Abstract
A surgical access port for insertion into a body cavity can have an elongate tubular body extending along an axis between a proximal end and a distal end, and a tip at the distal end of the tubular body for penetrating through a body wall and into the body cavity. The distal tip moves from a first, penetrating position to a second, retaining position when the body wall has been traversed. The surgical access port may further comprise a seal housing connected to the proximal end of the tubular body, the seal housing having an access port providing an opening into the tubular body to allow passage of surgical instruments. The distal tip may be sharp, pointed or bladed. The distal tip may also be substantially blunt or have a conical surface. The access port may further comprise a retention member for connecting the tubular body and the distal tip.
Claims
1. A laparoscopic surgical access port system comprising: a trocar cannula comprising an elongate thin-walled tubular body having a proximal end and a distal end and a longitudinal axis extending between the proximal end and the distal end, the elongate tubular body having an inner diameter, an outer diameter, and comprising a lumen disposed radially inwardly of the inner diameter, the lumen extending longitudinally between the proximal end and the distal end, the lumen sized and configured to receive laparoscopic surgical instruments; a tissue-separating distal tip member pivotably coupled to the trocar cannula at the distal end, the distal tip member comprising a slot formed therein, and the distal tip member movable from a first position aligned with the longitudinal axis to a second position to one side off axis from the longitudinal axis; and a retention member fitted into the wall of the tubular body of the trocar cannula at the distal end radially between the inner diameter and the outer diameter and extending into the slot in the distal tip member.
2. The laparoscopic surgical access port system of claim 1, further comprising a seal housing operably connected to the proximal end of the trocar cannula.
3. The laparoscopic surgical access port system of claim 1, wherein the retention member comprises a flat ribbon.
4. The laparoscopic surgical access port system of claim 3, wherein the retention member is biased to maintain the distal tip member in the first position.
5. The laparoscopic surgical access port system of claim 3, wherein the retention member is biased to maintain the distal tip member in the second position.
6. The laparoscopic surgical access port system of claim 3, wherein the retention member has a detent configuration to position the distal tip member stably in one of the first position and the second position.
7. The laparoscopic surgical access port system of claim 1, wherein the retention member has a curved cross-sectional profile.
8. The laparoscopic surgical access port system of claim 1, wherein the distal tip member comprises a rounded proximally facing extension sized and configured to nest into the distal end of the trocar cannula.
9. The laparoscopic surgical access port system of claim 1, wherein the distal tip member comprises a single-piece tip.
10. The laparoscopic surgical access port system of claim 1, wherein the retention member extends distally of the distal end of the cannula into the slot in the distal tip member.
11. A laparoscopic surgical access port system for placement through a body wall comprising: a trocar cannula comprising an elongate tubular body having a proximal end and a distal end and a longitudinal axis extending between the proximal end and the distal end, the elongate tubular body comprising a lumen extending longitudinally between the proximal end and the distal end, the lumen sized and configured to receive laparoscopic surgical instruments; and a single-piece tip member pivotably connected to the trocar cannula at the distal end, the tip member sized and configured to separate body tissue and guide the elongate tubular body through the body wall, the tip member comprising a hollow member sized and configured to receive a specimen therein; wherein the single-piece tip member is pivotable from a first position substantially blocking the lumen at the distal end of the elongate tubular body and aligned with the longitudinal axis to a second position off axis with the longitudinal axis; and wherein the tip member automatically realigns with the longitudinal axis as the trocar cannula is withdrawn from the body wall.
12. The laparoscopic surgical access port system of claim 11, further comprising a seal housing operably connected to the proximal end of the trocar cannula.
13. The laparoscopic surgical access port system of claim 11, wherein the tip member has a substantially blunt dilating exterior surface.
14. The laparoscopic surgical access port system of claim 11, wherein the tip member is biased to the second position.
15. The laparoscopic surgical access port system of claim 11, wherein the single-piece tip member has an over-center pivot configuration such that the single-piece tip member is alternately positionable in the first position and the second position.
16. The laparoscopic surgical access port system of claim 15, further comprising a substantially flat metal ribbon pivotably connecting the single-piece tip member to the trocar cannula, the metal ribbon configured to provide the over-center pivot.
Description
DESCRIPTION OF THE DRAWINGS
(1) FIG. 1 illustrates a conventional laparoscopic access port having a cutting tip;
(2) FIG. 2 illustrates a conventional laparoscopic access port having a blunt tip;
(3) FIG. 3 is a top-perspective view of the conventional laparoscopic access port of FIG. 1 showing the proximal position of an obturator handle;
(4) FIG. 4 is a top-perspective view of a laparoscopic access port according to the first embodiment of the invention showing the seal housing with no obturator in place;
(5) FIG. 5 illustrates the first step in placing the access port of the invention through a body wall;
(6) FIG. 6 illustrates the second step in placing the access port of the invention through a body wall;
(7) FIG. 7 illustrates the third step in placing the access port of the invention through a body wall;
(8) FIG. 8 illustrates the removal step for removing the access port of the invention through a body wall;
(9) FIG. 9 is an enlarged view of the initiation of the removal step of FIG. 8;
(10) FIG. 10 is an enlarged view of the completed removal step of FIG. 8;
(11) FIG. 11 is a schematic view of the distal cannula portion in a retention position;
(12) FIG. 12 is a schematic view of the distal cannula portion in an insertion or removal position;
(13) FIG. 13 is a side-section view of a tissue separating distal cannula portion in accordance with another embodiment of the invention having a hinge member and a centering portion;
(14) FIG. 14 is an end view of the tissue separating distal cannula portion of FIG. 13;
(15) FIG. 15 is a side-section view of a distal cannula portion having a centering portion in accordance with another embodiment of the invention;
(16) FIG. 16 is a side-section view of the tissue separating distal cannula portion of FIG. 13 in a partial retention condition;
(17) FIG. 17 is a perspective exploded view of a cannula in accordance with another embodiment of the invention, illustrating the placement of a spring-hinge in a solid distal tip;
(18) FIG. 18 is a perspective exploded view of a cannula in accordance with another embodiment of the invention, illustrating the placement of a spring-hinge in the cannula wall;
(19) FIG. 19 is a perspective view of the cannula of FIG. 18 with the spring-hinge being placed in the cannula wall; and
(20) FIGS. 20(a)-20(c) illustrate perspective views of an access port having a single-piece distal tip, a two-piece distal tip and a three-piece distal tip, respectively.
DESCRIPTION OF PREFERRED EMBODIMENTS AND BEST MODE OF THE INVENTION
(21) Referring to FIGS. 1-3, there are shown conventional laparoscopic access port systems of the prior art. In particular, FIG. 1 illustrates a conventional laparoscopic access port system 10 having a cuffing tip 12. FIG. 2 illustrates a conventional laparoscopic access port system 20 having a blunt tip 22; and FIG. 3 illustrates a top-perspective view of a conventional laparoscopic access port system 30 showing a proximal position of an obturator handle 32. In each of the above conventional laparoscopic access port systems 10, 20, 30, there are included a cannula or elongate tubular body 14, 24, 34, a seal housing 16, 26, 36, respectively, and an obturator (not shown). The cannula 14, 24, 34 for the respective access port system 10, 20, 30 provides a tubular pathway through a body wall. The seal housing 16, 26, 36 provides isolation between the two sides of the body wall. The obturator provides a cutting or dilating instrument for placing the cannula through the body wall. The three combined elements of the access port systemcannula, seal housing and obturatorare generally referred to as a trocar.
(22) Referring to FIG. 4, there is shown a top-perspective view of a laparoscopic access port 40 according to the first embodiment of the invention. The access port 40 includes a cannula or elongate tubular body 42 having a proximal end and a distal end, a seal housing 44 operably connected at the proximal end of the cannula 42, and an access port 46 formed in the seal housing 44. A feature of the invention is it contemplates the use of the access port system 40 without the need for an obturator. An advantage of the invention is it simplifies the insertion of an access port through a body wall. In particular, with the access port 40 of the invention, at least the following steps of operating the conventional access port systems of the prior art will be eliminated: (1) placing an obturator into an access port; (2) holding the obturator in place during placement of the access port; (3) subsequently removing the obturator when access is complete; and (4) disposal of the obturator. The distal end of the cannula 42 comprises a tip 48 that is sized and configured to guide the tubular portion of the cannula 42 through a body wall. Distal tip 48 may be sharp, pointed or bladed. In one aspect of the invention, the tip 48 comprises a substantially blunt or rounded frusto conical structure having at least one tissue engaging helical raised pattern upon the conical surface.
(23) Referring to FIGS. 5-10, there is shown a method of inserting the surgical access port of the present invention and, in particular, there are shown a series of illustrations of the surgical access port in use to provide access through a body wall and into an internal portion of a body. First, an entry is initiated by a small skin incision as illustrated in FIG. 5, followed by insertion of the distal portion of the access port 42 as illustrated in FIG. 6. The access port 40 is advanced into the fascial defect until the innermost layer of tissue is penetrated. When the distal portion of the access port 40 passes through the final layer of tissue, it repositions itself to one side of the cannula 42 as illustrated in FIG. 7. The repositioned distal tip 48 remains in a substantially right-angled, off-axis, condition until removal of the access port. The distal tip 48 automatically realigns with the axis of the cannula 42 as the access port is withdrawn from the body wall as illustrated in FIG. 8. FIGS. 9 and 10 are enlarged views of the initiation and completion of the removal step of FIG. 8.
(24) Stated another way, the present invention contemplates the use of a distal portion that separates body tissue rather than cutting the tissue. The resulting residual defect is minimal and easily corrected. In addition, the blunt or rounded configuration of the distal tip allows it to remain in the angled, off-axis condition during use since there are no sharp, pointed or cutting elements associated with the distal portion.
(25) FIGS. 11-16 illustrate the details of the construction of access port 40 according to the present invention. In particular, access port 40 comprises a cannula or elongate tubular body 42 having a proximal end and a distal end, seal housing 44 operably connected at the proximal end, and tip 48 disposed at the distal end. Cannula 42 is formed from a very thin walled tube that is sized and configured to allow passage of surgical instruments through a body wall and into a body cavity. The distal tip 48 may be solid or hollow. The hollow tip may act as a specimen bag by closing on a specimen and pulled inside the tip during removal of the access port. The tip 48 is sized and configured to facilitate the placement of the tubular cannula 42. The tip 48 comprises conical, tapered or rounded shape that separates tissue layers and provides a small fascial defect through which the associated cannula 42 may pass. A metal or plastic retention member 47 is associated with the sidewall of the cannula tube and extends into the distal tip 48. The distal tip 48 may swing to one side when no axial load is present to hold it in axial alignment with the cannula tube. The retention member 47 may be biased to hold the distal tip 48 in an off-axis position when there is no axial load or the tip 48 may be lightly held in axial alignment and subsequently deflected in the presence of instruments within the cannula 42. FIGS. 20(a)-20(c) illustrate perspective views of a single-piece 48(a), a two-piece 48(a)/48(b) and a three-piece 48(a)/48(b)/48(c) distal tip, respectively, that may swing to the side of the tubular cannula 42 when no axial load is present to hold them in axial alignment with the tubular cannula 42.
(26) A biased condition may be achieved using a spring, spring wire, offset hinge or a plastic living hinge. Considering the thin-wall nature of the cannula itself, a substantially flat ribbon of metal may comprise a preferred embodiment in the present invention where the ribbon is insert molded or fitted into the wall of the cannula 42 radially between an inner diameter 50 and an outer diameter 52 and subsequently inserted into a slot 49 in the distal tip 48. (FIGS. 13, 15-16). The ribbon may be configured to bias the distal tip in either the axial or off-axis condition or both. A detent or over-center configuration may be achieved by forming the hinge-ribbon into a cross sectional semi-circle to match the cross section of the cannula tube. The semi-circular cross section of the ribbon results in a snap-over or click that places the tip in axial alignment or, alternately, out of axial alignment upon urging from an included instrument. A rounded or tapered proximally facing extension upon the proximal end of the distal tip that is sized and configured to fit or nest into the distal end of the cannula tube assures correct axial alignment of the tip and the cannula.
(27) Referring to FIGS. 17-19, there is shown another aspect of the present invention including alignment features associated with the distal tip and the cannula tube. Proximally facing extensions associated with the tip fit into distally facing slots or features associated with the distal end of the cannula. These features allow the assembly to be twisted without challenging the retention member.
(28) It will be understood that many other modifications can be made to the various disclosed embodiments without departing from the spirit and scope of the invention. For these reasons, the above description should not be construed as limiting the invention, but should be interpreted as merely exemplary of preferred embodiments.
