member to effect a surgical procedure. In an embodiment, the compressive force is applied by sliding a member distally relative to the elongate surgical access member. In another embodiment, the compressive force is applied by rotating at least one camming member. In addition, the compressive force can be applied by withdrawing a surgical tool from the elongate surgical access member and the flexible sleeve, where the compressed condition is the natural state of the flexible sleeve.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • [0011]
    The invention will be more fully understood from the following detailed description taken in conjunction with the accompanying drawings, in which:
  • [0012]
    FIG. 1A is a front view of one embodiment of a surgical access device in a relaxed condition;
  • [0013]
    FIG. 1B is a front view of the device of FIG. 1A, in a compressed condition;
  • [0014]
    FIG. 1C is an exploded view of the device of FIG. 1A;
  • [0015]
    FIG. 2A is a front view of another embodiment of a surgical access device in the relaxed condition;
  • [0016]
    FIG. 2B is a front view of the device of FIG. 2A, in the compressed condition;
  • [0017]
    FIG. 2C is an exploded view of the device of FIG. 2A;
  • [0018]
    FIG. 3A is a further embodiment of a surgical access device in the relaxed condition;
  • [0019]
    FIG. 3B is a cross-section of the device of FIG. 3A, showing the compressed condition;
  • [0020]
    FIG. 3C is an exploded view of the device of FIG. 3A;
  • [0021]
    FIG. 4A is a front view of an exemplary embodiment of a surgical access device having a body and a flexible sleeve; and
  • [0022]
    FIG. 4B is a front view of the device of FIG. 4B, in the compressed condition.
  • DETAILED DESCRIPTION
  • [0023]
    Certain exemplary embodiments will now be described to provide an overall understanding of the principles of the structure, function, manufacture, and use of the devices and methods disclosed herein. One or more examples of these embodiments are illustrated in the accompanying drawings. Those skilled in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary embodiments and that the scope of the present invention is defined solely by the claims. The features illustrated or described in connection with one exemplary embodiment may be combined with the features of other embodiments. Such modifications and variations are intended to be included within the scope of the present application.
  • [0024]
    The present application provides methods and devices useful for accessing an interior surgical site using an access portal which can be inserted and removed with minimal tissue damage and which can form a seal with tissue while inserted. In an embodiment illustrated in FIGS. 1A-1C, a surgical access device 100 is provided having an elongate surgical access member 102 with a generally cylindrical body and a bore formed therethrough configured for receiving a surgical tool or other device. A proximal most end of the elongate surgical access member 102 can include two flange portions, a first flange portion 104 and a second flange portion 106, each of which have a larger diameter that the elongate surgical access member 102. As will be appreciated by those skilled in the art, the elongate surgical access member 102 and the first and second flanges 104, 106 can be configured to seat and receive surgical tools, valve systems, trocars, obturators, vacuum systems and any other devices that may aid in a surgical procedure. Threads 108 can be formed on an exterior surface of the elongate surgical access member 102, and while the threads 108 can be formed at any location along a length of the elongate surgical access member 102, in the illustrated embodiment, they are formed on a proximal portion of the elongate surgical access member 102 situated at a distance below the second flange 106. The threads 108 are configured to mate with corresponding threads on a substantially rigid collar, as will be described in detail below. A tapered portion 110 can be formed on a distal most end of the elongate surgical access member 102. As will be appreciated by a person skilled in the art, the size of the tapered portion 110 and the amount of tapering can vary depending on the surgical tools expected to be received by the device. A proximal portion of the tapered portion 110 can also include a lip 112 which has a diameter greater than a diameter of the elongate surgical access member 102. In an exemplary embodiment, the lip 112 can seat and/or mate to a distal portion of a deformable surgical access member or flexible sleeve 114 as will be described in detail below. As will be appreciated by those skilled in the art, the elongate surgical access member 102 can be rigid, flexible, and/or semi-rigid and can be formed from a variety of biocompatible materials, including but not limited to polycarbonate, ABS, polyetheretherketone (PEEK), polyetherimide, polystyrene, polyvinylchloride,polyester, polypropelene, polyethelene, polyurethane. One of ordinary skill in the art will appreciate that other polymers or blends thereof may be used to achieve similar properties.
  • [0025]
    In the embodiment illustrated in FIGS. 1A-1C, the substantially rigid collar is in the form of a two-part rotatable bushing 120 divided into a ring 122 and a nut 124. The ring 122 can include threads formed on an interior surface thereof which are configured to mate with the corresponding threads 108 formed on the exterior surface of the proximal portion of the elongate surgical access member 102, as described above. The ring 122 can also be configured to mate with the nut 124 by way, for example, of a press fit or sliding fit, so that the ring 122 can be rotated with respect to the nut 124. The nut 124 can include a proximal male portion 126 configured to seat the ring 122 and a distal male portion 128 configured to mate with a flange 116 formed on a proximal end of the flexible sleeve 114. In this way, the ring 122 can be rotated via the mated threads with respect to both the nut 124 and the flexible sleeve 114. As noted above, the bushing 120 can be substantially rigid and can be formed from a variety of biocompatible materials, including but not limited to polycarbonate, ABS, polyetheretherketone (PEEK), polyetherimide, polystyrene, polyvinylchloride, polyester, polypropelene, polyethelene, polyurethane. One of ordinary skill in the art will appreciate that other polymers or blends thereof may be used to achieve similar properties.
  • [0026]
    The flexible sleeve 114 can be a substantially tubular member which can be configured to receive the elongate surgical access member 102 within a bore formed therein. In one embodiment, illustrated in FIGS. 1A-1C, a distal most end 118 of the flexible sleeve 114 rests on the lip 112 of the elongate surgical access member 102 and is mated thereto so that the distal most end 118 of the flexible sleeve 114 cannot be moved relative to the elongate surgical access member 102. The flange 116 on the proximal most end of the flexible sleeve 114 can be coupled to the distal male portion 128 of the bushing 120, and can be configured to be movable with the bushing 120 relative to the elongate surgical access member 102. The flexible sleeve 114 is deformable and can be formed from a variety of biocompatible materials, including but not limited to polyvinylchloride, polyurethane, silicone, polyetherimide, polyeetherester, thermoplastic polyolefins. One of ordinary skill in the art will appreciate that other polymers or blends thereof may be used to achieve similar properties.
  • [0027]
    The flexible sleeve is designed to be selectively configured in a relaxed condition and in a compressed condition. In the relaxed condition, which is the normal or natural state of the flexible sleeve 114, an outer tissue-contacting surface 132 of the flexible sleeve 114 has a relatively smooth surface, as shown in FIG. 1A, with a first diameter D1. While the flexible sleeve 114 can be configured in many different ways, in one embodiment, in the relaxed condition, the flexible sleeve 114 is configured to fit relatively tightly around an outer tissue-contacting surface of the elongate surgical access member 102. Accordingly, in one exemplary embodiment, in the relaxed condition, the difference between the outer diameter of the elongate surgical access member 102 and the first diameter of the flexible sleeve 114 is essentially the thickness of the flexible sleeve 114 itself.
  • [0028]
    In an embodiment in which the flexible sleeve 114 is configured to be in the compressed condition, a plurality of protrusions 130 can form on the outer surface of the flexible sleeve 114. In the illustrated embodiment, the plurality of protrusions 130 are in the form of threads which are disposed on a distal portion of the flexible sleeve 114. A person skilled in the art will appreciate, however, that the protrusions 130 can also be ridges, threads, ribs or other surface irregularities which can be formed over the entire outer surface of the flexible sleeve 114, or over only a very particular area of the outer surface 132. Therefore, if the flexible sleeve 114 is configured in a compressed condition, the outer surface 132 of the flexible sleeve 114 has a second diameter D2 shown in FIG. 1B, measured from the outermost boundary of the protrusions 130, which is greater than the first diameter D1. In an exemplary embodiment, the first diameter D1 in the relaxed condition can be in the range of about 1 to 5 mm, and more preferably in the range of about 2 to 3 mm. In the compressed condition, the second diameter D2 can be in the range of about 2 to 10 mm, and more preferably in the range of about 4 to 6 mm. A person skilled in the art will appreciate that the device 100 can have any first and second diameter necessary for a particular procedure, or to accommodate any size surgical tool as needed. The protrusions 130 can engage and form a seal with tissue when the device 100 is in the compressed condition.
  • [0029]
    In one embodiment, the protrusions 130 in the flexible sleeve 114 can be pre-formed in the material of the flexible sleeve 114 so that the outer surface 132 remains relatively smooth in the relaxed condition, and threads, ribs, or other surface irregularities will form when the flexible sleeve 114 is configured in the compressed condition. A person skilled in the art will appreciate the various ways that the protrusions 130 can be pre-formed in the flexible sleeve 114.
  • [0030]
    In an exemplary embodiment, in use, the device 100 can be inserted into an incision in a patient in an insertion condition in which the flexible sleeve 114 is in a relaxed condition such that the outer surface 132 of the flexible sleeve 114 is relatively smooth. After the device 100 is inserted and positioned as needed within the patient, the ring 122 can be rotated, for example, in a clockwise direction, via the mated threads to configure the flexible sleeve in a compressed condition as the nut 124 and the flexible sleeve 114 are moved in a distal direction. As this action moves the flexible sleeve 114 in a distal direction, the flexible sleeve 114 is compressed between the nut 124 and the lip 112 formed on the tapered portion 110 of the elongate surgical access member 102 so as to cause protrusions 130 to form in the outer surface 132 of the flexible sleeve 114. The protrusions 130 can be configured to engage tissue to prevent pullout and/or movement and to form a seal with the surrounding tissue. Surgical instruments can be inserted and removed through the bore in the elongate surgical access member 102 to perform surgical procedures as needed. At a point in time when the device 100 is no longer needed within the patient, the ring 122 can be rotated in an opposite direction, for example, counter-clockwise, via the mated threads to cause the nut 124 and the flexible sleeve 114 to move in a proximal direction. As the flexible sleeve 114 is moved proximally, the protrusions 130 in the flexible sleeve 114 disengage from sealing contact with the surrounding tissue and essentially disappear as the compression is removed from the flexible sleeve 114 so that the outer surface 132 of the flexible sleeve 114 is relatively smooth and in the relaxed or insertion condition. The device 100 can then be removed from the incision with minimal tissue damage.
  • [0031]
    In another embodiment, shown in FIGS. 2A-2C, an access device 200 is provided having the rigid elongate surgical access member 102 and flexible sleeve 114 as described above. In addition, the device 200 can include an activation mechanism for configuring the flexible sleeve 114 in the relaxed condition and the compressed condition. The activation mechanism can include a slider member 220 having a bore formed therethrough for receiving the elongate surgical access member 102 and at least one camming member. In the illustrated embodiment, the activation mechanism includes two camming members 230. The slider member 220 can include a proximal flange 222, a base portion 224, and a male mating portion 226 configured to mate with the flange 116 formed on the proximal end of the flexible sleeve 114. The slider member 220 can be configured in many ways, but in the illustrated embodiment, the slider member 220 is adapted to slide relative to the elongate surgical access member 102. In an exemplary embodiment, the camming members 230 are rotatable members coupled to a proximal portion of the elongate surgical access member 102 and are configured to rotate via pins 232 or other connection means known in the art. The camming members 230 are disposed adjacent to the proximal flange 222 of the slider member 220 and are adapted to act upon the proximal flange 222 when the activation mechanism is activated to configure the flexible sleeve 114 in a relaxed condition or a compressed condition, as will be described below.
  • [0032]
    In an exemplary embodiment, in use, the device 200 can be inserted into an incision in a patient in an insertion condition in which the flexible sleeve 114 is in a relaxed condition such that the outer surface 132 of the flexible sleeve 114 is relatively smooth, as shown in FIG. 2A. After the device is inserted and positioned as needed within the patient, the camming members 230 can be rotated, such as by ninety degrees, as shown in FIG. 2B to cause the slider member 220 to move in a distal direction. As the slider member 220 moves in a distal direction, the proximal end of the flexible sleeve 114 is also moved distally so as to compress the flexible sleeve 114 between the slider member 220 and the lip 112 formed on the tapered portion 110 of the elongate surgical access member 102 and configure the flexible sleeve 114 in a compressed condition. As the flexible sleeve 114 is compressed, protrusions 130 form on the outer surface 132 of the flexible sleeve 114 to engage and form a seal with the surrounding tissue, thereby preventing movement and pullout of the device 200 from the incision. Surgical instruments can be inserted and removed through the bore in the elongate surgical access member 102 to perform surgical procedures as needed. At a point in time when the device is no longer needed within the patient, the camming members 230 can be rotated ninety degrees in the opposite direction, as shown in FIG. 2A, to cause the slider member 220 and the proximal end of the flexible sleeve 114 to move in a proximal direction. As the flexible sleeve 114 is moved proximally, the protrusions 130 in the flexible sleeve 114 disengage with the surrounding tissue and disappear as the compression is removed from the flexible sleeve 114 so that the outer surface 132 of the flexible sleeve 114 is relatively smooth and in the relaxed condition. The device 200 can be removed from the incision with minimal tissue damage.
  • [0033]
    In a further embodiment, shown in FIGS. 3A-3C, a device 300 is provided having a cage member 310 coupled to a receiver body 320. The cage member 310 can include a proximal ring 312 that can be rigidly mated with an interior surface of the receiver body 320 by any means known in art, for example a snap fit, press fit, or adhesive. The receiver body 320 and the cage member 310 can have a bore formed therethrough for receiving a surgical tool or other instrument. In an exemplary embodiment, the receiver body 320 can include a proximal flange 322 and a threaded male portion 324 adapted to mate with a corresponding threaded female portion 328 of a substantially rigid collar 326. The rigid collar 326 can have a bore formed therethrough that is configured to receive the cage member 310 when the rigid collar 326 is threadedly mated with the receiver body 320. The cage member 310 can also include about 2 to 10, and more preferably about 4 to 6, vertical bars 316 extending from the proximal ring 312 to a distal ring 314 to form the cage-like structure of the cage member 310. The distal ring 314 of the cage member 310 can be configured to mate with a distal compression member 330 by any means known in the art such as a press fit, a snap fit, or adhesive. A flexible sleeve 114 is disposed between a distal end of the rigid collar 326 and a proximal surface of the distal compression member 330 and includes a bore formed therethrough for receiving the cage member 310.
  • [0034]
    In an exemplary embodiment, in use, the device 300 can be inserted into an incision in a patient in an insertion condition in which the flexible sleeve 114 is in a relaxed condition such that the outer surface 132 of the flexible sleeve 114 is relatively smooth, as shown in FIG. 3A. After the device 300 is inserted and positioned as needed within the patient, the receiver body 320 can be rotated via the mated threads “out” of the rigid collar 326 to move in a proximal direction. As the receiver body 320 is moved proximally, the cage member 310 and the distal compression member 330 are both pulled proximally, thereby compressing the flexible sleeve 114 between the rigid collar 326, which is not moving, and the distal compression member 330. As the flexible sleeve 114 is compressed, protrusions 130 form on the outer surface 132 thereof to engage and form a seal with the surrounding tissue, thereby preventing movement and pullout of the device 300 from the incision. Surgical instruments can be inserted and removed through the bore in the elongate surgical access member 102 to perform surgical procedures as needed. At a point in time when the device 300 is no longer needed within the patient, the receiver body 320 can be rotated via the mated threads back “into” the rigid collar 326 to move in a distal direction, thereby moving the cage member 310 and the distal compression member 330 distally. As the distal compression member 330 is moved distally, the flexible sleeve 114 disengages from a seal with the surrounding tissue and returns to the insertion or relaxed condition as the compression is removed to have a relatively smooth outer surface 132. The device 300 can then be removed from the incision with minimal tissue damage.
  • [0035]
    In another embodiment, shown in FIGS. 4A and 4B, a device 400 is provided having a substantially rigid collar 420 disposed adjacent to the flexible sleeve 114. The device 400 can also include a distal ring 430 coupled to the distal end of the flexible sleeve 114. A bore can be formed through the rigid collar 420, the flexible sleeve 114, and the distal ring 430 adapted for receiving a body 410. The body 410 can be any device or surgical tool known in the art, and in the illustrated embodiment, the body 410 is an obturator. In an exemplary embodiment, the body 410 can include a flange 412 configured to be disposed adjacent to a proximal flange 422 on the rigid collar 420 when the body 410 is disposed within the bore. The body 410 can have an outer diameter OD that is larger than an inner diameter ID of the distal ring 430 so that the body 410 can be contained within the bore while being prevented from passing through the distal ring 430. When the body 410 is contained within the bore, the flexible sleeve 114 is stretched so that the flexible sleeve 114 has a relatively smooth outer surface 132, as shown in FIG. 4A. When the body 410 is removed from the bore, the flexible sleeve 114 returns to its natural state in which it is compressed between the distal ring 430 and the rigid collar 420, causing protrusion 130 to form in the outer surface 132. In the illustrated embodiment, the protrusions 130 are in the form of threads.
  • [0036]
    In an exemplary embodiment, in use, the device 400 can be inserted into an incision in a patient with the body 410 contained within the bore. The body 410 causes the flexible sleeve 114 to be stretched such that the outer surface 132 of the flexible sleeve 114 is relatively smooth in an insertion condition, allowing the device 400 to be inserted with minimal tissue damage. After the device 400 is placed as needed within the patient, the body 410 can be removed from the bore, thereby causing the flexible sleeve 114 to be compressed between the proximal collar 420 and the distal ring 430 in a compressed condition. As the flexible sleeve 114 is compressed, protrusions 130 form on the outer surface 132 of the flexible sleeve 114 to engage and form a seal with the surrounding tissue. Surgical instruments can be inserted and removed through the bore in the elongate surgical access member 102 to perform surgical procedures as needed. At a point in time when the device 400 is no longer needed within the patient, the body 410 can be inserted into the bore, thereby moving the distal ring 430 distally and removing the compression from the flexible sleeve 114 so that the protrusions 130 are removed from the outer surface 132. The flexible sleeve 114 disengages from a seal with the surrounding tissue as the compression is removed, and the device 400 can then be removed from the incision with minimal tissue damage.
  • [0037]
    The devices disclosed herein can also be designed to be disposed of after a single use, or they can be designed to be used multiple times. In either case, however, the device can be reconditioned for reuse after at least one use. Reconditioning can include any combination of the steps of disassembly of the device, followed by cleaning or replacement of particular pieces, and subsequent reassembly. In particular, the device can be disassembled, and any number of the particular pieces or parts of the device can be selectively replaced or removed in any combination. Upon cleaning and/or replacement of particular parts, the device can be reassembled for subsequent use either at a reconditioning facility, or by a surgical team immediately prior to a surgical procedure. Those skilled in the art will appreciate that reconditioning of a device can utilize a variety of techniques for disassembly, cleaning and/or replacement, and reassembly. Use of such techniques, and the resulting reconditioned device, are all within the scope of the present application.
  • [0038]
    Preferably, the devices described herein will be processed before surgery. First, a new or used device is obtained and if necessary cleaned. The device can then be sterilized. In one sterilization technique, the device is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and device are then placed in a field of radiation that can penetrate the container, such as gamma radiation, x-rays, or high-energy electrons. The radiation kills bacteria on the device and in the container. The sterilized device can then be stored in the sterile container. The sealed container keeps the device sterile until it is opened in the medical facility. It is preferred that the device is sterilized. This can be done by any number of ways known to those skilled in the art including beta or gamma radiation, ethylene oxide, or steam.
  • [0039]
    One skilled in the art will appreciate further features and advantages based on the above-described embodiments. Accordingly, the application is not to be limited by what has been particularly shown and described, except as indicated by the appended claims. All publications and references cited herein are expressly incorporated herein by reference in their entirety.
Patent Citations
Cited PatentFiling datePublication dateApplicantTitle
US3344791 *12 Feb 19653 Oct 1967Foderick John WBulbous urinary catheter with axial extension means
US3970090 *3 Feb 197520 Jul 1976Physio Medics, Inc.Catheter
US4430081 *6 Jan 19817 Feb 1984Cook, Inc.Hemostasis sheath
US4475548 *1 Jun 19829 Oct 1984Rudolph MutoFitting for endotracheal tube apparatus and method of making the fitting
US4655752 *7 Apr 19867 Apr 1987Acufex Microsurgical, Inc.Surgical cannula
US5053013 *18 Jun 19901 Oct 1991The Regents Of The University Of MichiganImplantable infusion device
US5176652 *26 Apr 19915 Jan 1993Cordis CorporationHemostasis valve
US5197971 *18 Dec 199030 Mar 1993Bonutti Peter MArthroscopic retractor and method of using the same
US5203773 *18 Oct 199120 Apr 1993United States Surgical CorporationTissue gripping apparatus for use with a cannula or trocar assembly
US5207656 *19 Apr 19904 May 1993Cordis CorporationMedical instrument valve having foam partition member
US5273545 *15 Oct 199128 Dec 1993Apple Medical CorporationEndoscopic cannula with tricuspid leaf valve
US5290249 *17 Sep 19921 Mar 1994Vance Products IncorporatedSurgical access sheath
US5443449 *22 Jun 199322 Aug 1995Applied Medical Resources CorporationCholangiography catheter
US5478329 *6 May 199426 Dec 1995Ternamian; Artin M.Trocarless rotational entry cannula
US5643227 *19 Jan 19951 Jul 1997Stevens; Robert C.Hemostasis cannula valve apparatus and method of using same
US5779697 *28 May 199714 Jul 1998Linvatec CorporationArthroscopic cannula with fluid seals
US5836913 *2 May 199717 Nov 1998Innerdyne, Inc.Device and method for accessing a body cavity
US5857999 *5 May 199512 Jan 1999Imagyn Medical Technologies, Inc.Small diameter introducer for laparoscopic instruments
US5888196 *5 Jun 199530 Mar 1999General Surgical Innovations, Inc.Mechanically expandable arthroscopic retractors
US6123689 *28 Mar 199726 Sep 2000Applied Medical Resources CorporationReusable cannula with disposable seal
US6210397 *13 Jan 19993 Apr 2001A-Med Systems, Inc.Sealing cannula device
US6432085 *7 Mar 200013 Aug 2002Tyco Healthcare Group LpSelf-retaining surgical access instrument
US6450992 *2 Jul 199917 Sep 2002Smith & Nephew, Inc.Cannula interface
US6610031 *18 Apr 200126 Aug 2003Origin Medsystems, Inc.Valve assembly
US6613062 *29 Oct 19992 Sep 2003Medtronic, Inc.Method and apparatus for providing intra-pericardial access
US6632197 *16 Apr 199914 Oct 2003Thomas R. LyonClear view cannula
US6695816 *26 Aug 200224 Feb 2004Smith & Nephew, Inc.Cannula interface
US6837871 *31 Mar 20034 Jan 2005Applied Medical ResourcesSelf-deploying catheter assembly
US7235064 *25 Feb 200326 Jun 2007Sherwood Services AgMethod and apparatus for anchoring laparoscopic instruments
US7311719 *8 Apr 200325 Dec 2007General Surgical Innovations, Inc.Active cannulas
US20010049502 *25 Nov 19986 Dec 2001Light Sciences CorporationGuide sheath for repeated placement of a device
US20020193806 *2 Aug 200219 Dec 2002Stephen P. MoenningApparatus and procedure for protecting a port site opening in the wall of a body cavity and reducing electrosurgical injuries
US20030009175 *26 Aug 20029 Jan 2003Smith & Nephew, Inc.Cannula interface
US20030093104 *25 Sep 200215 May 2003Bonner Matthew D.Methods and apparatus for providing intra-pericardial access
US20030167069 *31 Mar 20034 Sep 2003Gonzales Joseph A.Self-deploying catheter assembly
US20030195472 *23 May 200316 Oct 2003Green David T.Valve assembly for introducing instruments into body cavities
US20040024435 *26 Jun 20035 Feb 2004Leckrone Michael E.Method and apparatus for providing intra-pericardial access
US20040034364 *16 Aug 200219 Feb 2004Snyder Stephen J.Endoscopic cannula fixation system
US20050119685 *15 Oct 20042 Jun 2005Smith Robert C.Expandible surgical access device
US20050209607 *22 Mar 200422 Sep 2005John LipchitzMedical cannula assembly
US20060079925 *27 May 200313 Apr 2006Stephen KerrDirect vision port site dissector
US20060212062 *16 Mar 200521 Sep 2006David FarascioniRadially expandable access system including trocar seal
US20070032703 *27 Jun 20068 Feb 2007Sankaran Meera LRadially expansive surgical instruments for tissue retraction and methods for using the same
US20070060939 *2 Sep 200515 Mar 2007Zimmer Spine, Inc.Expandable and retractable cannula
US20070162066 *10 Jan 200612 Jul 2007Lyon Thomas RClear view cannula
US20080058723 *31 Oct 20076 Mar 2008Smith & Nephew, Inc.Medical Cannula Assembly
US20080065140 *31 Oct 200713 Mar 2008Bonutti Peter MActive cannulas
US20080086165 *4 Oct 200710 Apr 2008Lyon Thomas RExpanding cannula
Referenced by
Citing PatentFiling datePublication dateApplicantTitle
US916183923 Apr 201320 Oct 2015Pivot Medical, Inc.Method and apparatus for accessing the interior of a hip joint, including the provision and use of a novel telescoping access cannula and a novel telescoping obturator
US9408631 *27 Sep 20139 Aug 2016Depuy Mitek, LlcFlexible cannula and obturator
US951081318 Jun 20126 Dec 2016Covidien LpMedical device
US967537910 Mar 201413 Jun 2017Cannuflow, Inc.Arthroscopic flexible portal cannula device and delivery system
US9808282 *4 Jun 20157 Nov 2017Medos International SarlSurgical cannula system and method of use
US20110028795 *13 Apr 20103 Feb 2011Tyco Healthcare Group LpSurgical portal device including textured surface
US20120283775 *7 May 20128 Nov 2012Edward H CullyEchogenic Sleeve
US20130190573 *28 Dec 201225 Jul 2013Covidien LpWound protector including flexible and rigid liners
US20150094543 *27 Sep 20132 Apr 2015Depuy Mitek, LlcFlexible cannula and obturator
US20160354113 *4 Jun 20158 Dec 2016DePuy Synthes Products, Inc.Surgical Cannula System and Method of Use
CN103596506A *7 May 201219 Feb 2014W.L.戈尔及同仁股份有限公司Echogenic sleeve
WO2011077243A2 *14 Dec 201030 Jun 2011Polytouch Medical Ltd.Medical device
WO2011077243A3 *14 Dec 201018 Aug 2011Polytouch Medical Ltd.Medical device
Classifications
U.S. Classification604/264
International ClassificationA61M25/00
Cooperative ClassificationA61B2017/3458, A61B2017/3435, A61B17/0218, A61B17/3423, A61B2017/0225, A61B2017/3419, A61B2017/3484, A61B17/3439, A61B2017/349, A61B17/3421
European ClassificationA61B17/34G4H, A61B17/34G4
Legal Events
DateCodeEventDescription
29 May 2008ASAssignment
Owner name: DEPUY MITEK, INC., MASSACHUSETTS
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:WHITTAKER, GREGORY R.;MCALISTER, GARY;HAMILTON, JASON;REEL/FRAME:021013/0548;SIGNING DATES FROM 20080416 TO 20080528
15 Apr 2013ASAssignment
Owner name: DEPUY MITEK, LLC, MASSACHUSETTS
Free format text: CHANGE OF NAME;ASSIGNOR:DEPUY MITEK, INC.;REEL/FRAME:030212/0716
Effective date: 20120613