Patent Publication Number: US-11045222-B1

Title: Method of reducing insufflation gas leakage from a trocar

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This patent application claims priority as a continuation from co-pending U.S. Non-Provisional Patent Application Ser. No. 17/092,954, filed 9 Nov. 2020, entitled “METHOD OF REDUCING INSUFFLATION GAS LEAKAGE FROM A TROCAR”, which has a common applicant herewith and being incorporated herein in its entirety by reference. 
    
    
     FIELD OF THE DISCLOSURE 
     The disclosures made herein relate generally to sealing devices and, more particularly, to sealing devices for use with apparatuses such as, for example, surgical instruments used during manual and robotic surgical procedures that have an extension portion that is engaged with a sealing device. 
     BACKGROUND 
     Surgical procedures utilizing in vivo visualization of target surgical sites are well known as a form of a concealed operation site. Examples of these surgeries include, but are not limited to, endoscopic surgery, laparoscopic surgery, thoracoscopic surgery and the like. These surgical procedures all utilize a surgical instrument having an integrated visualization device for providing in vivo visualization of a target surgical site within a surgical space of the patient. Although it is common for the surgical instrument to be referred to in the context of the specific type of surgical procedure (e.g., endoscope for endoscopic surgery, laparoscope for laparoscopic surgery, and the like), these surgical instruments are generally referred to herein as an “endoscope”. 
     As shown in  FIG. 1 , an endoscope  1  used in these surgical procedures is characterized as having a user interface portion  5  and an extension member  10  connected at its proximate end  15  to the user interface portion  5 . Scopes for endoscopic surgery generally have an extension member that is substantially flexible, whereas scopes for other types of surgical procedures—e.g., for laparoscopic surgery, as shown in  FIG. 1 —generally have an extension member  10  that is substantially rigid. The extension member  10  has an imaging element  20  such as a lens at its distal end portion  25 . The imaging element  20  can have an exposed surface that is typically generally flush with or that defines an end face of the extension member  10 . The imaging element  20  is connected to an optical fiber or other image transmitting element that is internal to the endoscope. The optical fiber or other image transmitting element extends along the length of the extension member  10  and terminates at an eyepiece  30  on the user interface portion  5 . The eyepiece  30  enables the imaging element  30  to be connected to a visualization device (e.g., a camera connected to a visual display console) through which target surgical sites can be viewed by surgery personnel. 
     As shown in  FIG. 2 , during a surgical procedure, the endoscope  1  (i.e., a surgical instrument) is operably engaged with a trocar  50  (i.e., an example of a surgical implement). As is well known in the art, trocars such as the trocar  50  serve as an access device for placing a surgical instrument through an abdominal wall  52  of a patient. The trocar  50  has a seal housing  54  and a cannula  56  attached to the seal housing  54 . A central passage  57  of the trocar  50  (i.e., the working channel) extends through the seal housing  54  and the cannula  56 , thereby defining a working channel extending through the trocar  50  along a longitudinal axis L of the trocar  50 . The central passage  57  has an inside diameter sized as a function of an outside diameter of an extension member of a surgical instrument intended to be used with the trocar  50  (e.g., extension member  10  of the endoscope  1 ). The cannula  56  is adapted for being placed through the abdominal wall  52  of the patient. Once the trocar  50  is placed, the extension member of the endoscope  1  (or other type of surgical instrument) is placed through the working channel of the trocar  50  for enabling abdominal cavity access for a distal end of the endoscope  1 . The seal housing  54  includes one or more seals for providing the functionalities of limiting leakage of insufflation gas when the surgical instrument is within the working channel of the trocar  50  and, limiting leakage of insufflation gas when the surgical instrument is withdrawn from within the working channel of the trocar  50 . Conventional seals integral to trocars are well known in the art. 
     It is also well known in the art that a surgical instrument such as, for example, the endoscope  1  is moved in a plurality of movement directions during a surgical procedure while engaged with a trocar. For example, as shown in  FIG. 2 , the endoscope  1  is well known to be moved in an axial direction along a longitudinal axis L of the trocar  50  (i.e., axial movement), to be moved in a pivotal manner about one or more pivot axes extending perpendicular to the longitudinal axis L of the trocar  50  (i.e., pivotal movement) and to be moved rotationally about the longitudinal axis L of the trocar  50  (i.e., rotational movement). Additionally, the longitudinal axis of the endoscope  1  can be laterally offset of the longitudinal axis L of the trocar  50  (i.e., not colinear axes). The one or more seals of the trocar  50  are intended to provide sufficient mitigation of insufflation gas leakage during such types of movement of the surgical instrument. Conventional trocars are known to exhibit insufflation gas leakage during both static positioning and dynamic movement of a surgical instrument engaged with a trocar. 
     Limiting insufflation gas leakage at the interface of a trocar and surgical instrument is desirable for several long-standing reasons. One such long-standing reason is maintaining necessary insufflation of a patient&#39;s abdominal cavity. Another such long-standing reason is reducing cost of insufflation gas utilized during a surgical procedure. Still another such long-standing reason is reducing gas-carried particles from compromising sealing functionality provided by the one or more seals of the trocar. 
     Notably, the recent emergence of coronavirus disease COVID-19 presents a new and potentially crucial reason for limiting insufflation gas leakage at the interface of a trocar and surgical instrument. Prior to its leakage, insufflation gas resides within the abdominal cavity. As such, for a patient who is positive for COVID-19, the insufflation gas may become contaminated from exposure to particulate matter (e.g., solid, liquid and/or gaseous materials) within the patient&#39;s abdominal cavity. Accordingly, the potential exists for leaked insufflation gas to expose medical personnel within an operating room to coronavirus and to contaminate the operating room with coronavirus. For apparent reasons, both of these potential situations are highly undesirable. Thus, particularly in view of the emergence of COVID-19, it is desirable to further limit, if not inhibit, the levels of insufflation gas leakage present at the interface of a trocar and surgical instrument during a surgical procedure when a conventional trocar is used for providing abdominal cavity access. 
     Therefore, an effective, efficient and reliable approach for improving insufflation gas containment within a trocar would be advantageous, desirable and useful. 
     SUMMARY OF THE DISCLOSURE 
     Embodiments of the present disclosure are directed to improving insufflation gas containment during a surgical procedure when a trocar is used for providing abdominal cavity access. More specifically, embodiments of the present disclosure are directed to improving insufflation gas containment in relation to trocars (and/or other related type of devices) that are used for enabling a surgical instrument such, for example, a laparoscope, to gain access to an abdominal cavity (or other body cavity). By providing for such improved insufflation gas containment, embodiments of the present disclosure are advantageous, desirable and useful in view of long-standing reasons for limiting insufflation gas leakage and in view of newly recognized reasons stemming from outbreak of COVID-19 disease for limiting insufflation gas leakage. 
     In one or more embodiments of the present disclosure, a sealing device for atrocar configured for use with a surgical instrument comprises an extension member seal and a securement body attached to the extension member seal. The extension member seal has a central passage with a diameter enabling an extension member of the surgical instrument to be sealingly engaged therewith. The securement body includes an elongated skirt in a rolled configuration and wherein the elongated skirt is adapted for being unrolled into secure engagement with one or more side surfaces of a seal housing of the trocar. 
     In one or more embodiments of the present disclosure, a sealing device for atrocar configured for use with a surgical instrument comprises an extension member seal and a securement body attached to the extension member seal. The extension member seal comprises a sealing member, a compressive force material and a retention body. The opposing end portions of the sealing member are each retained by a respective one of spaced-apart sealing member retention portions of the retention body whereby an interior space is provided between the sealing member and the retention body and wherein the compressive force material extends around the sealing member in contact therewith within the interior space. The securement body includes one or more engagement portions adapted for being selectively engageable with a seal housing of the trocar. 
     In one or more embodiments of the present disclosure, a trocar comprises a trocar body and extension member seal mounted within the central passage of the seal housing. The trocar body comprising a seal housing and a cannula attached to the seal housing, wherein a longitudinal axis of a central passage of the seal housing is colinearly with a longitudinal axis of a central passage of the cannula. The extension member seal comprises a sealing member, a compressive force member and a retention body. The opposing end portions of the sealing member are each retained by a respective one of the spaced-apart sealing member retention portions of the retention body whereby an interior space is provided between the sealing member and the retention body. The compressive force member extends around the sealing member in contact therewith within the interiorspace. 
     In one or more embodiments of the present disclosure, a method of reducing insufflation gas leakage from a trocar comprising a plurality of steps. A step is performed for providing a trocar comprising a seal housing and a cannula attached to the seal housing. The trocar has a working channel jointly defined by a central passage of the seal housing and a central passage of the cannula. A longitudinal axis of the central passage of the seal housing extends colinearly with a longitudinal axis of the central passage of the cannula thereby jointly defining a longitudinal axis of the working channel. A step is performed for providing a sealing device comprising an extension member seal and a securement body attached to the extension member seal. One or more seal housing engagement portions of the securement body are selectively engageable with the seal housing. A step is performed for contacting the sealing device with a top surface of the seal housing. Thereafter or in conjunction with contacting the sealing device with a top surface of the seal housing, a step is performed for engaging said one or more seal housing engagement portions of the securement body with the seal housing. 
     It is an object of one or more embodiments of the present disclosure for the elongated skirt to extend entirely around the extension member seal and the elongated skirt to be concentric with the central passage of the extension member seal. 
     It is an object of one or more embodiments of the present disclosure for the elongated skirt to be a sleeve and the sleeve is attached at an end portion thereof to the extension member seal. 
     It is an object of one or more embodiments of the present disclosure for the elongated skirt being adapted for being unrolled including the elongated skirt being made from a conformable, elastic material. 
     It is an object of one or more embodiments of the present disclosure for the elongated skirt, the sealing member, or both to be made from one of a material comprising silicone and a material consisting essentially of silicone. 
     It is an object of one or more embodiments of the present disclosure for a support body to be attached to the extension member seal, for the support body to include a central passage through which the central passage of the extension member seal is accessible, for the support body to be attached to an upper portion of the extension member seal and for the elongated skirt to be positioned adjacent to a lower portion of the extension member seal. 
     It is an object of one or more embodiments of the present disclosure for the compressive force member to be a ring-shaped member. 
     It is an object of one or more embodiments of the present disclosure for the ring-shaped member to be a helically-wound spring having at least one of opposing end portions thereof overlapping and opposing end portions thereof attached thereto. 
     It is an object of one or more embodiments of the present disclosure for the ring-shaped member to be an O-ring. 
     It is an object of one or more embodiments of the present disclosure for the sealing member to be a sleeve having opposing end portions thereof engaged with the spaced-apart sealing member retention portions of the retention body. 
     It is an object of one or more embodiments of the present disclosure for engagement of the compressive force member with the sealing member to cause the compressive force member to be in a radially-expanded state such that a compressive force is exerted on the sealing member by the compressive force member. 
     It is an object of one or more embodiments of the present disclosure for the compressive force material to be engaged with the sealing member such that the compressive force material is a radially-expanded state to cause a compressive force is exerted on the sealing member by the compressive force material. 
     It is an object of one or more embodiments of the present disclosure for the compressive force material to comprise one of a ring-shaped piece of material and a c-shaped piece of material. 
     It is an object of one or more embodiments of the present disclosure for the compressive force material to comprise a helically-wound spring having at least one of opposing end portions thereof overlapping and opposing end portions thereof attached thereto. 
     It is an object of one or more embodiments of the present disclosure for the compressive force material to comprise a fluidic material. 
     It is an object of one or more embodiments of the present disclosure for the fluidic material to at least partially fill the interior space between the sealing member and the retention body. 
     It is an object of one or more embodiments of the present disclosure for a method to include the step of aligning a longitudinal axis of a central passage of the extension member seal with the longitudinal axis of the working channel prior to or in conjunction with contacting the sealing member with the sealing housing. 
     It is an object of one or more embodiments of the present disclosure for the step of aligning the longitudinal axis of the central passage of the extension member seal with the longitudinal axis of the working channel in conjunction with contacting the sealing device with the top surface of the seal housing to includes inserting a distal end portion of an extension member through the central passage of the extension member seal inserting the distal end portion of the extension member into the working channel. 
     It is an object of one or more embodiments of the present disclosure for a method to include the step of aligning the longitudinal axis of the central passage of the extension member seal with the longitudinal axis of the working channel prior to performing contacting the sealing member with the seal housing. 
     It is an object of one or more embodiments of the present disclosure for a method to include the steps of placing the cannula through an abdominal wall of a patient prior to contacting the sealing member with the seal housing, inserting a distal end portion of an extension member of a laparoscope through the central passage of the extension member seal after placing the trocar and prior to engaging tone or more seal housing engagement portions of the securement body with the seal housing, and inserting the distal end portion of the extension member into the working channel after placing the trocar and prior to engaging the one or more seal housing engagement portions of the securement body with the seal housing. 
     It is an object of one or more embodiments of the present disclosure for the one or more seal housing engagement portions of the securement body to comprise an elongated skirt in a rolled configuration, for the elongated skirt to be adapted for being unrolled into secure engagement with one or more side surfaces of the seal housing and for engaging the one or more seal housing engagement portions of the securement body with the seal housing to comprise unrolling the elongated skirt. 
     These and other objects, embodiments, advantages and/or distinctions of the present disclosure will become readily apparent upon further review of the following specification, associated drawings and appended claims. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  is a perspective view of a prior art endoscope; 
         FIG. 2  is a diagrammatic view showing a prior art trocar with the prior art endoscope of  FIG. 1  engaged therewith; 
         FIG. 3A  is top perspective view showing a first embodiment of a trocar sealing device in accordance with the disclosures made herein; 
         FIG. 3B  is bottom perspective view of the trocar sealing device shown in  FIG. 3A ; 
         FIG. 3C  is a cross-sectional view taken along the line  3 C- 3 C in  FIG. 3A ; 
         FIG. 3D  is a diagrammatic view showing the prior art trocar of  FIG. 2  with the trocar sealing device of  FIGS. 3A-3C  installed thereon; 
         FIG. 4A  is top perspective view showing a second embodiment of a trocar sealing device in accordance with the disclosures made herein; 
         FIG. 4B  is bottom perspective view of the trocar sealing device shown in  FIG. 4A ; 
         FIG. 4C  is a cross-sectional view taken along the line  4 C- 4 C in  FIG. 4A ; and 
         FIG. 5  is a perspective view showing an embodiment of a trocar in accordance with the disclosures made herein. 
     
    
    
     DETAILED DESCRIPTION 
     Referring to  FIGS. 3A-3D , a first embodiment of a trocar sealing device (sealing device  100 ) in accordance with the disclosures made herein is shown. The sealing device  100  includes a support body  102 , an extension member seal  104  and a securement body  106 . Jointly, as shown in  FIG. 3D  and discussed below in greater detail, the support body  102 , the extension member seal  104  and the securement body  106  enable the sealing device  100  to be mounted on a seal housing of a trocar (e.g., the seal housing  54  of the trocar  50  of  FIG. 2 ). Advantageously, the sealing device  100  has a structural configuration allowing it to be mounted on the trocar and to impart the trocar with supplemental sealing functionality that serves to improve insufflation gas containment when an extension member of a surgical instrument (e.g., the endoscope  1  discussed above in reference to  FIG. 1 ) is movably engaged with the trocar during a surgical procedure. 
     The support body  102  is engaged with an upper end portion  108  of the extension member seal  104 . As shown in  FIG. 3C , the extension member seal  104  has a groove  110  (i.e., an engagement feature) that is engaged with a flange member  111  (i.e., a mating engagement feature) of the extension member seal  104 . The support body  102  has a central passage  112  through which a central passage  114  of the extension member seal  104  is accessibly. The support body  102  provides a rigid or semi-rigid structural element to engage (e.g., grasp by fingers or a hand) during installation of the sealing device  100  on a trocar. The support body  102  is preferably round but can have an overall shape other than round and can include contoured portions for enhancing finger engagement. The support body  102  can be made from a rigid or semi-rigid material (e.g., a polymeric material such as a thermoplastic or thermosetting material). Alternatively, the support body  102  can be made from a material exhibiting elasticity, but where a shape and/or bulk of the support body  102  provides the support body  102  with a rigid or semi-rigid configuration. The extension member seal  104  can be made from a resilient material—e.g., a latex material, an elastomeric material, a synthetic rubber material, or the like. In preferred embodiments, the extension member seal  104  can be made from a material comprising or consisting essentially of silicone. 
     The central passage  114  of the extension member seal  104  is round (or approximately round) and has an inside diameter that can be specified as a function of an outside diameter of an extension member of surgical instruments intended to be used with a trocar on which the sealing device  100  is mounted. For example, if the trocar is designed for use with surgical instruments having has an extension member with a 5 mm outside diameter, the central passage  114  of the extension member seal  104  can be dimensioned as a function of the 5 mm outside diameter of the extension member. More specifically, the central passage  114  of the extension member seal  104  can have an inside diameter that is 0.X mm smaller than the outside diameter of the extension member, Y % smaller than the outside diameter of the extension member, or the like. The underlying objective of dimensional specification of the inside diameter of the central passage  114  of the extension member seal  104  is to form secure engagement of the material of the extension member seal  104  defining the central passage  114  around the extension member of the surgical instrument, particularly during the various modes of movement of the surgical instrument relative to the trocar—i.e., lateral. axial, pivotal and rotational movements. 
     The securement body  106  can be attached directly to the extension member seal  104 , as shown. Alternatively, the securement body  106  can be attached to the support body  102  or to both the support body  102  and the extension member seal  104 . It is disclosed herein that such attachment of the securement body  106  can be provided by one or more known attachment techniques—e.g., adhesive, thermal bonding, mechanical fixation, or the like. In one or more embodiments of the disclosures made herein, the support body  102  can be omitted 
     As best shown in  FIGS. 3C and 3D , the securement body  106  comprises an elongated skirt  116  (i.e., a trocar engaging member) that is provided in a rolled configuration and that can be unrolled onto the seal housing of a trocar (e.g., the seal housing  54  of the trocar  1  shown in  FIG. 2 ). The elongated skirt  116  extends around the extension member seal  104  and is concentric with the central passage  114  of the extension member seal  104 . The elongated skirt  116  preferably has a wall thickness and is made from a material having resilient and elastomeric properties enabling the elongated skirt  116  to be provided in a rolled configuration and to be unrolled into secure engagement with the seal housing of a trocar. In addition to enabling the elongated skirt  116  to be rolled and unrolled, the resilient and elastomeric properties of the material from which the elongated skirt  116  is made enables the elongated skirt  116  to exert compressive force on the seal housing of the trocar when unrolled onto it for securing the sealing device  100  in a generally fixed position on the seal housing. When the seal housing of the trocar has a non-uniform shape and/or has protrusions extending therefrom, the resilient and elastomeric properties of the material from which the elongated skirt  116  also enables the elongated skirt  116  to stretch over (i.e., be sufficiently elastic) and/or conform to such non-uniform shape and/or protrusions (i.e., be sufficiently conformable). Examples of materials exhibiting sufficient conformability and elasticity include, but are not limited to, a latex material, an elastomeric material, a synthetic rubber material, or the like. In preferred embodiments, at least the elongated skirt  116  of the securement body  106  can be made from a material comprising or consisting essentially of silicone and can be in the form of a thin-walled piece of elastic and/or conformable sleeve (e.g., a piece of tubing). 
     Referring to  FIG. 3D , engagement of the sealing device  100  onto the seal housing of a trocar (e.g., the seal housing  54  of the trocar  50  of  FIG. 2 , as shown) preferably includes the central passage  114  of the extension member seal  104  to be axially aligned (e.g., precisely aligned as opposed to generally aligned) with the central passage of the trocar (e.g., the central passage  57  of the trocar  50 , as shown). Such alignment serves to cause the extension member seal  104  to exert substantially uniform force onto the extension member of a surgical instrument engaged within the central passage of the trocar, thereby aiding in providing the desired secure engagement of the material of the extension member seal  104  defining the central passage  114  around the extension member of the surgical instrument, particularly during the aforementioned various modes of movement of the surgical instrument relative to the trocar. 
     The elongated skirt  116  of the securement body  106  is a one example of a trocar engaging element of sealing devices in accordance with the disclosures made herein. In other embodiments of one or more other sealing devices in accordance with the disclosures made herein, trocar engaging elements can have different constructions. Examples of such other constructions can include, but are not limited to, one or more engagement members (e.g., legs, protruding tabs, circumferential ring, etc.) that extend from the support body and/or extension member seal into engagement with one or more passages extending through an exterior surface of the seal housing (i.e., mating feature(s) in the form of one or more seal housing engagement portions), one or more engagement members (e.g., legs, protruding tabs, circumferential ring, etc.) that extend from the support body and/or extension member seal into engagement with one or more recess(es) within the exterior surface of the seal housing (i.e., mating feature(s) in the form of one or more seal housing engagement portions), one or more engagement members (e.g., legs, protruding tabs, circumferential ring, etc.) that extend from the support body and/or extension member seal into mechanical, adhesive and/or frictional engagement with one or more exterior surfaces of the seal housing (i.e., mating feature(s) in the form of one or more seal housing engagement portions), or the like. 
       FIGS. 4A-4C  show a second embodiment of a trocar sealing device (sealing device  200 ) in accordance with the disclosures made herein. The sealing device  200  has an overall construction and functionality similar to that the sealing device  100  discussed above in reference to  FIGS. 3A-3D . The differentiating aspects of the sealing device  200  of  FIGS. 4A-4C  with respect to the sealing device  100  of  FIGS. 3A-3D  will now be discussed without specific discussion of the similarity in the overall construction and functionality to that of the sealing device  100  discussed above in reference to  FIGS. 3A-3D . 
     The sealing device  200  includes a support body  202 , an extension member seal  204  and a securement body  206 . The support body  202  can be attached to the extension member seal  204  and/or the securement body  206 . The securement body  206  can be attached to the support body  202  and/or the extension member seal  204 . In the same or similar manner as discussed above in reference to the sealing device  100  of  FIGS. 3A-3D , the securement body  206  enables the sealing device  200  to be engaged with a seal housing of a trocar (e.g., the seal housing  54  of the trocar  50  of  FIG. 2 ). For example, the securement body  206  can include an elongated skirt  116  or other form of trocar engaging element for enabling the sealing device  200  to be attached to a trocar. 
     The extension member seal  204 , which can be used as a sealing device in standalone apparatuses and implements, comprises a sealing member  232 , a compressive force member  234 , an interior sealing member retainer  236 , an upper exterior sealing member retainer  238  and a lower exterior sealing member retainer  239 . The interior sealing member retainer  236  and the exterior sealing member retainers  238 ,  239  jointly form a retention body  242  having opposing retention structures that each retain one of the opposing end portions  232 A,  232 B of the sealing member  232 . Engagement of the opposing end portions  232 A,  232 B of the sealing member  232  with the retention body  242  provides an interior space  244  between the sealing member  232  and the retention body  242 . As shown, in one or more embodiments, the exterior sealing member retainers  238 ,  239  each include an annular shoulder  238 A,  239 A with a retention member  238 B,  239 B. The retention members  238 B,  239 B each engage a mating retention recess  236 A of the interior sealing member retainer  236 . The opposing end portions  232 A,  232 B of the sealing member  232  are each retained within a respective retention slot  240  formed between adjacent portions of the interior sealing member retainer  236  and the exterior sealing member retainers  238 ,  239 . In this manner, each slot  240  serves as a spaced-apart sealing member retention portions of the retention body  242 . 
     The compressive force member  234  is located within the interior space  244  between the sealing member  232  and the retention body  242  and extends partially (e.g., 350-degrees), exactly (e.g., 360-degrees), or more than fully (e.g., 380-degrees) around a central passage  214  of the sealing member  232  (i.e., around a longitudinal centerline reference axis of the central passage  214 ). For example, the compressive force member  234  can be a ring-shaped member. Examples of the ring-shaped member include, but are not limited to, a helically-round spring with attached and/or overlapping end portions, a polymeric O-ring, an elastomeric O-ring, a synthetic rubber O-ring, a rubber band, a c-spring (e.g., opposing ends spaced part) and the like. Additionally, it is disclosed herein that the interior space  244  between the sealing member  232  and the retention body  242  can be a fluidic material (e.g., a flowable material such as liquid, gaseous, gelatinous, etc). It is disclosed herein that the aforementioned compressive force members and the aforementioned flowable material provide common functionality (i.e., exertion of compressive force on the sealing member  232 ) and are both examples of a compressive force material in accordance with the disclosure made herein. 
     The sealing member  232  is positioned within a central passage of the compressive force member  234  prior to the opposing end portions  232 A,  232 B of the sealing member  232  being engaged with the retention body  242 . It is disclosed herein that, in one or more embodiments, a ring-shaped member can be a unitary component of the sealing member (i.e., extruded or molded therein). The distance between the opposing end portions  232 A,  232 B of the sealing member  232  with the respective slot of the retention body  242  is such that the sealing member  232  is pulled at least tautly (or alternatively tightly) against the compressive force member  234 . In this manner, the compressive force member  234  exerts a radial inward force on the sealing member  232  (i.e., the sealing member  232  maintains the compressive force member  234  is in a radially-expanded state from a static state, at rest state such that a compressive force is exerted on the sealing member  232  by the compressive force member  234 ). 
     The central passage  214  of the sealing member  232  is round (or approximately round) and has an inside diameter sized as a function of an outside diameter of an extension member of surgical instruments intended to be used with a trocar on which the sealing device  100  is mounted. As can be seen in  FIG. 4C , engagement of the sealing member with the retention body (i.e., a free length of the sealing member  232  between the slots  240  of the retention body  242 ), engagement of the compressive force member  234  with the sealing body  232  and a thickness of the sealing member  232  jointly define a diameter of the central passage  214  of the extension member seal  204 . As similarly discussed above in reference to  FIGS. 3A-3D , the underlying objective of dimensional specification of the inside diameter of the central passage  212  of the sealing member  232  is to form secure engagement of the material of the sealing member  232  defining the central passage  212  around the extension member of the surgical instrument (i.e., being sealingly engaged) during the various modes of movement of the surgical instrument relative to the trocar—i.e., axial, pivotal and rotational movements. To this end, the sealing member  232  can be a sleeve (e.g., a thin-walled piece of flexible and/or conformable tubing (i.e., a tubular body)) made from a resilient material. For example, the sealing member  232  can be made from a material comprising or consisting essentially of an elastomer or synthetic rubber (e.g., a material comprising or consisting essentially of silicone). 
     As shown in  FIG. 4C , the sealing member  232  has a centrally tapered shape (e.g., an hourglass shape). In combination with the compressive force member  234 , this shape contributes to the sealing member  232  being able to expand around a variety of diameters while maintaining its stability and contributing minimal friction to the insertion of an elongated portion of a device (e.g., a surgical instrument). A medial portion of the sealing member  232  contributes an inwardly compressive radial force on an inserted elongation portion of a device and the opposing end portions  232 A,  232 B of the sealing member contribute an outward compressive force to the retention body  242  with which the sealing member is engaged. Additionally, open space around the medial portion of the sealing member  232  allows for a greater freedom of expansion and device tracking without imparting unacceptable insertion drag on the elongated portion of the device. 
     Advantageously, the extension member seal  204  provides for improved sealing of an extension member of an apparatus (e.g., a surgical instrument such as a laparoscope or other type of apparatus having an extension member). In particular, the extension member seal  204  provides for improved sealing of the extension member of apparatus that exhibits various modes of movement of the apparatus relative to a structure upon which the extension member seal  204  is mounted—i.e., lateral, axial, pivotal and rotational movements. Such sealing by the extension member seal  204  of an extension member of an apparatus that exhibits various modes of movement is referred to herein as multi-axis dynamic sealing. More specifically, multi-axis dynamic sealing refers to the construction and interaction of the sealing unit (e.g., a sealing member and a compressive force member thereof) providing a sealing interface that is capable of movement and/or conforming along a plurality of axes. It is disclosed herein that that such multi-axis dynamic sealing is not unnecessarily limited to being provided by any particular structure. For example, in addition to or alternatively to, multi-axis dynamic sealing can be provided through geometric of a single piece of material—e.g., a 3-dimensional structure such as an elastomeric sealing body having concentric wavy (e.g., sinusoidal waves in a cross-sectional view) rings extending around a central passage. The wavy rings provide available 3-dimensional material that enables movement of the central passage (e.g., lateral displacement) without causing stress/strain in the sealing body material resulting in unacceptable deformation of the central passage. 
     In one or more embodiments, the above-discussed axial alignment of a central passage of an extension member seal in accordance with the disclosure made herein (e.g., the extension member seal  104  or  204 ) with a working channel of a trocar (e.g., a trocar commercially available, directly or indirectly, from a manufacturer of trocars for use in surgical procedures) can be achieved by using an extension member to axially align the central passage of the extension member seal with the central passage of the trocar during engagement of the sealing device onto the seal housing of the trocar. A longitudinal axis of a central passage of the seal housing that extends colinearly with a longitudinal axis of a central passage of a cannula thereby jointly defining a longitudinal axis of the working channel. To perform such axial alignment, a distal end portion of the extension member of a surgical instrument or an extension member seal installer device (e.g., an extension member with handle attached to a proximate end portion thereof) can be inserted through the central passage of the extension member seal and the extension member then inserted into the working channel of the trocar until the extension member seal comes into contact with a top surface of the seal housing. The surgical instrument and the extension member seal installer device are examples of an alignment device having an extension member. In this regard, the elongated skirt is a seal housing engagement portion of the securement body that is selectively engageable with the seal housing and unrolling the elongated skirt is an embodiment of engaging a seal housing engagement portion of the securement body with the seal housing. 
     With the extension member seal in contact with the top surface of the seal housing, a skirt of the sealing device can be unrolled over one or more side surfaces of the seal housing and, optionally, over features protruding therefrom (e.g., as shown in  FIG. 3D ). The central passage of the extension member seal is now axially aligned with the working channel of the trocar, and the extension member can optionally be withdrawn from within the central passage of the extension member seal and the working channel of the trocar. 
     Aligning the longitudinal axis of the central passage of the extension member seal with the longitudinal axis of the working channel can be performed in conjunction with contacting the sealing device with the top surface of the seal housing. This can include inserting the distal end portion of the extension member through the central passage of the extension member seal and inserting the distal end portion of the extension member into the working channel. In one technique, prior to unrolling the skirt, the distal end portion of the extension member can be inserted through the central passage of the extension member seal and the distal end portion of the extension member can be inserted into the working channel. For example, inserting the distal end portion of the extension member through the central passage of the extension member seal can be performed after contacting the sealing device with the top surface of the seal housing and prior to inserting the distal end portion of the extension member into the working channel. 
     In one or more embodiments, the extension member seal installer device can be an obturator used for placing the trocar through the abdominal wall (or other body cavity wall) of a patient. In one or more other embodiments, the extension member seal installer device can be a laparoscope used during a surgical procedure after placing the trocar through the abdominal wall (or other body cavity wall) of the patient. In preferred embodiments, a sealing device in accordance with the disclosures herein is engaged with the trocar after its placement in the patient. 
     Referring now to  FIG. 5 , a sealing apparatus  300  configured in accordance with the disclosures made herein is shown. As shown, the sealing apparatus  300  is a trocar used in surgical procedures. However, in other embodiments, the sealing apparatus  300  can be useful in other applications and industries non-related to surgical procedures. The sealing apparatus  300  include a trocar body  330  (i.e., a support body) and the extension member seal  204  (shown in  FIGS. 4A-4C ) mounted on a seal housing  335  of the trocar body  330 . A cannula  340  extends from the seal housing  306 . A longitudinal axis L 1  of the seal housing  335  is axially aligned with a longitudinal axis L 2  of the cannula  340  such that the seal housing  335  and the cannula  340  have longitudinal axes that are colinear. A central passage  342  of the seal housing  335  defines the longitudinal axis L 1  thereof and a central passage  344  of the cannula  340  defines the longitudinal axis L 2  thereof. Jointly, the central passage of the seal housing  335  and the central passage of the cannula  340  define a working channel  346  of the trocar  300 . In this regard, incorporation of the extension member seal  204  of  FIGS. 4A-4C  results in the trocar advantageously exhibiting multi-axis dynamic sealing in accordance the disclosures made herein. 
     Example—Assessment of Reduction in Insufflation Gas Leakage Through Trocar-Laparoscope Interface by Trocar Sealing Device 
     Materials 
     
       
         
           
               
             
               
                 TABLE 1 
               
               
                   
               
               
                 MATERIALS 
               
               
                   
               
             
            
               
                   
               
            
           
           
               
               
            
               
                   
                 Trocar from Applied Medical Resources Corporation; Kii Fios;  
               
               
                   
                 Model No. CTF03; 5 × 100 mm 
               
               
                   
                 Laparoscope from Stryker; Precision Model no. 0502-503-010;  
               
               
                   
                 5 mm diameter 0-degree end face 
               
               
                   
                 Latex elastic O-ring; Sectioned from piece of thin-walled tubing  
               
               
                   
                 to provide a rectangular cross-section O-ring (4.7625 ID, 6.35 mm  
               
               
                   
                 OD, 4.45 mm Height); 40A Durometer 
               
               
                   
                 Silicone elastic tubing (10.83 mm ID, 13.87 OD, 47.91 mm  
               
               
                   
                 Length); Medium Soft Durometer (about 40A) 
               
               
                   
                 Commercially-available sewing thread 
               
               
                   
                 Rigid PVC pipe 
               
               
                   
                 Air compressor 
               
               
                   
                 Air pressure regulator 
               
               
                   
                 Mass flow meter 
               
               
                   
                 Tape measure 
               
               
                   
                 Air flow conduit 
               
               
                   
                 Data logger 
               
               
                   
                 Laptop with data logger interface 
               
               
                   
               
            
           
         
       
     
     Trocar Sealing Device Construction 
     The silicone elastic tubing was extended through the central opening of the latex elastic O-ring. A portion of the tubing was then partially folded over the O-ring, and sewn to constrain the O-ring within the folded-over portion of the tubing to thereby produce a trocar sealing device. The folded-over portion of the tubing was nominally 12.12 mm long such that the remaining portion of the tubing formed a 35.97 mm long skirt extending below the O-ring. 
     Test Configurations 
     
       
         
           
               
             
               
                 TABLE 2 
               
             
            
               
                   
               
               
                 TEST CONFIGURATIONS 
               
            
           
           
               
               
            
               
                 Config- 
                   
               
               
                 uration 
                 Set-Up 
               
               
                   
               
               
                 1 
                 As-manufactured trocar; No trocar sealing device engaged 
               
               
                   
                 with head of trocar; 5 mm shaft of laparoscope extending 
               
               
                   
                 through central passage of trocar 
               
               
                 2 
                 As-manufactured trocar; Trocar sealing device engaged 
               
               
                   
                 with head of trocar; 5 mm shaft of laparoscope engaged 
               
               
                   
                 through central passage of trocar sealing device and central 
               
               
                   
                 passage of trocar 
               
               
                 3 
                 Modified trocar (with plastic head adapter and internal 
               
               
                   
                 valve unit removed to provide trocar without insufflation 
               
               
                   
                 gas containment capability); Trocar sealing device engaged 
               
               
                   
                 with head of trocar; 5 mm shaft of laparoscope engaged 
               
               
                   
                 through central passage of trocar sealing device and central 
               
               
                   
                 passage of modified trocar 
               
               
                   
               
            
           
         
       
     
     Test Equipment Set-Up 
     The test equipment set-up included the following steps: 
     1. Attach a first end portion of a length of PVC pipe to in-vivo end of trocar in a sealed manner to create an insufflation chamber. 
     2. Using the air flow conduit, connect the air compressor to air pressure regulator, the air pressure regulator to the mass flow meter, the mass flow meter to the insufflation chamber at the second end portion of the length of PVC pipe. 
     3. Turn on the mass flow meter, data logger, laptop and air compressor. 
     4. Record the initial mass flow meter pressure reading for ambient room pressure. 
     5. With the air pressure regulator valve closed, adjust the mass flow meter until the pressure is +15 mmHg greater than the ambient room pressure reading. 
     6. Lay the tape measure along the length of the insufflation chamber with at least 6″ of the tape measure extended past the end of the insufflation chamber that includes the laparoscope port of the trocar. 
     7. For test configuration 1, insert the shaft of the laparoscope into the port of the trocar until only 3 inches of the laparoscope shaft remains exposed outside of the insufflation chamber. 
     8. For test configurations 2 and 3, place the trocar sealing device over the port end of the trocar and then insert the shaft of the laparoscope through the central passage of the trocar sealing device and into the port of the trocar until only 3 inches of the laparoscope shaft remains exposed outside of the insufflation chamber. 
     Test Procedures and Results 
     Procedure 1: Static (motionless) use case testing. This is a “uncompromised valve scenario” use case. Although it does occur, the likelihood during a case of laparoscopic instruments (e.g. a laparoscope) of this scenario is not common. This is a best-case scenario because there is no leak-compromising interaction between instrument-trocar valve interface. 
     The laparoscope was left to rest inside the insufflation chamber for 30 seconds, while measuring a gas leakage rate of air passing out of the insufflation chamber at the interface between the shaft of the laparoscope and the central passage of the trocar sealing device. Three (3) trials of this test procedures were performed for each of the trocar sealing device constructions and the average of these three trials was computed and recorded. 
     Procedure 1 Results: 
     
       
         
           
               
             
               
                 TABLE 3 
               
             
            
               
                   
               
               
                 Procedure 1 Results 
               
            
           
           
               
               
               
               
               
            
               
                   
                   
                   
                 Average 
                 Estimated  
               
               
                   
                   
                   
                 Total 
                 Total Leakage 
               
               
                   
                   
                 Average 
                 Leakage over 
                 Volume of 1 
               
               
                   
                   
                 Leak 
                 ~30 second 
                 hour of surgery  
               
               
                   
                 Config- 
                 Rate 
                 Procedure 
                 through 1 trocar  
               
               
                   
                 uration 
                 (mL/s) 
                 (mL) 
                 port (mL) 
               
               
                   
               
               
                   
                 1 
                 0.062968 
                 1.826029 
                 219.123 
               
               
                   
                 2 
                 0.058975 
                 1.768665 
                  212.239 (−3.1%) 
               
               
                   
                 3 
                 0.059695 
                 1.72989  
                 2.07.586 (−5.3%) 
               
               
                   
               
            
           
         
       
     
     The results for this test procedure show relatively comparable performance between the configurations during this static use case testing. Although relatively comparable, it is worth noting that the configurations with the trocar sealing device outperformed the commercially-available trocar. 
     Procedure 2: Dynamic (motion) use case testing. This is a “motion compromised valve scenario” use case for laparoscopic surgeries because such surgeries require the near-constant movement of instruments throughout the entirety of surgery. Even the most minor movements may create motion which may still compromise insufflation leakage scenarios through interaction at the instrument-trocar valve interface. 
     The laparoscope was left to rest inside the Trocar setup Configuration with roughly 3 inches of the scope instrument left protruding, and then was slowly retracted 3 inches and slowly re-inserted 3 inches back to its original resting state. The rate of movement was roughly 1 in/second. Three (3) trials of this test procedures were performed for each of the trocar sealing device constructions and the average of these three trials was computed and recorded. 
     Procedure 2 Results: 
     
       
         
           
               
             
               
                 TABLE 4 
               
             
            
               
                   
               
               
                 Procedure 2 Results 
               
            
           
           
               
               
               
               
               
            
               
                   
                   
                   
                 Average 
                 Estimated  
               
               
                   
                   
                   
                 Total 
                 Total Leakage 
               
               
                   
                   
                 Average 
                 Leakage over 
                 Volume of 1 
               
               
                   
                   
                 Leak 
                 ~45 second 
                 hour of surgery  
               
               
                   
                 Config- 
                 Rate 
                 Procedure 
                 through 1 trocar  
               
               
                   
                 uration 
                 (mL/s) 
                 (mL) 
                 port (mL) 
               
               
                   
               
               
                   
                 1 
                 0.184493 
                 8.149929 
                 651.994 
               
               
                   
                 2 
                 0.135028 
                 6.019311 
                 481.544 (−26%) 
               
               
                   
                 3 
                 0.136944 
                 5.80192  
                 464.153 (−29%) 
               
               
                   
               
            
           
         
       
     
     The results for this test procedure show significantly greater performance for the test configurations including the trocar sealing device. Notably, the trocar sealing device alone can provide exceptional insufflation gas leakage mitigation. 
     CONCLUSIONS 
     The above example illustrate that insufflation gas leakage can be reduced (i.e., mitigated) by implementation of trocar sealing devices in accordance with the disclosures made herein during surgical procedures. In particular, the test results for Procedure 2 show that use of such a trocar sealing device notably reduces insufflation leakage. Furthermore, results of Configurations 2 and 3 even further illustrate that the sealing valve structure already found in some commerciality-available trocars is rendered moot with the inclusion of trocar sealing devices configured in accordance with embodiments of the disclosures made herein. Finally, such reductions in insufflation gas leakage provided for by trocar sealing devices in accordance with the disclosures made herein can be critically valuable in the era of COVID-19. During in vivo exposure of the insufflation gas in a patient suffering from COVID-19, the insufflation gas can become contaminated with the virus (i.e., Coronavirus) that causes COVID-19. Accordingly, leakage of such contaminated insufflation gas can expose the operating room (OR) and personnel therein to Coronavirus. Use of a trocar sealing in accordance with the disclosures made herein can beneficially reduce this exposure. 
     Although the invention has been described with reference to several exemplary embodiments, it is understood that the words that have been used are words of description and illustration, rather than words of limitation. Changes may be made within the purview of the appended claims, as presently stated and as amended, without departing from the scope and spirit of the invention in all its aspects. Although the invention has been described with reference to particular means, materials and embodiments, the invention is not intended to be limited to the particulars disclosed; rather, the invention extends to all functionally equivalent technologies, structures, methods and uses such as are within the scope of the appended claims.