Abstract:
An expandable adapter collar assembly is provided for use with a surgical access port having an outer diameter in order to increase the apparent outer diameter of the combination of the surgical access port and expandable collar in order to conform to the size of a surgical incision. The expandable adapter collar is an inflatable collar which is selectively detachably positionable so as to surround the surgical access port and expandable from a deflated or contracted smaller diameter to an inflated or expanded larger diameter to fill the surgical incision. The expandable adapter collar may be provided as part of an expandable collar assembly including a source of inflation fluids. There is also provided a method of adapting a surgical access port for use in a surgical incision having a size larger than the original design parameters for the surgical access port.

Description:
CROSS REFERENCE TO RELATED APPLICATION 
       [0001]    The present application claims the benefit of and priority to U.S. Provisional Application Ser. No. 61/466,564, filed on Mar. 23, 2011, the entire contents of which are incorporated herein by reference. 
     
    
     BACKGROUND 
       [0002]    1. Technical Field 
         [0003]    The present disclosure relates to an expandable adapter collar assembly for use with a surgical access port. More particularly, the present disclosure relates to a surgical access port expandable collar assembly including an inflatable collar for use with a surgical access port to allow use of the access port through a large diameter surgical incision having a size greater than the intended design parameters of the surgical access port. 
         [0004]    2. Background of Related Art 
         [0005]    Certain surgical procedures require forming an incision into the body wall of a patient and positioning a surgical access port through the incision. The body cavity under the body wall of the patient is then filled with insufflation fluids or insufflated to create an expanded working space within the body cavity. The surgical access port provides a sealed passageway for the insertion of surgical instrumentation into the body of the patient while preventing the escape of insufflation fluids. A surgical access port typically has a predetermined outer dimension and is chosen to fit snugly within the size of the surgical incision to prevent the escape of the insufflation fluids. 
         [0006]    Some surgical procedures require the removal of a body organ or tissue specimen as part of the surgical procedure. In these instances, the initial surgical incision may not be large enough to withdraw the body organ or tissue sample from the body cavity. In this situation, the body cavity is deflated, the surgical access port is removed from the initial incision and a second or larger diameter surgical incision is made to allow for removal of the body organ or tissue specimen. However, upon reinsertion of the surgical access port into the secondary incision, the size of the surgical access port may not be sufficiently large enough to completely seal within the secondary incision thereby risking the escape of insufflation fluids. 
         [0007]    Therefore, there exists a need for an adapter device, usable with a surgical access port having a predetermined outer size, to adjust the overall outer size of the surgical access port and adapter device assembly to conform to the size of the surgical incision. There additionally exists the need for an adapter device usable with a surgical access port to assist the surgical access port in anchoring within the surgical incision. 
       SUMMARY 
       [0008]    There is disclosed an expandable adapter collar assembly for use in various sized surgical incisions. The expandable collar assembly generally includes an expandable adapter collar defining an inflation chamber and a fluid inflation source in fluid communication with the inflation chamber. Passage of fluid into the inflation chamber from the inflation source moves the expandable adapter collar from a smaller diameter or collapsed, deflated state to a larger diameter expanded state to engage and seal against edges of a surgical incision. The expandable adapter collar assembly includes an inflation tube in fluid communication with the inflation chamber and connectable to an outside source of inflation fluids. 
         [0009]    In one embodiment, the expandable adapter collar is doughnut shaped. In an alternative embodiment, the expandable adapter collar is bell shaped. In a specific embodiment, the expandable adapter collar is formed of a stretchable material. 
         [0010]    In one particular embodiment, the fluid inflation source is an air source. Alternatively, the fluid inflation sources may be saline or carbon dioxide. 
         [0011]    There is also disclosed a surgical access port assembly for use in various sized surgical incisions and generally including an access port having at least one opening for receipt of surgical instruments and an expandable adapter collar assembly mountable around the surgical access port. The expandable adapter collar assembly is movable from a collapsed condition to an expanded condition. 
         [0012]    The access port has an hourglass shape defining a waist and the expandable adapter collar assembly is positionable around the waist. The expandable adapter collar assembly includes an inflatable collar defining an inflation chamber and a source of inflation fluids. 
         [0013]    In one embodiment, the source of inflation fluids is an air source. In alternative embodiments, the source of inflation fluid is a saline source or a carbon dioxide source. 
         [0014]    In one particular embodiment, the inflatable adapter collar is doughnut shaped. 
         [0015]    In an alternative embodiment, the inflatable adapter collar is bell shaped. In this embodiment, the inflatable adapter collar includes a cylindrical portion and a flange portion extending distally from the cylindrical portion. The flange portion of the inflatable adapter collar extends around a lower lip of the access port when the inflatable adapter collar is in the expanded condition. 
         [0016]    There is further disclosed a method of securing a surgical access port in an incision having a diameter larger than a waist area of the surgical access port. The method includes providing an inflatable adapter collar around the waist area of the surgical access port and expanding the inflatable adapter collar from a collapsed condition to a larger expanded condition to engage an incision in a body wall having a diameter larger than the diameter of the waist area of the surgical access port. The method may additionally include the step of expanding the inflatable adapter collar to engage a lower lip of the surgical access port and an inner surface in the body wall. 
     
    
     
       DESCRIPTION OF THE DRAWINGS 
         [0017]    Various embodiments of the presently disclosed adapter collars for use with an access port are disclosed herein with reference to the drawings, wherein: 
           [0018]      FIG. 1  is a perspective view of a first embodiment of an access port assembly including an inflatable adapter collar and access port; 
           [0019]      FIG. 2  is a perspective view, with parts separated and partially shown in section, of the access port assembly of  FIG. 1 ; 
           [0020]      FIG. 3  is a perspective view similar to  FIG. 1 , partially shown in section; 
           [0021]      FIG. 4  is a partial side view, in section, of the access port assembly of  FIG. 1  illustrating the inflatable adapter collar inflated with air; 
           [0022]      FIG. 5  is a view similar to  FIG. 4  illustrating the inflatable adapter collar inflated with saline; 
           [0023]      FIG. 6  is a perspective view, partially shown in section, of the access port inserted through an incision in tissue; 
           [0024]      FIG. 7  is a perspective view, partially shown in section, of the inflatable adapter collar being fitted over the access port and the incision enlarged; 
           [0025]      FIG. 8  is a perspective view of the access port assembly being inserted into the enlarged incision; 
           [0026]      FIG. 9  is a perspective view, partially shown in section, of the access port assembly with the inflatable adapter collar inflated to fill the enlarged incision; 
           [0027]      FIG. 10  is a perspective view of an alternate embodiment of an access port assembly with an alternative inflatable adapter collar and an access port; 
           [0028]      FIG. 11  is a perspective view, with parts separated and partially shown in section, of the access port assembly of  FIG. 10 ; 
           [0029]      FIG. 12  is a perspective view, partially shown in section, of the alternative inflatable adapter collar being fitted over the access port and the incision enlarged; 
           [0030]      FIG. 13  is a perspective view of the alternative embodiment of the access port assembly being inserted into the enlarged incision; 
           [0031]      FIG. 14  is a perspective view, partially shown in section, of the access port assembly with the alternative inflatable adapter collar inflated to fill the enlarged incision; and 
           [0032]      FIG. 15  is a partial side view, shown in section, taken along line  15 - 15  of  FIG. 14 . 
       
    
    
     DETAILED DESCRIPTION OF EMBODIMENTS 
       [0033]    Embodiments of the presently disclosed access port assembly will now be described in detail with reference to the drawings wherein like numerals designate identical or corresponding elements in each of the several views. As is common in the art, the term “proximal” refers to that part or component closer to the user or operator, i.e. surgeon or physician, while the term “distal” refers to that part or component further away from the user. 
         [0034]    Referring to  FIGS. 1-9  and initially to  FIGS. 1 and 2 , there is disclosed a surgical access port assembly  10  having an access port  12  and an adapter collar assembly  14 . Adapter collar assembly  14  is provided to allow use of access port  12  in an incision having an opening greater than the design parameters of the access port by filling the space between the access port and an inner edge of the incision. Adapter collar assembly  14  includes a generally doughnut shaped expandable collar  16  and an inflation tube  18 . 
         [0035]    As best shown in  FIGS. 2 and 3 , expandable collar  16  is hollow and defines an inflation chamber  20 . A distal end  22  of inflation tube is in fluid communication with inflation chamber  20  and a proximal end  24  of inflation tube  18  is connectable to a source of inflation fluid in a manner described in more detail hereinbelow. Expandable collar  16  may be formed from a variety of materials including stretchable materials such as, for example, polymers, rubber, etc. The stretchable material allows expandable collar  16  to lie flat against access port  12  in a deflated state prior to inflation and can be inflated and expanded away from access port  12  to adjust the size of expandable collar  16  to the incision size in order to secure access port  12  within the incision. Alternatively, expandable collar  16  may be formed from non-stretchable materials such as, for example, plastics, etc. In this situation, expandable collar  16  may include folds, etc. to allow expandable collar  16  to lie flat against access port  12  during insertion into the incision. 
         [0036]    As best shown in  FIG. 2 , expandable collar  16  includes an inwardly projecting or inner surface  26  and an outwardly projecting or outer surface  28 . Inner surface  26  defines a central opening  27  for receipt of access port  12 . Access port  12  includes an hourglass shaped center portion  30 , a proximal or upper lip  32  and a distal or lower lip  34 . Hourglass shaped center portion  30  is narrowest at a waist  36 . With reference to  FIGS. 2 and 3 , access port  12  includes a plurality of ports  38  which extends through access port  12  for the receipt and passage of surgical instrumentation. Access port  12  additionally includes a plurality of longitudinally extending slits  40  which also extend through access port  12  for receipt of surgical instrumentation. 
         [0037]    Expandable collar  16  is assembled to access port  12  by positioning expandable collar  16  adjacent access port  12  ( FIG. 2 ) and stretching expandable collar  16  such that it fits over upper lip  32  of access port  12 . Thereafter, expandable collar  16  is moved along access port  12  to a position adjacent and surrounding hourglass shaped center portion  30  ( FIG. 3 ). In this manner, the expandable collar  16  may be selectively attached and detached to the access port  12 . 
         [0038]    As best shown in  FIG. 4 , in this position, inner surface  26  of expandable collar  16  engages and lies flush against waist  36  of hourglass shaped center portion  30  of access port  12 . As noted herein above, access port assembly  10  includes, or is connectable to, a fluid source such as, for example, fluid air source  42 . Fluid air source  42  is provided in order to inject air  44  through inflation tube  18  and into inflation chamber  20  in order to move expandable collar  16  from the deflated to an inflated condition. Specifically, air source  42  is connected to proximal end  24  of inflation tube  18 . 
         [0039]    Referring for the moment to  FIG. 5 , alternatively, the fluid source may be a saline source  46  which is connectable to proximal end  24  of inflation tube  18 . Saline source  46  is provided to supply a source of saline  48  into inflation chamber  20  of expandable collar  16  to move expandable collar  16  from the deflated to an inflated condition. It should be noted that carbon dioxide and other standard operating room fluid sources may also be used as inflation sources. 
         [0040]    Referring now to  FIGS. 6-9 , and initially to  FIG. 6 , the use of access port assembly  10  will now be described. A surgical procedure is performed by making a first or initial incision II through a body wall BW to access a body cavity BC. Access port  12  is inserted into initial incision II such that hourglass center portion  30  engages the inner surfaces of the initial incision II. Upper lip  32  engages outer surface OS body wall BW and lower lip  34  engages inner surface IS body wall BW to secure access port  12  within body wall BW. Thereafter, a surgical procedure may be performed by inserting surgical instrumentation through ports  38  or slits  40 . 
         [0041]    Referring now to  FIGS. 7 and 8 , once the first surgical procedure has been performed, access port  12  may be removed from body wall BW and initial incision II enlarged to form a larger secondary insertion SI ( FIG. 7 ). As best shown in  FIG. 7 , adapter collar assembly  14  is then positioned over access port  12  and seated against waist portion  30  of access port  12 . Specifically, access port  12  is inserted through central opening  27  in expandable collar  16 . 
         [0042]    With specific reference to  FIG. 8 , access port assembly  10  is then inserted into secondary incision SI. As shown, diameter D 2  of secondary incision SI is greater than the diameter D 1  of initial incision II or upper and lower lips  32  and  34 , respectively, of access port  12 . Adapter collar assembly  14  is in a deflated state and lies against access port  12 . Inflation tube  18  extends outward of body wall BW. 
         [0043]    Referring now to  FIG. 9 , fluid source  42  ( FIG. 4 ) is then actuated to inject fluid into inflation chamber  20  of expandable collar  16  to move expandable collar  16  from the contracted or deflated state to an expanded or inflated state wherein outer surface  28  of expandable collar  16  engages the inner surfaces of the secondary incision SI to secure access port assembly  10  within body wall BW. At this point, a surgical instrument such as, for example, surgical instrument  50  is inserted through port  38  to position a surgical tool  52  at a distal end  54  of surgical instrument  50  within body cavity BC. Thereafter, actuation structure (not shown) located at proximal end  56  of surgical instrument  50  may be actuated to operate surgical tool  52 . Once the secondary surgical procedure has been completed, fluid air source  42  ( FIG. 4 ) may be again actuated to deflate expandable collar  16  allowing removal of access port assembly  10  from secondary incision SI. In this manner, access port assembly  10  and, in particular expandable collar  16 , allows use of access port  12  in varying diameter surgical incisions. 
         [0044]    Referring now to  FIGS. 10-15 , and initially with regard to  FIGS. 10 and 11 , there is disclosed an alternative embodiment of an access port assembly  60  including access port  12  and an adapter collar assembly  62 . Access port  12  is identical to access port  12  described hereinabove including hourglass shaped center portion  30 , upper lip  32  and lower lip  34 . As noted hereinabove, hourglass shaped center portion  30  includes a narrow waist  36  and through ports  38  for receipt of surgical instrumentation along with longitudinal slits  40 . 
         [0045]    Adapter collar assembly  62  generally includes an expandable bell shaped collar  64  and an inflation tube  66 . As best shown in  FIG. 11 , bell shaped collar  64  includes a proximal or upper cylindrical portion  68  and a distal or lower flange portion  70  which together define an inflation chamber  72 . A distal end  74  of inflation tube  66  is in fluid communication with inflation chamber  72  and a proximal end  76  of inflation tube  66  is connectable to a source of fluid in a manner described in more detail hereinbelow. 
         [0046]    It should be noted that bell shaped collar  64  is formed of a material similar to that described herein above with regard to doughnut shaped collar  16 . Lower flange portion  70  is sufficiently flexible that, upon inflation, it can wrap around and under lower lip  34  of access port  12 . Specifically, an inner surface  78  of cylindrical portion  68  is configured to engage hourglass center portion  30  of access port  12  while an inner surface  80  of lower flange portion  70  is configured to engage and surround lower lip  34  of access port  12 . Inner surfaces  78  and  80  of cylindrical portion  68  and lower lip  34 , respectively, define a central opening  81  for receipt of access port  12 . An outer surface  82  of expandable collar  64  is engaged within incision formed in the body wall of a patient in a manner described in more detail hereinbelow. 
         [0047]    Referring now to  FIGS. 12-15 , the use of access port assembly  60  will now be described. As with the procedure described herein above, surgical access port  12  is utilized to perform a surgical procedure through an initial incision II ( FIG. 6 ). Thereafter, in order to remove a specimen from body cavity BC, access port  12  is removed and expandable collar  64  is fitted over access port  12 . With specific reference to  FIG. 12 , adapter collar assembly  62  is slid over access port  12  such that inner surface  78  engages hourglass shaped portion  30  of access port  12  and inner surface  80  of distal flange  70  engages lower lip  34  of access port  12 . 
         [0048]    Referring now to  FIG. 13 , as noted herein above, a secondary incision SI is formed having a diameter D 2 , which is greater then the diameter D 1  of initial incision II. Thereafter, access port assembly  60  is inserted into secondary incision SI with bell shaped expandable collar  64  in the deflated state. A source of fluids such as, for example, source of fluid  42  ( FIG. 4 ) is connected to inflation tube  66  and used to force an inflation fluid into inflation chamber  72  to expand bell shaped expandable collar  64  from the deflated state to an expanded state engaging secondary incision SI in body wall BW ( FIG. 14 ). 
         [0049]    As best shown in  FIGS. 14 and 15 , lower flange portion  70  of bell shaped expandable collar  64  engages inner surface IS of body wall BW to prevent access port assembly  60  from backing out of body wall BW during a surgical procedure. With specific reference to  FIG. 15 , inner surface  80  of lower flange portion  70  engages and wraps around lower lip  34  of access port  12  to further secure bell shaped expandable collar  64  about access port  12  during a surgical procedure. 
         [0050]    Referring back for the moment to  FIG. 14 , similar to the surgical procedure described hereinabove with regard to access port assembly  10 , surgical instrument  50  may be inserted through port  38  in access port  12  to position tool  52  within body cavity BC to thereby remove a specimen (not shown) from within body cavity BC. Once a specimen has been grasped by tool  52  of surgical instrument  50 , fluid within inflation chamber  72  may be removed through inflation tube  66  to deflate bell shaped expandable collar  64  and allow removal of access port assembly  60  along with surgical instrument  50  and any grasped specimen through secondary incision SI. 
         [0051]    In this manner, access port assembly  60  provides a variable diameter access port for use with various sized incisions and includes structure to facilitate additional anchoring of access port assembly  60  within an enlarged surgical incision and allows use of a standard sized surgical access port through a larger than indicated incision. 
         [0052]    It will be understood that various modifications may be made to the embodiments disclosed herein. For example, the disclosed expandable collar may have other shapes including a full hourglass shape, a rectangular cross section, etc. Further, inflation fluids may be provided into the inflation chamber via a syringe. Additionally, the disclosed expandable collars may be formed from compressible materials rather than an inflatable chamber and be formed of foam, solid rubber, etc. 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.