Abstract:
An access assembly is provided. The access assembly includes an access member defining a central longitudinal axis and having a longitudinal opening therethrough for reception and passage of surgical instrument, the access member dimensioned for positioning within tissue to provide access to underlying tissue, and first and second seal members mounted to the access member in juxtaposed relation, the first seal member defining an opening therethrough, the second seal member defining an elongated arcuate passage, wherein the first and second seal members are adapted for rotational movement about the central longitudinal axis whereby the opening of the first seal member is axially alignable with the elongated arcuate passage of the second seal member to permit reception and passage of the surgical instrument in substantial sealed relation therewith, the first and second seal members further adapted for relative rotational movement whereby the first seal member is capable of rotating relative to the second seal member during manipulation and traversal of the surgical instrument through the elongated arcuate passage of the second seal member to maintain the substantial sealed relation about the instrument.

Description:
CROSS REFERENCE TO RELATED APPLICATION 
     The present application claims the benefit of and priority to U.S. Provisional Application Ser. No. 61/053,064 filed on May 14, 2008, the entire contents of which are incorporated herein by reference. 
    
    
     BACKGROUND 
     1. Technical Field 
     The present disclosure relates to assemblies for accessing a body cavity, and more particularly, the disclosure relates to an access assembly for receiving more than one instrument therethrough, and for manipulating the instruments relative to each other. 
     2. Background of Related Art 
     Trocars and other access assemblies are used by surgeons to operate on a patient without having to create large incisions that may become infected and may cause major scaring. Access assemblies are known in the art, as are the instruments inserted therethrough for operating within the body cavity. Typically, an access assembly includes a housing configured receiving an instrument, and a tubular member or cannula affixed to the housing and configured for insertion into a body cavity. These assemblies generally include at least one seal mounted within the housing and/or cannula to prevent the escape of insufflation gas. 
     Tradition access assemblies are configured to receive a single instrument. Therefore, a surgeon must use multiple access assemblies to complete an operation requiring the simultaneous use of more than one instrument. Inserting multiple access assemblies into a patient increases the length of the procedure, as well as increases the potential sites for infection and/or complications. 
     Therefore, it would be beneficial to have an access assembly capable of receiving more than one instrument. It would further be beneficial if, once received, the instruments could be manipulated relative to one another. 
     SUMMARY 
     An access assembly is provided. The access assembly includes an access member defining a central longitudinal axis and having a longitudinal opening therethrough for reception and passage of surgical instrument, the access member dimensioned for positioning within tissue to provide access to underlying tissue, and first and second seal members mounted to the access member in juxtaposed relation, the first seal member defining an opening therethrough, the second seal member defining an elongated arcuate passage, wherein the first and second seal members are adapted for rotational movement about the central longitudinal axis whereby the opening of the first seal member is axially alignable with the elongated arcuate passage of the second seal member to permit reception and passage of the surgical instrument in substantial sealed relation therewith, the first and second seal members further adapted for relative rotational movement whereby the first seal member is capable of rotating relative to the second seal member during manipulation and traversal of the surgical instrument through the elongated arcuate passage of the second seal member to maintain the substantial sealed relation about the instrument. 
     In the access assembly, the opening of the first seal member and the elongated arcuate passage of the second seal member are radially spaced from the central longitudinal axis. The elongated arcuate passage is arranged to at least partially circumscribe the central longitudinal axis. Each of the first and second seal members includes the opening and the elongated arcuate passage whereby the opening of the second seal member is axially alignable with the elongated arcuate passage of the first seal member to permit reception and passage of a second surgical instrument in substantial sealed relation therewith. 
     The access assembly may include a third seal member mounted to the access member in juxtaposed relation with the second seal member, the third seal member including the opening and the elongated arcuate passage therethrough, the third seal member adapted for rotational movement about the central longitudinal axis. The third seal member may be adapted for rotational movement relative to at least one of the first and second seal members. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The foregoing summary, as well as the following detailed description will be better understood when read in conjunction with the appended figures. For the purpose of illustrating the present disclosure, a preferred embodiment is shown. It is understood, however, that the present disclosure is not limited to the precise arrangement and instrumentalities shown. 
         FIG. 1  is a cross-sectional side view of an access assembly according to embodiment of the present disclosure; 
         FIG. 2  is a top view of a seal member of the access assembly of  FIG. 1 ; 
         FIG. 3  is a top view of the seal member of  FIG. 2  including seal members; 
         FIG. 4  is a cross-sectional side view of the seal members of the access assembly of  FIG. 1 ; 
         FIG. 5  is a cross-sectional side view of the seal members of  FIG. 4  receiving an endoscopic instruments therethrough; 
         FIG. 6  is a top view of the seal members of  FIGS. 4 and 5  including endoscopic instruments inserted therethrough; 
         FIG. 7  is a top view of the seal members of  FIGS. 4-6  as the first and second seal members are rotated relative to each other; 
         FIG. 8  is a cross-sectional side view of an alternate embodiment of seal members according to the present disclosure; 
         FIG. 9  is a cross-sectional side view of an alternate embodiment of a seal member according to the present disclosure; 
         FIG. 10  is a top view of another embodiment of a seal member according to the present disclosure; 
         FIG. 11  is a top view of yet another embodiment of a seal member according to the present disclosure; 
         FIG. 12  is a top view of still another embodiment of a seal member according to the present disclosure; 
         FIG. 13  is a top view of further embodiment of a seal member according to the present disclosure; 
         FIG. 14  is a top view of another embodiment of a seal member according to the present disclosure; and 
         FIG. 15  is a top view of yet another embodiment of a seal member according to the present disclosure. 
     
    
    
     DETAILED DESCRIPTION 
     Referring now to the drawings wherein like reference numerals illustrate similar components throughout the several views. As shown in the drawings and as described throughout the following description, as is traditional when referring to relative positioning on an object, the term “proximal” refers to the end of the apparatus which is closer to the user and the term “distal” refers to the end of the apparatus which is further from the user. 
     With reference initially to  FIG. 1 , an embodiment of an access assembly in accordance with the aspects of the present disclosure is shown generally as access assembly or member  10 . Access assembly  10  includes a housing  12  and a cannula  14  extending from housing  12 . Access assembly  10  defines a longitudinal passageway  11  having a central axis “X”. Access assembly  10  is configured for receiving one or more endoscopic instruments “I 1 ”, “I 2 ” ( FIG. 5 ) therethrough. 
     Still referring to  FIG. 1 , housing  12  defines a cylindrical cavity  13  for receiving a first and second seal member  20 ,  30 , although it is envisioned that cavity  13  may be configured to receive any number of seal members. As will be described in further detail below, seal members  20 ,  30  are configured to cooperatively receive one or more endoscopic instruments “I 1 ”, “I 2 ” in a sealing manner. Seal members  20 ,  30  are further configured to permit the manipulation of endoscopic instruments “I 1 ”, “I 2 ” relative to one another and relative to housing  12 . Cylindrical cavity  13  is sized and dimensioned such that seal members  20 ,  30  may rotate freely about axis “X” relative to housing  12  and relative to each other. Seal members  2   0 ,  30  are sealed within housing  12  by an O-ring  16  or other suitable sealing means. 
     Seal members  20 ,  30  will now be described with reference to  FIGS. 2 and 3 . Seal members  20 ,  30  are substantially identical, and therefore will only be described as relates to seal member  20 . Referring initially to  FIG. 2 , seal member  20  includes a substantially circular base member  22  defining an opening  24  radially spaced from axis “X” ( FIG. 1 ) and an elongated arcuate slot  26  radially spaced from and at least partially circumscribing about central axis “X”. Opening  24  and slot  26  are sized and dimensioned to receive endoscopic instruments “I 1 ”, “I 2 ” therethrough. Arcuate slot  26  defines an elongated arcuate passage extending through an arc “m” which subtends an angle “k” greater than 0° with respect to the axis “X”. Alternatively, the angle “k” may be at least 90° with respect to the central longitudinal axis, or at least 180° with respect to the axis “X”. 
     Turning now to  FIG. 3 , seal member  20  includes a first seal element  25  secured within opening  24 . Seal member  20  further includes a second seal element  27  secured within slot  26 . Each of first and second seal elements  25 ,  27  are configured to receive endoscopic instrument “I 1 ”, “I 2 ”, respectively, in a sealing manner. First seal element  25  includes a flat flexible ring defining an opening  25   a . First seal element  25  is configured to stretch in order to accommodate an endoscopic instrument “I 1 ” in a sealing manner. Alternatively, or in addition, first seal element  25  may define a zero-closure seal such that opening  24  is sealed in the absence of endoscopic instrument “I”. Second seal element  27  includes first and second over-lapping flexible members  28   a ,  28   b  ( FIG. 4 ). First and second over-lapping members  28   a ,  28   b  define a slit  29  extending substantially the length of slot  26  for reception of endoscopic instrument “I 2 ”. 
     With reference now to  FIGS. 4-7 , operation of access assembly  10  will be described. As discussed above, although the following description will relate only to first and second seal members  20 ,  30 , it is envisioned that access assembly  10  may be modified to accommodate three or more seal members. Initially first seal member  20  is positioned adjacent to second seal member  30  such that opening  24  of first seal member  20  is in vertical alignment with a slot  36  formed in seal member  30 . In this manner, when a first endoscopic instrument “I 1 ” is inserted through first seal element  25  of first seal member  20  instrument “I 1 ” also passes through a second seal element  37  of second seal member  30 . As will be discussed in further detail below, the configuration of first and second seal elements  25 ,  37  of first and second seal members  20 ,  30 , respectively, increases the integrity of the seal about endoscopic instrument “I 1 ”, thereby reducing the amount of insufflation gas that may escape through access assembly  10 . This is particularly important as endoscopic instrument “I 1 ” is manipulated within access assembly  10  and also as endoscopic instrument “I 1 ” is manipulated relative to endoscopic instrument “I 2 ”. First seal element  25  and second seal element  37  operate together to reduce cat-eyeing or other deformation of seal elements  25 ,  37  during manipulation of endoscopic instrument “I 1 ” that would otherwise compromise the integrity of seal elements  25 ,  37  individually. 
     Still referring to  FIGS. 4-7 , a second endoscopic instrument “I 2 ” may be received through slot  26  of seal element  27  and passes through opening  25   a  of first seal element  25 . Thus, second endoscopic instrument “I 2 ” is also received through a double seal for increased integrity of the seal. Once received through access assembly  10  in the manner described above, first and second endoscopic instrument “I 1 ”, “I 2 ” may be rotated together with respect to housing  12  ( FIG. 1 ). In this manner, first and second seal members  20 ,  30  rotate as one, as indicated by arrow “A” in  FIG. 6 , within cavity  13  ( FIG. 1 ) of access assembly  10 . Additionally, first and second endoscopic instrument “I 1 ”, “I 2 ” may be manipulated relative to each other within access assembly  10 . In this manner, first and second seal members  20 ,  30  rotate relative to each other, as indicated by arrow “B” and “C” in  FIG. 7 , within cavity  13  of access assembly  10 . A lubricant (not shown) may be provided between first and second seal members  20 ,  30  to reduce the friction therebetween and to permit free rotation thereof. The configuration of first and second seal elements  25 ,  35 ,  27 ,  37  of first and second seal members  20 ,  30 , respectively, also permit first and second endoscopic instrument “I 1 ”, “I 2 ” to be individually manipulated. In this manner, first and second endoscopic instruments “I 1 ” I 2 ” may be moved in any direction relative to each other and to housing  12  ( FIG. 1 ). 
     Turning now to  FIGS. 8 , alternate embodiment of first and second seal members  20 ,  30  are shown generally as first and second seal members  120 ,  130 . First and second seal members  120 ,  130  are substantially similar to first and second seal member  20 ,  30  and will only be described as relates to the differences therebetween. First and second seal member  120 ,  130  will be described as relates to first seal member  120 . First seal member includes an opening  124  having first seal element  125  and a slot  126  including a second seal element  127 . First and second seal elements  125 ,  127  include bristles for receiving a first and second endoscopic instruments “I 1 ”, “I 2 ” therethrough in a sealing manner. Alternatively, the bristles may be replaced by tubular members ( FIG. 9 ). 
     Turning to  FIG. 9 , an alternate embodiment of first and second seal elements  25 ,  27  are shown generally as first and second seal elements  225 ,  227 . First and second seal elements  225 ,  227  include a pair of tubular bumpers  225   a ,  225   b ,  227   a ,  227   b , respectively. The operation of tubular bumpers  225   a ,  225   b ,  227   a ,  227   b  will be described as relates to tubular bumpers  225   a ,  225   b . Tubular bumpers  225   a ,  225   b  are vertically spaced apart within opening  224  of seal member  220 . Tubular members  225   a ,  225   b  are sized and dimensioned such that opening  224  is sealed in the absence of an endoscopic instrument “I 1 ” being inserted therethrough. Tubular members  225   a ,  225   b  are further configured to received an endoscopic instrument “I 1 ” therethrough in a sealing manner. Tubular bumpers  225   a ,  225   b  deform to accommodate the passage of endoscopic instrument “I 1 ” through opening  224  in a sealing manner. A fluid “F” may be included between tubular bumpers  225   a ,  225   b  to increase the integrity of the seal around endoscopic instrument “I 1 ”. 
     Alternative seal members and seal elements for access assembly  10  will now be described in detail with reference to  FIGS. 10-15 . Throughout the following description, similar elements will be identified with like numerals. 
     Turning initially to  FIG. 10 , a seal member  320  includes a rim  322 , a hub  323  and an inner member  324  extending from hub  323 . Inner member  324  is configured to ride within a groove  322   a  formed in rim  322  and groove  323   a  formed in hub  323 . As shown, inner member  324  includes three first seal elements  325 ; however, it is envisioned that inner member  324  may include more or fewer first seal elements  325 . Although shown formed as a single unit, each of first seal elements  325  formed in inner member  324  may instead be individually formed such that each first seal element  325  may be moved relative to each other. Each of first seal elements  325  is configured to receive an endoscopic instrument therethrough. Seal member  320  further includes a second seal element  327  formed from a flexible sheet and including a slit  329 . Slit  329  is configured to receive an endoscopic instrument therethrough in a sealing manner. As with first and second seal elements  25 ,  37  described hereinabove with respect to seal members  20 ,  30 , first and second seal elements  325 ,  327  operate to reduce leakage of insufflation gases as endoscopic instruments “I 1 ”, “I 2 ”, inserted therethrough, are manipulated. Second seal element  327  may be affixed to rim  322 , inner member  324  or may alternatively be formed as a second seal member. 
     Turning now to  FIG. 11 , seal member  420  is substantially similar to seal member  320  and will only be described as relates to the differences therebetween. Seal member  420  includes rim  422 , a hub  423  extending from rim  422 , and an inner member  424  including first seal elements  425 . Seal member  420  is configured such that inner member  424  may be rotated relative to rim  422  and hub  423 . A second seal element  427  is attached to rim  422  and hub  423 . 
     With reference now to  FIG. 12 , seal member  520  includes a rim  522 , a hub  523  and an inner member  524 . Inner member  524  may be affixed to hub  523 . Alternatively, inner member  524  may be configured to move independent of hub  523 . Hub  523  includes extensions  523   a  configured to ride within a groove (not shown) formed in rim  522 . Inner member  524  includes first seal elements  525 . Seal member  520  further includes a second seal element  527 . 
     Turning now to  FIG. 13 , seal member  620  is substantially similar to seal member  520 . Seal member  620  includes a rim  622 , and first, second and third hub portion  623   a ,  632   b ,  623   c , and corresponding inner members  624   a ,  624   b ,  624   c . Although three hub portions are shown, it is envisioned that seal member  620  may include two or more hub portions. Hub portions  623   a ,  623   b ,  623   c  are configured to ride in independent grooves (not shown) formed in rim  622 . Each inner member  624   a ,  624   b ,  624   c  corresponds to a first seal element  625   a ,  625   b ,  625   c , respectively. Seal member  620  further includes a second seal element  627 . 
     With reference now to  FIG. 14 , seal member  720  includes a rim  722 , a hub  723  spanning rim  722  and an inner member  724  affixed to hub  723 . Hub  723  and inner member  724  are configured to ride within a groove (not shown) formed in rim  722 . Inner member  724  includes three first seal elements  725 , although two or more seal elements may be included. Seal member  720  further includes a second seal element  727 . 
     Turning now to  FIG. 15 , yet another embodiment of the present disclosure is shown generally as seal member  820 . Seal member  820  includes a rim  822 , a first inner member  824   a , an inner ring  823   a , a second inner member  824   b , and a hub  823   b . Each of first inner member  824   a , second inner member  824   b  and hub  823   b  include a first seal element  825  and are configured to rotate relative to and independent of each other. Seal member  820  further includes at least a second seal element  827 . 
     Although the illustrative embodiments of the present disclosure have been described herein with reference to the accompanying drawings, it is to be understood that the disclosure is not limited to those precise embodiments, and that various other changes and modifications may be effected therein by one skilled in the art without departing from the scope or spirit of the disclosure.