Abstract:
A surgical portal and introducer assembly includes an introducer and a portal member positionable within a longitudinal passageway of the introducer. The portal member is adapted for positioning within a tissue tract and has at least one longitudinal port for passage of a surgical object. The portal member comprises a compressible material and is adapted to transition between a first expanded condition and a second compressed condition. The assembly may include an expandable restraining member that may be disposed within the longitudinal passageway. The restraining member is adapted to expand and compress the portal member to cause the portal member to transition to the compressed condition.

Description:
CROSS REFERENCE TO RELATED APPLICATION 
     The present application claims the benefit of and priority to U.S. Provisional Application Ser. No. 61/164,977 filed on Mar. 31, 2009, the entire contents of which are incorporated herein by reference. 
    
    
     BACKGROUND 
     1. Technical Field 
     The present disclosure relates generally to ports for use in minimally invasive surgical procedures, such as endoscopic and/or laparoscopic procedures, and more particularly, relates to an access port and an associated introducer to assist in deploying the port within a tissue tract of a patient. 
     2. Description of Related Art 
     Minimally invasive surgery is a type of surgery performed through one or more small incisions in a patient&#39;s body, usually less than an inch in dimension. Some advantages of minimal invasive surgery is that patients have less trauma to the body, lose less blood, have smaller surgical scars, and need less pain medication. 
     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&#39;s body through the incision in tissue. In general, prior to the introduction of the surgical object into the patient&#39;s body, insufflation gasses are used to enlarge the area surrounding the target surgical site to create a larger, more accessible work area. Accordingly, the maintenance of a substantially fluid-tight seal is desirable so as to prevent the escape of the insufflation gases and the deflation or collapse of the enlarged surgical site. 
     To this end, various ports with 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 an access port and associated introducer which can position the access port with relative ease and with minor inconvenience for the surgeon. 
     SUMMARY 
     Accordingly, a surgical port and introducer assembly includes an introducer having a longitudinal passageway and a portal member positionable within the longitudinal passageway of the introducer. The portal member is adapted for positioning within a tissue tract and has at least one longitudinal port for passage of a surgical object. The portal member comprises a compressible material and is adapted to transition between a first expanded condition to facilitate securing of the portal member within the tissue tract and in substantial sealed relation with tissue surfaces defining the tissue tract, and a second compressed condition to facilitate at least partial insertion of the portal member within the tissue tract. The assembly further includes an expandable restraining member at least partially disposed within the longitudinal passageway of the introducer. The restraining member is adapted to expand and compress the portal member to cause the portal member to assume the compressed condition thereof, to thereby facilitate passage of the portal member through the longitudinal passageway of the introducer and into the tissue tract. 
     The restraining member may be a substantially annular member defining a substantially annular opening for at least partially accommodating the portal member. The restraining member may be a balloon member adapted to expand upon the introduction of fluids. The balloon member may define a general toroidal shape. 
     The introducer may include an introducer housing and an elongated introducer segment extending from the introducer housing with the restraining member being disposed within the introducer housing. The introducer may further include a deployment member adapted to longitudinally advance within the longitudinal passageway of the introducer to deploy the portal member from the introducer and within the tissue tract. 
     The portal member may define leading and trailing ends. The at least one longitudinal port of the portal member may extend between the leading and trailing ends, and be adapted for 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 portal member may comprise one of a foam material or a gel material. The portal member may include a plurality of longitudinal ports. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The above and other aspects, features, and advantages of the present disclosure will become more apparent in light of the following detailed description when taken in conjunction with the accompanying drawings in which: 
         FIG. 1A  is a longitudinal cross-sectional view of a surgical port and introducer assembly in accordance with the principles of the present disclosure; 
         FIG. 1B  is a view of a perspective view of a port of the assembly of  FIG. 1A ; 
         FIG. 2A  is a longitudinal cross-sectional view of the surgical port and introducer assembly of  FIG. 1A  illustrating the expandable restraining member in an inflated state; 
         FIG. 2B  is a top plan view of the surgical port and introducer assembly of  FIG. 1A  illustrating the expandable restraining member in an inflated state; 
         FIG. 3  is a longitudinal cross-sectional view of the surgical port and introducer assembly of  FIG. 1A  illustrating the compressible port being deployed into a tissue passage of a surgical site by a plunger; and 
         FIG. 4  is a longitudinal cross-sectional view of the surgical port and introducer assembly of  FIG. 1A  illustrating the port introducer removed from the surgical site and the compressible port deployed in a tissue passage of a surgical site. 
     
    
    
     DETAILED DESCRIPTION 
     Particular embodiments of the present disclosure will be described herein with reference to the accompanying drawings. As shown in the drawings and as described throughout the following description, and as is traditional when referring to relative positioning on an object, the term “proximal” or “trailing” refers to the end of the apparatus that is closer to the user and the term “distal” or “leading” refers to the end of the apparatus that is further from the user. In the following description, well-known functions or constructions are not described in detail to avoid obscuring the present disclosure in unnecessary detail. 
     One type of minimal invasive surgery described herein is referred to as a single-incision laparoscopic surgery (SILS). SILS is an advanced minimally invasive surgical procedure which would permit a surgeon to operate through a single entry point, typically the patient&#39;s navel. The disclosed SILS procedure involves insufflating the body cavity and positioning a portal member within, e.g., the navel of the patient. Instruments including an endoscope and additional instruments such as graspers, staplers, forceps or the like may be introduced within the portal member to carry out the surgical procedure. 
     The port assembly in the SILS procedure may be introduced into an incision with a Kelly clamp. However, the Kelly clamp may limit the surgeon&#39;s ability to properly place a SILS port due to the limited length of the Kelly clamp&#39;s arm and handle. Furthermore, visibility may become an issue due to the presence of the clamp and the surgeon&#39;s hand holding the clamp. Removal of the Kelly clamp subsequent to placement of the port may also present undesired obstacles. 
     Referring now to the drawings, in which like reference numerals identify identical or substantially similar parts throughout the several views,  FIGS. 1A-2B  illustrates a port and introducer assembly  100  for use in, e.g., the above-identified SILS procedure. The surgical port and introducer assembly  100  includes introducer  102  and portal member  104  which is positionable within the introducer  102 . Introducer  102  includes introducer housing  106  and elongate member  108  extending from the introducer housing  106 . Introducer housing  106  includes an expandable member  110  mounted therein. Expandable member  110  may be any element which may expand upon reception of fluids within its interior  110   a . In one embodiment, expandable member  110  is an inflatable balloon element secured within the internal volume of introducer housing  106 , and adapted to expand from an initial uninflated or unexpanded state to an inflated or expanded state upon reception of fluids from fluid source  112 . In one embodiment, expandable element  110  is substantially toroidal in configuration to circumscribe portal member  104  and compress the portal member  104  prior to advancement through elongate element  106 . Fluid connection between fluid source  112  and expandable member  110  may be affected through any conventional means including tubing  115  as shown. Any means for securing expandable member  110  within introducer housing  110  are envisioned including cements, adhesives, spot welding or the like. Expandable element  110  may also include one or more ribs  114  disposed on the inner surface diameter of the expandable member. Ribs  114  may enhance the structural integrity of expandable member  110 . In addition the ribs or struts  114  may be, for example, but not limited to, a series of poly(tetrafluoroethylene) (PTFE) lined ribs or struts  114  to aid in an effortless deployment of the compressible portal member  104  by permitting the compressible portal member  104  to slide along the ribs  114  during advancement or deployment of the compressible portal member  104  through introducer  102 . Ribs  114  may include a lubricious coating such as silicon to enhance sliding movement of portal member. 
     Introducer housing  106  and elongate introducer segment or element  108  define longitudinal passageway  116  with respect to longitudinal axis “k” extending the length of introducer  102 . Elongate element  108  is dimensioned for insertion within the tissue tract “p” and may be a sleeve element defining an internal dimension or diameter “d 1 ”. The dimension “d 1 ” may be substantially constant along the length of elongate member  108 . In the alternative, dimension “d 1 ” may generally decrease from proximal or trailing end  118  of the elongate member  108  to distal or leading end  120 . The dimension “d 1 ” may range from about 3 mm to about 15 mm. 
     Portal member  104  includes at least one longitudinal port  122 , possibly, a plurality of longitudinal ports  122  extending along the axis “k” of the portal member  104 . At least one or more inner longitudinal ports  122  are dimensioned to receive a surgical object (not shown) therethrough. Upon introduction through a respective port  122 , the inner surface portions defining the port  122  establish and maintain a substantial sealed relation about the instrument or surgical object. Portal member  104  may define an hour glass shape as shown. Trailing and leading ends  124 , 126  may define flange segments which may be integrally formed with portal member  104 . Portal member  104  may be made from a disposable, compressible, and/or flexible type material, for example, but not limited to, a suitable foam or gel material having sufficient compliance to form a seal about one or more surgical objects, shown generally as surgical object, and also establish a sealing relation with the tissue. The foam is preferably sufficiently compliant to accommodate off axis motion of the surgical object. In one embodiment, the foam includes a polyisoprene material. Suitable portal members are disclosed in commonly assigned U.S. patent application Ser. No. 12/244,024, filed Oct. 2, 2008, the entire contents of which is hereby incorporated by reference herein. 
     In use, elongate member  108  of introducer  102  is positioned within tissue tract “p” as depicted in  FIG. 1A  with expandable member  110  is in its unexpanded state. Portal member  104  is positioned within introducer housing  106 , e.g., within the opening defined within expandable member  110 . In one embodiment, introducer housing  106  and uninflated expandable member  110  are dimensioned to receive portal member  104  without compressing the portal member  104 . With portal member  104  within introducer housing  106 , fluid source  112  is activated to deliver fluids within expandable member  110  to inflate or expand the member  110 . During expansion, expandable member  110  exerts a radial inward compressive force on portal member  104 , e.g., uniformally about the periphery of the portal member  104 , to reduce the outer dimension of the portal member  104  to at least the inner diameter “d 1 ” of elongate member  104 , and, even less than the internal diameter “d 1 ” as depicted in  FIG. 2A . In other words, the portal member  104  is compressed by expandable member  110  to a dimension to pass through longitudinal passageway  116  of elongate member  108 , and subsequently into a tissue passage “p” of a patient&#39;s tissue. 
     With continued reference to  FIG. 2A , a plunger  128  as part of the surgical port and introducer assembly  100  is advanced within longitudinal passageway  116  of introducer  102 . Plunger  128  may include plunger head  130  and plunger rod  132 . Plunger  128  is advanced whereby plunger head  130  engages compressed portal member  104  and advances the portal member  104  through elongate member  108  to deploy the compressible portal member  104  into the tissue passage “p” of a patient&#39;s tissue ( FIG. 3 ). After deployment of the portal member  104  into the tissue passage “p” of a patient, as shown in  FIG. 4 , the introducer  102  is removed from the tissue tract, thus allowing portal member  104  to return toward an uncompressed state. More specifically, trailing and proximal ends  124 ,  126  return toward their initial dimension to respectively engage opposed sides of the tissue passage “p”. In addition, portal member  104  prevents the escape of fluids (e.g., gases in a laparoscopic procedure or saline in an arthroscopic procedure) by engaging the internal surfaces of the tissue passage “p” in sealed relation therewith. Thereafter, surgical instruments may be introduced within one or more longitudinal ports  122  (also in sealed relation as discussed hereinabove) to perform the desired surgery. 
     While several embodiments of the disclosure have been shown in the drawings and/or discussed herein, it is not intended that the disclosure be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. Therefore, the above description should not be construed as limiting, but merely as exemplifications of particular embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.