Abstract:
A surgical portal and introducer assembly includes an introducer dimensioned for at least partial positioning within a tissue tract, and having a longitudinal introducer channel extending therethrough and a portal positionable within the longitudinal channel of the introducer. The introducer defines leading and trailing ends, and further has a frangible segment adapted to separate to expose the introducer channel. The portal has at least one longitudinal port for passage of a surgical object. The portal comprises a compressible material and is adapted to transition from a first expanded condition to a second compressed condition upon advancement through the longitudinal channel of the introducer to facilitate passage through the introducer whereby, upon separating of the frangible segment, the portal is released from the longitudinal channel to transition toward the first expanded condition to be generally secured within the tissue tract.

Description:
CROSS REFERENCE TO RELATED APPLICATION 
       [0001]    The present application claims the benefit of and priority to U.S. Provisional Application Ser. No. 61/228,204 filed on Jul. 24, 2009, the entire contents of which are incorporated herein by reference. 
     
    
     BACKGROUND 
       [0002]    1. Technical Field 
         [0003]    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. 
         [0004]    2. Description of Related Art 
         [0005]    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 diameter. Some potential 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. 
         [0006]    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 gas 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. 
         [0007]    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 
       [0008]    Accordingly, a surgical portal and introducer assembly includes an introducer dimensioned for at least partial positioning within a tissue tract, and having a longitudinal introducer channel extending therethrough and a portal positionable within the longitudinal channel of the introducer. The introducer defines leading and trailing ends, and further has a frangible segment adapted to separate to expose the introducer channel. The portal has at least one longitudinal port for passage of a surgical object. The portal comprises a compressible material and is adapted to transition from a first expanded condition to a second compressed condition upon advancement through the longitudinal channel of the introducer to facilitate passage through the introducer whereby, upon separating of the frangible segment, the portal is released from the longitudinal channel to transition toward the first expanded condition to be generally secured within the tissue tract. 
         [0009]    The frangible segment may include a tear line defined along the wall of the introducer. A tether may be secured to the introducer adjacent the tear line with the tether being manipulated to cause tearing along the tear line. The introducer may define a generally tapered configuration where an internal dimension of the longitudinal introducer channel generally decreases from the trailing end thereof to the leading end thereof. 
         [0010]    The portal may define leading and trailing ends. The at least one longitudinal port may extend between the leading and trailing ends and is 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 may include a plurality of longitudinal ports. The portal may comprise one of a foam material or a gel material. 
     
    
     
       DESCRIPTION OF THE DRAWINGS 
         [0011]    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: 
           [0012]      FIG. 1  is a side elevational view of the surgical portal and introducer assembly in accordance with the principles of the present disclosure; 
           [0013]      FIG. 2  is a side elevational view of the surgical portal of the assembly of  FIG. 1 ; 
           [0014]      FIG. 3  is a side elevational view of the introducer of the assembly of  FIG. 1 ; and 
           [0015]      FIG. 4  is a partial cross-sectional view of another embodiment of the assembly. 
       
    
    
     DETAILED DESCRIPTION 
       [0016]    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. 
         [0017]    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. 
         [0018]    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. 
         [0019]    Referring now to the drawings, in which like reference numerals identify identical or substantially similar parts throughout the several views,  FIG. 1  illustrates a surgical port and introducer assembly  100  including portal member  102  and introducer member  104  in accordance with the principles of the present disclosure. Portal member  102  is depicted enclosed within introducer member  104  in  FIG. 1 . As best depicted in  FIG. 2 , portal member  102  is adapted for insertion within a tissue tract “T”, e.g., through the abdominal or peritoneal lining in connection with a laparoscopic surgical procedure. Portal member  102  includes at least one longitudinal port  106 , possibly, a plurality of longitudinal ports  106  extending along the axis “k” of the portal member  102 . At least one or more inner longitudinal ports  106  are dimensioned to receive a surgical object, e.g. a surgical instrument (not shown) therethrough. Upon introduction through a respective port  106 , the inner surface portions defining the port  106  establish and maintain a substantial sealed relation about the instrument or surgical object. Portal member  102  may define an hourglass shape as shown. Trailing and leading ends  108 ,  110  may define flange segments, which may be integrally formed with portal member  102 . Portal member  102  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, 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. When inserted within the tissue tract “T”, portal member  102  is adapted to establish a substantial seal within the tract “T”, i.e., with the tissue surfaces defining the tract “T”. During insertion, portal member  102  may be compressed to a compressed condition to permit at least partial passage through the tract “T”. Once within the tract “T”, portal member  102  will return toward the normal expanded condition with the outer wall  112  of the portal member  102  establishing a seal with the tissue defining the tissue tract “T”. Portal member  102  may include an insufflation conduit  114  mounted within one of passageways  106  and connectable to a source of insufflation gases to permit passage of gases, CO2, to maintain the pneumoperitoneum. Suitable portal members  102  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. 
         [0020]    With reference to  FIGS. 1 and 3 , introducer member  104  is adapted to facilitate insertion of portal member  102  within the tissue tract “T”. Introducer member  104  is substantially elongated defining longitudinal axis “m” and trailing or proximal end  116  and leading or distal end  118 . Introducer member  102  defines a longitudinal introducer channel  120  for reception and passage of portal member  102 . In one embodiment, introducer member  102  defines a generally tapered or funnel shaped configuration having an internal dimension which decreases from proximal to distal. The relatively narrow configuration of leading or distal end  118  facilitates insertion within tissue tract “T”. Introducer member  104  may be made of any type of suitable material, for example, but not limited to, a polymeric material, and may be rigid or flexible. 
         [0021]    Introducer member  104  includes a frangible tear segment or line  122  extending along the wall of the introducer member  102 . Frangible tear segment  122  may include a perforated or score line or may incorporate a weakened section in the wall of introducer member  104 . Introducer member  104  is adapted to tear along the tear line  122  to permit removal of the introducer member  104  subsequent to insertion of portal member  102  within the tissue tract “T”. Frangible tear segment  122  is oriented along a wall of the introducer member  104  between the proximal end  116  and the distal leading end  118 . Introducer member  104  may further include slit  124  that is defined along the wall of the introducer member  104 . Slit  124  is dimensioned to permit insufflation conduit  114  of the portal member  102  to pass therethrough as the portal member  102  is advanced through introducer member  104 . 
         [0022]    A tether  126  may be attached adjacent frangible segment or line  122  and extending toward distal leading end  118  of introducer member  104 . Tether  126  may be made of a material, such as, wire, suture, or shape-memory alloy. Tether  126  is adapted to separate the wall of the introducer  104  along the frangible tear line  122  as the tether  126  is selectively pulled in a proximal trailing direction. 
         [0023]    In embodiments of the present disclosure, surgical portal and introducer  100  may come preassembled with portal member  102  disposed within introducer member  104 . In the alternative, portal member  102  may be positioned within introducer member  104  at the surgical theatre or site. 
         [0024]    A method of introducing and deploying portal member  102  includes positioning leading or distal end  118  of introducer member  104  within the tissue tract “T” and advancing the leading end  118  to a predetermined depth. It is envisioned that the introducer member  104  may be made from a translucent-type material such that the clinician may monitor the depth the introducer/portal combination is being deployed within a tissue tract “T”. Thereafter, portal member  102  is positioned within proximal or trailing end  116  of introducer member  104  (if not preassembled as hereinabove discussed). Upon insertion, portal member  102  compresses to fit within the inner boundary of introducer channel  120  of introducer member  104 . Portal member  102  is advanced relative to tissue tract “T” by either advancing the portal member  102  within introducer member  104  or advancing the introducer member  104  further into the tract “T”. During advancement, insufflation conduit  114  of portal member  102  may traverse slit  124  in the wall of introducer member  104 . Once portal member  102  is located within the tissue tract “T”, e.g., with leading and trailing ends  118 ,  116  of the portal member  102  on opposed sides of the body wall (e.g., the abdominal cavity wall), introducer member  104  is removed by pulling tether in a general proximal direction or radial outward direction relative to longitudinal axis “m” to effect tearing of the introducer member  104  along frangible segment  122 . Introducer member  104  is removed and portal member  102  expands toward its normal expanded condition in sealed engagement with the tissue defining the tissue tract. 
         [0025]    In another embodiment illustrated in  FIG. 4 , a portal member  102  is shown wrapped with a suitable band material  200 , for example, but not limited to, a tape material or a thin plastic material. Band material  200  may be kept intact by an adhesive and/or hook and loop fastener, such as VELCRO. At least a length (or, possibly, the entire length) of portal member  102  may be wrapped by the band material  200  such that portal member  102  is compressed. After portal member  102  is wrapped and compressed by band material  200 , the portal member  102  is inserted into a tissue tract “T” of a patient at a desired depth. It is envisioned that a thin tether  202 , e.g., wire or suture, is disposed within the band material  200 . In this configuration, when the tether  202  is pulled by a clinician, it results in cutting and tearing the band material  200  to release portal member  102  to permit the portal member  102  to assume or move toward an expanded state. In embodiments, band material  200  may be perforated. 
         [0026]    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.