Surgical access device

A valve assembly for use with a surgical instrument is disclosed. The valve assembly includes a housing and a seal assembly disposed within the housing, the seal assembly including a septum seal including an orifice configured to sealingly engage a surgical instrument inserted therethrough, at least a portion of the septum seal defining a seal curvature, a first guard member including a plurality of curved first guard portions defining slits therebetween, and a second guard member including a plurality of curved second guard portions defining slits therebetween. The first and second guard members may be positioned in an overlapping relationship with the plurality of first guard portions rotationally offset with respect to the second guard portions. The wide, triangular shaped slits of the guard members may improve flexibility of the guard portions.

TECHNICAL FIELD

The present disclosure relates to a surgical access device. More particularly, the present disclosure relates to a trocar assembly.

BACKGROUND OF RELATED ART

Endoscopic and laparoscopic minimally invasive procedures have been used for introducing medical devices inside a patient and for viewing portions of the patient's anatomy. Typically, to view a desired anatomical site, a surgeon may insert a rigid or flexible endoscope inside the patient to render images of the anatomical site. In endoscopic surgical procedures, surgery is performed in any hollow organ or tissue of the body through a small incision or through narrow endoscopic tubes (cannulas) inserted through a small entrance wound in the skin. In laparoscopic procedures, surgical operations in the abdomen are performed through small incisions (usually about 0.5 to about 1.5 cm). Laparoscopic and endoscopic procedures often require the surgeon to act on organs, tissues and vessels far removed from the incision.

Typically, a trocar includes a cannula and an obturator. The cannula remains in place for use during the laparoscopic procedure, and the obturator includes a tip for penetrating the body cavity.

Accordingly, the present disclosure is directed to further improvements in trocar assemblies for use, e.g., in laparoscopic procedures.

SUMMARY

The present disclosure relates to a valve assembly for use with a surgical instrument, the valve assembly comprising: a housing; a seal assembly disposed within the housing, the seal assembly including: a septum seal including an orifice configured to sealingly engage a surgical instrument inserted therethrough, at least a portion of the septum seal defining a seal curvature; a first guard member including a plurality of curved first guard portions defining slits therebetween, each one of the plurality of curved first guard portions having a first guard curvature; a second guard member including a plurality of curved second guard portions defining slits therebetween, each one of the plurality of curved second guard portions having a second guard curvature, the first and second guard members positioned in an overlapping relationship with the plurality of first guard portions rotationally offset with respect to the second guard portions, and wherein the first guard curvature generally matches the second guard curvature and is greater than the seal curvature.

In embodiments, the first and second guard curvatures may be greater than the seal curvature so as to help prevent the first and second guard members from being inverted when an instrument is withdrawn therethrough. Also, the first and second guard curvature may be greater than the seal curvature so as to help prevent the septum seal from being inverted when an instrument is withdrawn therethrough. The valve assembly may also include an upper seal support and a lower seal support, the septum seal and the first and second guard members being retained between the upper and lower seal supports.

The slits of the first guard member may be aligned with the curved guard portions of the second guard member, and the slits of the second guard member may be aligned with the curved guard portions of the first guard member. The first and second guard members also may include respective center apertures and respective flat guard portions, one or more of the slits extending from the center aperture to the flat guard portion. Each slit may progressively increase in width as it extends radially outward from the center aperture. Each slit may be generally triangular in shape. Each slit may extend radially beyond the curved guard portions. The valve assembly may include a septum seal with bellows.

The present invention also relates, in accordance with still various embodiments, to a valve assembly for use with a surgical instrument, the valve assembly comprising: a housing; a seal assembly disposed within the housing, the seal assembly including: a septum seal including an orifice configured to sealingly engage a surgical instrument inserted therethrough; a first guard member including a plurality of first guard portions defining slits therebetween, each slit progressively increasing in width as it extends radially outward from a center aperture so as to be generally triangular in shape; a second guard member positioned in an offset relationship relative to the first guard member, the second guard member including a plurality of second guard portions defining slits therebetween, each slit progressively increasing in width as it extends radially outward from a center aperture so as to be generally triangular in shape.

In various embodiments, the septum seal may include at least a portion defining a seal curvature, the plurality of curved first and second guard portions having varying curvature. The first and second guard curvatures may be greater than the seal curvature so as to prevent one or more of the first guard portions, the second guard portions and/or the septum seal from being inverted by an instrument being withdrawn therethrough. The valve assembly may also include an upper seal support and a lower seal support, the septum seal and the first and second guard members being retained between the upper and lower seal supports. The slits of the first guard member may overlay the guard portions of the second guard member, and the slits of the second guard member overlay the curved guard portions of the first guard member. The first and second guard members may also include respective flat guard portions, one or more of the slits extending from the center aperture to the flat guard portion. Each slit may extend radially beyond the curved guard portions. The septum seal may include bellows.

The present disclosure also relates to a surgical access device comprising an obturator assembly and a cannula assembly. The obturator assembly comprises an obturator member and a tip member disposed adjacent a distal portion of the obturator member. The obturator member has an outer diameter of about 10 mm. A portion of the tip member has an outer diameter of between about 14 mm and about 15 mm. The cannula assembly comprises an elongated portion configured to allow the obturator member and the tip member to slide therethrough. An inner diameter of the elongated portion approximates the outer diameter of the tip member.

A valve assembly for use with a surgical instrument, the valve assembly comprising: a housing; a seal assembly disposed within the housing, the seal assembly including: a septum seal including an orifice configured to sealingly engage a surgical instrument inserted therethrough; a first guard member including a plurality of first guard portions defining slits therebetween, wherein, in a rest position of the first guard member, each slit progressively increases in width as it extends radially outward from a center aperture such that the slits are generally triangular in shape; a second guard member positioned in an offset relationship position relative to the first guard member, the second guard member including a plurality of second guard portions defining slits therebetween, wherein, in a rest position of the second guard member, each slit progressively increases in width as it extends radially outward from a center aperture such that the slits are generally triangular in shape.

In embodiments, the septum seal includes at least a portion defining a seal curvature, the plurality of curved first and second guard portions having varying curvature. The first and second guard curvatures may be greater than the seal curvature so as to prevent one or more of the first guard portions, the second guard portions and the septum seal from being inverted by an instrument being withdrawn therethrough. The valve assembly may also include an upper seal support and a lower seal support, the septum seal and the first and second guard members being retained between the upper and lower seal supports. The slits of the first guard member may align with the guard portions of the second guard member, and the slits of the second guard member align with the curved guard portions of the first guard member. The first and second guard members may also include respective flat guard portions, one or more of the slits extending from the center aperture to the flat guard portion. Each slit may extend radially beyond the curved guard portions.

In embodiments, the septum seal may include bellows. The first and second guard members may both be located proximally of the septum seal. The first and second guard members may both be located distally of the septum seal. The valve assembly may also include a third guard member and a fourth guard member, the first and second guard members being located proximally of the septum seal and the third and fourth guard members located distally of the septum seal.

DETAILED DESCRIPTION

As used herein, the term “distal” refers to that portion of the instrument, or component thereof which is farther from the user while the term “proximal” refers to that portion of the instrument or component thereof which is closer to the user.

In various embodiments, the present invention relates to aspects of a trocar assembly. The trocar assembly may be employed during, e.g., laparoscopic surgery and may, in various embodiments, provide for the sealed access of laparoscopic surgical instruments into an insufflated body cavity, such as the abdominal cavity. Generally, and as will be described in additional detail below, the trocar assemblies of the present invention include a trocar cannula (having a valve housing mounted on a cannula tube) and a trocar obturator insertable therethrough. The trocar cannula and obturator are separate components but are capable of being selectively connected together. For example, the obturator may be inserted into and through the trocar cannula until the handle of the obturator engages, e.g., selectively locks into, the proximal valve housing of the trocar cannula. In this initial position, the trocar assembly is employed to tunnel through an anatomical structure, e.g., the abdominal wall, either by making a new passage through the structure or by passing through an existing opening through the structure. Once the trocar assembly has tunneled through the anatomical structure, the trocar obturator is removed, leaving the trocar cannula in place in the structure, e.g., in the incision created by the trocar assembly. The proximal valve housing of the trocar cannula may include valves that prevent the escape of insufflation gases from the body cavity, while also allowing surgical instruments to be inserted into the cavity.

With respect to the trocar obturators, in various embodiments, a bladeless optical obturator—an example of which is set forth in additional detail below—may be provided that permits separation of tissue planes in a surgical procedure and visualization of body tissue fibers as they are being separated, thereby permitting a controlled traversal across a body wall. In other embodiments, the obturator may be bladeless without being optical, e.g., without providing contemporaneous visualization thereof through the distal tip of an obturator. The bladeless obturator may be provided for the blunt dissection of the abdominal lining during a surgical procedure. Various examples of obturator components are disclosed and illustrated herein, e.g., bladed, bladeless, blunt, optical, non-optical, etc. as will be described in additional detail below. However, it should be recognized that various other types of obturators may be employed, e.g., obturators having tip geometries other than those shown.

The proximal valve housing of the trocar cannula may include various arrangements and/or components. In various embodiments, the proximal valve housing includes an instrument valve assembly (having an instrument valve component) that is selectively attachable to, and detachable from, a distal housing component (which may or may not be permanently attached to a cannula tube and which may or may not include additional valves, e.g., a zero seal valve such as a duckbill valve. Example embodiments of such arrangements are set forth in greater detail below.

With reference toFIGS. 1-15, and with particular reference toFIG. 1, instrument valve assembly210includes a first housing portion2190, a second housing portion2192and instrument valve component or valve assembly230A. Instrument valve component230A is positioned between and maintained within first housing portion2190and second housing portion2192. First housing portion2190and second housing portion2192of instrument valve assembly210may be welded together.

With reference toFIG. 2, instrument valve component230A includes an elastomeric septum seal2160, a lower seal retainer2120, and an upper seal retainer2180. Lower seal retainer2120and upper seal retainer2180may be referred to as a lower seal support and an upper seal support, respectively. Instrument valve component230A further includes first and second guard members2140,2142. In alternate embodiments, fewer or more guard members (seeFIGS. 5A-5D) than the two guard members shown herein may be employed.

With reference toFIG. 2, septum seal2160is configured to provide a seal around an outer surface of an instrument passing therethrough. Septum seal2160includes a bellowed outer seal portion2163, an intermediate flat guard portion2169, and a curved inner seal portion2167(or first sloped portion). The bellowed outer seal portion2163includes an inner bellows2164, an outer bellows2162and a radially outermost lip2165. Flat guard portion2169includes a plurality of apertures2168annularly disposed therethrough. Inner seal portion2167has an orifice2166at its radial center. It should be noted that, while the bellowed outer seal portion2163is shown and described herein as having an inner and outer bellows, in alternate embodiments, fewer or more bellows may be employed.

Curved inner seal portion2167(or first sloped portion) is disposed between flat guard portion2169and second sloped portion2170(FIG. 2). Curved inner seal portion2167may be sloped at a first angle, whereas second sloped portion2170may be sloped at a second angle, where the first and second angles are different. In particular, the angle of second sloped portion2170may be greater than the angle of curved inner seal portion2167. Second sloped portion2170is configured to accommodate orifice2166of septum seal2160. The varying angles of curved portions2167,2170of septum seal2160may facilitate guiding instrument211(FIG. 15) toward orifice2166. In addition, varying the angles of curved portions2167,2170of septum seal2160may help prevent the septum seal2160from inverting when an instrument is withdrawn.

Upper seal retainer2180includes a ring2182and a plurality of fingers or pins2186extending downwardly from ring2182. Lower seal retainer2120is a ring that includes an annular channel2122. It should be recognized that, although the plurality of fingers or pins2186is shown as extending downwardly from upper seal retainer2180for engagement with the lower seal retainer2120, in other embodiments, the plurality of fingers or pins2186may instead extend upwardly from lower seal retainer2120for engagement with the upper seal retainer2180, or the pins and fingers may be located on both the upper and lower seal retainers2120,2180and extend both upwardly and downwardly. In addition, it should also be recognized that, while the lower seal retainer2120is shown and described herein as including an annular channel2122, the lower seal retainer2120may instead include one or more discrete openings for receiving the corresponding fingers or pins, which may improve the engagement of the pins/fingers with the lower seal ring and increase the retention therebetween once connected to each other. An advantage of employing a channel, however, is that circumferential alignment of the upper and lower rings prior to connecting them may be avoided.

First guard member2140includes a plurality of curved guard portions2141and a flat guard portion2143. Flat guard portion2143includes a plurality of apertures2150annularly disposed therethrough. The plurality of curved guard portions2141collectively define an orifice2144at their radial center. First guard member2140further defines a plurality of slits2152between the plurality of curved guard portions2141and extending from orifice2144toward flat guard portion2143. Slits2152include four slits that define a substantially “cross” configuration.

Second guard member2142includes a plurality of curved guard portions2141′ and a flat guard portion2143′. Flat guard portion2143′ includes a plurality of apertures2150′ annularly disposed therethrough. The plurality of curved guard portions2141′ collectively define an orifice2144′ at their radial center. Second guard member2142further defines a plurality of slits2152′ between the plurality of curved guard portions2141′ and extending from orifice2144′ toward flat guard portion2143′. Slits2152′ include four slits that define a substantially “cross” configuration.

While first and second guard members2140,2142are shown and described herein as each having four slits2152,2152′, respectively, it should be recognized that a greater number or a lesser number of slits for each guard member2140,2142may be employed. Likewise, while first and second guard members2140,2142are shown and described herein as each having four guard portions2141,2141′, respectively, it should be recognized that a greater number or a lesser number of guard portions for each guard member2140,2142may also be employed. For example, slits and/or guard portions numbering between2and10for each guard member2140,2142are contemplated.

Additionally, while each slit2152,2152′ and each guard portion2141,2141′ is shown to be substantially triangular in shape, it should be recognized that other geometrical shapes for each of slits2152,2152′ and guard portions2141,2141′ of the first and second guard members2140,2142, respectively, may be employed. Still further, while the guard portions2141,2141′ are shown and described herein as being curved, such guard portions could instead be straight or may each have multiple curved portions. In an embodiment, each of the guard portions2141,2141′ may have a curvature that match the curvature of the curved inner seal portion2167of the septum seal2160. Additionally or alternatively, each of the guard portions2141,2141′ may have a curvature that exceeds, e.g., that is more curved than, the curvature of the curved inner seal portion2167of the septum seal2160—such an arrangement may help prevent the curved inner seal portion2167of the septum seal2160and the guard portions2141,2141′ from being inverted, e.g., bent proximally, when an instrument is withdrawn therethrough.

FIG. 3is an assembled view of instrument valve assembly210, whileFIGS. 4A and 4Bare a side view and a side cross-sectional view, respectively, of instrument valve component230A. When instrument valve component230A is assembled, pins2186of upper seal retainer2180, apertures2150,2150′ of first and second guard members2140,2142, and apertures2168of septum seal2160are longitudinally aligned, such that each one of pins2186extend through respective ones of apertures2150,2150′ of first and second guard members2140,2142and through respective ones of apertures2168of septum seal2160. The distalmost ends of pins2186engage annular channel2122of lower seal retainer2120and are retained therein by any suitable technique, such as by snap-fit, friction-fit, welding, etc., such that septum seal2160and first and second guard members2140,2142are secured between upper seal retainer2180and lower seal retainer2120.

As shown inFIGS. 3-4B, when instrument valve component230A is assembled, first and second guard members2140,2142are rotationally offset with respect to each other by 90 degrees (relative to the longitudinal axis), such that slits2152of first guard member2140and slits2152′ of second guard member2142are also rotationally offset from each other by 90 degrees (relative to the longitudinal axis). The rotational offset of first and second guard members2140,2142with respect to each other provides for the plurality of curved guard portions2141of first guard member2140to span the width of slits2152′ of second guard member2142, and for the plurality of curved guard portions2141′ of second guard member2142to span the width of slits2152of first guard member2140.

The rotational offset of first and second guard members2140,2142with respect to each other facilitates the protection of septum seal2160when instrument valve component230A is disposed within the housing of a cannula assembly200(FIG. 6) and an instrument is inserted through orifices2144,2144′. It should be recognized that the first and second guard members2140,2142may instead be aligned with each other, depending on the shape and number of the guard portions. Additionally, it should be recognized that the first and second guard members2140,2142may be misaligned by more or less than 90 degrees with respect to each other, depending on the shape and number of the guard portions.

In the embodiment shown in, e.g.,FIG. 4B, the height of outer bellows2162is greater than the height of inner bellows2164. Inner and outer bellows2164,2162extend generally perpendicular to flat guard portion2169. Inner and outer bellows2164,2162extend generally radially on septum seal2160. In other embodiments, the height of inner and outer bellows2164,2162may be substantially equal, or the height of inner bellows2164may be greater than the height of outer bellows2162. Additionally, the width of inner bellows2164may be substantially equal to the width of outer bellows2162. The width of inner bellows2164may be greater than or less than the width of outer bellows2162. For example, outer bellows2162may be twice the width of inner bellows2164, or vice versa.

In the embodiment shown, each one of the slits2152of the first guard member2140has an equal width and length with respect to the other slits2152. For example, as shown, the width of each one of the slits2152progressively increases as slits2152extend from the orifice2144to the flat guard portion2143so as to define a substantially triangular configuration. Therefore, the narrowest part of slits2152is near orifice2144and the width of each slit2152increases from a distal end2147to a proximal end2149of each slit2152. Moreover, in the embodiment shown, the width of curved guard portions2141is greater at a given radial location than the width of slits2152. For example, the width of a curved guard portion2141, at a given radial location, may be more than twice the width of a slit2152. The width of slits2152may be selected such that the guard portions2141experience adequate flexibility when surgical instrument211(FIG. 15) is inserted through orifice2144while still providing adequate protection to the septum seal2160upon insertion and withdrawal of an instrument.

In various embodiments, the slits2152may extend beyond curved guard portion2141and into flat guard portion2143. Slits2152may or may not extend to the outer radial edge of flat guard portion2143, although having slits2152not extend to the outer radial edge of flat guard portion2143may provide the advantage of the first guard member2140being a single component that is more easily handled during manufacture. Slits2152may extend less than half the length of flat guard portion2143. This extension of slits2152beyond curved guard portion2141may provide for additional flexibility of the curved guard portions2141, as well as first guard member2140, when a surgical instrument211is inserted through orifice2144.

Advantageously, the slits2152′ and curved guard portions2141′ of second guard member2142may exhibit the same geometries as described above with regard to slits2152and curved guard portions2141, respectively, of first guard member2140. Curved guard portion2141may have a first curvature or angle, and curved guard portion2141′ may have a second curvature or angle, where the first and second angles/curvatures are equal to each other. When second guard member2141is positioned adjacent to or in abutting relationship with first guard member2140, the matching angles/curvatures of curved guard portions2141,2141′ may allow for a relatively smooth surface with minimal voids therebetween, reducing the likelihood of an instrument or feature of an instrument sliding between or getting trapped between the respective guard members. It should also be recognized that, if the slits2152′ and curved guard portions2141′ of second guard member2142have the same geometries as slits2152and curved guard portions2141of first guard member2140, the first and second guard members2140,2142may also have the same overall geometries, enabling them to be formed on the same tools/molds so as to achieve manufacturing and assembly efficiencies.

In the embodiment shown, the diameter of first guard member2140is substantially equal to the diameter of second guard member2142. The diameter of septum seal2160may be greater than the diameter of first and second guard members2140,2142. First and second guard members2140,2142are adapted and dimensioned to be accommodated within the inner boundaries of inner bellows2164of septum seal2160such that the outer peripheral edge of first and second guard members2140,2142contacts the inner bellows2164. Manipulation of surgical instrument211, while in orifice2166of septum seal2160, causes the inner and outer bellows2164,2162to move. The flexibility provided by bellows2164,2162helps to minimize the likelihood that an instrument positioned within the aperture2166of the septum seal2160will cause the orifice to cat-eye and thereby leak insufflation gas. In addition, the bellows2164,2162function to move the aperture2166of the septum seal2160back to the central longitudinal axis B of the device when no instrument is positioned therein, which also increases the likelihood that a subsequently inserted instrument will travel through the aperture2166, and minimizes the likelihood that such a subsequently inserted instrument will contact the radially outer portions of the septum seal and thereby tear it.

Once instrument valve component230A has been assembled as shown inFIGS. 3-4B, it is incorporated into instrument valve assembly210as shown inFIG. 1. Specifically, instrument valve component230A is maintained in position within instrument valve assembly210by positioning radially outermost lip2165of valve component230A between first and second housing portions2190,2192of proximal housing component210a(FIGS. 9-12) and then connecting, e.g., by snap-fit, welding, etc., first and second housing portions2190,2192together.

Assembled instrument valve assembly210is selectively attachable to, and detachable from, various types of distal cannula assemblies (shown and described in further detail below) in order to collectively provide various types of cannula assemblies.

FIGS. 5A-5Dillustrate another embodiment of an instrument valve component or valve assembly230B. With reference toFIG. 5A, instrument valve component230B includes an elastomeric septum seal2160, a lower seal retainer2120, and an upper seal retainer2180. Lower seal retainer2120and upper seal retainer2180may be referred to as a lower seal support and an upper seal support, respectively. Instrument valve component230B further includes first and second guard members2140,2142. All these elements have been described above with reference toFIGS. 2-4Band their description will be omitted for sake of clarity. In contrast toFIGS. 2-4B,FIGS. 5A-5Dillustrate a third guard member2240and a fourth guard member2242directly beneath or at a distal end of the septum seal2160.

Third guard member2240includes a plurality of curved guard portions2241and a flat guard portion2243. Flat guard portion2243includes a plurality of apertures2250annularly disposed therethrough. The plurality of curved guard portions2241collectively define an orifice2244at their radial center. Third guard member2240further defines a plurality of slits2252between the plurality of curved guard portions2241and extending from orifice2244toward flat guard portion2243. Slits2252include four slits that define a substantially “cross” configuration.

Fourth guard member2242includes a plurality of curved guard portions2241′ and a flat guard portion2243′. Flat guard portion2243′ includes a plurality of apertures2250′ annularly disposed therethrough. The plurality of curved guard portions2241′ collectively define an orifice2244′ at their radial center. Fourth guard member2242further defines a plurality of slits2252′ between the plurality of curved guard portions2241′ and extending from orifice2244′ toward flat guard portion2243′. Slits2252′ include four slits that define a substantially “cross” configuration.

While third and fourth guard members2240,2242are shown and described herein as each having four slits2252,2252′, respectively, it should be recognized that a greater number or a lesser number of slits for each guard member2240,2242may be employed. Likewise, while third and fourth guard members2240,2242are shown and described herein as each having four guard portions2241,2241′, respectively, it should be recognized that a greater number or a lesser number of guard portions for each guard member2240,2242may also be employed. For example, slits and/or guard portions numbering between two and ten for each guard member2240,2242are contemplated.

Additionally, while each slit2252,2252′ and each guard portion2241,2241′ is shown to be substantially triangular in shape, it should be recognized that other geometrical shapes for each of slits2252,2252′ and guard portions2241,2241′ of the third and fourth guard members2240,2242, respectively, may be employed. Still further, while the guard portions2241,2241′ are shown and described herein as being curved, such guard portions could instead be straight or may each have multiple curved portions. In an embodiment, each of the guard portions2241,2241′ may have a curvature that is similar to or matches the curvature of the curved inner seal portion2167of the septum seal2160. Additionally or alternatively, each of the guard portions2241,2241′ may have a curvature that is less than or exceeds the curvature of the curved inner seal portion2167of the septum seal2160.

As shown inFIGS. 5B-5D, when instrument valve component230B is assembled, first and second guard members2140,2142are rotationally offset with respect to each other by 45 degrees (relative to the longitudinal axis), such that slits2152of first guard member2140and slits2152′ of second guard member2142are also rotationally offset from each other by 45 degrees (relative to the longitudinal axis). The rotational offset of first and second guard members2140,2142with respect to each other provides for the plurality of curved guard portions2141of first guard member2140to span the width of slits2152′ of second guard member2142, and for the plurality of curved guard portions2141′ of second guard member2142to span the width of slits2152of first guard member2140.

Additionally, third and fourth guard members2240,2242are rotationally offset with respect to each other by 45 degrees (relative to the longitudinal axis), such that slits2252of third guard member2240and slits2252′ of fourth guard member2242are also rotationally offset from each other by 45 degrees (relative to the longitudinal axis). The rotational offset of third and fourth guard members2240,2242with respect to each other provides for the plurality of curved guard portions2241of third guard member2240to span the width of slits2252′ of fourth guard member2242, and for the plurality of curved guard portions2241′ of fourth guard member2242to span the width of slits2252of third guard member2240.

The rotational offset of first and second guard members2140,2142, as well as of third and fourth guard members2240,2242, with respect to each other discourages unwanted contact between, and thereby facilitates the protection of, septum seal2160when instrument valve component230B is disposed within the housing of a cannula assembly200(FIG. 6) and an instrument is inserted and/or withdrawn through orifices2166,2144,2144′,2244,2244′.

Cannula assembly200will now be discussed in detail with reference toFIGS. 6-13.FIG. 6illustrates instrument valve assembly210prior to its attachment to a representative distal cannula assembly, e.g., distal cannula assembly2021. Distal cannula assembly2021includes an elongate tubular portion202, defining a longitudinal axis “B-B” and a distal housing component210b. Distal housing component210bincludes a zero-closure seal250that prevents the escape of insufflation gas when no instrument is present through the valve housing.

As previously mentioned, the instrument valve assembly210may be selectively attachable to, and detachable from, distal housing component210b. Various different types of connection mechanisms can be employed in this regard, e.g., snap-fit, latches, bayonet coupling, threaded couplings, etc.FIGS. 7-8illustrate one such connection mechanism, and specifically illustrate additional features, according to an embodiment of the present invention, by which instrument valve assembly210is selectively attachable to, and detachable from, distal housing component210b.

Referring toFIG. 7, distal housing component210bdefines annular lips1124,1126located on an inner surface of an outer wall. Located circumferentially between lips1124,1126is an annular channel1301. In addition, distal housing component210balso includes a radially outward user-actuatable portion1508of a rotation prevention mechanism1500(which will be described in greater detail below). Radially outward user-actuatable portion1508of rotation prevention mechanism1500is a tab1507that is integrally formed with an outer circumferential edge of distal housing component210b. Tab1507further includes a radially-inward locking portion1509. Tab1507is configured for resilient movement relative to distal housing component210babout its point of attachment thereto, such that its user-actuatable portion1508is moveable distally relative to the circumferential edge of distal housing component210b.

Referring toFIG. 8, second housing portion2192of instrument valve assembly210defines first and second annular recesses1120,1122adjacent its distal end. Recesses1120,1122are sized and shaped to receive annular lips1124,1126of distal housing component210bwhen distal housing component210band instrument valve assembly210are initially brought together in the axial direction. Located circumferentially between recesses1120,1122of instrument valve assembly210are a pair of distal projections1509. Likewise, distal projections1509are sized and shaped to be received by annular channel1301of distal housing component210bwhen distal housing component210band instrument valve assembly210are initially brought together in the axial direction.

Second housing portion2192of instrument valve assembly210also has additional structures that engage with distal housing component210b. For example, second housing portion2192of instrument valve assembly210also has structures that comprise a first component1502of rotation prevention mechanism1500. These structures of instrument valve assembly210(e.g., the structures of first component1502of rotation prevention mechanism1500) engage with the above-described structures of distal housing component210b(e.g., the structures of radially outward user-actuatable portion1508of rotation prevention mechanism1500), and enable distal housing component210band proximal housing component210a, once initially brought together in the axial direction, to selectively attach and detach from each other via relative rotation of distal housing component210band proximal housing component210a. For example, and referring toFIGS. 8 and 11, distal projections1509of instrument valve assembly210each include a rib1200. Each distal projection1509also includes a groove1299located adjacent and proximal to its respective rib1200. Additionally, each distal projection1509includes a stop1210(FIG. 8) adjacent each rib1200. Also, distal projections1509include a first component1502of the above-referenced rotation prevention mechanism1500. First component1502includes a protuberance1503, having a ramped surface1504that is integrally formed on an outer circumferential surface of distal projection1509.

FIGS. 9 and 10illustrate instrument valve assembly210(including first and second housing portions2190,2192, with instrument valve component230A maintained therebetween) mounted on distal housing component210b. It is noted that instrument valve component230A may be replaced by instrument valve component230B, as shown inFIG. 9A. In fact, instrument valve components230A and230B may be interchangeable throughout the exemplary embodiments described herein. InFIG. 9, tab1507is in a first, rest position. In this first position, relative rotation of instrument valve assembly210and distal housing component210b(and thus decoupling of instrument valve assembly210and the distal housing component210b) is prevented, as will be described in further detail below. InFIG. 10, tab1507is deflected, as by a user, into a second, actuated position. In this second position, relative rotation of instrument valve assembly210and distal housing component210b(and thus decoupling of instrument valve assembly210and distal housing component210b) is possible.

FIGS. 11 and 12are cross-sectional views, taken along the lines11-11and12-12, respectively, ofFIG. 9, and illustrate the mating features of instrument valve assembly210and distal housing component210b.

Rotation prevention mechanism1500prevents inadvertent relative rotation and thus potential decoupling of instrument valve assembly210and distal housing component210b. Once instrument valve assembly210and distal housing component210bare brought together axially, instrument valve assembly210may be rotated in a first direction (e.g., clockwise in the views ofFIGS. 11-13), such that ramped surface1504of protuberance1503engages the locking portion1509of tab1507. Continued rotation of instrument valve assembly210causes protuberance1503to exert a force directed in the radially outward direction on locking portion1509of tab1507. The radially outward force is sufficient to cause tab1507to move radially outward relative to the circumferential edge of distal housing component210babout its point of attachment thereto, from its first position towards its second position. Additionally, the radially outward force causes the user actuatable portion1508of tab1507to move distally. After a predetermined amount of rotation of proximal housing component210a, protuberance1503passes tab1507, and causes locking portion1509of tab1507to move back to its first position and adjacent to a perpendicular surface1510(FIGS. 11 and 13) of protuberance1503. In this position, instrument valve assembly210is effectively prevented from counter-clockwise rotation with respect to distal housing component210b.

Additionally, when sufficient rotation of instrument valve assembly210causes protuberance1503to pass tab1507, protrusion1520(FIGS. 11 and 13) of instrument valve assembly210contacts a stop1522(FIGS. 11 and 13) of distal housing component210b, thus effectively preventing additional clockwise rotation between instrument valve assembly210and distal housing component210b. Accordingly, in the relative position of instrument valve assembly210and distal housing component210billustrated inFIG. 11, both directions of rotation of instrument valve assembly210are effectively prevented, and thus instrument valve assembly210is rotationally fixed with respect to distal housing component210b. Annular lips1124,1126of distal housing component210bare positioned within the respective grooves1299of the distal projections of instrument valve assembly210, and are maintained in the grooves by ribs1200, thereby also preventing instrument valve assembly210and distal housing component210bfrom moving axially relative to each other. In this manner, rotation prevention mechanism1500prevents instrument valve assembly210from inadvertently rotating relative to, and thus inadvertently becoming disconnected from distal housing component210bonce instrument valve assembly210reaches this locked position.

To remove instrument valve assembly210from distal housing component210b, a user exerts a force on tab1507directed in the distal direction, as shown inFIG. 10. A sufficient amount of distally-directed force causes the user actuatable portion1508of tab1507to move distally relative to the circumferential edge of distal housing component210babout its point of attachment thereto until locking portion1509of tab1507is located radially outward of protuberance1503. In this position, instrument valve assembly210is no longer prevented from rotating, but rather is free to rotate, in a second direction (e.g., counter-clockwise as shown by the arrow inFIG. 13) relative to distal housing component210b. In this manner, rotation prevention mechanism1500provides a selectively actuatable mechanism that, when actuated, enables a user to rotate and thereby disconnect instrument valve assembly210from distal housing component210b.

FIGS. 14 and 15illustrate the operation of the instrument valve assembly210in use during surgery.FIG. 14illustrates instrument valve assembly210in a rest position, whileFIG. 15illustrates instrument valve assembly210having a surgical instrument211inserted therethrough in an off-axis position. As shown inFIG. 15, when an instrument is moved through instrument valve assembly210, the elastomeric material of septum seal2160is protected by the first and second guard members2140,2142. For example, because the width of each one of the plurality of curved guard portions2141of first guard member2140is wider than slits2152′ of second guard member2142when instrument valve component230A is in the rest position, movement of instrument211through orifice2166of septum seal2160insures that at least one of the plurality of curved guard portions2141of first guard member2140prevents instrument211from tearing seal2160directly beneath slits2152′. As noted above, instrument valve component230B may be substituted for instrument valve component230A. In fact, instrument valve components230A and230B may be interchangeable throughout the exemplary embodiments described herein.

Likewise, because the width of each one of the plurality of curved guard portions2141′ of second guard member2142is wider than slits2152of first guard member2140when instrument valve component230A is in the rest position, movement of instrument211through orifice2166of septum seal2160insures that the instrument contacts at least one of the plurality of curved guard portions2141′ of second guard member2142rather than directly contacting, and potentially tearing, the elastomeric material of septum seal2160directly beneath the slits2152. Still further, the width of each one of the plurality of curved guard portions2141,2141′ is sufficiently greater than the respective slits2152,2152′ which they span, such that as the curved guard portions2141,2141′ spread apart as an instrument is inserted therethrough, thereby widening the slits2152,2152′, as well as still cover their respective slits2152,2152′. This reduces the likelihood that an inserted instrument will inadvertently contact and tear the elastomeric material of the seal and allows the arrangement to accommodate a variety of different sized instruments.

In addition, by virtue of the bellows arrangement, orifice2166of septum seal2160may be moved to an off-center location (FIG. 15) with minimal force, thereby reducing the likelihood that the elastomeric material of septum seal2160directly around orifice2166is caused to cat-eye and leak by such off-axis movement. In addition, upon removal of the instrument, the bellowed arrangement helps to urge orifice2166back towards the radial center of instrument valve component230A, such that orifice2166is in a centered location for reception of a subsequently-inserted surgical instrument. Urging orifice2166back towards the radial center of instrument valve component230A prior to reception of a subsequently-inserted surgical instrument increases the likelihood that the subsequently-inserted surgical instrument is received by orifice2166and reduces the likelihood that the subsequently-inserted surgical instrument tears the elastomeric material of septum seal2160.

As set forth above, various different types of obturators, e.g., bladed, bladeless, blunt, optical, non-optical, etc. may be employed in the trocar assemblies of the present invention. Several of these types are described in additional detail hereinbelow, although it should be recognized that various other types of obturators may be employed, e.g., obturators having structure, e.g., tip geometries, other than those shown.

Referring toFIGS. 16-21, a first example embodiment of a blunt obturator for separating tissue planes in an endoscopic surgical procedure is shown and described. With reference toFIGS. 16 and 17, obturator2500includes an obturator housing2510and an elongate shaft2520. Elongate shaft2520includes a proximal end, a distal end, and a tubular member therebetween. Proximal end of elongate shaft2520may be connected, e.g., snap-fit, welded, etc., to obturator housing2510and extends proximally out of the proximal end of a cannula housing2504(FIG. 21) when obturator2500is fully positioned therewithin. The distal end of elongate shaft2520extends distally out of a distal end2502aof a cannula tube2502(FIG. 21) when obturator2500is positioned therewithin. The distal end of elongate shaft2520includes a member2522that closes the distal end of elongate shaft2520. Member2522is adapted for blunt tissue dissection and includes a hemispherical outer surface that functions to help separate tissue along natural tissue planes. The hemispherical outer surface of the distal end defines a radius of curvature dimensioned to be atraumatic to tissue. Elongate shaft2520and member2522are monolithically fabricated from any suitable material such as an acrylonitrile butadiene styrene plastic material (“ABS”) that may be opaque. Obturator housing2510and/or member2522may additionally or alternatively be fabricated from a material that is transparent or translucent.

With reference toFIGS. 18-20, elongate shaft2520has an inner surface2520aand an outer surface2520bthat define an outer wall2520c. Inner surface2520adefines a central bore2524that extends through the tubular member from the proximal end of elongate shaft2520to an arcuate surface2520dat a distal end of inner surface2520a.

The tubular portion of elongate shaft2520includes a pair of proximal apertures2526, a pair of intermediate apertures2528, and a pair of distal apertures2530. Each aperture2526,2528, and2530extends through inner and outer surfaces2520a,2520bof elongate shaft2520. When obturator2500is fully positioned within cannula2550, apertures2526,2528, and2530are all positioned within, and covered by, cannula tube2502of cannula2550(FIG. 21).

In operation, member2522enables initial insertion of obturator2500within an opening in tissue, e.g., a pre-cut scalpel incision. Member2522facilitates advancement of obturator2500between tissue layers to gently dissect tissue and enlarge the opening without any cutting or incising of the tissue.

As illustrated above inFIG. 21, obturator2500is disposed within a cannula2550. Cannula2550includes cannula tube2502extending distally from cannula housing2504. Obturator housing2510is releasably coupled to cannula housing2504. When obturator2500is coupled to cannula2550, a portion of elongate shaft2520and member2522extend distally beyond distal end2502aof cannula tube2502. Each of the apertures (2526,2528, and2530) is positioned within cannula tube2502and proximal of distal end2502aof cannula tube2502.

Referring toFIGS. 22-30, a second embodiment of an obturator for separating tissue planes in an endoscopic surgical procedure is presented.

With reference toFIG. 22, obturator2600includes an elongate shaft2612having a proximal end2612a, a distal end2612b, and a tubular member extending therebetween. Although not shown in these figures, the obturator2600may also include a handle or housing, e.g., like the housing of2510of the obturator2500. Referring additionally toFIG. 26, elongate shaft2612includes an inner surface2612cand an outer surface2612dthat define an outer wall2612e. With reference also toFIGS. 28 and 29, a bore2614originates at proximal end2612aand extends into elongate shaft2612to an arcuate surface2612f(FIG. 28) at a distal end of inner surface2612c.

With reference again toFIGS. 26 and 27, the tubular portion of elongate shaft2612includes a pair of proximal apertures2616, a pair of intermediate apertures2618, and a pair of distal apertures2620. Each aperture2616,2618, and2620extends through inner and outer surfaces2612c,2612dof elongate shaft2612. When obturator2600is fully positioned within cannula2650, apertures2616,2618, and2620are all positioned within, and covered by, cannula tube2602of cannula2650(FIG. 30).

Referring again toFIG. 23, a distal portion of elongate shaft2612includes a member2622. Elongate shaft2612and member2622may be monolithically fabricated from any suitable material such as an acrylonitrile butadiene styrene plastic material (“ABS”) that may be opaque. Elongate shaft2612and/or member2622may additionally or alternatively be fabricated from a material that is transparent or translucent.

Referring toFIG. 24, an enlarged top view of the distal portion of elongate shaft2612is illustrated. This top view is rotationally offset 90 degrees relative to an enlarged side view of a distal portion of elongate shaft2612depicted inFIG. 25. As seen inFIGS. 24 and 25, member2622includes a proximal section2622a, a central section2622b, and an atraumatic guiding nub2622c. An imaginary line2624(shown to illustrate curvature) separates proximal section2622aand central section2622b. Similarly, an imaginary line2626(shown to illustrate curvature) separates central section2622band atraumatic guiding nub2622c.

Central section2622bextends distally from proximal section2622asuch that, together, proximal and central section's2622a,2622binclude a pair of diametrically opposed outer surfaces2628a,2628b. Each of opposed outer surfaces2628a,2628bis generally convex. Atraumatic guiding nub2622cextends distally from central section2622band includes a rounded end2630. Rounded end2630defines a radius of curvature dimensioned to be atraumatic to tissue. More specifically, rounded end2630includes rounded outer surfaces2630athat function to help separate tissue along natural tissue planes. Proximal section2622aincludes a pair of diametrically opposed outer surfaces2632a,2632b. Each of opposed outer surfaces2632a,2632bis generally convex. Central section2622bincludes a pair of diametrically opposed concave outer surfaces2634a,2634bthat are positioned between the pair of diametrically opposed outer surfaces2632a,2632bof proximal section2622aand rounded outer surfaces2630aof rounded end2630.

FIGS. 24A-24Jdelineate a plurality of lines of cross-section.FIGS. 24A-24Jshow the cross-sections taken along lines5-5and6-6of distal portions of elongate shaft2612, which are circular, the cross-sections taken along lines7-7of proximal section2622aand8-8of central section2622b, which are generally circular or irregular shape, the cross-sections taken along lines9-9,10-10,11-11,12-12, and13-13of central section2622b, which are oval or generally oval shapes, and the cross-section taken along line14-14through atraumatic guiding nub2622c, which is circular. The length from cross-section9-9through cross-section13-13is less than one-half of the overall length of the member2622. Thus, the majority of the length of member2622is either circular or irregularly shaped.

In operation, atraumatic guiding nub2622cenables initial insertion of obturator2600within an opening in tissue, e.g., a pre-cut scalpel incision, and facilitates advancement of member2622between tissue layers to gently dissect tissue without any cutting or incising of the tissue. After initial insertion and continued distal insertion, central section2622band proximal section2622acontinue to gently enlarge the opening in tissue.

As illustrated above inFIG. 30, obturator2600is disposed within a cannula2650. Cannula2650includes cannula tube2652extending distally from cannula housing2604. Obturator housing2610is releasably coupled to cannula housing2604. When obturator2600is coupled to cannula2650, a portion of elongate shaft2612and member2622extend distally beyond distal end2652aof cannula tube2652. Each of the apertures (2616,2618, and2620) is positioned within cannula tube2652and proximal of distal end2652aof cannula tube2652. Obturator housing2610may be made from any suitable material such as ABS and may be opaque and may be welded to elongate shaft2612.

Referring toFIGS. 31-37, a third embodiment of an obturator for separating tissue planes in an endoscopic surgical procedure is presented.

With reference toFIGS. 31 and 32, obturator2700includes an obturator housing2710and an elongate shaft2720. Elongate shaft2720includes a proximal end, a distal end, and a tubular member extending therebetween. The proximal end of elongate shaft2720may be welded or otherwise fixedly attached to obturator housing2710and extends proximally out of the proximal end of a cannula housing2704(FIG. 37) when the obturator is fully positioned therewithin. The distal end of elongate shaft2720extends distally out of a distal end2752aof a cannula tube2752(FIG. 37) when the obturator is positioned therewithin. The distal end of elongate shaft2720includes a member2722that closes the distal end of elongate shaft2720. Member2722is adapted for blunt tissue dissection. Elongate member2720and member2722may be monolithically fabricated from any suitable material such as acrylonitrile butadiene styrene plastic material (“ABS”) that may be opaque. Obturator housing2710may be fabricated from any suitable material such as ABS that may be opaque. Member2722includes a proximal section2722aand a rounded tip2722bthat extends distally from proximal section2722a. Proximal section2722ahas a frustoconical shape. Rounded tip2722bincludes rounded outer surfaces that function to help separate tissue along natural tissue planes and define a radius of curvature dimensioned to be atraumatic to tissue.

FIG. 33is an enlarged side view illustrating a distal end portion of elongate shaft2720including member2722.FIGS. 33A-33Fillustrate cross-sections of elongate shaft2720as taken through the plurality of corresponding section lines. In particular, the cross-sections taken along lines1-1,2-2,3-3,4-4,5-5, and6-6through member2722of elongate shaft2720are circular.

With reference toFIGS. 34-36, elongate shaft2720has an inner surface2720aand an outer surface2720bthat define and outer wall2720c. Inner surface2720adefines a central bore2724that extends through the tubular member from the proximal end of elongate shaft2720to a frustoconcial surface2720dhaving an arcuate end surface2720eat a distal end of inner surface2720a.

The tubular portion of elongate shaft2720includes a pair of proximal apertures2726, a pair of intermediate apertures2728, and a pair of distal apertures2730. Each aperture2726,2728, and2730extends through inner and outer surfaces2720a,2720bof elongate shaft2720. When obturator2700is fully positioned within cannula2750, apertures2726,2728, and2730are all positioned within, and covered by, cannula tube2752of cannula2750(FIG. 37).

In operation, rounded tip2722benables initial insertion of obturator2700within an opening in tissue, e.g., a pre-cut scalpel incision, and facilitates advancement of member2722between tissue layers to gently dissect tissue without any cutting or incising of the tissue. After initial insertion and continued distal insertion, proximal section2722acontinues to gently enlarge the opening in tissue.

As illustrated below inFIG. 37, obturator2700is disposed within a cannula2750. Cannula2750includes cannula tube2752extending distally from cannula housing2754. Obturator housing2710is releasably coupled to cannula housing2704. When obturator2700is coupled to cannula2750, a portion of elongate shaft2720and member2722extend distally beyond distal end2752aof cannula tube2752. Each of the apertures (2726,2728, and2730) is positioned within cannula tube2752and proximal of distal end2752aof cannula tube2752.

FIGS. 38A-45illustrate still another embodiment of the present invention.FIG. 38Ais an exploded view of an obturator assembly11, in accordance with an example embodiment of the present invention.FIG. 38Bis a perspective view of a surgical access system10in which such an obturator is employed. In this embodiment, the obturator is an example of a bladeless optical obturator, which allows visualization during entry via an endoscope inserted into the obturator.

In this embodiment, the system10includes an obturator assembly11and a cannula assembly200which at least partially receives the obturator assembly11. The obturator assembly11includes an obturator housing212disposed in mechanical cooperation with an elongated obturator member214, and defines a longitudinal axis “A-A.” The elongated obturator member214extends distally from the obturator housing212.

The obturator member214includes an obturator shaft218mechanically coupled to the obturator housing212, and an optical member220at the distal end of the obturator shaft218. The obturator shaft218is made from either steel or a polymeric material. The optical member220, which includes a hollow interior, includes a proximal section322, a central section324, and an atraumatic guiding nub226. In use, a distal viewing tip of an endoscope is brought into engagement with a sloped surface301(FIGS. 43B and 43C) within the optical member220, as will be described hereinbelow. An imaginary line228(shown to illustrate curvature) delineates the boundary between the proximal section322and the central section324.

With reference toFIG. 40, a top view of the optical member220is illustrated. As depicted, the proximal section322includes a pair of diametrically opposed convex surfaces328, and the central section324includes a pair of diametrically opposed concave surfaces342. The atraumatic guiding nub226extends distally from the central section324and includes a rounded end362. The rounded end362defines a radius of curvature dimensioned to be atraumatic to tissue. The guiding nub226and the rounded end362are discussed in further detail hereinafter.

With reference toFIG. 41, an end or axial view of the optical member220illustrates the circular profile of the rounded end362, the reduced profile of the central section324, and the circular profile of the proximal section322.

With reference toFIG. 42, a side view of the optical member220is illustrated. This side view is radially offset 90° relative to the top view ofFIG. 41. As shown, the proximal section322of the optical member220further includes a pair of diametrically opposed outer surfaces330which are generally linear and/or convex. The central section324also includes a pair of opposed outer surfaces344which are convex. Thus, the central section324of the optical member220is inclusive of both concave surfaces342(FIG. 40) and convex surfaces344(FIG. 42).

FIG. 43Ais a cross-sectional view of the optical member220taken at approximately the longitudinal midpoint thereof. The figure illustrates that the optical member220includes rounded outer surfaces231that function to help separate tissue along the natural tissue planes.

The atraumatic guiding nub226permits initial insertion within an opening, e.g., a pre-cut scalpel incision, in the tissue and facilitates the advancement of the optical member220between the tissue layers to gently dissect tissue, without any cutting or incising of the tissue. After initial insertion and continued distal insertion, the central section324and the proximal portion322continue to gently enlarge the opening in tissue.

With reference toFIGS. 43B and 43C, the optical member220may be fabricated from a polymeric or thermoplastic material, and may be transparent or translucent to permit passage of light rays. During assembly, the optical member220is overmolded onto a radially outward flared portion234of the obturator shaft218to connect the components. The overmolded optical member220encapsulates flared portion234.

The optical member220defines an internal chamfered or sloped surface301which is obliquely arranged relative to the longitudinal axis “A-A.” The chamfered surface301is directly engaged by the outermost periphery of the distal end of the endoscope25(seeFIG. 43D) such that light is transmitted radially within the outer periphery of the endoscope25and travels across an air gap prior to being received by the chamfered or sloped surface301. The optical member220permits the passage of light rays to enable viewing, with the endoscope25, of tissue adjacent the optical member220during the insertion and/or advancement of the trocar assembly.

As shown above inFIG. 43D, the distal end of the endoscope25engages the tapered surface301between the proximal and distal ends of the tapered surface301. The obturator shaft218is positioned in a lumen of the elongated portion202of the cannula assembly200. When the distal end of the endoscope25is engaged with the tapered surface301and the obturator shaft218is seated in the elongated portion202, the distal end of the endoscope25is positioned proximally of the distalmost end of the elongated portion202of cannula assembly200such that the distalmost end of the elongated portion202extends beyond the distal end of the endoscope25.

Referring toFIGS. 43E and 43F, a distal portion of the obturator assembly11including the optical member220is illustrated. The cross-sections taken along lines1-1and2-2through the proximal section322and flat surface240are substantially circular. The cross-sections taken along lines3-3and4-4through the central section324have a generally circular or irregular shape with pairs of diametrically opposed rounded outer surfaces231. Cross-sections taken along lines5-5,6-6,7-7,8-8, and9-9, through the central section324have a generally oval configuration. The cross-section taken along line10-10through the atraumatic guiding nub226of the optical member220is circular.

Referring toFIGS. 43G and 43H, detailed views of the atraumatic guiding nub226are illustrated. As shown inFIG. 43H, the cross-sections taken along lines11-11and12-12through the atraumatic guiding nub226are circular with a constant diameter. The cross-section taken along line13-13through the central section324has a generally oval configuration.

The obturator member214is configured for insertion through the cannula assembly200, as discussed above. The optical member220of the obturator assembly11is dimensioned such that an outer surface291of its proximal portion322provides a desired fit within the elongated portion202of the cannula assembly200.

The obturator housing212of the obturator assembly11includes an opening260(FIG. 44) and a scope retention member270(FIG. 45A) adjacent the opening260. The scope retention member270may be fabricated from an elastomeric material, and defines a central opening272for receiving the endoscope and four radial slits274extending outwardly from the central opening272. The radial slits274permit flexure of the scope retention member270and enlargement of the central opening272upon insertion of the endoscope. The scope retention member270is adapted to engage the outer surface of the endoscope in frictional engagement therewith to assist in retaining the relative positioning of the endoscope within the obturator assembly11without locking the endoscope in position relative thereto.

In an alternative embodiment, a scope retention member370(FIG. 45B) is positioned adjacent the opening260of the obturator housing212of the obturator assembly11. The scope retention member370may also be fabricated from an elastomeric material, and may define a central opening372for receiving the endoscope without any radial slits extending outwardly from the central opening372. Instead, the central opening372is surrounded by a smooth surface374having an uninterrupted configuration (i.e., no slits or indentations). The scope retention member370is adapted to engage the outer surface of the endoscope in frictional engagement therewith to assist in retaining the relative positioning of the endoscope within the obturator assembly11without locking the endoscope in position relative thereto. The scope retention member370is capable of functioning as an instrument seal for a wider range of endoscopes or other instrumentation inserted through the central opening372(e.g., smaller scope or instrument sizes will also be sealed).

The use and function of system10will now be discussed in relation toFIG. 46. In embodiments, in laparoscopic surgery, the abdominal cavity is insufflated with a suitable biocompatible gas such as, e.g., CO2gas, to insufflate the body cavity and lift the body cavity wall away from the internal organs therein. The insufflation may be performed with an insufflation needle or similar device as is conventional in the art and/or the insufflation gas may be provided through the trocar assembly. In alternative embodiments, system10may also be utilized in a space that has not been insufflated.

In use, an initial incision “I” is made in tissue “T” (e.g., skin) by a surgical instrument (e.g., a scalpel). The incision “I” is preferably small, for example, within a range from about 2 mm to about 7 mm. Obturator assembly11of surgical access system10is at least partially introduced within cannula assembly100with obturator member extending through aperture2166of septum seal2160and through zero-closure seal250(seeFIG. 6). The assembled unit is positioned within the initial incision and against the target tissue, e.g., the abdominal lining. An endoscope411may be inserted through obturator assembly11such that the distal viewing end of endoscope411is positioned against the chamfered surface of optical member20. Endoscope411may be retained at this relative position within obturator assembly11by scope retention member170.

During insertion, the tissue adjacent optical member20is viewed with endoscope411. During advancement of system10, endoscope411is utilized to view the path along which the system is advanced to ensure that any underlying tissue or organ site is prevented from contact with obturator assembly11and also to confirm entry within the body cavity.

Once system10is positioned at the desired location, as shown inFIG. 46, endoscope411may be used to monitor the desired surgical procedure being performed within the cavity. Obturator assembly11may then be removed from cannula assembly100. Instruments, such the same endoscope of various other types of instruments, may be introduced within cannula assembly100to perform a surgical procedure.

While various embodiments of the present disclosure have been shown and described herein, it will be obvious to those skilled in the art that these embodiments are provided by way of example only. Numerous variations, changes, and substitutions will now occur to those skilled in the art without departing from the present disclosure. Accordingly, it is intended that the invention be limited only by the spirit and scope of the appended claims.