Note: Descriptions are shown in the official language in which they were submitted.
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SURGICAL DEVICE HAVING NON-CIRCULAR CROSS-SECTION
BACKGROUND
1. Technical Field
The present disclosure relates to a seal for use in a surgical procedure. More
particularly,
the present disclosure relates to a seal anchor member adapted for insertion
into an incision in
tissue, and, for the scaled reception of one or more surgical objects such
that a substantially fluid-
tight seal is formed with both the tissue and the surgical object, or objects.
2. Background of the 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, e.g., endoscopic, laparoscopic,
arthroscopic, thoracic
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
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to create a larger, more accessible work area. Accordingly, the maintenance of
a substantially
fluid-tight seal is desirable so as to inhibit the escape of the insufflation
gases and the deflation or
collapse of the enlarged surgical site.
To this end, various 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 a seal anchor
member that can be inserted directly into an incision in tissue in a narrow
area, such as a cavity
between two ribs, and that can accommodate a variety of surgical objects while
maintaining the
integrity of an insufflated workspace.
SUMMARY
According to an embodiment of the present invention, there is provided a
surgical
apparatus for positioning within a tissue tract accessing an underlying body
cavity includes a seal
anchor member comprising a compressible material and being adapted to
transition between a
first expanded condition and a second compressed condition. The first expanded
condition
facilitates a securing of the seal anchor member within the tissue tract and
in substantial scaled
relation with tissue surfaces defining the tissue tract, and the second
compressed condition
facilitates an at least partial insertion of the seal anchor member within the
tissue tract. The seal
anchor member may be formed of a foam material, which may be at least
partially constituted of
a material selected from the group consisting of polyisoprene, urethane, and
silicone.
Alternatively, the seal anchor member may be formed of a gel material.
The seal anchor member includes proximal and distal ends that define
elongated, e.g.,
oval or oblong, perimeters to facilitate the positioning of the seal anchor
member within a tissue
tract accessing an underlying body cavity. At least one of the proximal and
distal ends of the seal
anchor member may exhibit an arcuate configuration, which may be either
concave or convex.
The seal anchor member may be rolled, twisted, or otherwise deformed to fit
nonlinearly into the
tissue tract. The seal anchor member may also be cut to better suit a surgical
procedure.
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At least one port extends between the proximal and distal ends and is adapted
for the
reception of an object whereby compressible material defining the at least one
port is adapted to
deform to establish a substantial sealed relation with the object. The at
least one port may contain
at least an undercut to protect against fluid leaks. The seal anchor member
may include a
plurality of ports that maybe configured linearly with respect to the major
diameter of the
perimeter of at least one of the distal and proximal ends. Each port may be
spaced equally from
its neighboring ports.
According to an embodiment of the present invention, there is provided a
surgical
apparatus for positioning within a tissue tract accessing an underlying body
cavity, which
comprises: a seal anchor member comprising a compressible material. The seal
anchor member
may be adapted to transition between a first condition for insertion of at
least a portion of the seal
anchor member within a tissue tract and a second condition to facilitate a
securing of the seal
anchor member within a tissue tract and in substantial scaled relation with
tissue surfaces
defining a tissue tract. The seal anchor member may have proximal and distal
ends and define at
least one port extending between the proximal and distal ends, the at least
one port being adapted
for the reception of an object whereby compressible material defining the at
least one port is
adapted to deform to establish a substantial sealed relation with the object.
The seal anchor
member may have a non-circular cross-section.
The seal anchor member may be formed of a foam material. The foam material may
be at
least partially constituted of a material selected from the group consisting
of polyisoprene,
urethane, and silicone. The seal anchor member may also be formed of a gel
material. The at
least one port may include at least one undercut to reduce the likelihood of
leaks therethrougli.
Also, the surgical apparatus may include indicia that indicates to a user a
location at which the
apparatus may be cut. The seal anchor member may include a plurality ofports,
and the
plurality of ports may be configured linearly with respect to each other. Each
port of the
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plurality of ports may be spaced equally from its neighboring ports. In use,
the seal anchor
member may have an initial expanded condition, and may be adapted to be
compressed by an
external compressing force from the initial expanded condition to the first
condition to
facilitate insertion of at least a portion of the seal anchor member within a
tissue tract, the
anchor seal member being further adapted upon removal of the compressing force
to expand
towards its initial expanded condition and to its second condition to
facilitate a securing of the
seal anchor member within a tissue tract and in substantial sealed relation
with tissue surfaces
defining a tissue tract.
According to another embodiment of the present invention, there is provided a
surgical
apparatus for positioning within a tissue tract accessing an underlying body
cavity, which
comprises: a seal anchor member comprising a compressible material; the seal
anchor member
being adapted to transition between a first condition for insertion of at
least a portion of the seal
anchor member within a tissue tract and a second condition to facilitate a
securing of the seal
anchor member within a tissue tract and in substantial sealed relation with
tissue surfaces
defining a tissue tract, the seal anchor member having proximal and distal
ends and defining a
plurality of ports extending between the proximal and distal ends, at least
one of the plurality of
ports being adapted for the reception of an object whereby compressible
material defining the at
least one port is adapted to deform to establish a substantial sealed relation
with the object,
wherein the plurality of ports are arranged linearly relative to each other.
The seal anchor member may be formed of a foam material. The foam material may
be
at least partially constituted of a material selected from the group
consisting of polyisoprene,
urethane, and silicone. The seal anchor member may also be formed of a gel
material. The
port may include at least one undercut to reduce the likelihood of leaks
therethrough. The
surgical apparatus may include indicia that indicates to a user a location at
which the apparatus
may be cut. The seal anchor member may have a non-circular cross-section. Each
port may be
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spaced equally from its adjacent ports. In use, the seal anchor member may
have an initial
expanded condition, and may be adapted to be compressed by an external
compressing force
from the initial expanded condition to the first condition to facilitate
insertion of at least a portion
of the seal anchor member within a tissue tract, the anchor seal member being
further adapted
upon removal of the compressing force to expand towards its initial expanded
condition and to
its second condition to facilitate a securing of the seal anchor member within
a tissue tract and in
substantial sealed relation with tissue surfaces defining a tissue tract.
According to still another embodiment of the present invention, there is
provided a
surgical apparatus for positioning within a tissue tract accessing an
underlying body cavity,
which comprises: a seal anchor member comprising a compressible material; the
seal anchor
member being adapted to transition between a first condition for insertion of
at least a portion of
the seal anchor member within a tissue tract and a second condition to
facilitate a securing of the
seal anchor member within a tissue tract and in substantial sealed relation
with tissue surfaces
defining a tissue tract, the seal anchor member having proximal and distal
ends and defining at
least one port extending between the proximal and distal ends, the at least
one port being adapted
for the reception of an object whereby compressible material defining the at
least one port is
adapted to deform to establish a substantial sealed relation with the object,
and wherein the at
least one port includes an undercut to reduce the likelihood of leaks
therethrough.
According to still another embodiment of the present invention, there is
provided a seal
anchor member formed from a foam material and being elongated in cross-
section, the member
being configured and dimensioned to be compressed for insertion into an
incision and, once
inserted, to expand so as to be secured within and seal against the incision,
the seal anchor
member defining at least one port extending generally longitudinally and being
adapted for
sealed reception of a surgical object. When the seal anchor member is
positioned within an
incision, the seal anchor member may exert a biasing force against the
incision. Advantageously,
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when positioned within an elongated incision, the biasing force exerted by the
seal anchor
member against the incision is substantially equal around a perimeter of the
seal anchor member.
The foam material may be at least partially constituted of a material selected
from the group
consisting of polyisoprene, urethane, and silicone. The seal anchor member may
include a
plurality of ports.
According to still another embodiment of the present invention, there is
provided a seal
anchor member formed from a foam material, the member being configured and
dimensioned to
be compressed for insertion into an elongated incision and, once inserted, to
expand so as to
exert a biasing force against the elongated incision, the seal anchor member
having a shape in
cross-section such that the biasing force exerted by the seal anchor member
against the elongated
incision is substantially equal around a perimeter of the seal anchor member.
The seal anchor
member may define at least one port extending generally longitudinally and
being adapted for
sealed reception of a surgical object. The foam material may be at least
partially constituted of a
material selected from the group consisting of polyisoprene, urethane, and
silicone. The seal
anchor member may include a plurality of ports. The seal anchor member may
define a major
diameter in a first direction and a minor diameter in a second direction that
is perpendicular to
the first direction, the major diameter being greater than the minor diameter.
The seal anchor
member may include an intermediate portion and an end portion, at least one of
a major diameter
and a minor diameter of the end portion being greater than a major diameter or
a minor diameter
of the intermediate portion so as to aid in retaining the seal anchor member
within an incision.
BRIEF DESCRIPTION OF THE DRAWINGS
Various embodiments of the present disclosure are described hereinbelow with
references
to the drawings, wherein:
FIG.1 is a top, perspective view of a surgical apparatus in accordance with
the principles
of the present disclosure shown in an expanded condition illustrating a seal
anchor member
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positioned relative to the tissue;
FIG. 2 is a side, schematic view of the seal anchor member of FIG. 1;
FIG. 3 is a cross-sectional view of the seal anchor member of FIG. 1 taken
along section
line 3-3 of FIG. I illustrating a plurality of ports defining undercuts;
FIG. 4 is a side, schematic view of a port of the seal anchor member of FIG. 2
with a
surgical object inserted therethrough;
FIG. 5 is a perspective, schematic view of the seal anchor member of FIG.1
shown in a
compressed condition prior to the insertion thereof into an incision in
tissue;
FIG. 6 is a perspective, schematic view of the seal anchor member of FIG. 1
shown in
the expanded condition and subsequent to its insertion into the incision;
FIG. 7 is a lop, plan view of the seal anchor member of FIG. 1 in a rolled
state; and
FIGS. 8A-8D are perspective views of a surgical apparatus in accordance with
another
embodiment of the present disclosure illustrating a seal anchor member cut to
varying lengths.
DETAILED DESCRIPTION OF THE EMBODIMENTS
In the drawings and in the description which follows, in which like references
numerals
identify similar or identical elements, the term "'proximal" will refer to die
end of the apparatus
which is closest to the clinician during use, while the term "distal" will
refer to the end which is
furthest from the clinician, as is traditional and known in the art.
With reference to FIGS. 1-4, a surgical apparatus 10 for use in a surgical
procedure, e.g.,
a minimally invasive procedure is illustrated. Surgical apparatus 10 includes
seal anchor member
100 having proximal end 102 and distal end 104. Seal anchor member 100
includes one or more
ports 108, i.e., lumen, that extend through seal anchor member 100 between
proximal end 102
and distal end 104.
Seal anchor member 100 is formed from a suitable foam material having
sufficient
compliance to form a seal about one or more surgical objects, shown generally
as surgical object
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"I" (FIG. 4), and also establish a scaling relation with tissue "T". The foam
is sufficiently
compliant to accommodate motion of the surgical object "I". In one embodiment,
the foam
includes a polyisoprene material. An example of an anchor member formed of,
e.g., foam, is
disclosed in applicant's co-pending U.S. Patent Application Serial Number
12/244,024, filed
October 2, 2008, the entire contents of which are hereby incorporated by
reference herein.
Proximal end 102 of seal anchor member 100 defines a first major diameter D,
and distal
end 104 defines a second major diameter D2. In an embodiment of seal anchor
member 100, the
respective first and second major diameters Dr, D2 of the proximal and distal
ends 102,104 are
substantially equivalent, as seen in FIG. 2, although an embodiment of seal
anchor member 100
in which diameters D1, D2 are different is also within the scope of the
present disclosure. Also,
proximal end 102 of seal anchor member 100 defines a first minor diameter D3
and distal end
104 defines a second minor diameter D4. In an embodiment of seal anchor member
100, the
respective first and second minor diameters D3,D4 of the proximal and distal
ends 102, 104 are
substantially equivalent, as seen in FIG. 2, although an embodiment of seal
anchor member 100
in which diameters D3, Da are different is also within the scope of the
present disclosure.
Advantageously, first and second major diameters Dr, D2 of the proximal and
distal ends 102,
104 are greater than first and second minor diameters D3, D4 of the proximal
and distal ends 102,
104, such that the seal anchor member 100 has, in cross-section, a non-
circular, e.g., oblong,
oval, race-track, etc., shape.
As depicted in FIG. 1, positioning members 114 of proximal and distal ends
102, 104
may define arcuate surfaces to assist in the insertion of seal anchor member
100 within a tissue
tract 12 defined by tissue surfaces 14 and formed in tissue "T", e.g., an
incision, as discussed in
further detail below. Alternatively, proximal and distal ends 102, 104 may
define substantially
planar surfaces or substantially arcuate surfaces. Embodiments are
contemplated herein in which
either or both of proximal and distal ends 102, 104 define surfaces that are
either or both arcuate
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or planar. The arcuate surfaces may be either or both concave or convex.
Intermediate portion 106 extends between proximal and distal ends 102, 104 to
define a
dimension, or length, "L" therealong. Intermediate portion 106 further defines
an intermediate
major diameter "R" substantially parallel to major diameters D1, D2. The
dimension "R" of
intermediate portion 106 may remain substantially uniform along the dimension
"L" thereof.
Alternatively, the dimension "R" of intermediate portion 106 may vary along
the dimension, or
length, "L" thereof, thereby defining a cross-sectional dimension that varies
along its length
"L", which facilitates the anchoring of seal anchor member 100 within tissue
"T". In
addition. intermediate portion 106 may further define an intermediate minor
diameter "R2"
substantially perpendicular to major diameter R. Advantageously, the
intermediate minor
diameter "R2" may be smaller than the major diameter R, such that the seal
anchor member
100 has, in cross-section, a non-circular, e.g., oblong, oval, race-track,
etc., shape.
The dimension "R" of intermediate portion 106 maybe appreciably less than the
respective major axes D1, D2 of proximal and distal ends 102, 104 to assist in
anchoring seal
anchor member 100 within tissue "T" as discussed in further detail below.
However, in an
alternate embodiment, the dimension "R" of intermediate portion 106 may be
substantially
equivalent to the respective major axes Dr, D2 of proximal and distal ends
102, 104. In cross
section, intermediate portion 106 may exhibit any suitable elongated
configuration, e.g.,
substantially oval or oblong, for insertion into a narrow incision.
Each port 108 is configured to removably receive the surgical object "1".
Prior to
the insertion of surgical object "I", port 108 is in a first state in which
port 108 defines a first
or initial dimension Dpl. Port 108 may define an opening within seal anchor
member 100
having an initial open state. Alternatively, Dpi may be about Omm such that
the escape of
insufflation gas (not shown) through port 108 of seal anchor member 100 in the
absence of
surgical object "I" is substantially inhibited. For example, port 108 may be a
slit extending
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the length "L" of seal anchor member 100 through proximal and distal ends 102,
104.
Upon the introduction of surgical object "I", port 108 transitions to a second
slate in
which port 108 defines a second, larger dimension DP2 that substantially
approximates the
diameter Dl of surgical object "I" such that a substantially fluid-tight seal
is formed therewith,
thereby substantially inhibiting the escape of insufflation gas (not shown)
through port 108 of
seal anchor member 100 in the presence of surgical object "I". D1, and thus
DP2, will
generally lie within the range of about 5mm to about 12mm, as these dimensions
are typical of the
surgical objects used during the course of minimally invasive procedures.
However, a seal
anchor member 100 including a port 108 that is capable of exhibiting
substantially larger, or
smaller, dimensions in the second state thereof is not beyond the scope of the
present disclosure.
Seal anchor member 100 may include a plurality of generally tubular port
segments (not shown)
defining ports 108. In addition, seal anchor 100 may be devoid of ports 108.
With this
arrangement, ports 108 are created within seal anchor member 100 during the
insertion of the
surgical object "I". In accordance with this embodiment, seal anchor member
100 is formed of
a flowable or sufficiently compliant material such as a foam material, e.g.,
an open-cell
polyurethane foam, or a gel.
Ports 108 may include ports 108a, which contain at least one undercut 118 that
collects
insufflation gas that leaks through the substantially fluid-light seal between
a surgical instrument
"I" and a port 108a. Each undercut 118 defines a diameter DP3 greater than DP2
and a length
along a port 108a less than "L". lnsufflation gas that leaks through a
substantially fluid-tight seal
between an instrument "I" and a port 108a may collect in an undercut 118 to
inhibit further
leakage of the gas through the substantially fluid-tight seal. Furthermore,
the undercuts 118
provide edges (where the respective diameters DP1 of the lumen 108 transition
to the diameters
DP3 of the undercut 118) that engage the outer surfaces of the instruments "I"
inserted
therethrough to further reduce leakage. Ports 108 may also include ports 108b,
which do not
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contain undercuts 118, or any combination of ports 108a and ports 108b.
Generally, ports 108 are arranged linearly with respect to major diameter D1.
Ports 108
may alternatively be arranged linearly with respect to major diameter D2 or
dimension "R".
However, embodiments in which ports 108 are arranged nonlinearly, e.g., an
oval or zigzag
pattern, are also within the scope of this disclosure. Each port 108 may be
spaced equally from its
neighboring ports. However, embodiments in which ports 108 are spaced
unequally are also
within the scope of this disclosure.
Referring now to FIGS. 1 and 5, seal anchor member 100 is adapted to
transition from an
expanded condition (FIG. 1) to a compressed condition (FIG. 5) so as to
facilitate the insertion
and securement thereof within tissue tract 12 in tissue "T". In the expanded
condition, seal
anchor member 100 is at rest and the respective major axes D 1, D2 of the
proximal and distal ends
102, 104 of seal anchor member 100, as well as the dimension "R" of the
intermediate portion
106 are such that the seal anchor member 100 cannot be inserted within tissue
tract 12.
However, as seen in FIG. 5, in the compressed condition, proximal and distal
ends 102, 104 of
seal anchor member 100 as well as intermediate portion 106 are dimensioned for
insertion into
tissue tract 12.
Seal anchor member 100 is formed of a biocompatible compressible material that
facilitates the resilient, reciprocal transitioning of seal anchor member 100
between the expanded
and compressed conditions thereof. In one embodiment, the compressible
material is a
"memory" foam. An external force "F" is applied to seal anchor member 100 to
cause the seal
anchor member 100 to assume the compressed condition. External force "F" is
directed
inwardly and when seal anchor member 100 is subjected thereto, e.g., when seal
anchor member
100 is squeezed, seal anchor member 100 undergoes an appreciable measure of
deformation,
thereby transitioning into the compressed condition.
As depicted in FIG. 5, as seal anchor member 100 is compressed under the
influence of
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external force "F" an internal biasing force "F11" is created within seal
anchor member 100 that
is directed outwardly, opposing force "F". Internal biasing force "FBI"
endeavors to expand
seal anchor member 100 and thereby return seal anchor member 100 towards the
expanded
condition thereof. Accordingly, as long as seal anchor member 100 is subject
to external force
"F" greater than biasing force "FBI", seal anchor member 100 is compressed,
and. once
compressed, as long as external force "F" at least equals biasing force "FBI",
seal anchor
member 100 remains in the compressed condition. Upon the removal of external
force "F"
biasing force "FBI" acts to return seal anchor member 100 towards the expanded
condition.
The compressible material comprising seal anchor member 100 also facilitates
the
resilient transitioning of port 108 between its first state (FIGS. 1-3) and
its second state (FIG.
5). As previously discussed, prior to the insertion of surgical object "I",
port 108 is in its first
state in which port 108 defines a first or initial dimension DPI. Port 108 may
incorporate a slit
extending the length "L" of seal anchor member 100. In this first state, port
108 is at rest and
is not subject to any external forces. However, upon the introduction of
surgical object "I"
through port 108 as depicted in FIG. 4, the surgical object "I" exerts a force
"F," upon port
108 that is directed radially outward. Force "F1" acts to enlarge the
dimensions of port 108
and thereby transition port 108 into the second stale thereof in which port
108 defines a
second, larger dimension DP2 that substantially approximates the diameter DI
of surgical object
"I". Consequently, an internal biasing force "FB2" is created that is directed
radially inward, in
opposition to force "F,". Internal biasing force "FB2" endeavors to return
port 108 to reduce
the internal dimension of port 108 and thereby return port 108 to the first
state thereof. Internal
biasing force "FB2" is exerted upon surgical object "I" and acts to create a
substantially fluid-
tight seal therewith. The significance of forces "FBI" and "FB2" will be
discussed in further
detail below.
It should be noted that, according to various embodiments of the present
invention, a
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particular advantage of the seal anchor member 100 maybe that, when the seal
anchor member
100 is positioned within an elongated incision, the biasing force exerted by
the seal anchor
member 100 against the incision is substantially equal around a perimeter of
the seal anchor
member 100. For example, many incisions made during surgery are formed by a
surgeon cutting
through skin and/or tissue with a scalpel, which generally forms an incision
shaped like a slit.
This slit-shaped incision is elongated, e.g., relatively narrow in one
direction and relatively long
in the perpendicular direction - thus, a seal anchor member that has a
circular cross-section is
required to be more compressed in one direction than in another direction in
order to be inserted
within an elongated incision, making such a seal anchor member more difficult
to insert within
the incision. Additionally, once a seal anchor member with a circular cross-
section is positioned
within the incision, such a seal anchor member may generate different biasing
forces against the
incision at various positions around its perimeter. This may cause the sealing
effect between
such a seal anchor member to be different at various positions around the seal
anchor member's
perimeter and may result in an increased likelihood of leakage, e.g., at the
furthermost ends of
the elongated incision where the seal anchor member has experienced the least
amount of
compression and thus is exerting the least amount of biasing force against the
incision. In
contrast, an elongated seal anchor member, e.g., that has a major diameter
that is greater than a
minor diameter, may advantageously be compressed a substantially equal amount
in all directions
in order to be inserted within an elongated incision, thus easing its
insertion. Furthermore, once an
elongated seal anchor member is positioned within the incision, the elongated
seal anchor
member may generate substantially equal biasing forces against the incision
around its entire
perimeter. This may result in a more constant sealing effect between the seal
anchor member
and the incision at all of the various positions around the seal anchor
member's perimeter,
thereby reducing the likelihood of leakage, particularly at the furthermost
ends of the elongated
incision where conventional seal anchor member have typically experienced the
greatest
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likelihood of leakage.
Referring again to FIG. 1, one or more positioning members 114 maybe
associated with
either or both of proximal end 102 and distal end 104 of seal anchor member
100. Positioning
members 114 may be composed of any suitable biocompatible material that is at
least semi-
resilient such that positioning members 114 may be resiliency deformed and may
exhibit any
suitable elongated configuration, e.g., substantially oblong or oval. Prior to
the insertion of seal
anchor member 100, positioning members 114 are deformed in conjunction with
the respective
proximal and distal ends 102, 104 of seal anchor member 100 to facilitate the
advancement
thereof through tissue tract 12 (FIG. 6). Subsequent to the insertion of seal
anchor member
100 within tissue tract 12, the resilient nature of positioning members 114
allows positioning
members to return towards their normal, e.g., substantially oblong or oval,
configuration, thereby
aiding in the expansion of either or both of the respective proximal and
distal ends 102, 104 and
facilitating the transition of seal anchor member 100 from its compressed
condition to its
expanded condition. Positioning members 114 also may engage the walls defining
the body
cavity to further facilitate securement of seal anchor member 100 within the
body tissue. For
example, positioning member 114 at leading end 104 may engage the internal
peritoneal wall and
positioning member 114 adjacent trailing end 102 may engage the outer
epidermal tissue adjacent
the incision 12 within tissue "T". In another embodiment of seal anchor member
100, one or
more additional positioning members 114 may be associated with intermediate
portion 106.
The use of seal anchor member 100 will be discussed during the course of a
typical
minimally invasive procedure. Initially, the peritoneal cavity (not shown) is
insufflated with a
suitable biocompatible gas, such as CO2 gas, such that the cavity wall is
raised and lifted away
from the internal organs and tissue housed therein, providing greater access
thereto. The
insufflation maybe performed with an insufflation needle or similar device, as
is conventional in
the art. Either prior or subsequent to insufflation, a tissue tract 12 is
created in tissue "T", the
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dimensions of which may be varied dependent upon the nature of the procedure.
Prior to the insertion of seal anchor member 100 within tissue tract 12, seal
anchor
member 100 is in its expanded condition in which the dimensions thereof
prohibit the insertion
of seal anchor member 100 into tissue tract 12. To facilitate insertion, the
clinician transitions
seal anchor member 100 into the compressed condition by applying a force "F"
thereto, e.g., by
squeezing seal anchor member 100. Force "F" acts to reduce the dimensions DI
and D2 of the
proximal and distal ends 102, 104, respectively, to DI' and D2' (FIG. 5)
including positioning
members 114 (if provided) and to reduce the dimension "R" of intermediate
portion 106 to
"R"' such that seal anchor member 100 maybe inserted into tissue tract 12. As
best depicted in
FIG. 6, subsequent to its insertion, distal end 104, positioning member 114
(if provided), and at
least a section 112 of intermediate portion 106 are disposed beneath the
tissue "T". Seal
anchor member 100 is caused to transition fi-om the compressed condition to
the expanded
condition by removing force "F" therefrom.
During the transition from the compressed condition to the expanded condition,
the
dimensions of seal anchor member 100, i.e., the respective dimensions DI', D2'
(FIG. 5) of the
proximal and distal ends 102, 104 are increased towards DI and D2 (FIG. 6) and
the dimension
"R"' is increased towards "R". The expansion of distal end 104 is relatively
uninhibited
given the disposition thereof beneath tissue "T", and accordingly, distal end
104 is permitted
to expand substantially, if not completely. However, as seen in FIG. 5, the
expansion of the
section 112 of the intermediate portion 106 is limited by the tissue surfaces
14 (FIG. 1)
defining tissue tract 12, thereby subjecting intermediate portion 106 to an
external force "F"
that is directed inwardly. As discussed above, this creates an internal
biasing force "FB1" that is
directed outwardly and exerted upon tissue surfaces 14, thereby creating a
substantially fluid-
tight seal between the seal anchor member 100 and tissue surfaces 14 and
substantially
inhibiting the escape of insufflation gas around seal anchor member 100 and
through tissue
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tract 12.
In the expanded condition, the respective dimensions D1, D2 of the proximal
and distal
ends 102, 104 are larger than the dimension "R." of the intermediate portion
106.
Subsequent to insertion, the dimension D2 of distal end 104 and positioning
member 114 is
also substantially larger than the dimensions of the tissue tract 12.
Consequently, seal anchor
member 100 may not be removed from tissue tract 12 in the expanded condition
and thus, seal
anchor member 100 will remain anchored within the tissue "T" until it is
returned to its
compressed condition.
After successfully anchoring seal anchor member 100 within the patient's
tissue "T",
one or more surgical objects "I" may be inserted through ports 108. FIG. 6
illustrates a
surgical object "I" introduced through one of ports 108. As previously
discussed, prior to the
insertion of surgical object "I", port 108 is in its first slate in which port
108 defines an initial
dimension DPI which may be negligible in that port 108, in one embodiment, is
a slit.
Accordingly, prior to the escape of insufflation gas through port 108, in the
absence of
surgical object "I" is minimal, thereby preserving the integrity of the
insufflated workspace.
Surgical object "I" maybe any suitable surgical instrument and, accordingly,
may vary
in size. Suitable surgical objects to be introduced within one or more of the
ports 108 include
minimally invasive grasper instruments, forceps, clip-appliers, staplers,
cannula assemblies, etc.
Upon the introduction of surgical object "I", port 108 is enlarged, thereby
transitioning into its
second state in which port 108 defines a second dimension D12 (FIG. 4) that
substantially
approximates the diameter Dr of surgical object "I", thereby creating a
substantially fluid-tight
seal with surgical object "I" and substantially inhibiting the escape of
insufflation gas (not
shown) through port 108 of seal anchor member 100 in the presence of a
surgical object "I", as
previously discussed.
Turning now to FIGS. 8A-8D, a surgical apparatus, in accordance with an
alternate
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embodiment of the present disclosure, is generally designated as 20. Surgical
apparatus 20 is
substantially identical to surgical apparatus 10 and thus will only be
discussed in detail herein to
the extent necessary to identify differences in construction and operation
thereof.
As seen in FIG. 8A, surgical apparatus 20 comprises a seal anchor member 200
defining
a plurality of ports 208. If seal anchor member 200 defines more ports 208
than are required for
a particular surgical procedure, seal anchor member 200 may be cut to have a
fewer number of
ports 208. FIGS. 8B-8D illustrate resulting seal anchor members 210, 220, and
230 when seal
anchor member 200 is cut along segment lines 8B-8B, 8C-8C, and 8D-8D
respectively. Seat
anchor member 200 may include indicia, e.g., lines or markings along segment
lines 8B-8B, 8C-
8C, and 8D-8D, etc., that indicate to a user a location at which to make such
a cut if desired.
Additional or alternatively, the seal anchor member 200 may include a weakened
region, e.g.,
perforations, slits, etc., at such locations that facilitate or ease the
making of such a cut. Seal
anchor member 200 and resulting seal anchor members 210, 220, and 230, maybe
used in a
surgical procedure in a substantially similar manner to seal anchor member 100
as discussed
hereinbefore.
As set forth above, the prevent invention, according to various embodiments
thereof,
may provide particular advantages for, e.g., thoracic procedures (for example,
thymectomies,
lobectomies, pneurnonectomy, esophagectomy, mediastinal tumor resection,
sympathectomy,
etc.) and/or single incision laparoscopic procedures in which it may be
desirable to access an
abdominal cavity off-midline. For example, during thoracic procedures, access
is typically
attained by placing caruiulas or instruments between a patient's ribs. The
elongated shape,
when viewed in cross-section, of the seal anchor member, along with the linear
arrangement of
the ports therethrough, allows the seal anchor member to be inserted between a
patient's ribs
and to move with the natural curvature of the ribcage. In single incision
laparoscopic
procedures, the shape of the seal anchor member may enable it to be positioned
between
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CA 02709618 2010-07-12
muscle groups, e.g., parallel to and on the lateral edge of the rectus
abdominus muscles.
Advantageous positioning of the seal anchor member, as described hereinabove,
may provide
additional benefits of reducing stretching, trauma and post-operative pain.
In some instances, thoracic procedures may not require insufflation. For other
types of
surgical procedures, e.g., laparoscopic procedures, insufflation may be used -
for these types
of procedures, the seal anchor member may be provided with insufflation tubing
(not shown) or
one of the ports may be specifically employed for insufflation put-poses.
Although the illustrative embodiments of the present disclosure have been
described
herein with reference to the accompanying drawings, the above description,
disclosure, and
figures should not be construed as limiting, but merely as exemplifications of
particular
embodiments. It is to be understood, therefore, that the disclosure is not
limited to those
precise embodiments, and that various other changes and modifications may be
effected therein
by one skilled in the art without departing from the scope or spirit of the
disclosure.
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