Abstract:
A surgical portal apparatus includes a portal housing, an elongated portal member connected to the portal housing and depending therefrom, and a seal member comprising a resilient material and being mounted to the portal housing. The portal housing and the portal member have an axial bore for reception and passage of a surgical object. The seal member includes leading and trailing faces and has inner portions defining a passage to permit passage of a surgical object. One of the leading and trailing faces defines a plurality of recessed cells formed within interconnected struts. The interconnected struts are relatively flexible to flex upon radial offset manipulation of the object to permit corresponding movement of the passage while substantially maintaining a seal about the surgical object. At least some of the recessed cells define a generally rectangular arrangement. Preferably, the leading end face of the seal member has the recessed cells.

Description:
CROSS REFERENCE TO RELATED APPLICATION 
     The present application claims the benefit of and priority to U.S. Provisional Application Ser. No. 61/075,533 filed on Jun. 25, 2008, the entire contents of which are incorporated herein by reference. 
    
    
     BACKGROUND 
     1. Technical Field 
     The present disclosure relates to a surgical portal for accessing underlying body tissue to permit the introduction of surgical objects in conjunction with a medical procedure. More particularly, the present disclosure relates to a surgical portal including a seal defining a gridiron or waffle pattern adapted to flex and facilitate offset manipulation of a surgical object while substantially maintaining a sealing relation therewith. 
     2. Discussion of Related Art 
     Surgical portals are employed in various minimally invasive procedures including laparoscopic or endoscopic procedures. Such portals are inclusive of trocar cannulas, catheters, or, in the event of a minimally invasive hand assist procedures, hand access devices. Surgical portals typically incorporate a seal mechanism to form a fluid tight seal about an instrument or hand passed through the portal. The seal mechanisms, however, often are limited by their ability to sustain a seal when an instrument, particularly, a smaller diameter instrument, is moved off-axis relative to a central axis of the portal. Moreover, the seal mechanisms are also limited by their ability to sustain their integrity when the surgical instrument is angulated. Such extreme ranges of motion of smaller diameter surgical instruments within the portal can create a “cat eye” or crescent shaped gap about the instrument resulting in fluid loss (e.g., insufflation gas loss). 
     SUMMARY 
     Accordingly, the present disclosure is directed to a surgical portal apparatus. The surgical portal apparatus includes a portal housing, an elongated portal member connected to the portal housing and depending therefrom, and a seal member comprising a resilient material and being mounted to the portal housing. The portal housing and the portal member have an axial bore for reception and passage of a surgical object. The seal member includes leading and trailing faces and has inner portions defining a passage to permit passage of a surgical object. One of the leading and trailing faces defines a plurality of recessed cells formed within interconnected struts. The interconnected struts are relatively flexible to flex upon radial offset manipulation of the object to permit corresponding movement of the passage while substantially maintaining a seal about the surgical object. At least some of the recessed cells define a generally rectangular arrangement. Preferably, the leading end face of the seal member has the recessed cells. 
     The trailing end face of the seal member may define a seal recess circumscribing the passage to facilitate reception and passage of the surgical object through the passage. The seal recess may be generally annular. The seal member may include an annular seal collar depending from the trailing end face. The annular seal collar includes an internal wall surface which may be tapered to facilitate alignment of the surgical object with the passage during introduction of the surgical object within the seal member. The trailing end face may include an internal tapered wall circumscribing the passage to facilitate alignment of the surgical object with the passage during passage through the seal member. 
     The seal member may define an aperture therethrough functioning as the passage. The seal member may comprise a gel material. A zero closure seal may be disposed within the portal housing to substantially close the axial bore in the absence of the surgical object. 
     Other embodiments are also envisioned. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       Preferred embodiments of the present disclosure will be better appreciated by reference to the drawings wherein: 
         FIG. 1  is a perspective view with parts separated of the surgical portal apparatus in accordance with the principles of the present disclosure illustrating, the seal assembly and the surgical portal assembly; 
         FIG. 2  is a side cross-sectional view of the seal assembly and the portal housing of the surgical portal assembly; 
         FIG. 3  is a perspective view with parts separated of the seal assembly of the surgical portal apparatus; 
         FIGS. 4 and 5  are frontal and rear perspective views of the seal member of the seal assembly; 
         FIGS. 6 and 7  are front and rear plan views of the seal member of the seal assembly; 
         FIG. 8  is a side plan view of the seal member; and 
         FIGS. 9 and 10  are frontal and rear perspective views of an alternate embodiment of the seal member of the seal assembly. 
     
    
    
     DETAILED DESCRIPTION OF THE EMBODIMENTS 
     The portal apparatus of the present disclosure is capable of accommodating objects of varying diameters, e.g., including instruments from about 4.5 millimeter (mm) to about 15 millimeter (mm), during a minimally invasive surgical procedure. Moreover, the portal apparatus contemplates the introduction and manipulation of various types of surgical objects or instrumentation adapted for insertion through a trocar and/or cannula assembly while maintaining a fluid tight interface about the instrumentation to prevent gas and/or fluid leakage from the established pneumoperitoneum so as to preserve the atmospheric integrity of a surgical procedure. Specifically, the portal apparatus includes a seal assembly which facilitates lateral and/or angular manipulation of the surgical instrument while also maintaining a seal about the instrument. 
     Examples of instrumentation contemplated for use with the portal apparatus include clip appliers, graspers, dissectors, retractors, staplers, laser probes, photographic devices, endoscopes and laparoscopes, tubes, obturators and the like. Such instruments will be collectively referred to herein as “instruments or instrumentation”. 
     In the following discussion, the term “proximal” or “trailing” will refer to the portion of the portal apparatus nearest to the clinician during operation while the term “distal” or “leading” will refer to that portion of the portal apparatus most remote to the clinician. 
     Referring now to the drawings, in which like reference numerals identify identical or substantially similar parts throughout the several views,  FIG. 1  illustrates the portal apparatus  100  of the present disclosure. Portal apparatus  100  includes portal assembly  200  and seal assembly  300 . Seal assembly  300  may be an integral component of portal assembly  200 , or, in the alternative, may be releasably connectable to the portal assembly  200  via various contemplated means. Seal assembly  300  will be discussed in greater detail hereinbelow. Portal assembly  200  may be any member suitable for the intended purpose of accessing a body cavity and typically defines a passageway permitting introduction of instruments or the clinician&#39;s hand therethrough. Portal assembly  200  is particularly adapted for use in laparoscopic surgery where the peritoneal cavity is insufflated with a suitable gas, e.g., CO 2 , to raise the cavity wall from the internal organs therein. Portal assembly  200  is typically used with an obturator assembly  400  which may be blunt, a non-bladed, or a sharp pointed instrument positionable within the passageway of the portal apparatus  100 . Obturator assembly  400  is utilized to penetrate the abdominal wall to introduce the portal apparatus  100  through the abdominal wall, and then subsequently is removed from the portal assembly  200  to permit introduction of the surgical instrumentation utilized to perform the procedure through the passageway. An example of suitable obturator assembly  400  is disclosed in commonly assigned U.S. Pat. No. 6,497,716 to Green et al., the entire contents of which are incorporated herein by its entirety. 
     Portal assembly  200  includes portal housing  202  and portal member  204  connected to the portal housing  202  and extending therefrom. Portal member  204  defines a longitudinal axis “k” extending along the length of the portal member  204 . Portal housing  202  and portal member  204  further define internal longitudinal passage  206  dimensioned to permit passage of surgical instrumentation. Portal member  204  may be formed of any suitable medical grade material, such as stainless steel or other rigid materials, including polymeric materials, such as polycarbonate, or the like. Portal member  204  may be transparent or opaque. The diameter of portal member  204  may vary, but, typically ranges from about 4.5 millimeters (mm) to about 15 millimeters (mm). Portal housing  202  and portal member  204  may be separate components securely connected to each other, or, in the alternative may be a single monolithically formed unit. 
     Referring now to  FIGS. 1-2 , portal housing  202  defines a generally circular cross-section and possesses diametrically opposed leg portions  208 . Zero closure seal  210  fabricated from a resilient material, e.g., rubber, is positioned within the interior of portal housing  202 . Seal  210  includes circumferential flange portion  210   a  which rests on a correspondingly dimensioned circumferential ledge  212  within portal housing  202 . Seal  210  generally defines a duck bill shape having two planar tapering portions  216  which intersect at their distal ends to define slit  218 . Slit  218  permits passage of the elongated object through the seal  210 , but, in the absence of an instrument, and particularly when portal member  204  is positioned within an insufflated body cavity, slit  218  closes to seal longitudinal passage  206 . Seal  210  also includes at least one, preferably two, reinforcing ribs  220  to stabilize the seal. Ribs  220  are positioned to engage the instrument to guide the instrument through slit  218  and prevent piercing of the seal  210  by the tip of the instrument. 
     Portal assembly  200  also includes stabilizing plate  220  which is positioned against flange portion  210   a  of seal  208  to provide support for seal  208  during introduction and withdrawal of an elongated instrument. Stabilizing plate  220  includes two diametrically opposed extensions  222  ( FIG. 1 ) which are received within the correspondingly dimensioned leg portions  228  of portal housing  202 . In the preferred embodiment, stabilizing plate  220  is securely attached to the portal housing  202  at contact points along the extensions of the respective components by spot welding, adhesives or the like. 
     Stop cock valve  226  may be incorporated as part of portal housing  202  to permit the passage of insufflation gases through portal member  204  and into the body cavity. A suitable valve for this purpose is available from the Burron OEM Division of B. Braun Medical, Inc. (Model No. 55401022). 
     Referring now to  FIG. 3 , in conjunction with  FIG. 2 , the seal assembly  300  of surgical portal apparatus  100  will be described in detail. Seal assembly  300  includes end cap  302 , stabilizer plate  304 , seal member  306  and seal housing  308 . End cap  302 , stabilizer plate  304  and seal housing  308  form the outer seal body of seal assembly  300 , which houses the sealing component, i.e., seal member  306 . 
     End cap  302  is generally cylindrically-shaped and includes a proximal end portion  302   a  defining a diameter which is less than the diameter of the remaining portion of the end cap  302  and an inner peripheral ledge  310  which supports stabilizer plate  304 . Stabilizer plate  304  defines an aperture  312  and assists in supporting seal member  306  and retaining the seal member  306  between end cap  302  and seal housing  308 . Seal housing  308  includes central opening  312 , and defines inner annular rib  314 . Seal housing  308  receives end cap  302  when in the assembled condition to enclose the sealing components. The distal end face of seal housing  308  includes two opposed rib portions  316  extending radially inwardly. Rib portions  316  assist in mounting seal assembly  300  to portal assembly  200  as will be appreciated from the description provided below. 
     Referring now to  FIGS. 4-8 , in conjunction with  FIGS. 2-3 , seal member  306  will be discussed in detail. Seal member  306  is mounted within seal housing  308  by any conventional means. For example, seal member  306  may be secured within end cap  302  and secured between inner peripheral ledge  310  and inner annular rib  314  of seal housing  308 . Seal member  306  may be secured within seal housing  308  in a manner to prevent longitudinal or radial movement of the entire seal member, i.e., secured in fixed relation with end cap  302  and seal housing  308 . 
     Seal member  306  is generally disk shaped and defines leading (distal) and trailing (proximal) ends faces  318 ,  320 . Trailing end face  320  includes an annular recess  322  generally concentrically arranged about seal axis “m”. Annular recess  322  is in communication with central seal aperture or passage  324 . Annular recess  322  may be adapted to receive and/or guide the surgical object toward seal aperture  324  during introduction of the surgical object. 
     Seal aperture  324  extends through leading and trailing end faces  318 ,  320  of seal member  300 . Seal aperture  324  is defined within inner seal portions  326  ( FIG. 2 ) and is adapted to expand upon insertion of the object whereby the inner seal portions  326  defining the seal aperture  324  establish a fluid tight seal about the surgical object. Although shown as a circular in configuration, seal aperture  324  may assume the configuration including rectangular and may also be in the form of a slit. 
     Leading end face  318  defines a grid or waffle structure having a plurality of interconnected struts  328  with recesses  330  therebetween. Struts  328  preferably extend in perpendicular arrangement to define rectangular or square recesses  330  at least adjacent central seal aperture  324 . Recesses  330  adjacent the outer periphery of seal member  306  may include an arcuate outer side as provided by the circular periphery of the seal member. 
     Struts  328  define a lattice structure which is capable of flexing during offset or angular manipulation of a surgical object and return to its original configuration upon removal of the object. Moreover, the lattice or waffle geometry assists in preventing “cat-eyeing” that is caused by off-axis manipulation of the surgical object. In particular, struts  328  with the assistance of recesses  330  are capable of flexing to permit seal aperture  326  to follow the off-set motion of the instrument. 
     Seal member  306  may accommodate instruments ranging from 4.5 mm to about 12.5 mm in diameter, to seal against a minimum pressure of 12 mm Hg provided by an insufflated body cavity and create very little frictional force with instruments inserted through the seal member. Seal member  306  may be fabricated from suitable thermoplastic elastomers. In the alternative, seal member  306  may be fabricated from a low durometer thermoplastic elastomer or a gel material. Other materials are also envisioned. 
     The assembly of seal assembly  300  now will be discussed. Stabilizer plate  304  is positioned within end cap  302  such that the plate  304  rests on inner peripheral ledge  310  defined within the end cap  302 . Thereafter, seal member  306  is positioned onto stabilizer plate  304 . Seal housing  308  is positioned over the entire unit with the seal housing  308  receiving the distal portion of end cap  302 . In this assembled condition, seal member  306  is trapped between inner peripheral ledge  310  of end cap  302  and annular rib  314  of seal housing  308 . 
     Seal assembly  300  now in its fully assembled condition can be mounted to portal assembly  200 . With reference to  FIGS. 1-3 , assembled seal assembly  200  is detachably mounted adjacent stabilizing plate  228  with the partial annular thread  228  ( FIG. 2 ) of the stabilizing plate  220  being received within peripheral groove  322  defined in seal housing  308 . Seal assembly  300  is rotated to cause engagement of the radially inwardly projecting rib portions  316  with partial annular thread  228  to releasably lock the seal assembly  200  to the cannula housing  202 . Other means for detachably connecting the seal assembly  200  to cannula housing  202  can be readily determined by one skilled in the art such as screw threads, adhesives, bayonet locking, and the like. 
       FIGS. 9-10  illustrate an alternate embodiment of seal member  500 . In accordance with this embodiment, seal member  500  includes leading and trailing end faces  502 ,  504 . Trailing or proximal end face  504  includes an annular wall  506  depending therefrom. Annular wall  506  defines an enlarged aperture  508  for receiving the surgical object to guide the surgical object toward seal aperture  510 . Annular wall  506  may include inner tapered wall surface  512  to also assist in guiding the surgical object toward the seal axis “m”. Trailing end face  504  further defines a tapered wall surface  514  circumscribing seal aperture  510  to guide the surgical object toward the aperture. 
     Leading end face  502  of seal member  500  includes a gridiron or waffle arrangement defined by a plurality of perpendicular struts  516  in intersecting relation. Adjacent parallel struts  516  are spaced a greater distance than the prior embodiment to define relatively enlarged rectangular recesses  518 . This arrangement may provide greater flexibility than the embodiment of  FIGS. 1-8  to further assist or permit offset manipulation of the surgical object. 
     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.