Abstract:
A surgical access port that includes a cylindrical member having a proximal end and a distal end and defining a longitudinal axis; at least two lumen extending through the cylindrical member along the longitudinal axis; at least one cavity defined in the cylindrical member and positioned radially within the at least two lumen; and a source of inflation fluid coupled to the at least one cavity, the source of inflation configured to permit selectable inflation of the at least one cavity, whereby inflation of the at least one cavity increases the radial distance between the at least two lumen.

Description:
CROSS REFERENCE TO RELATED APPLICATION 
       [0001]    The present application claims the benefit of and priority to U.S. Provisional Application Ser. No. 61/435,442, filed on Jan. 24, 2011, the entire contents of which are incorporated herein by reference. 
     
    
     BACKGROUND 
       [0002]    1. Technical Field 
         [0003]    The present disclosure relates to an access port for use in minimally invasive surgical procedures, such as endoscopic or laparoscopic-type procedures, and more particularly to an expanding surgical access port for use in minimally invasive procedures. 
         [0004]    2. Background of Related Art 
         [0005]    Today, many surgical procedures are performed through small incisions in the skin, as compared to the larger incisions typically required in traditional procedures, in an effort to reduce both trauma to the patient and recovery time. Generally, such procedures are referred to as “endoscopic”, unless performed on the patient&#39;s abdomen, in which case the procedure is referred to as “laparoscopic”. Throughout the present disclosure, the term “minimally invasive” should be understood to encompass both endoscopic and laparoscopic procedures. During a typical minimally invasive procedure, surgical objects, such as surgical access ports (e.g., trocar and/or cannula assemblies), endoscopes, or other instruments, are inserted into the patient&#39;s body through the incision in tissue. Prior to the introduction of the surgical object into the patient&#39; body, insufflation gasses may be 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. 
         [0006]    To this end, various access members are used during the course of minimally invasive procedures and are widely known in the art. A continuing need exists for an access member of a universal size that can be inserted into a variety of tissue incision sites and expands to fit such a variety of larger tissue incision sites. It is desirable to accommodate a variety of tissue incisions, and adapt to changing conditions at the surgery site. 
       SUMMARY 
       [0007]    In accordance with various embodiments, the present disclosure is directed toward a surgical access port having at least one internal inflation cavity. The internal inflation cavity is capable of receiving and retaining fluid such that the internal inflation cavity, and thus the size of the surgical access port as a whole, increases under supplied inflation fluid. This increase is desirable to cause a more substantial seal between the surgical access port walls and the incision site, thereby maintaining the insufflated workspace. The surgical access port may additionally be capable of both radial and axial expansion under supplied inflation fluid. 
         [0008]    The inflation cavity is internal to a cylindrical body that generally has an hourglass shape, defines a longitudinal axis, and is coupled to a source of inflation fluid. In use, the operator of the surgical access port supplies inflation fluid from the source of inflation fluid, and the internal inflation cavity, and consequently, the body of the surgical access port expands in response to the supplied fluid. The driving force of the inflation fluid may be provided by a pump, reservoir, or any other suitable pressure-generating device. The internal inflation cavity is coupled to the source of inflation fluid through the use of an inflation coupling that provides a substantially fluid-tight seal between the internal inflation cavity and the source of inflation fluid. 
         [0009]    The cylindrical body is formed of a material capable of both expansion and contraction. In embodiments, this material may be foam, or any other biocompatible material that is flexible in both radial and axial directions, yet resilient enough to resist deformation under the stress of the walls of an incision site. The cylindrical body has a proximal and a distal end, both substantially perpendicular to the longitudinal axis. 
         [0010]    Disposed within, and extending through the cylindrical body along the longitudinal axis, is at least one lumen. The lumen provides a path from the proximal end of the surgical access port, through the cylindrical body, to the distal end of the surgical access port. The lumen or lumens may also change relative positioning with each other and other components of the surgical access port in response to expansion from supplied inflation fluid. Specifically, the lateral spacing between lumens with respect to the longitudinal axis will change in response to expansion of the surgical access port under supplied inflation fluid. By virtue of the flexible and compressible nature of the cylindrical body, lumen diameter may be reduced as a result of the expansion of the cylindrical body, and a tighter seal may form about an instrument disposed within a lumen. Additionally, the lumens may alter their path in response to deflection of an inserted instrument relative to the longitudinal axis. 
         [0011]    Also provided is a method for accessing an internal body cavity. The method includes the steps of positioning the surgical access port in an internal body cavity, expanding the surgical access port to a desired size with fluid from the source of inflation fluid, and accessing the internal body cavity via the surgical access port. The surgical access port allows the passage of surgical tools and other devices into the body cavity. Removal of the device involves contracting the surgical access port such that it decreases in size so to allow generally unobstructed removal from an incision site. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0012]      FIG. 1  is a top perspective view of a surgical access port containing four lumens, a central internal inflation cavity, and an inflation coupling; 
           [0013]      FIG. 2  is top plan cross-sectional view along the line  2 - 2  of the surgical access port of  FIG. 1 , showing four lumens, a central internal inflation cavity, and a first state diameter; 
           [0014]      FIG. 3  is a top perspective view of the surgical access port shown in  FIG. 1 , in a first state and inserted into tissue through an incision site, having an inflation coupling and two surgical instruments disposed within two of the lumens; 
           [0015]      FIG. 4  is a side view of the surgical access port of  FIG. 1 , as shown in  FIG. 3  with two instruments disposed therethrough; 
           [0016]      FIG. 5  is a top plan cross-sectional view along the line  2 - 2  of the surgical access port as shown in  FIG. 2 , in a second state and showing a corresponding second state diameter; 
           [0017]      FIG. 6  is a side view of the surgical access port shown in  FIG. 5  in an expanded second state and showing a corresponding increase in lumen spacing; and 
           [0018]      FIG. 7  is a top plan cross-sectional view of a surgical access port having four lumens and four separate internal inflation cavities in a first state. 
       
    
    
     DETAILED DESCRIPTION OF EMBODIMENTS 
       [0019]    The present disclosure will now describe in detail embodiments of a surgical access port with reference to the drawings in which like reference numerals designate identical or substantially similar parts in each view. Throughout the description, the term “proximal” will refer to the portion of the assembly closest to the operator, whereas the term “distal” will refer to the portion of the assembly farthest from the operator. Although discussed in terms of an incision for a minimally invasive procedure, the presently disclosed surgical access port may be used in any naturally occurring orifice (e.g. mouth, anus, or vagina). 
         [0020]    Referring initially to  FIG. 1 , a surgical access port  100  is shown. The surgical access port  100  includes a cylindrical member  110  having a generally hourglass shape, a proximal end  140   a  and a distal end  140   b , and defining a longitudinal axis A 1 . The proximal end  140   a  and the distal end  140   b  are substantially perpendicular to the longitudinal axis A 1  and are each surrounded by an outer rim  150   a  and  150   b , respectively. Extending through the cylindrical member  110  along the longitudinal axis A 1  is at least one lumen  120 , and in embodiments, a plurality of lumens  120 . An example of an access port is disclosed in U.S. Patent Application Publication No. 2010/0240960 A1, the entire disclosure of which is incorporated by reference herein. 
         [0021]    Also within the cylindrical member  110 , separate from the lumens  120 , is an internal inflation cavity  130 . The internal inflation cavity  130  may be symmetrical and centrally disposed as shown here, but in embodiments, may be of shape, plurality, and placement so as to maximize its effect on the surrounding lumens  120 . In embodiments, internal inflation cavity  130  may be of a generally “X” shape, with rounded edges. The internal inflation cavity  130  extends from some distance along the longitudinal axis A 1  from the proximal end  140   a  of the cylindrical member  110 , and terminates at some distance along the longitudinal axis A 1  before the distal end  140   b  of the cylindrical member  110 . 
         [0022]    Coupled to the internal inflation cavity  130  is an inflation coupling  160 , which may be in the form of a tube or a port configured to be attached to the source of inflation fluid  170 . The inflation coupling  160  is coupled on its distal end to the internal inflation cavity  130 , and on its proximal end to a source of inflation fluid  170 . The internal inflation cavity  130  will be capable of retaining the inflation fluid. To this end, the internal inflation cavity  130  or the inflation coupling  160  may incorporate a structure to control the flow of inflation fluid to the internal inflation cavity. This structure may be a ball valve or other suitable flow control. Additionally, the inflation coupling  160  may contain a structure to contribute to maintaining a substantially fluid-tight seal with the surgical access port  100 . Such structure may be a press-fit member, bayonet-type, or threaded configuration. 
         [0023]    The source of inflation fluid  170  may be any source capable of supplying the inflation fluid to the internal inflation cavity  160 . Such a capable source may be a syringe, pump, or reservoir. The source of inflation fluid  170  will supply inflation fluid that is biocompatible and suitable for surgical procedures, such as CO 2 , air, or saline. 
         [0024]    In embodiments, a surgical access port  100  may also include a port for the communication of insufflation fluid to an internal body cavity  220  (see  FIG. 4 ). Alternatively, one of the lumens  120  may communicate the insufflation fluid to the internal body cavity  220 . 
         [0025]    Turning to  FIG. 2 , the surgical access port  100  is shown in cross section along section line  2 - 2 . In this view, each of the lumens  120  can be seen disposed radially about the internal inflation cavity  130 . The lumens  120  are placed such that an expansion of the inflation cavity  130  will cause a shifting in the relative placement of the lumens  120 . Such a shifting may allow greater dexterity and range in performing a surgical procedure with instruments  210  (see  FIG. 3 ) disposed within the lumens  120 . When the inflation cavity  130  is not inflated, as shown here, a first state is defined. In a first state, the inflation cavity  130  has an internal pressure that is essentially equalized with that of the surrounding environment. A first state diameter D 1  is associated with the first state, measured transverse to the longitudinal axis A 1 . 
         [0026]    Referring to  FIG. 3 , the surgical access port  100  is shown in top perspective view inserted into tissue  180  through an incision site  190 . The proximal end  140   a  of the cylindrical member  110  can be seen extending through the surface of the tissue  180 . In this arrangement, surgical instruments  210  can be inserted into lumens  120 , and can be seen extending therethrough as shown in phantom view. Also shown in phantom view is the internal inflation cavity  130 . Extending through the top of the proximal end  140   a  of cylindrical member  110  is inflation coupling  160 . Thus, the surgical access port  100  in  FIG. 3  is shown in a first, unexpanded, state. 
         [0027]    Turning to  FIG. 4 , a side view of the surgical access port of  100  is shown. In this view, the surgical instruments  210  can be seen extending completely through the lumens  120  (shown in phantom view). Also shown is a relative spacing measurement X 1 , measured transverse to the longitudinal axis A 1  between the centers of lumens  120 , while the surgical access port  100  is in a first, unexpanded, state. 
         [0028]    In use, the operator of the surgical access port  100  will first place the surgical access port  100  in an incision site  190  such that the surgical access port is disposed within a layer of tissue  180 , as shown in  FIG. 3 . The operator of the surgical access port  100  will then couple the inflation coupling  160  to the source of inflation fluid  170 , allowing the internal inflation cavity  130  to expand when fluid is introduced to the internal inflation cavity  130 . The source of inflation fluid  170  supplies pressurized fluid to expand the internal inflation cavity  130 . This may be accomplished by pumps or reservoirs, or any other suitable pressure-generating apparatus. The operator of the surgical access port  100  will allow the internal inflation cavity  130  to expand such that the walls of the cylindrical member  110  expand to fill the space between the cylindrical member  110  and the walls of the incision site  190 , until a substantially fluid-tight seal is formed between the walls of the cylindrical member  110  and the walls of the incision site  190 . The surgical access port  100  is then ready for surgical instruments and tools  210  to be inserted therethrough for use in minimally invasive surgical procedures. 
         [0029]    Referring now to  FIG. 5 , a cross-sectional view along the line  2 - 2  as shown in  FIG. 2  is shown, now with the surgical access port  100  in an expanded, second state. Here, the second state diameter D 2  is shown, clearly different than first state diameter D 1 . It is also shown that internal inflation cavity  130  has expanded and cylindrical member  110  has expanded in response. 
         [0030]    Turning to  FIG. 6 , the surgical access port  100  is in an expanded second state. The relative spacing measurement X 2 , measured transverse to the longitudinal axis between the centers of lumens  120  (shown in phantom view) is clearly different than the relative spacing measurement of the first state, X 1 . As a result, the lumens  120  enjoy greater relative spacing and greater freedom of movement. This greater spacing may also provide access to point in an internal body cavity  220  that may have been accessible by the surgical instruments  210  while the surgical access port  100  was in the first state. Additionally, the forces exerted by the expanded surgical access port  100  may also serve to retract tissue outward from an incision site  190 . Further, the compressible nature of the cylindrical member  110  may cause the lumens  120  to form a tighter seal about surgical instruments  210  disposed therethrough in the second state. 
         [0031]    In order to remove the device, the operator of the surgical access port  100  will uncouple the source of inflation fluid  170  from the inflation coupling  160 . Surgical instruments and tools  210  will then be removed from the lumens  120 , and inflation fluid will be released from the internal inflation cavity  130 . This latter step may include opening a plug, seal, or other port in order to release pressurized inflation fluid. The surgical access port  100  will then transition from a second state to a first state, with a corresponding decrease in diameter, measured transverse to the longitudinal axis A 1 . The surgical access port can then be easily removed from an incision site  180 . 
         [0032]    Referring to  FIG. 7 , a surgical access port  200  is shown in a first state, with four lumens  120  spaced evenly about the longitudinal axis A 1 , as well as four separate inflation cavities  230 , shown here evenly spaced about the longitudinal axis A 1 . Separate internal inflation cavities  230  may function to maximize spacing between lumens  120  upon transition of the surgical access port  200  from a first state to a second state. 
         [0033]    It is additionally contemplated that the surgical access port may be coated with any number of medicating substances or materials to facilitate healing, or to make the use of the surgical access port during surgery more effective. 
         [0034]    It will be understood that various modifications may be made to the embodiments disclosed herein. Therefore, the above description should not be construed as limiting, but merely as exemplifications of embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the present disclosure. what d