Surgery – Means for introducing or removing material from body for... – Treating material introduced into or removed from body...
Reexamination Certificate
2000-08-30
2003-04-22
Walberg, Teresa (Department: 3742)
Surgery
Means for introducing or removing material from body for...
Treating material introduced into or removed from body...
C604S099030, C604S264000, C604S167030
Reexamination Certificate
active
06551270
ABSTRACT:
FIELD OF THE INVENTION
This invention relates to a device for use in laparoscopic or other minimally invasive surgery and more particularly to an improved access port for use in laparoscopic surgery.
BACKGROUND OF THE INVENTION
In laparoscopic procedures, surgery is performed in the interior of the abdomen through a small incision. In endoscopic procedures, surgery is performed in any small area of the body through narrow or small diameter tubes inserted through a small entrance incision in the skin. Laparoscopic and endoscopic procedures generally require that any instrumentation that is inserted into the body be of minimal diameter and preferably be sealed with respect to the tissue of the patient to retain the gas that is added to insufflate the area of the surgery to create a working space for the surgeon. Moreover, laparoscopic and endoscopic procedures often require the surgeon to act on organs, tissues and vessels that are far removed from the incision, thereby requiring that any instruments used in such procedures be relatively long and of a small diameter. Additionally, because many of these procedures are performed on the abdomen or other areas that are visible to other people, there is a desire to use as few incisions as possible and to minimize the size and location of any resulting scars.
For such procedures, the introduction of a tube into the anatomical cavity, such as the abdomen, is usually accomplished through the use of a trocar assembly consisting of a port assembly and a trocar. The port assembly generally consists of a tubular port and a sealing member. Since the port assembly is in direct communication with the abdominal cavity of the patient, the sealing member must maintain a tight seal between the abdominal cavity and the atmosphere throughout the procedure, including as each instrument is inserted and manipulated therethrough. Surgical procedures in the abdominal cavity of the body, often require the use of insufflating gases to raise the cavity wall away from vital organs to form the working space. Therefore, a Veres needle is often used to initially pierce the abdominal wall and then introduce the gas into the abdominal cavity. Thereafter a pointed trocar is inserted into the port assembly and is used to pierce the abdominal wall. The gas raises the inner wall surface away from the vital organs thereby avoiding unnecessary and potentially dangerous contact with the organs as the instruments are inserted into the port assembly. Following removal of the trocar, laparoscopic or endoscopic instruments may then be inserted through the port assembly to perform surgery within the body cavity.
In view of the need to prevent leakage of the insufflation gas from the cavity, the port assembly is typically provided with a valve or seal assembly to permit introduction of the trocar and surgical instrument therethrough while minimizing communication between the abdominal cavity and the atmosphere. In this regard, there have been many attempts to provide a secure seal as part of the port assembly to allow for the secure insertion of a single instrument through the port. It frequently occurs during surgery that an additional instrument is temporarily required or desirable. Inserting this extra instrument typically involves creating an additional incision with a trocar. It is preferable that the number of incisions be minimized and that all of the required instruments remain in the cavity. Although larger port assemblies have been manufactured that may allow temporary access for multiple instruments through a single port, the seal may be lost and the insufflation gas will pass through leaks in the seal because the seals are designed for sealing around a single instrument. Additionally, as the second instrument is manipulated around the first instrument, the sealing member is unable to seal around the shaft of both instruments even if the surgeon is able to insert both instruments through the common port assembly. Therefore, the wall of the cavity will collapse and the likelihood of accidentally contacting tissue or organs with one or more of the instruments is increased.
At least one attempt has been made to allow the use of multiple instruments through a single port assembly. An example of this approach is disclosed in U.S. Pat. No. 5,395,367 granted to Wilk. In this disclosure, a device having multiple distal end effectors and multiple proximal actuators is disclosed. The device disclosed in the Wilk patent includes an elongate rigid sleeve having a pair of instruments movable therein. The rigid sleeve is inserted into a standard trocar sleeve or port assembly. The locking elements of this device are used to fix the position of the instruments relative to each other and limit the relative movement of the instruments through the rigid sleeve. Despite the availability of a plurality of end effectors through the common port assembly, this device still requires the use of a unique and relatively complicated instrument to perform multiple manipulations through the common port. Additionally, the instruments used with this device require that the end effectors be located adjacent to each other and cannot be oriented at different angles with respect to each other. Therefore, there is a need to provide a port assembly that allows the surgeon to use multiple instruments through a common incision. It is further desirable to allow the surgeon to use the instruments that they are familiar with and allow them to use a specialized port assembly that may be used with one instrument or a second instrument if desired without changing their technique.
SUMMARY OF THE INVENTION
An object of the present invention is to provide an improved port assembly and an associated method for facilitating laparoscopic or endoscopic surgery.
Another object of the present invention is to provide a port assembly that facilitates the utilization of an increased number of instruments without changing the technique of the surgeon or the number of incisions required to accomplish the desired procedure.
Yet another object of the present invention is to provide a port assembly that is sufficiently versatile to allow the surgeon to use the port assembly with either a single instrument or to add a second instrument through the same port.
Yet another object of the present invention is to provide a port assembly that is sufficiently versatile to allow independent movement and use of two instruments through the same port assembly.
Yet another object of the present invention is to provide a port assembly that includes floating valves to allow independent movement and use of two instruments through the same port assembly.
A preferred form of the present invention includes a port assembly that permits introduction of one or more elongate objects such as laparoscopic or endoscopic instruments therethrough. These instruments typically have a circular cross section and are inserted through the port assembly and into the body of the patient to perform the desired manipulation, cutting, suturing or removal desired by the surgeon. The port assembly of the present invention preferably includes a pair of floating valves or seals that allows independent dual access through the access opening of the port while maintaining a seal between the cavity and the atmosphere.
Additionally, one form of the present invention includes one or more valve bodies formed of a resilient material that will cause the flexible material surrounding the access opening to surround and resiliently engage the instrument or instruments in a substantially gas tight manner. The access opening may further include one or more slit valves or flexible flap members that are normally closed to further seal the port assembly. In a further embodiment, the access openings extend from the body of the port assembly such that individual sealing members may be used and opened by the individual instruments as the access is needed or desired. In this embodiment, the access openings open into a larger body area which is positioned in the tissue of the patient so tha
Bimbo Frank
Garrish Chad
Leonard Robert F.
Lock Adrian C.
Dahbour Fadi H.
Smith , Gambrell & Russell, LLP
Snowden Pencer, Inc.
Walberg Teresa
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