Abstract:
A surgical portal apparatus is provided which includes a housing and a portal member. The portal member is connected to the housing which extends therefrom. The portal member has a longitudinal axis which includes a longitudinal passageway for permitting a surgical object to pass therethrough. A seal mount is mounted to the housing and has an internal seal adapted to establish a substantial sealed relation with the surgical object, the seal mount adapted to articulate relative to the housing between a first position relative to the housing and at least one second position relative to the housing, the seal mount being normally biased toward the first position.

Description:
CROSS-REFERENCE TO RELATED APPLICATION(S) 
       [0001]    This patent application claims priority to and the benefit of U.S. Provisional Patent Application No. 61/163,490, filed in the U.S. Patent and Trademark Office on Mar. 26, 2009. 
     
    
     BACKGROUND 
       [0002]    1. Technical Field 
         [0003]    The present disclosure relates to a surgical portal apparatus adapted to permit the introduction of surgical instrumentation into a patient&#39;s body. In particular, the present disclosure relates to a surgical portal apparatus including an articulating valve system adapted to receive an instrument in sealing engagement therewith. 
         [0004]    2. Description of the Related Art 
         [0005]    Minimally invasive and laparoscopic procedures generally require that any instrumentation inserted into the body is sealed, i.e., provisions must be made to ensure that gases and/or fluids do not enter or exit the body through an endoscopic incision, such as, for example in surgical procedures where the surgical region is insufflated. For such procedure, the introduction of a tube into anatomical cavities, such as the peritoneal cavity, is usually accomplished by use of a system incorporating a trocar and cannula assembly. Since the cannula is in direct communication with the interior of the peritoneal cavity, insertion of the cannula into an opening in the patient&#39;s body to reach the inner abdominal cavity should be adapted to maintain a fluid tight interface between the abdominal cavity and the outside atmosphere. In view of the need to maintain the atmospheric integrity of the inner area of the cavity, a seal assembly for a cannula, which permits introduction of a wide range of surgical instrumentation and maintains the atmospheric integrity of the inner area of the cavity is desirable. In this regard, there have been a number of attempts in the prior art to achieve such sealing requirements. A difficulty encountered with conventional seal assemblies, however, is the inability of accommodating the wide range of sizes of instrumentation. In addition, angulation and/or manipulation of instrumentation within the cannula often present difficulties with respect to maintaining seal integrity. 
       SUMMARY 
       [0006]    Accordingly, the present disclosure is directed to a surgical portal apparatus which includes a housing and a portal member. The portal member is connected to the housing and extends therefrom. The portal member also defines a longitudinal axis, which includes a longitudinal passageway that permits a passage for a surgical object to be inserted therethrough. 
         [0007]    A seal mount is mounted to the housing and has an internal or object seal which is secured by a seal cap to establish a substantial sealed relation with the surgical object. The seal mount is articulated relative to the housing between a first position and a second position. A biasing member, (e.g., a spring), is mounted within the seal mount for biasing, (i.e., returning), the seal mount toward the first position relative to the housing. 
         [0008]    The seal mount includes an articulating segment defining an arcuate surface that cooperates with a corresponding surface of the housing to facilitate articulating movement of the seal mount upon offset manipulation of the surgical object. The housing defines an outer arcuate surface that cooperates with a corresponding surface of the seal mount during offset manipulation of the surgical object. The housing also defines a first axis and the seal mount defines a second axis, where the first axis and the second axis is in general alignment at the first position. 
         [0009]    The seal mount further includes an enclosure segment operatively connected to the articulation segment and engages the spring member to facilitate mounting of the spring member relative to the seal mount. 
         [0010]    Additionally, a closure valve is mounted between the seal housing and the base housing, where the closure valve is adapted to substantially close the longitudinal passageway in the absence of a surgical object. 
         [0011]    In embodiments, the seal cap and the seal mount may be connected by a bayonet-type fitting, a threaded fitting, a snap fitting, a glue fitting, or a weld fitting. In the same manner, the enclosure segment and the articulating segment may be connected by the above-mentioned connections. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0012]    The foregoing features of the present disclosure will become more readily apparent and will be better understood by referring to the following detailed description of embodiments, which are described hereinbelow with reference to the drawings wherein: 
           [0013]      FIG. 1  is a perspective view of a surgical portal apparatus in accordance with the principles of the present disclosure; 
           [0014]      FIG. 2  is a perspective view with parts separated of the portal apparatus; 
           [0015]      FIG. 3  is a perspective view of a seal cap and seal mount of the portal apparatus of  FIG. 1 ; 
           [0016]      FIG. 4  is a side cross-sectional view of an alternate embodiment of a seal mount of a portal apparatus; 
           [0017]      FIG. 5A  is a side cross-sectional view of the seal mount of  FIG. 1  showing the seal mount in a first position; 
           [0018]      FIG. 5B  is a side cross-sectional view of the seal mount of  FIG. 1  showing the seal mount in a second position; 
           [0019]      FIG. 6A  is a side cross-sectional view of the seal mount of  FIG. 1  showing a surgical object in a first position; and 
           [0020]      FIG. 6B  is a side cross-sectional view of the seal mount of  FIG. 1  showing the surgical object in a second position. 
       
    
    
     DETAILED DESCRIPTION 
       [0021]    A surgical portal apparatus  2  of the present disclosure provides access to underlying body tissue and also provides a substantial seal between a body cavity of a patient and the outside atmosphere before, during, and after insertion of an instrument. Moreover, the portal apparatus  2  of the present disclosure is capable of accommodating instruments of varying diameters, e.g., from 5 mm to 15 mm, by providing a substantially air tight seal when a surgical instrument is inserted therethrough. The present surgical portal apparatus allows a user, during endoscopic surgery, to utilize a variety of instruments having different diameters, which are often needed during a single surgical procedure. The surgical portal apparatus also provides various positions for the user to angulate the instrument within the body cavity of the patient by manipulating the instrument and a seal mount. 
         [0022]    The portal apparatus  2  incorporates a seal adapted for the introduction and manipulation of various types and sizes of instruments while maintaining a fluid tight interface about the instrumentation to preserve the atmospheric integrity of a surgical procedure from gas and/or fluid leakage. Specifically, the seal mount accommodates angular manipulation of the surgical instrument relative to the longitudinal axis of the portal apparatus. This feature of the present disclosure minimizes the stress put on the seal as the instrument is manipulated by the user. Examples of instrumentation include clip appliers, graspers, dissectors, retractors, staplers, laser probes, photographic devices, endoscopes and laparoscopes, tubes, and the like. Such instruments will be collectively referred to herein as “instruments or instrumentation”. 
         [0023]    In the following description, as is traditional, the term “proximal” refers to the portion of the instrument closest to the user, while the term “distal” refers to the portion of the instrument farthest from the user. 
         [0024]    Referring now to the drawings, in which like reference numerals identify identical or substantially similar parts throughout the several views, the figures illustrate the surgical portal apparatus  2  of the present disclosure. Portal apparatus  2  may be adapted for use as a cannula suitable for the intended purpose of accessing a body cavity, for example, the abdominal cavity, and permit introduction of instruments therethrough. As an alternate embodiment, portal apparatus  2  may be adapted to receive the hand and possibly the arm of the surgeon during a minimally invasive procedure where hand access is desired. Portal apparatus  2  is particularly adapted for use in laparoscopic surgery where the peritoneal cavity of the patient is insufflated with a suitable gas, e.g., CO 2 , to raise the cavity wall from the internal organs therein. Portal apparatus  2  is typically used with an obturator assembly (not shown) which is a sharp pointed instrument positionable within the passageway of the portal apparatus  2 . The obturator assembly is utilized to penetrate the abdominal wall and then subsequently removed from the portal apparatus to permit introduction of the surgical instrumentation utilized to perform the procedure. 
         [0025]    Referring now to  FIG. 1 , a portal apparatus  2  is illustrated having a portal member  4 , a seal mount  12  and a seal cap  20 . The seal mount  12  and its components will be discussed in further detail below. The portal member  4  includes a portal sleeve  6  having a proximal end  8  and distal end  10 , where a seal housing  18  is attached to the proximal end  8  of portal sleeve  6  by conventional means or may be integrally bound with sleeve  6 . The portal sleeve  6  defines a longitudinal axis “A” extending along the length of sleeve  6  and further defines an internal longitudinal passage  22  dimensioned to permit passage of surgical instrumentation. The sleeve  6  may be formed of stainless steel or any other suitable rigid material such as a polymeric material titanium, or the like. The sleeve  6  may also be configured to be clear or opaque to allow the user to monitor the instrument as it is being inserted and/or removed through the portal member  4 . The diameter of sleeve  6  may vary, but typically ranges from 10 to 15 mm for use with the seal housing  18  of the present disclosure. 
         [0026]    Turning now to  FIG. 2 , a perspective view is depicted with parts of portal apparatus  2  separated. The seal cap  20  is configured to attach on the proximal portion of seal mount  12 , which is also referred to as an enclosure segment  14  to secure and contain an object seal  24 . The seal mount  12  provides for mounting object seal  24  and to facilitate in maneuvering object seal  24  over the housing  18 . 
         [0027]    As depicted in  FIG. 3 , seal cap  20  is secured onto the enclosure segment of seal mount  12  by a bayonet-type fitting. The enclosure segment  14  defines an inner channel  25  alongside the perimeter and also having grooves  23 . Seal cap comprises a plurality of tabs  21 , which are defined on the inner lip of seal cap  20 . As the seal cap  20  is placed on the enclosure segment  14 , the tabs  21  are configured and dimensioned to pass through the grooves  23  of enclosure segment  14 . When seal cap  20  is placed into grooves  23 , seal cap may be rotated, in either a clockwise or counter-clockwise direction, where tabs  21  are guided within the inner channel  25 . The inner channel  25  of enclosure segment  14  may also have a slight incline to guide tabs  21  along the inner channel  25 . As tabs  21  move along the inner channel  25 , a frictional force may be exerted towards tabs  21 , thus creating a secure seal towards object seal  24 . In embodiments, seal cap  20  may be connected to seal mount  12  by any conventional technique including a snap fit arrangement, threaded coupling, clamp coupling, bayonet coupling, etc. 
         [0028]    During a surgical procedure, the user may require to use a different type and/or sized surgical instrument. When a situation such as this occurs, the user may remove the seal cap  20  from the portal apparatus  2  and replace the existing object seal  24  with a different sized object seal. By replacing only the object seal, the user may safely and effectively use a different type sized surgical instrument, without the need of replacing portal apparatus  2  with a different type and/or sized portal apparatus. 
         [0029]    Additionally, in accordance with the present disclosure, object seal  24  may be constructed from a rubber or any other suitable elastomeric material contemplated in the art. As mentioned above, the longitudinal passageway  22  of object seal  24  may vary in size depending on the types of instruments being utilized. During the surgical procedure, the object seal  24  is configured to minimize the loss of insufflated gasses through portal member  4  by forming a substantial seal about surgical object “I”, e.g., surgical instrument, as shown in  FIGS. 6A and 6B . 
         [0030]    Turning now to  FIG. 4 , another embodiment of a portal apparatus  102  having a seal mount  112  is configured in a one-piece design. The seal mount  112  includes a seal cap  120 , an object seal  124 , a biasing member  128 , and a zero-closure valve  126 , as similarly shown in portal apparatus  2 . The seal cap  120  and the object seal  124  are secured onto seal mount  112  in a similar fashion as mentioned above with respect to portal apparatus  2 . The one-piece seal mount  112  may be constructed from an elastic material to allow the articulating segment of seal mount  112  to expand over seal housing  118 , thus allowing seal mount  112  to have substantially similar manipulative properties as seal mount  12 , which will be described in detail below. 
         [0031]    Referring back to  FIG. 2 , the enclosure segment  14  of seal mount  12  facilitates to the securement of closure valve on to housing  18 . Articulating segment  16  is configured in a cup-shaped design and is constructed from any suitable material or combinations of materials (e.g., metal or plastic, polyurethane, etc). The articulating segment  16  of seal mount  12  includes a spherical internal surface to provide a rotational swiveling motion around the bottom portion of housing  18 . 
         [0032]    The seal mount  12  also includes a biasing member  28  which is contained within the enclosure segment  14  and the articulating segment  16 , where both segments define a biasing member channel  12   a . The biasing member  28 , (e.g., a spring) helps to facilitate in restoring seal mount  12  to return to a first position, which is a flat, normally perpendicular position with respect to housing  18 . As shown in  FIGS. 6A and 6B , the biasing member  28  provides a comfortable, flexible and resistive motion thus allowing the seal mount  12  to be articulated about housing  18  by a user to any second position, defining the “B” axis. The seal mount  12  is adapted to return back to the first position relative to the housing  18 , which is along the “A” axis, upon the user selecting the surgical instrument “I”. 
         [0033]      FIG. 2  also illustrates a zero-closure valve  26  enclosed and situated within enclosure segment  14  and housing  18 . Zero-closure valve sits on housing  18 , while enclosure segment  14  facilitates securement to zero-closure valve  26 . Closure valve  26  may be a duck bill valve, which tapers distally and inwardly to a sealed configuration as shown in the figure. Valve  26  opens to permit passage of the surgical instrumentation and closes in the absence of the instrumentation “I”. The valve  26  is adapted to close upon exposure to the forces exerted by the insufflation gases in the internal cavity. Other zero closure valves are also contemplated including single or multiple slit valve arrangements, trumpet valves, flapper valves, etc. 
         [0034]      FIGS. 5A and 5B  illustrates a side cross-sectional view of portal apparatus  2 , further illustrating the seal mount  12  in first and second positions. Both housing  18  and seal mount  12  contain longitudinal passageways, axis “A” and variable axis “B”, respectively. When both housing  18  and seal mount  12  are in the first position, (i.e., aligned with each other), the instrument “I” passes through seal mount  12  and housing  18 , thus passing through both longitudinal passageways “A” and “B”. Housing  18  is in a fixed position relative to the portal apparatus  2 . However, seal mount  12  is not fixed in one position, as mentioned above, and is movable about housing  18 . Movement of the seal mount  12  is provided by articulating segment  16  of seal mount  12  having an arcuate surface. The inner arcuate surface of seal mount  12  cooperates with the outer arcuate surface of housing  18  to facilitate articulating movement of seal mount  12  upon any offset manipulation of instrument “I”, shown in  FIG. 6A . 
         [0035]    As shown in  FIG. 6B , seal mount  12  may be moved to a second position, along the variable “B” axis, which may be anywhere articulating member  16  may rotate and swivel around housing  18 . When seal mount  12  is in a first position, seal mount  12  and housing  18  are in alignment with each other, thus axis “A” and axis “B” are in alignment with each other. When seal mount  12  is in a second position, seal mount  12  and housing  18  are not in alignment, thus the position of axis “B” varies and is not in alignment with axis “A”. 
         [0036]    As shown in  FIGS. 6A and 6B , instrument “I” passes further distally into seal mount  18 , passing through zero closure valve  26  and portal sleeve  6  and into the body cavity of a patient (not shown). The above-mentioned articulation, allows the user to easily manipulate instrument “I”, without adding substantial stress to the internal seals of portal apparatus  2 , since the seal mount  12  is configured to substantially move about axis “B” along with instrument “I”. 
         [0037]    While the invention has been particularly shown, and described with reference to the embodiments, it will be understood by those skilled in the art that various modifications and changes in form and detail may be made therein without departing from the scope and spirit of the invention. Accordingly, modifications such as those suggested above, but not limited thereto, are to be considered within the scope of the invention.