JP5503451B2 - Surgical device having indicia for cutting to an appropriate size - Google Patents

Description

(Refer to related applications)
This application claims the benefit of US Provisional Application No. 61 / 231,798, filed Aug. 6, 2009, and priority to that provisional application, the entire contents of which are hereby incorporated by reference. The

(background)
(1. Technical field)
The present disclosure relates to seals used in surgical procedures. More particularly, the present disclosure is adapted to be inserted into a tissue incision so that a substantially fluid tight seal is formed for the tissue and the surgical object or surgical objects. The present invention relates to a seal anchor member adapted to be hermetically received by one or more surgical objects.

(2. Background of related technology)
Today, many surgical procedures are performed through small incisions in the skin, compared to the larger incisions typically required in conventional procedures, in an effort to reduce both patient trauma and recovery time. Such a procedure is generally referred to as an “endoscopic procedure” except when performed on the patient's abdomen, and when performed on the patient's abdomen, the procedure is referred to as a “laparoscopic procedure”. . Throughout this disclosure, the term “minimally invasive” should be understood to include, for example, endoscopic procedures, laparoscopic procedures, arthroscopic procedures, thoracic procedures, and the like.

  During a typical minimally invasive procedure, surgical objects such as, for example, trocar and cannula assemblies, or surgical access devices such as endoscopes, are inserted through a tissue incision and into a patient's body. . In general, before introducing a surgical object into the patient's body, a vent gas is used to enlarge the area surrounding the target surgical site to create a larger and more accessible working area. Accordingly, it is desirable to maintain a substantially fluid tight seal so as to prevent leakage of vent gas and contraction or dent of the enlarged surgical site.

  For this purpose, various valves and seals are used during the course of minimally invasive procedures and they are well known in the art. However, it is a seal anchor member that can be inserted directly into a tissue incision in a narrow area, such as a cavity between two ribs, and accommodates various surgical objects while maintaining the integrity of the aeration workspace There is a continuing need for seal anchor members that may be.

(Overview)
In accordance with an embodiment of the present invention, a surgical device for positioning in a tissue tract accessing an underlying body cavity, the surgical device including a compressible material, wherein the first expanded state and the second compressed state A surgical device is provided that includes a seal anchor member that is adapted to transition between. The first expanded state is a relationship that facilitates securing the seal anchor member within the tissue tract and substantially seals with the tissue surface defining the tissue tract, and the second compressed state is within the tissue tract. Facilitating at least partial insertion of the seal anchor member; The seal anchor member may be formed from a foam material, and the foam material may be at least partially constructed from a material selected from the group consisting of polyisoprene, urethane, and silicone. Alternatively, the seal anchor member can be formed from a gel material.

  The seal anchor member includes a proximal end and a distal end that define an elongate perimeter, such as an oval or a rectangle, to facilitate positioning 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 represent an arcuate configuration, and the arcuate configuration may be either concave or convex. The seal anchor member can be rolled, twisted or deformed and can be non-linearly suitable within the tissue tract. The seal anchor member can also be cut to better fit the surgical procedure.

  At least one port extends between the proximal and distal ends and is adapted to receive the object, wherein the compressed material defining the at least one port is substantially sealed with the object. Adapted to transform to establish relationship. At least one port may include at least an undercut to protect against fluid leakage. The seal anchor member may include a plurality of ports that may be configured linearly with respect to a large diameter around at least one of the distal end and the proximal end. Each port may be equally spaced from adjacent ports of each port.

  In accordance with one embodiment of the present invention, a surgical device for positioning within a tissue tract accessing an underlying body cavity, the surgical device comprising a seal anchor member comprising a compressible material, the surgical device comprising: Provided. The seal anchor member facilitates securing the seal anchor member within the tissue tract in a first state in which at least a portion of the seal anchor member is inserted into the tissue tract and substantially with the tissue surface defining the tissue tract. It may be adapted to transition between a second state that is in a sealed relationship. The seal anchor member may have a proximal end and a distal end, and may define at least one port extending between the proximal end and the distal end, the at least one port receiving an object Wherein the compressed material defining the at least one port is adapted to deform to establish a substantially sealed relationship with the object. The seal anchor member may have a non-circular cross section.

  The seal anchor member may be formed from a foam material. The foam material may be at least partially composed of a material selected from the group consisting of polyisoprene, urethane, and silicone. The seal anchor member can also be formed from a gel material. At least one port may include at least one undercut to reduce the likelihood of leakage through the port. The surgical device may also include an indicia that indicates to the user where the device can be cut. The seal anchor member may include a plurality of ports, and the plurality of ports may be configured linearly with respect to each other. Each port of the plurality of ports may be equally spaced from adjacent ports of each port. In use, the seal anchor member may have an initial expanded state that is compressed from the initial expanded state to the first state by an external compressive force to facilitate insertion of at least a portion of the seal anchor member into the tissue tract. The anchor seal member can be adapted to expand toward its initial expanded state and to its second state when the compressive force is removed, securing the seal anchor member within the tissue tract. It may be further adapted to facilitate and be in a substantially sealed relationship with the tissue surface defining the tissue tract.

  In accordance with another embodiment of the present invention, a surgical device for positioning in a tissue tract accessing an underlying body cavity, the surgical device comprising a seal anchor member comprising a compressible material. A seal anchor member is provided that includes a first condition for inserting at least a portion of the seal anchor member into the tissue tract, and a tissue surface that facilitates securing the seal anchor member within the tissue tract and defines the tissue tract And a second state in a substantially sealed relationship, the seal anchor member having a proximal end and a distal end, A plurality of ports extending between, wherein at least one of the plurality of ports is adapted to receive the object, wherein the compressed material defining the at least one port is substantially the same as the object. Dense It is adapted to deform to establish a relationship, wherein the plurality of ports are arranged linearly relative to each other.

  The seal anchor member may be formed from a foam material. The foam material may be at least partially composed of a material selected from the group consisting of polyisoprene, urethane, and silicone. The seal anchor member can also be formed from a gel material. At least one port may include at least one undercut to reduce the likelihood of leakage through the port. The surgical device may also include an indicia that indicates to the user where the device can be cut. The seal anchor member may have a non-circular cross section. Each port may be equally spaced from adjacent ports of each port. In use, the seal anchor member may have an initial expanded state that is compressed from the initial expanded state to the first state by an external compressive force to facilitate insertion of at least a portion of the seal anchor member into the tissue tract. The anchor seal member can be adapted to expand toward its initial expanded state and to its second state when the compressive force is removed, securing the seal anchor member within the tissue tract. It may be further adapted to facilitate and be in a substantially sealed relationship with the tissue surface defining the tissue tract.

  In accordance with yet another embodiment of the present invention, a surgical device for positioning within a tissue tract accessing an underlying body cavity, the surgical device comprising a seal anchor member comprising a compressible material, A surgical device is provided, wherein the seal anchor member facilitates securing a seal anchor member within the tissue tract and a first condition for inserting at least a portion of the seal anchor member into the tissue tract and defining the tissue tract The seal anchor member is adapted to transition between a second state in a substantially sealed relationship with the tissue surface, the seal anchor member having a proximal end and a distal end, the proximal end and the distal end Defining at least one port extending between the ends, wherein the at least one port is adapted to receive an object, wherein the compressed material defining the at least one port is substantially sealed with the object Shi It is adapted to deform to establish a relationship, wherein at least one port includes an undercut to reduce the likelihood of leaks therethrough port.

  In accordance with yet another embodiment of the present invention, a seal anchor member is provided, the seal anchor member compressed to be inserted into the incision, and once inserted, secured within the incision and into the incision. At least one port configured and dimensioned to expand against the seal, the seal anchor member extending generally longitudinally and adapted to sealingly receive the surgical object The seal anchor member has indicia and is formed from a material suitable for being cut along the indicia, for example, by a surgeon's scalpel. The indicia may be positioned such that when the seal anchor member is separated along the indicia, such as by cutting, the seal anchor member has a cross-sectional shape that is different from the initial cross-sectional shape of the anchor seal member. . The indicia can be one of a plurality of lines or a plurality of markings on the surface of the seal anchor member. The seal anchor member may also include weakened areas that facilitate cutting of the seal anchor member, consistent with the indicia. The weakened area may include drilling and / or slits.

  In accordance with yet another embodiment of the present invention, a seal anchor member is provided, the seal anchor member compressed to be inserted into the incision, and once inserted, secured within the incision and into the incision. At least one port configured and dimensioned to expand against the seal, the seal anchor member extending generally longitudinally and adapted to sealingly receive the surgical object The seal anchor member has an indicia that indicates to the user the location of the weakened area on the seal anchor member, which allows the size of the seal anchor member to be reduced. The weakened area can be one of a punch or a slit. The seal anchor member may include a plurality of ports, and the indicia indicates a position where the number of ports of the seal anchor member is reduced when the seal anchor member is separated in the indicia. Alternatively, the indicia is positioned such that when the seal anchor member is separated at the indicia, the size can be reduced so that the seal anchor member is received in the smaller incision without reducing the number of ports. Can show.

For example, the present invention provides the following items.
(Item 1)
A surgical device for positioning in a tissue tract accessing an underlying body cavity, the surgical device comprising:
A seal anchor member including a compressible material;
The seal anchor member includes a first state in which at least a portion of the seal anchor member is inserted into the tissue tract, a tissue surface that facilitates securing the seal anchor member within the tissue tract and defines the tissue tract; Adapted to transition between a second state in a substantially sealed relationship,
The seal anchor member has a proximal end and a distal end, and defines at least one port extending between the proximal end and the distal end, the at least one port receiving an object. Wherein the compressible material defining the at least one port deforms and establishes a substantially sealed relationship with the object;
The surgical device includes an indicia that indicates to a user where the device can be cut to reduce the size of the seal anchor member.
(Item 2)
The surgical apparatus according to any one of the above items, wherein the seal anchor member is formed of a foam material.
(Item 3)
The surgical apparatus according to any of the preceding items, wherein the foamed material is at least partially composed of a material selected from the group consisting of polyisoprene, urethane, and silicone.
(Item 4)
The surgical apparatus according to any one of the above items, wherein the seal anchor member is formed of a gel material.
(Item 5)
The surgical apparatus according to any of the preceding items, wherein the indicia is one of a line or a marking on the surface of the seal anchor member.
(Item 6)
The surgical apparatus according to any of the preceding items, wherein each port of the plurality of ports is equally spaced from an adjacent port of each port.
(Item 7)
The seal anchor member has an initial expanded state and is compressed from the initial expanded state to the first state by an external compressive force so that at least a portion of the seal anchor member is easily inserted into the tissue tract. And the anchor seal member expands toward its initial expanded state and into its second state when the compressive force is removed, securing the seal anchor member within the tissue tract A surgical device according to any of the preceding items, further adapted to facilitate and to be in a substantially sealed relationship with the tissue surface defining the tissue tract.
(Item 8)
A seal anchor member, wherein the seal anchor member is compressed for insertion into the incision, and when inserted, is secured within the incision and expands to seal against the incision. Configured and dimensioned in such a manner, the seal anchor member defines at least one port that extends generally longitudinally and is adapted to be hermetically received in a surgical object, the seal anchor member being A seal anchor member having an indicia and formed from a material suitable for being cut along the indicia by a surgeon's scalpel.
(Item 9)
The indicia is such that when the seal anchor member is cut along the indicia by a surgeon's scalpel, the seal anchor member has a cross-sectional shape that is different from the initial cross-sectional shape of the anchor seal member. The seal anchor member according to any one of the above items, wherein the position is determined at a position.
(Item 10)
The seal anchor member according to any one of the above items, wherein the indicia is one of a plurality of lines or a plurality of markings on a surface of the seal anchor member.
(Item 11)
The seal anchor member according to any of the preceding items, wherein the seal anchor member also includes a weakened area that coincides with the indicia and facilitates cutting of the seal anchor member.
(Item 12)
The seal anchor member according to any of the preceding items, wherein the weakened region includes one of drilling and slitting.
(Item 13)
A seal anchor member, wherein the seal anchor member is compressed for insertion into the incision, and when inserted, is secured within the incision and expands to seal against the incision. Configured and dimensioned in such a manner, the seal anchor member defines at least one port that extends generally longitudinally and is adapted to be hermetically received in a surgical object, the seal anchor member being A seal anchor member having an indicia that indicates to a user the location of the weakened area on the seal anchor member, the weakened area allowing the size of the seal anchor member to be reduced.
(Item 14)
The seal anchor member according to any one of the above items, wherein the weakened region is one of drilling and slitting.
(Item 15)
The seal anchor member includes a plurality of ports, and the indicia indicates a position where the number of ports of the seal anchor member is reduced when the seal anchor member is separated in the indicia. The seal anchor member according to any one of the above.
(Item 16)
Any of the preceding items, wherein the indicia indicates a position where the seal anchor member is reduced in size so that the seal anchor member is received in a relatively smaller incision when the seal anchor member is separated at the indicia. A seal anchor member according to claim 1.

(Summary)
A surgical device positioned within a tissue tract that accesses an underlying body cavity. The apparatus can include a seal anchor member that includes a compressible material. The seal anchor material facilitates securing the seal anchor member within the tissue tract in a first state in which at least a portion of the seal anchor member is inserted into the tissue tract and substantially with the tissue surface defining the tissue tract. It may be adapted to transition between a second state that is a sealing relationship. The seal anchor member may have a proximal end and a distal end, and may define at least one port extending between the proximal end and the distal end, the at least one port receiving an object Wherein the compressed material defining at least one port is adapted to deform and establish a substantially sealed relationship with the object. The seal anchor member may include indicia that indicates to the user where the member can be cut to reduce the size of the member.

  Various embodiments of the present disclosure are described below with reference to the drawings.

FIG. 1 is a top perspective view of a surgical device according to the principles of the present disclosure, shown in an expanded state, illustrating a seal anchor member for positioning with respect to tissue. FIG. 2 is a schematic side view of the seal anchor member of FIG. 3 is a cross-sectional view of the seal anchor member of FIG. 1 taken along section line 3-3 of FIG. 1, illustrating a plurality of ports defining undercuts. FIG. 4 is a side schematic view of the port of the seal anchor member of FIG. 2 through which a surgical object is inserted. FIG. 5 is a perspective schematic view of the seal anchor member of FIG. 1 shown in a compressed state before it is inserted into a tissue incision. FIG. 6 is a perspective schematic view of the seal anchor member of FIG. 1, shown in an expanded state, after it has been inserted into the incision. FIG. 7 is a top view of the seal anchor member of FIG. 1 in a rolled state. FIG. 8A is a perspective view of a surgical apparatus according to another embodiment of the present disclosure, illustrating seal anchor members cut to various lengths. FIG. 8B is a perspective view of a surgical apparatus according to another embodiment of the present disclosure, illustrating seal anchor members cut to various lengths. FIG. 8C is a perspective view of a surgical apparatus according to another embodiment of the present disclosure, illustrating seal anchor members cut to various lengths. FIG. 8D is a perspective view of a surgical apparatus according to another embodiment of the present disclosure, illustrating seal anchor members cut to various lengths.

(Detailed description of embodiment)
In the drawings and the following description, like reference numerals identify similar or identical elements, and as is conventional and known in the art, the term “proximal” is most commonly used by healthcare professionals in use. Close, refers to the end of the device, while “distal” refers to the end furthest to the healthcare professional.

  With reference to FIGS. 1-4, a surgical apparatus 10 used in a surgical procedure, such as a minimally invasive procedure, is illustrated. Surgical device 10 includes a seal anchor member 100 having a proximal end 102 and a distal end 104. Seal anchor member 100 includes one or more ports 108, or lumens, extending through seal anchor member 100 between proximal end 102 and distal end 104.

  Seal anchor member 100 forms a seal around one or more surgical objects, generally shown as surgical object “I” (FIG. 4), and establishes a sealing relationship with tissue “T”. It is formed from a suitable foam material with sufficient suitability. The foam is sufficiently compatible to accommodate the movement of the surgical object “I”. In one embodiment, the foam includes a polyisoprene material. An example of an anchor member formed from foam, for example, is disclosed in Applicant's co-pending US patent application Ser. No. 12 / 244,024 filed Oct. 2, 2008, and the contents of that patent application. The entirety is incorporated herein by reference.

The proximal end 102 of the seal anchor member 100 defines a _first large diameter D1, and the distal end 104 defines a _second large diameter D2. In one embodiment of seal anchor member 100, proximal 102 and the first large-diameter D ₁ and second diameter D ₂ of the respective distal end 104, substantially as seen in FIG. 2 equivalent However, embodiments of the seal anchor member 100 with different diameters D ₁ and D ₂ are also within the scope of the present disclosure. Further, the proximal end 102 of seal anchor member 100 defines a first diameter _{D 3,} the distal end 104 defines a second diameter _{D 4.} In one embodiment of seal anchor member 100, each of the first small diameter D ₃ and the second small diameter D ₄ of the proximal and distal ends 102, 104 are substantially equivalent, as seen in FIG. 2 However, embodiments of the seal anchor member 100 having different diameters D ₃ and D ₄ are also within the scope of the present disclosure. Advantageously, the first large diameter D ₁ of the proximal end 102 and the second large diameter D ₂ of the distal end 104 are the first small diameter D ₃ of the proximal end 102 and the first large diameter D ₃ of the distal end 104. greater than 2 of the small-diameter D _4, as a result, the seal anchor member 100 has in cross-section, for example, rectangular, elliptical, non-circular shape, such as race road shape.

  As depicted in FIG. 1, the positioning members 114 at the proximal end 102 and the distal end 104 may define an arcuate surface, as will be discussed in more detail below, and are defined by the tissue surface 14, for example It may help to insert the seal anchor member 100 into the tissue tract 12 formed in a tissue “T” such as an incision. Alternatively, proximal end 102 and distal end 104 may define a substantially flat surface or a substantially arcuate surface. Embodiments where either or both the proximal end 102 and the distal end 104 define an arched or flat surface or an arched and flat surface are contemplated herein. Either or both of the arcuate surfaces can be concave or convex.

Intermediate portion 106 extends between proximal end 102 and distal end 104 and defines a dimension or length “L” along it. The intermediate portion 106 further defines an intermediate large diameter “R” that is substantially parallel to the large diameters D ₁ , D ₂ . The dimension “R” of the intermediate portion 106 may remain substantially constant along the dimension “L” of the intermediate portion. Alternatively, the dimension “R” of the intermediate portion 106 may vary along the dimension or length “L” of the intermediate portion, thereby defining a cross-sectional dimension that varies along the length “L” of the intermediate portion. This, in turn, facilitates securing the seal anchor member 100 within the tissue “T”. Further, the intermediate portion 106 may further define an intermediate small diameter “R ₂ ” that is substantially perpendicular to the large diameter R. Advantageously, the intermediate small diameter “R ₂ ” is smaller than the large diameter R, so that the seal anchor member 100 has a non-circular shape in cross section, such as, for example, rectangular, elliptical, raceway shape, etc.

The dimension “R” of the intermediate portion 106 is significantly smaller than the respective major axes D ₁ , D ₂ of the proximal end 102 and the distal end 104, as discussed in more detail below, and within the tissue “T”. It may help to secure the seal anchor member 100. However, in alternative embodiments, the dimension “R” of the intermediate portion 106 may be substantially equivalent to the respective major axes D ₁ , D ₂ of the proximal end 102 and the distal end 104. In cross section, the intermediate portion 106 may represent any suitable elongated configuration, such as a substantially oval or rectangular shape, for insertion into a narrow incision.

Each port 108 is configured to removably receive a surgical object “I”. Prior to insertion of surgical object “I”, port 108 is in a first state in which port 108 defines a first dimension or initial dimension D _P1 . Port 108 may define an opening in seal anchor member 100 having an initial open condition. Alternatively, D _P1 can be about 0 mm so that leakage of vent gas (not shown) through the port 108 of the seal anchor member 100 is substantially prevented when there is no surgical object “I”. The For example, the port 108 may be a slit that extends the length “L” of the seal anchor member 100 through the proximal end 102 and the distal end 104.

When surgical object “I” is introduced, port 108 transitions to a second state in which port 108 substantially approximates diameter D ₁ of surgical object “I”. Defines a second, larger dimension D _P2 that results in the formation of a substantially fluid-tight seal therewith so that when there is a surgical object “I”, the port of the seal anchor member 100 Leakage of vent gas (not shown) through 108 is substantially prevented. D ₁ and thus _{D P2} is generally in the range of about 5mm~ about 12 mm. This is because these dimensions are typical of surgical objects used during the course of minimally invasive procedures. However, a seal anchor member 100 that includes a port 108 that can represent a substantially larger or smaller dimension in the second state of the port is not outside the scope of the present disclosure. Seal anchor member 100 may include a plurality of generally tubular port portions (not shown) that define ports 108. Further, the seal anchor 100 may have no ports at all. With this arrangement, the port 108 is created in the seal anchor member 100 during the insertion of the surgical object “I”. In accordance with this embodiment, the seal anchor member 100 is formed from a flowable material, such as a foam material, such as an open cell polyurethane foam or a sufficiently compatible material, or a gel.

Port 108 may include port 108a, which includes at least one undercut 118 that collects vent gas that leaks through a substantially fluid tight seal between surgical instrument “I” and port 108a. . Each undercut 118 defines a diameter D _{P3 that is} greater than D _P2 and a length along port 108a that is less than “L”. Vent gas that leaks through the substantially fluid tight seal between the instrument “I” and the port 108a can collect in the undercut 118, preventing further leakage of gas through the substantially fluid tight seal. obtain. Further, the undercut 118 provides an edge (where each diameter D _P1 of the lumen 108 transitions to the diameter D _{P3 of the} undercut 118), which edge is inserted through the port. Engage with the outer surface of "I" to further reduce leakage. Port 108 may also include a port 108b that does not include an undercut, or any combination of ports 108a and 108b.

Generally, ports 108 are arranged linearly with respect to major diameter _{D 1.} The port 108 may alternatively be arranged linearly with respect to the large diameter D ₂ or the dimension “R”. However, embodiments in which the ports 108 are arranged in a non-linear fashion, such as an oval or zigzag pattern, are also within the scope of the present disclosure. Each port 108 may be spaced equally from its neighboring ports. However, embodiments in which the ports 108 are spaced at unequal intervals are also within the scope of this disclosure.

Referring now to FIGS. 1 and 5, seal anchor member 100 is compressed from an expanded state (FIG. 1) to facilitate insertion and fixation of seal anchor member 100 within tissue tract 12 of tissue “T”. Adapted to transition to the state (FIG. 5). In the expanded state, seal anchor member 100 is stationary and the major axis D ₁ , D ₂ of each of proximal end 102 and distal end 104 of seal anchor member 100 and dimension “R” of intermediate portion 106 is The seal anchor member 100 cannot be inserted into the tissue tract 12. However, as seen in FIG. 5, in the compressed state, the proximal end 102 and distal end 104 of the seal anchor member 100 and the intermediate portion 106 are sized to be inserted into the tissue tract 12.

  The seal anchor member 100 is formed from a biocompatible compressible material that facilitates the transition of the elastic reciprocating motion of the seal anchor member 100 between the expanded and compressed states of the seal anchor member 100. In one embodiment, the compressible material is a “memory” foam. When an external force is applied to the seal anchor member 100, the seal anchor member 100 is brought into a compressed state. When the seal anchor member 100 is subjected to an external force, such as when the external force “F” is directed inward, eg, the seal anchor member 100 is tightened, the seal anchor member 100 is subjected to a considerable degree of deformation and thereby compressed. Transition to the state.

As depicted in FIG. 5, when the seal anchor member 100 is compressed under the influence of an external force “F”, an internal biasing force “F _B1 ” is created in the seal anchor member 100 and the internal biasing force “F”. F _B1 ”is directed outward and counters the force“ F ”. The internal biasing force “F _B1 ” attempts to expand the seal anchor member 100 and thereby return the seal anchor member 100 to its expanded state. Therefore, as long as the seal anchor member 100 receives an external force “F” greater than the biasing force “F _B1 ”, the seal anchor member 100 is compressed, and once compressed, the external force “F” is at least the biasing force “F”. As long as it is equal to “F _B1 ”, the seal anchor member 100 remains in a compressed state. When the external force “F” is removed, the biasing force “F _B1 ” acts to return the seal anchor member 100 to the expanded state.

The compressible material comprising the seal anchor member 100 also facilitates an elastic transition between the first state of the port (FIGS. 1-3) and the second state of the port (FIG. 5). As previously discussed, prior to insertion of surgical object “I”, port 108 is in a first state of the port where port 108 defines a first or initial dimension D _P1 . Port 108 may incorporate a slit extending the length “L” of seal anchor member 100. In this first state, the port 108 is stationary and is not receiving any external force. However, as depicted in FIG. 4, when surgical object “I” is introduced through port 108, surgical object “I” exerts a force “F ₁ ” directed radially outward on port 108. Work. The force “F ₁ ” acts to increase the size of the port 108, thereby causing the port 108 to transition to the second state of the port, in which the port 108 moves the surgical object “I defining a second larger dimension D _P2 that substantially approximates the diameter D ₁ of the ". As a result, an internal biasing force “F _B2 ” that is directed radially inward and opposes the force “F ₁ ” is created. The internal biasing force “F _B2 ” attempts to return the port 108 to reduce the internal dimensions of the port 108, thereby returning the port 108 to its first state. The internal biasing force “F _B2 ” is exerted against the surgical object “I” and serves to create a substantially fluid tight seal on the surgical object “I”. The importance of the forces “F _B1 ” and “F _B2 ” is discussed in further detail below.

  Referring again to FIG. 1, one or more positioning members 114 may be associated with either or both of the proximal end 102 and the distal end 104 of the seal anchor member 100. The positioning member 114 can be composed of any suitable biocompatible material, which can be elastically deformed, for example, substantially rectangular or oval. It is at least semi-elastic so that it can represent any suitable elongated configuration. Prior to insertion of seal anchor member 100, positioning member 114 is deformed relative to each of proximal end 102 and distal end 104 of seal anchor member 100 to cause seal anchor member 100 to pass through tissue tract 12. Facilitates advancement (FIG. 6). After inserting the seal anchor member 100 into the tissue tract 12, the elastic nature of the positioning member 114 allows the positioning member to return to the normal configuration of the positioning member, eg, a substantially rectangular or elliptical configuration. , Thereby assisting in the expansion of either or both of the proximal end 102 and the distal end 104 and facilitating the transition of the seal anchor member 100 from the compressed state to its expanded state. The positioning member 114 may also engage a wall defining the body cavity to further facilitate securing the seal anchor member 100 within the body tissue. For example, the positioning member 114 at the front end 104 may engage the inner peritoneal wall and the positioning member 114 adjacent the rear end 102 may engage the outer epidermal tissue adjacent the incision 12 in the tissue “T”. In another embodiment of the seal anchor member 100, one or more additional positioning members 114 can be associated with the intermediate portion 106.

The use of the seal anchor member 100 is considered during the course of a typical minimally invasive procedure. Initially, the peritoneal cavity (not shown) is vented by a suitable biocompatible gas such as CO _{2 so} that the cavity wall is lifted away from the internal organs and tissues contained within the cavity wall. And raised to provide greater access to the cavity wall. Ventilation may be performed using a vent needle or similar device, which is prior art in the art. Before or after ventilation, the tissue tract 12 is made into tissue “T” and the dimensions of the tissue tract can be varied according to the nature of the procedure.

Prior to inserting the seal anchor member 100 into the tissue tract 12, the seal anchor member 100 is in its expanded state, and in the expanded state, the dimensions of the seal anchor member 100 are such that the seal anchor member 100 enters the tissue tract 12. Prevent insertion. To facilitate insertion, the health care professional causes the seal anchor member 100 to transition to a compressed state, for example, by applying a force “F” to the seal anchor member, such as tightening the seal anchor member 100. The force “F” causes dimensions D ₁ and D ₂ of proximal end 102 and distal end 104 to dimension D ₁ ′ and D ₂ ′ (FIG. 5), including positioning member 114 (if provided), respectively. Decreasing and reducing the dimension “R” of the intermediate portion 106 to “R ′” so that the seal anchor member 100 can be inserted into the tissue tract 12. As best depicted in FIG. 6, following insertion of the seal anchor member 100, the distal end 104, the positioning member 114 (if provided), and at least a portion of the intermediate portion 106 have a tissue “T”. Placed below. The seal anchor member 100 is moved from the compressed state to the expanded state by removing the force “F” from the seal anchor member 100.

During the transition from the compressed state to the expanded state, the dimensions of the seal anchor member 100, ie the dimensions D ₁ ′ and D ₂ ′ (FIG. 5) of the proximal end 102 and the distal end 104, respectively, are D ₁ and D ₂ ( 6), the dimension “R ′” is increased toward “R”. The expansion of the distal end 104 is relatively unblocked when placed under the tissue “T”, thus allowing the distal end 104 to be significantly expanded if not complete. However, as seen in FIG. 5, the expansion of the portion 112 of the intermediate portion 106 is limited by the tissue surface 14 (FIG. 1) defining the tissue tract 12 so that the outer portion 106 is directed downward. Receive the force “F”. As discussed above, this creates an internal biasing force “F _B1 ” that is directed outwardly and applied against the tissue surface 14, thereby providing a seal between the seal anchor member 100 and the tissue surface 14. A substantially fluid tight seal and substantially prevents venting gas from leaking around the seal anchor member 100 and through the tissue tract 12.

In the expanded state, the respective dimensions D ₁ and D ₂ of the proximal end 102 and the distal end 104 are larger than the dimension “R” of the intermediate portion 106. Following insertion, the dimension D ₂ of distal end 104 and positioning member 114 is also substantially larger than the dimensions of the tissue tract 12. As a result, the seal anchor member 100 may not be removed from the tissue tract 12 in the expanded state, and therefore the seal anchor member 100 remains fixed in the tissue “T” until it returns to the compressed state.

One or more surgical objects “I” may be inserted through the port 108 after successfully sealing the seal anchor member 100 within the patient's tissue “T”. FIG. 6 illustrates a surgical object “I” introduced through one of the ports 108. As discussed previously, prior to the insertion of surgical object "I", port 108 is in a first state of the port 108 to port 108 defines an initial dimension D _P1, initial dimensions D _P1 is In one embodiment, port 108 can be ignored in that it is a slit. Thus, when there is no surgical object “I”, vent gas leakage through the port 108 is minimized, thereby preserving the integrity of the vented work space.

Surgical object “I” is any suitable surgical instrument and therefore may vary in size. Suitable surgical objects introduced into the one or more ports 108 include minimally invasive grasping instruments, forceps, clip appliers, staplers, cannula assemblies, and the like. When surgical object “I” is introduced, port 108 is enlarged so that port 108 has a second dimension D _P2 (FIG. 4) that substantially approximates diameter D ₁ of surgical object “I”. ) To the second state of the port 108 defining, thereby creating a substantially fluid tight seal with the surgical object “I” as previously discussed, and the surgical object “I”. When there is, the venting gas (not shown) is substantially prevented from leaking through the port 108 of the seal anchor member 100.

  Turning now to FIGS. 8A-8D, a surgical apparatus according to an alternative embodiment of the present disclosure is shown generally as 20. FIG. Surgical device 20 is substantially identical to surgical device 10, and is therefore discussed in detail herein to the extent necessary to identify differences in the structure and operation of surgical device 20.

  As seen in FIG. 8A, the surgical apparatus 20 includes a seal anchor member 200 that defines a plurality of ports 208, the seal anchor member of the seal anchor member 200, for example, by cutting or separating. It has the feature of reducing the size. Advantageously, the seal anchor member 200 is formed from a material, such as foam, that can be cut by a medical practitioner's scalpel. If the seal anchor member 200 defines more ports 208 than are required for a particular surgical procedure, the seal anchor member 200 may be cut and have a smaller number of ports 208. Similarly, if the surgeon desires to have an incision that is relatively smaller than the incision typically used for seal anchor member 200, seal anchor member 200 reduces its length, eg, large diameter. Can be cut so that when the seal anchor member is positioned within the incision, the size of the incision required to achieve an optimal seal is reduced and smaller incisions are more appropriate A biasing force / sealing force can be provided. Depending on the location of the cut to be made, cutting the seal anchor member may reduce the number of remaining ports or the number of ports may remain the same. 8B-8D illustrate the resulting seal anchor members 210, 220, and 230, respectively, when the seal anchor member 200 is cut along dividing lines 8B-8B, 8C-8C, and 8D-8D. The seal anchor member 200 includes indicia such as lines or markings along the dividing lines 8B-8B, 8C-8C, and 8D-8D, for example, to indicate to the user where to cut as necessary. obtain. Additionally or alternatively, the seal anchor member 200 may include weakened areas, such as holes, slits, etc., at locations that coincide with the indicia, such locations without losing the cuts made in the indicia, for example. Facilitates making such a cut by helping to ensure that the entire seal anchor member is passed, or cuts, for example, by reducing the effort that a surgeon can work when cutting To make it easier. Seal anchor member 200 and resulting seal anchor members 210, 220, and 230 may be used in a surgical procedure in a manner substantially similar to seal anchor member 100, as previously discussed herein. .

  As noted above, the present invention is directed to various embodiments of the present invention, such as thoracic procedures (eg, thymectomy, lobectomy, pulmonary resection, esophagectomy, mediastinal tumor resection, sympathectomy, etc. ), And / or may provide particular advantages, such as for a single incision laparoscopic procedure where it may be desirable to access the abdominal cavity off the midline. For example, during a chest procedure, access is typically achieved by placing a cannula or instrument between the patient's ribs. The elongated shape of the seal anchor member when viewed in cross-section, along with the linear arrangement of the ports through the seal anchor member, allows the seal anchor member to be inserted between the patient's ribs and move with the natural curvature of the rib cage To do. In a single incision laparoscopic procedure, the shape of the seal anchor member allows the seal anchor member to be positioned between muscle groups such as parallel to and above the transverse edge of the rectus abdominis muscle. obtain. As described hereinabove, advantageous positioning of the seal anchor member may provide the additional benefit of reducing tension, trauma and post-operative pain.

  In some instances, the chest procedure may not require ventilation. Ventilation may be used for other types of surgical procedures such as, for example, laparoscopic procedures, and for these types of procedures, the seal anchor member may be provided with a vent tube (not shown). Or one of the ports may be used specifically for venting purposes.

  While exemplary embodiments of the present disclosure have been described herein with reference to the accompanying drawings, the above description, disclosure and figures are not to be construed as limiting, but merely as specific embodiments. It should be construed as illustrative. Accordingly, it is to be understood that this disclosure is not limited to the precise embodiments described, and that various other changes and modifications can be accomplished herein by those skilled in the art without departing from the scope or spirit of this disclosure. It should be.

DESCRIPTION OF SYMBOLS 10 Surgical apparatus 12 Tissue tract 14 Tissue surface 20 Surgical apparatus 100 Seal anchor member 102 Proximal end 104 Distal end 106 Intermediate part 108 Port 114 Positioning member 118 Undercut 200 Seal anchor member

Claims (16)

A surgical device for positioning in a tissue tract accessing an underlying body cavity, the surgical device comprising:
A seal anchor member including a compressible material;
The seal anchor member includes a first state in which at least a portion of the seal anchor member is inserted into the tissue tract, a tissue surface that facilitates securing the seal anchor member within the tissue tract and defines the tissue tract; Adapted to transition between a second state in a substantially sealed relationship,
The seal anchor member has a proximal end and a distal end, and defines at least one port extending between the proximal end and the distal end, the at least one port receiving an object. Wherein the compressible material defining the at least one port deforms and establishes a substantially sealed relationship with the object;
The surgical device includes an indicia that indicates to a user where the device can be cut to reduce the size of the seal anchor member.   The surgical apparatus according to claim 1, wherein the seal anchor member is formed from a foam material.   The surgical apparatus according to claim 2, wherein the foam material is at least partially constructed from a material selected from the group consisting of polyisoprene, urethane, and silicone.   The surgical apparatus according to claim 1, wherein the seal anchor member is formed from a gel material.   The surgical apparatus according to claim 1, wherein the indicia is one of a line or a marking on a surface of the seal anchor member.   The surgical apparatus according to claim 1, wherein each port of the plurality of ports is equally spaced from an adjacent port of each port.   The seal anchor member has an initial expanded state and is compressed from the initial expanded state to the first state by an external compressive force so that at least a portion of the seal anchor member is easily inserted into the tissue tract. And the anchor seal member expands toward its initial expanded state and into its second state when the compressive force is removed, securing the seal anchor member within the tissue tract The surgical apparatus according to claim 1, further adapted to facilitate and to be in a substantially sealed relationship with a tissue surface defining a tissue tract.   A seal anchor member, wherein the seal anchor member is compressed for insertion into the incision, and when inserted, is secured within the incision and expands to seal against the incision. Configured and dimensioned in such a manner, the seal anchor member defines at least one port that extends generally longitudinally and is adapted to be hermetically received in a surgical object, the seal anchor member being A seal anchor member having an indicia and formed from a material suitable for being cut along the indicia by a surgeon's scalpel.   The indicia is such that when the seal anchor member is cut along the indicia by a surgeon's scalpel, the seal anchor member has a cross-sectional shape that is different from the initial cross-sectional shape of the anchor seal member. The seal anchor member of claim 8, wherein the seal anchor member is located at a position.   The seal anchor member according to claim 8, wherein the indicia is one of a plurality of lines or a plurality of markings on a surface of the seal anchor member.   The seal anchor member of claim 8, wherein the seal anchor member also includes a weakened area that coincides with the indicia to facilitate cutting of the seal anchor member.   The seal anchor member of claim 8, wherein the weakened region includes one of a drilling and a slit.   A seal anchor member, wherein the seal anchor member is compressed for insertion into the incision, and when inserted, is secured within the incision and expands to seal against the incision. Configured and dimensioned in such a manner, the seal anchor member defines at least one port that extends generally longitudinally and is adapted to be hermetically received in a surgical object, the seal anchor member being A seal anchor member having an indicia that indicates to a user the location of the weakened area on the seal anchor member, the weakened area allowing the size of the seal anchor member to be reduced.   The seal anchor member according to claim 13, wherein the weakened region is one of drilling and slitting.   The seal anchor member includes a plurality of ports, and the indicia indicates a position where the number of ports of the seal anchor member is reduced when the seal anchor member is separated in the indicia. A seal anchor member as described in 1.   14. The indicia indicates a position where when the seal anchor member is separated at the indicia, the position is reduced in size so that the seal anchor member is received in a relatively smaller incision. The seal anchor member described.

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