Abstract:
A laparoscopic device assembly provides a tubular diaphragm twist seal that responds to a slight rotation of an actuating ring in a first direction by coupling a motor spring power assisted rotation of a bottom circumference of the twist seal achieves a pneumatic seal in an adjustable access channel defined by the state of the twist seal for maintaining an insufflated body cavity for a hand assisted laparoscopic surgical procedure. A slight rotation of the actuating ring in an opposite second direction releases compression spring energy and energy in the twisted state of the twist seal so that an upper circumference of the twist seal is allowed to open the adjustable access channel.

Description:
CROSS REFERENCE TO RELATED APPLICATIONS 
     The present application is related to two commonly-owned U.S. patent applications filed on even date herewith, the disclosures of which are hereby incorporated by reference in their entirety: (1) Ser. No. 11/611,215, entitled “Handoscopy Interwoven Layered Seal Laparoscopic Disk” to Cropper et al. and (2) Ser. No. 11/611,167, entitled “Resiliently Supported Seal Cap for Hand Assisted Laparoscopic Surgical Procedures” to Kistler et al. 
     FIELD OF THE INVENTION 
     The invention generally relates to surgical access systems that facilitate sealed access across a body wall and into a body cavity during a laparoscopic surgical procedure. 
     BACKGROUND OF THE INVENTION 
     Abdominal surgery typically involves an incision in the abdominal wall large enough to accommodate a surgeon&#39;s hands, multiple instruments, and illumination of the body cavity. While large incisions simplify access to the body cavity during a surgery, it also increases trauma, requires extended recovery time, and can result in unsightly scars. In response to these drawbacks, minimally invasive surgical methods have been developed. 
     In minimally invasive abdominal surgery, or laparoscopic surgery, several smaller incisions are made into the abdominal wall. One of the openings is used to inflate the abdominal cavity with gas, which lifts the abdominal wall away from underlying organs and provides space to perform the desired surgery. This process is referred to as insufflation of the body cavity. Additional openings may be used to accommodate cannulas or trocars for illuminating and viewing the cavity, as well as instruments involved in actually performing the surgery, e.g., instruments to manipulate, cut, or resect organs and tissue. 
     Hand Assisted Laparoscopic Surgical (HALS) procedures are gaining increased acceptance as combining advantages of open surgery (e.g., tactile feedback) yet have some of the advantages of reduced scarring, reduced recovery time, and reduced incidence of complications of closed procedures. Laparoscopic disks are often used to provide an adjustable opening that allows insertion of the surgeon&#39;s hand to the insufflated body cavity, yet provide significant pneumatic sealing with or without the presence of the surgeon&#39;s hand. 
     While generally-known laparoscopic disks successfully support HALS procedures, improvements to increase patient and surgeon comfort and to enhance performance are desired. 
    
    
     
       DESCRIPTION OF THE FIGURES 
       The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments of the invention, and, together with the general description of the invention given above, and the detailed description of the embodiments given below, serve to explain the principles of the present invention. 
         FIG. 1  is an environmental perspective view of a patient prepared for a Hand Assisted Laparoscopic Surgery (HALS) procedure by the insertion of a laparoscopic disk having a power assisted adjustable access channel. 
         FIG. 2  is a perspective view of the laparoscopic disk of  FIG. 1  having the power assisted adjustable access channel in an open condition in response to an upper actuating ring rotated to a counterclockwise most position. 
         FIG. 3  is a perspective view of the laparoscopic disk of  FIG. 1  having the power assisted adjustable access channel in a closed condition in response to the lower actuating ring rotated to a clockwise most position. 
         FIG. 4  is a perspective exploded view of the laparoscopic device assembly of  FIG. 1 . 
         FIG. 5  is a top perspective view of the upper actuating ring of the laparoscopic device assembly of  FIG. 1 . 
         FIG. 6  is a bottom perspective view of the upper actuating ring of the laparoscopic device assembly of  FIG. 1 . 
         FIG. 7  is a top perspective view of an opening ring of the laparoscopic device assembly of  FIG. 1 . 
         FIG. 8  is a bottom perspective view of the opening ring of the laparoscopic device assembly of  FIG. 1 . 
         FIG. 9  is a top perspective view of a stationary ring of the laparoscopic device assembly of  FIG. 1 . 
         FIG. 10  is a bottom perspective view of the stationary ring of the laparoscopic device assembly of  FIG. 1 . 
         FIG. 11  is a top perspective view of a closure ring of the laparoscopic device assembly of  FIG. 1 . 
         FIG. 12  is a bottom perspective view of the closure ring of the laparoscopic device assembly of  FIG. 1 . 
         FIG. 13  is a perspective view of a winding actuator of the laparoscopic device of  FIG. 2 . 
         FIG. 14  is a top plan view of a lower base of the laparoscopic device assembly of  FIG. 1 . 
         FIG. 15  is a top plan view of the closure ring and winding actuator installed onto the lower base of  FIG. 14  during assembly of the laparoscopic device assembly of  FIG. 1 . 
         FIG. 16  is a top plan view of the stationary ring installed inside of the closure ring and lower base of  FIG. 15  during assembly of the laparoscopic device assembly of  FIG. 1 . 
         FIG. 17  is a top plan view of a bottom circumference of a tubular diaphragm twist seal and compression springs installed onto the stationary ring and a motor spring attached to the closure ring of the partially assembled laparoscopic device assembly of  FIG. 16  partially cut away to expose lock arms of the stationary disk engaged to lower recesses formed in the closure disk. 
         FIG. 18  is a top plan view of a top circumference of the tubular diaphragm twist seal attached to an opening ring of the partially assembled laparoscopic device assembly of  FIG. 17 . 
         FIG. 19  is a top plan view of the partially assembled laparoscopic device assembly of  FIG. 18  partially cut away to show a clockwise rotation made to the opening ring to allow spring blocks of the opening ring to drop in clockwise to channel blocks of the stationary ring as the lock arms of the opening ring are inwardly actuated by the inner diameter of the closure ring. 
         FIG. 20  is a top plan view of the partially assembled laparoscopic device assembly of  FIG. 19  after further clockwise rotation of the opening ring partially cut away to show engagement of the lock arms of the opening ring within upper recesses of the closure ring. 
         FIG. 21  is a top plan view of adding the actuating ring and the winding actuator to the partially assembled laparoscopic device assembly of  FIG. 20  to complete assembly. 
         FIG. 22  is a left side view in elevation of the assembled laparoscopic device assembly of  FIG. 21  with a staged cutaway through an upper pin of the opening ring, a counting hole of the stationary ring, and a winding pin of the closure ring. 
         FIG. 23  is a top plan view of the assembled laparoscopic device assembly of  FIG. 21  after a clockwise rotation of the actuating ring partially cut away to expose the clockwise rotation of the opening ring releasing motor stop arms of the stationary ring to release the closure ring for clockwise rotation. 
         FIG. 24  is a top plan view of the assembled laparoscopic device assembly of  FIG. 23  as the closure ring begins clockwise rotation and engages the lock arms of the opening ring. 
         FIG. 25  is a top plan view of the assembled laparoscopic device assembly of  FIG. 24  after the closure ring has full clockwise rotated, closing the twist seal and partially cut away to show the compressing of the compression springs between the spring blocks of the opening ring and the channel blocks of the stationary ring and the maintained engagement of the lock arms to the closure ring. 
         FIG. 26  is a top plan view of the assembled laparoscopic device assembly of  FIG. 25  after the actuating ring has been rotated clockwise partially cut away to expose the upper pins of the opening ring entering the clockwise terminations of the arcing grooves in the actuating ring that inwardly draw the lock arms out of engagement with the closure ring. 
         FIG. 27  is a top plan view of the assembled laparoscopic device assembly of  FIG. 26  as the stored energy of the compression spring and the fully closed twist seal are being leased into the opening ring as a counterclockwise rotation. 
         FIG. 28  is a top plan view of the assembled laparoscopic device assembly of  FIG. 27  after the opening ring completes the counterclockwise rotation so that the lock arms engage the next respective upper recesses in the closure ring, presenting an open condition of the twist seal. 
         FIG. 29  is a side view in vertical cross section through an alternative laparoscopic disk assembly. 
         FIG. 30  is a top detail view of the alternative laparoscopic disk assembly of  FIG. 29  horizontally cut away to show a closure lock arm of a closure ring engaged to a lower ratchet recess of a lower housing. 
         FIG. 31  is a top detail view of the alternative laparoscopic disk assembly of  FIG. 29  partially disassembled to show an opening lock arm of an opening ring engaged to an upper ratchet recess of a lower housing. 
         FIG. 32  is a top view of the alternative laparoscopic disk assembly of  FIG. 29  in an initial open state partially cut away to expose the closure and opening lock arms engaged to the lower housing. 
         FIG. 33  is a top view of the alternative laparoscopic disk assembly of  FIG. 32  partially cut away to expose the closure and opening lock arms as an actuating ring is rotated counterclockwise to disengage the closure lock arm from the lower housing. 
         FIG. 34  is a top view of the alternative laparoscopic disk assembly of  FIG. 33  partially cut away to expose the disengaged closure ring rotating clockwise one third of a rotation to reengage the lower housing at the next lower ratchet recess location. 
         FIG. 35  is a top view of the alternative laparoscopic disk assembly of  FIG. 34  partially cut away to expose an upward and small counterclockwise movement of the actuating ring to reposition an upper actuating pin of the opening lock arm to an adjacent arcing groove in the actuating ring to disengage the opening lock arm to release the opening ring for opening back to the state depicted in  FIG. 32 . 
         FIG. 36  is a plot diagram of measured reactive torque force of two types of twist seals as a function of a twist angle and a linear approximation of a power source transfer function for overcoming the reactive torque. 
     
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
     Referring now to  FIG. 1 , the environment for performing an endoscopic surgical procedure within an abdomen is illustrated, herein referred to as Hand Assisted Laparoscopic Surgery (HALS). A surgeon places a hand through a HALS laparoscopic disk assembly  10  that includes an exteriorly visible laparoscopic disk (seal cap)  12  attached to a retractor skirt  14  that retracts (widens) an incision  16  through an abdominal wall  18  of a patient. The retractor skirt  14  may be permanently affixed or detachable. The laparoscopic disk  12  provides an adjustable access channel  20  that may be readily opened with assistance of stored energy so that an instrument, depicted as a fingertip surgical instrument  22 , may be inserted through a tubular diaphragm twist seal  24  formed of materials such as isoprene, silicone, polyurethane and that provides an exterior pneumatic seal of the laparoscopic disk  12 . The instrument  22  passes through the incision  16  that is retracted (i.e., made wider) by a resilient waist  26  of the retractor skirt  14  through a lower opening  28  of the retractor skirt  14  which is defined by a flexible ring  30  that forms a lip of the retractor skirt  14 . The flexible ring  30  rests against an inner surface  32  of the abdominal wall  18  and surrounds the incision  16 . The flexible ring  30  allows insertion in a deformed state through the incision  16  with subsequent rebounding to the depicted relaxed, circular shape. 
     In  FIG. 2 , the laparoscopic disk  12  may be readily positioned to an open state wherein the tubular diaphragm twist seal  24  is only slightly twisted by positioning an upper actuating ring  34  to a counterclockwise position as viewed from above relative to a lower base  36 . A small outer portion  38  of the upper actuating ring  34  is cut away to allow this rotation to each side of a handle portion  40  of the lower base  36 . Finger ridges  42  about a larger outer portion  44  of the upper actuating ring  34  enhance single hand operation when the palm grasps the handle portion  40 . A winding actuator  46  extends outwardly proximate to and counterclockwise from the handle portion  40 . Shipping and storage of the laparoscopic disk is typically in an open state to avoid reducing the service life of the twist seal  24 . 
     In  FIG. 3 , the laparoscopic disk  12  may be readily positioned to a closed state wherein the tubular diaphragm twist seal  24  is fully twisted by positioning the upper actuating ring  34  to a clockwise position as viewed from above. Thus, the small outer portion  38  of the actuating ring  34  is shifted by pushing on the finger ridges. The detachable winding actuator  46  is removed, which may be the typical arrangement during use since sufficient energy is stored within the laparoscopic disk  12  for repeated opening and closing. It should be appreciated that the laparoscopic disk  12  may be partially opened to an intermediate state by rotating the actuating ring  34  on a portion, which may be desirable given the diameter of the hand or tool to reduce the loss of pneumatic insufflation pressure. A fully open position may be desirable when performing extracorporalization, the removal of internal organs. 
     In  FIG. 4 , the tubular diaphragm twist seal  24  is depicted prior to assembly in its cylindrical, relaxed shape. A top circumference  48  of the twist seal  24  passes up through an inner diameter  50  of an opening ring  52 , which is positioned under the upper actuating ring  34 , and stretched and curled outwardly and over an upwardly defined upper circular lip  54  of the opening ring  52 , held thereon by a top O-ring  56 . A bottom circumference  58  of the twist seal  24  extends downwardly through an inner diameter  60  of a lower stationary ring  62 , which is positioned below the opening ring  52 , and is stretched and curled outwardly and over a downwardly defined lower circular lip  64  on the stationary ring  62 , held thereon by a lower O-ring  66 . 
     A closure ring  70  has an inner diameter  72  with three radially spaced, clockwise ramped upper locking recesses  74  aligned for engagement with three radially spaced lock arms  76  extending outwardly from the encompassed opening ring  52 . The inner diameter  72  of the closure ring  70  also has three radially spaced, counterclockwise-ramped lower stop recesses  78  aligned for engagement with three radially spaced stop arms  80  extending outwardly from the encompassed stationary ring  62 . 
     An outer spool surface  82  of the closure ring  72  includes an elongate rectangular recess  84  having a button-headed post  86  attached near a counterclockwise end that is passed through a hole  88  in a narrow terminal tab  90  of a motor spring  92 . The lower base  36  has a handle recess  94  that is shaped to receive the motor spring  92  upon an integral vertical spindle  96 , with the recess  94  closed by a handle top cover  98  with fasteners  99 . A central hole  100  in the lower base  36  below which extends a circular engagement lip  102  ( FIG. 22 ), which receives an upper lip  104  of the retractor skirt  14 , is within an upwardly projecting circular ridge  105  that includes several radially spaced upwardly projecting pins  106  that engage the undersurface of the stationary ring  62 . A cylindrical recess  108  defined around the circular ridge  105  communicates with the handle recess  94  and is generally defined by an outer upward wall  110  whose outwardly reduced diameter portion  112  engages an outer groove  113  of a downward circular lip  114  from the larger outer portion  44  of the actuating ring  34  ( FIG. 22 ). Each end of the outer upward wall  110  transitions to each side of a three sided handle wall  116  that defines the handle recess  94 . A slit  118  passes laterally from adjacent to the handle portion  40  in a counterclockwise direction to receive the winding actuator  46 . 
     It should be appreciated that the illustrative version incorporates a motor spring  92  but that other biasing springs may be incorporated consistent with aspects of the invention, such as a constant force spring and a clock spring. In addition, biasing springs may include extension or compression springs. 
     An upwardly open circular spring channel  120  is defined into the stationary ring  62  circumscribing the inner diameter  60 , divided into two equal arcs  122  by a pair of channel blocks  124 . A pair of compression springs  126  reside respectively in each arc  122  positioned to contact a respective channel block  124  from a counterclockwise side when viewed from above. 
     In  FIGS. 5-6 , the upper actuating ring  34  is depicted as having three arcing grooves  128  that form a nearly complete circular pattern into an undersurface  130  ( FIG. 6 ) circumscribing a central large hole  132 . Each clockwise termination  134  (counterclockwise as viewed from below as in  FIG. 6 ) of each arcing groove  128  narrows by receding inwardly to a point and each counterclockwise termination  135  of the respective arcing groove  128  end in a squared off fashion. 
     In  FIGS. 7-8 , the opening ring  52  has an inner disk portion  136  defining an inner diameter  137  and with a pair of downwardly projecting spring blocks  138  ( FIG. 8 ) on opposite sides registered to be received in respective ones of the two equal arcs  122  of the spring channel  120  of the stationary ring  62 . An outer flange  140  attached to the inner disk portion  136  has three identical portions  142  that comprise a third of the circumference. Each includes a guiding portion  144  of about one-sixth of the circumference that is intended to contact for rotation the inner diameter  72  of the closure ring  70 . One of the three guiding portions  144  includes an upper seal alignment notch  146  used during assembly. Each identical portion  142  also includes an arm mount  148  that branches into the counterclockwise projecting lock arm  76  and a clockwise (viewed from above) projecting release arm  150 , with each generally extending to correspond to the encompassing inner diameter  72  of the closure ring  70 . Each lock arm  76  resiliently extends slightly outwardly when not urged inwardly by contact with the closure ring  70  for extending a locking tip  152  into locking engagement to the upper locking recess  74  of the closure ring  70  ( FIG. 4 ). An upward pin  154  ( FIG. 7 ) extending from each locking tip  152  is registered to travel in a respective one of the three arcing grooves  128  formed in the undersurface  130  ( FIG. 6 ). Each release arm  150  has a downward pin  158  ( FIG. 8 ) registered to interact with the stationary ring  62 . 
     In  FIGS. 9-10 , each equal arc  122  of the spring channel  120  of the stationary ring  62  receives one of the spring blocks  138  ( FIG. 8 ) from the opening ring  52 . The stationary ring  62  has an outer flange  160  divided into three identical portions  162 , with each including a holdout portion  164  of a substantial portion of a third of the circumference that is relieved on a counterclockwise portion  166  (when viewed from above) to form a counterclockwise projecting motor stop arm  168  with an upwardly projecting, parallelogram bypass key  170  outwardly biased to extend a motor stop corner  172  to engage the closure ring  70 . Each holdout portion  164  includes a mounting hole  174  that receives one of the projecting pins  106  from the lower base  36 . Each bypass key  170  presents a distal ramped surface  176  whose counterclockwise most corner is inward and a clockwise corner is outward with respect to the inner diameter  60 , which thus requires that an opposite ramped surface  178  be parallel. Thus, the motor stop arm  168  tends to be deflected inwardly by a clockwise moving downward pin  158  of the opening ring  52  and is allowed to remain outwardly engaged to the closure ring  70  by a counterclockwise moving downward pin  158  of the opening ring  52 . One of the holdout portions  164  includes a lower seal alignment notch  179  for reference during assembly. 
     In  FIG. 11-12 , the closure ring  70  is depicted in greater detail, including the upper locking recesses  74  aligned for engagement with the three radially spaced lock arms  76  extending outwardly from the encompassed opening ring  52  ( FIGS. 7-8 ) and the three radially spaced, counterclockwise-ramped lower stop recesses  78  for engagement with the three radially spaced stop arms  80  extending outwardly from the encompassed stationary ring  62 . In addition, in  FIG. 12 , A bottom surface  180  of the closure ring  70  has three radially spaced, downwardly projecting winding pins  182 . 
     In  FIG. 13 , the winding actuator  46  has a molded external gripping portion  184  attached to a thin clockwise projecting winding arm  186  with a hooked end  188  shaped to engage the winding pins  182  ( FIG. 12 ) for imposing a counterclockwise rotation to the closure ring  70  in opposition to the bias from the motor spring  92  ( FIG. 4 ). 
     In  FIGS. 14 and 4 , the lower base  36  is depicted as including a closure ring supporting surface  190  that closely circumscribes the upwardly projecting circular ridge  105  for supporting the bottom surface  180  of the closure ring  70 . The closure ring  70  in turn is closely circumscribed by a winding pin groove  192  that receives the winding pins  182 , which in turn is closely circumscribed by a hook supporting surface  194  of slightly deeper depth than the closure ring supporting surface  190  for guiding the winding arm  186  beneath the height of the bottom surface  180 , and thus below the closure ring  70 , as depicted in  FIG. 15 . 
     In  FIGS. 16-17 , in addition to the closure ring  70  added in  FIG. 15 , the stationary ring  62  has been inserted with the motor stop arms  168  outwardly relaxed in engagement to the lower stop recesses  68  ( FIG. 17 ) of the closure ring  70 . The lower seal alignment notch  179  is positioned on an opposite side of the lower base  36  to the handle portion  40 . In  FIG. 17 , the compression springs  126  are inserted into respective equal arcs  122  residing in contact from a counterclockwise side of a respective channel block  124 . The bottom circumference  58  ( FIG. 4 ) of the twist seal  24  has been installed onto the lower stationary ring  62  with the top circumference  48  of the twist seal  24  remaining relaxed. The motor spring  92  has also been installed upon the integral vertical spindle  96  with the tab  90  attached to the closure ring  70  to impart a clockwise bias. 
     In  FIG. 18 , the opening ring  52  has been prepared for installation with the upper seal alignment notch  146  positioned above the lower seal alignment notch  179  of the stationary ring  62  and the top circumference  48  of the twist seal  24  installed onto the opening ring  52 , presenting a fully open adjustable access channel  20 . The opening ring  52  has not been inserted within the inner diameter  72  of the closure ring  70  and thus the lock arms  76  of the closure ring  52  are in a relaxed, extended state above the closure ring  70 . 
     In  FIG. 19 , the opening ring  52  has been rotated clockwise less than a quarter turn until each spring block  138  of the opening ring  52  drops into a respective equal arc  122  of the spring channel  120  of the stationary ring  62  just clockwise of the respective channel blocks  124 , imparting a slight twist to the adjustable access channel  20 . The lock arms  76  are drawn out of the respective upper locking recesses  74  of the closure ring  70 . 
     In  FIG. 20 , the closure ring  52  has been further rotated clockwise, but still has not reached a quarter turn, until the lock arms  76  extend outwardly into the next encountered upper locking recesses  74  of the closure ring  70 . 
     In  FIG. 21 , the handle top cover  98  has been installed. The actuating ring  34  is at its counterclockwise most position such that each upward pin  154  extending from each locking tip  152  is received within the counterclockwise termination  134  respectively of one of the three arcing grooves  128  formed in the undersurface  130  of the actuating ring  34 . The winding handle  46  has been inserted into the lower base  36  and rotated counterclockwise until the hooked end  188  engages a winding pin  182  of the closure ring  70 . It should be appreciated that the winding handle  46  may be detachable or permanently affixed to the laparoscopic disk  10 . Thereby, one third of a counterclockwise rotation or more at a time may be imparted to the closure ring  60  to wrap the tab  90  around the spool surface  82  of the closure ring  70  to store the energy used thereafter in closing and opening the adjustable access channel  20  of the twist seal  24 . 
     In  FIG. 22 , the disk assembly  10  is depicted with engagement features radially aligned in cross section, including the circular engagement lip  102  that receives the upper lip  14  of the retractor skirt  14 , held in place by a bottom O-ring  196 . The lock arm  76  of the opening ring  52  is extended into locking engagement with the upper recess  74  of the closure ring  70  with the upward pin  152  residing in the acing groove  128  of the actuating ring  34 . The winding pin  182  extends down into the winding pin groove  192  formed in the lower base  36 . The projecting pin  106 , extending from the lower base  36 , passes into the mounting hole  174  of the stationary ring  62  for resisting rotation. The spool surface  82  of the closure ring  70  defines an annular recess for receiving the tab  90  of the motor spring  92  ( FIG. 4 ). The flexible ring  30  of the retractor skirt  14  is depicted as being assembled into lower opening  28 , which may allow for a desired amount of rigidity. 
     In  FIG. 23 , the actuating ring  34  is being turned clockwise such that the counterclockwise termination arcing grooves  128  impart a clockwise rotation to the upward pins  152  of the opening ring  52 , with the lock arms  76  being pulled out of any encountered upper recesses  74  of the closure ring  70  that may otherwise impede clockwise rotation of the closure ring  70 . Each release arm  150  of the opening ring  52  presents the downward pin  158  that encounters the distal ramped surface  176  of the bypass key  170  of the respective motor stop arm  168  of the stationary ring  62 , urging the motor stop arm  168  inwardly out of engagement with the respective lower recess  78  of the closure ring  70  ( FIG. 4 ). 
     In  FIG. 24 , with the closure ring  70  released from being blocked for clockwise rotation by both the opening and stationary rings  52 ,  62 , the stored energy of the motor spring  92  begins to rotate the closure ring  70 , which almost immediately results in the lock arms  76  reengaging the upper recesses  74  of the closure ring  70 . The upper pins  152  of the opening ring  52  do not impede the clockwise rotation of the opening ring  52  relative to the actuating ring  34  for the angular dimension of the respective arcing groove  128  of the actuating ring. Thus, in  FIG. 25 , the motor spring  92  rotates both the opening ring  52  and the closure ring  70  for approximately 30° one third of a rotation until the spring blocks  138  of the opening ring compress the respective compression spring  126  against the channel block  124  of the stationary ring  62 , and thus impart a like additional twist of the bottom circumference  58  of the twist seal  24  relative to the top circumference  48 , closing the adjustable access channel  20  to form a pneumatic seal. The upward pins  152  of the opening ring  52  are approaching the respective clockwise terminations  134  of the arcing grooves  128 , and have not yet been drawn inwardly but instead remain in the extended, locking condition. 
     In  FIG. 26 , the user has rotated the actuating ring  34  counterclockwise the amount allowed by the small outer portion  38  about the handle portion  40 , causing the clockwise termination  134  of the arcing groove  128  of the actuating ring  34  to present an inwardly ramping motion upon the respective upward pins  152  from the opening ring  52 , drawing the attached lock arms  76  inwardly out of engagement with the closure ring  70 . The compression springs  126  and the full twisted state of the adjustable access channel  20  of the twist seal  24  both impart a counterclockwise urging upon the opening ring  52 . 
     In  FIG. 27 , the opening ring  52  has begun to respond to this counterclockwise urging, releasing the compression springs  126  and allowing the twist seal  24  to open as the top circumference  48  rotates counterclockwise. The downward pin  158  of each release arm  150  of the opening ring  52  encounters the opposite ramping surface  178  of the bypass key  170  of the motor stop arms  168  of the stationary ring  62  and is urged inwardly, allowing the motor stop arms  168  to remain engaged within the lower recess  78  of the closure ring  70 . 
     In  FIG. 28 , the opening ring  52  has been fully rotated counterclockwise such that each lock arm  76  is allowed to engage the next encountered upper recess  74  of the closure ring  70 , preparing the laparoscopic device assembly  10  for the insertion of the surgeon&#39;s hand. The amount of biasing for closing and opening may be selected as approximate to achieve the desired amount of opening and closing at an appropriate rate, overcoming friction and resiliency characteristics of the twist seal  24 . Rapid closing (e.g., two seconds or less) is deemed efficacious to reduce pneumatic pressure loss. 
     In  FIGS. 29-35 , an alternate HALS laparoscopic disk assembly  210  incorporates two biasing springs, depicted as an upper motor spring  212  and a lower motor spring  214  that bias respectively an opening ring  216  and a closure ring  218  for independent movement in the same selected direction relative to an encompassing lower housing  220  for opening and closing. With particular reference to  FIG. 29 , a cylindrical lower bearing rail  222  of the lower housing  220  extends upwardly within a downwardly open cylindrical recess  224  formed in the closure ring  218 . In turn, a cylindrical upper bearing rail  226  of the closure rail  218  that is vertically aligned with the lower bearing rail  222  extends upwardly into a downwardly open cylindrical recess  228  formed in the opening ring  216 . These engagements constrain the rotational movement of the rings  216 ,  218  relative to the housing  220 . 
     An outward bobbin recess  230  formed outward from a downward cylindrical portion  232  of the closure ring  216  surrounding the lower bearing rail  226  forms a lower annular cavity  234  with a lower portion  236  of an upwardly projecting outer cylindrical wall  238  of the lower housing  220  for wrapping the lower motor spring  214  around the closure ring  218 . 
     In  FIGS. 29-30 , a closure lock arm  240  of the closure ring  218  resiliently extends outwardly received within a lower ratcheting recess  241  formed in the lower portion  236  of the lower housing  220 . A lower lip  242  contacts for rotational movement an inner diameter  243  of the upwardly projecting outer cylindrical wall  238  of the lower housing  220  and defines the lower limit of the bobbin recess  230 . In  FIG. 30 , an interrupted upper circumferential lip  244  of the closure ring  218  circumferentially brackets the one or more closure lock arms  240  for contacting for rotational movement the inner diameter  243  of the outer cylindrical wall  238  and defines the upper limit of the bobbin recess  230 . The closure lock arm  240  extends clockwise tending to abut a clockwise termination of the lower ratcheting recess  241 , preventing further clockwise rotation of the closure ring  218 . In  FIGS. 29-30 , the closure lock arm  240  upwardly presents a closing key  245  profiled to contact an inner side of a downward lower actuation pin  246  extending down from the opening ring  216 . Thus, a counterclockwise moving opening ring  216  unlocks the closure ring  218 . 
     Winding pins  247  extend downwardly from the downward cylindrical portion  232  of the closure ring  218  within an upwardly open annular winding pin recess  248  formed in the lower housing  220  outward from the lower bearing rail  222 . A winding actuator  250  presents an external handle  252  with an internal hook  254  extending inwardly for rotation within a horizontal winding slot  256  formed through the lower portion  236  of the lower housing  220  to engage and move a respective winding pin  247 . At least one winding ratchet arm  257  extends downwardly and clockwise from the opening ring  216  and is received in a counterclockwise upwardly ramped recess  259  formed on an upper surface of the closure ring  218 . Thus counterclockwise winding rotation of the closure ring  218  is communicated also to the opening ring  216 . 
     A downwardly projecting circular engagement lip  258  of the lower housing  220  surrounding an inner diameter  260  of the lower housing  220  has an outwardly open annular recess  262  that receives the upper lip  14  of the retractor skirt  14 , held in place by a bottom O-ring  264 . 
     The opening ring  216  is assembled from a lower disk portion  266  that has an outwardly open bobbin surface  268  and an upwardly cylindrical guide rail  270  that rotates again an actuating ring  272 . An upper disk portion  274  of the opening ring  216  has an upper lip  276  with an outwardly open annular recess  278  that receives the top circumference  48  of the twist seal  24  and is held there by a top O-ring  280 . The adjustable access channel  20  of the twist seal  24  passes through an inner diameter  281  of the opening ring  216  and an inner diameter  282  of the closure ring  218  with a bottom circumference  58  of the twist seal  24  downwardly stretched and curled outwardly and over a downwardly defined lower circular lip  284  and into an outwardly open annular recess  285  on the closure ring  218 , held thereon by a lower O-ring  286 . The upper disk portion  274  may be fastened to the lower disk portion  266  at a selected relative angular orientation, facilitating assembly with a proper angular pre-set of the twist seal  24 . 
     An upper portion  288  of the upwardly projecting outer cylindrical wall  238  includes an upper and outer cylinder edge  290  that contacts both a horizontal inner surface  292  and a vertical inner surface  294  of the actuating ring  272  at the circular attachment between a horizontal disk portion  296  and a downward cylindrical band  298  of the actuating ring  272 . The downward cylindrical band  298  terminates in an inward gripping lip  300  that snaps into an outwardly open annular recess  302  formed in the upper portion  288  below the outer guide lip  290 . 
     In  FIGS. 29 and 31 , the lower disk portion  266  of the opening ring  216  includes a lower lip  304  that contacts for rotational movement an inner diameter  306  of the upper portion  288  of the outer cylindrical wall  238  and defines a lower limit of the bobbin surface  268  of the opening ring  216 . At least one opening lock arm  308  radially bracketed by an interrupted upper circumferential lip  310  defines an upper limit of the bobbin surface  268 . The interrupted upper circumferential lip  310  contacts for rotational movement the inner diameter  306 . The opening lock arm  308  extends clockwise and is resiliently biased outwardly to engage a clockwise termination of an upper ratcheting recess  312  formed into an inner and upper portion of the inner diameter  306 , preventing further clockwise rotation of the opening ring  216 . An upper actuation pin  314  extends upwardly from the opening lock arm  308  to move within one of three downwardly presented arcing grooves  316  formed on the actuating ring  272  circumscribing a portion of a central large hole  318  of the actuating ring  272  that in turn surrounds the upper disk portion  274  of the opening ring  216 . In  FIG. 33 , each counterclockwise termination  320  (as viewed in cutaway from above) of each arcing groove  316  narrows by receding inwardly to a point and each clockwise termination  322  of the respective arcing groove  316  ends in a squared off fashion. Thus, a clockwise moving actuating ring  272  with the upper actuation pin  314  entering the counterclockwise termination  320  pulls inwardly the opening lock arm  308  out of engagement with the upper ratcheting recess  312 . 
     In  FIG. 32 , the laparoscopic disk assembly  210  is depicted with the adjustable access channel  20  defined by the amount of twist of the tubular diaphragm twist seal  24  in an open state. The opening lock arm  308  is engaged to the upper ratcheting recess  312  with the upper actuating pin  314  residing within the clockwise termination  322  of the arcing groove  316  of the actuating ring  272 . A small outer portion  324  of the upper actuating ring  272  is cut away to allow this rotation to each side of a handle portion  326  of the lower housing  220 . In  FIG. 32 , the small outer portion is rotated to a clockwise position with a larger opening to the left of the handle portion  326 . Finger ridges  328  about a larger outer portion  330  of the upper actuating ring  272  enhance single hand operation when the palm grasps the handle portion  326 . The closing lock arm  240  of the closure ring  218  is engaged to the lower ratcheting recess  241  with the closing key  245  just counterclockwise to the lower actuation pin  246  of the opening ring  216 . 
     In  FIG. 33 , the actuating ring  272  has been rotated counterclockwise. The arcing groove  316  has pulled the upper actuating pin  314  counterclockwise, rotating the opening ring  216  counterclockwise. Thereby, the lower actuation pin  246  ramps against the closing key  245 , pulling the closure lock arm  240  out of the lower ratchet recess  241 , releasing the closure ring  218  to rotate approximately one third of a clockwise rotation under the urging of the lower motor spring  214  until the closure lock arm  240  engages the next lower ratchet recesses  241 , as depicted in  FIG. 34 . 
     In  FIG. 35 , with the adjustable access channel  20  closed as previously described, the actuating ring  272  has been lifted while being rotated clockwise so that the upper actuating pin  314  moves from the clockwise termination  322  of one arcing groove  316  to the counterclockwise termination  320  of the adjacent arcing groove  316  that is clockwise thereto. Further clockwise movement of the actuating ring  272  that draws the upper actuating pin  314  radially inward disengages the opening lock arm  308  from the upper ratchet recess  312 , allowing the upper motor spring  212  to rotate the opening ring  216  clockwise, untwisting the twist seal  24 , until the opening lock arm  308  engages the next upper ratchet recess  312  approximately after one third of a rotation. 
     It should be appreciated that other unlocking implementations may be incorporated to selectively open and to selectively close the twist seal  24 . Further, it should be appreciated that rather than one third of a rotation, other spacing of ratchet recess may be incorporated into applications consistent with aspects of the invention, such as 1 or 2. Furthermore, while the upper motor spring  212  enhances the opening time of the lap disk assembly  210 , it should be appreciated that the stored torsional energy in the twist seal  24  may be sufficient to effect opening without the assistance of the motor spring  212  nor of the compression springs. 
     It should be appreciated that any patent, publication, or other disclosure material, in whole or in part, that is said to be incorporated by reference herein is incorporated herein only to the extent that the incorporated material does not conflict with existing definitions, statements, or other disclosure material set forth in this disclosure. As such, and to the extent necessary, the disclosure as explicitly set forth herein supersedes any conflicting material incorporated herein by reference. Any material, or portion thereof, that is said to be incorporated by reference herein, but which conflicts with existing definitions, statements, or other disclosure material set forth herein will only be incorporated to the extent that no conflict arises between that incorporated material and the existing disclosure material. 
     While the present invention has been illustrated by description of several embodiments and while the illustrative embodiments have been described in considerable detail, it is not the intention of the applicant to restrict or in any way limit the scope of the appended claims to such detail. Additional advantages and modifications may readily appear to those skilled in the art. 
     For example, while a passive biasing spring (e.g., motor spring) is depicted in the illustrative versions, applications consistent with aspects of the present invention may incorporate a powered source such as constant power source motor, battery, or pneumatics. The selected power source would provide closing power in excess of the reactive torque generated by the twist seal (e.g., isoprene, silicon), such as depicted in  FIG. 36 .