Patent Publication Number: US-2022218391-A1

Title: Cannula assembly including a suction cup seal

Description:
FIELD 
     The disclosure relates generally to surgical instruments, and more particularly, to a cannula assembly having a suction cup seal. 
     BACKGROUND 
     In order to facilitate minimally invasive surgery, a working space must be created in the desired surgical space. An insufflation gas, typically CO 2 , is introduced into the abdomen of the patient to create an inflated state called pneumoperitoneum. Cannula assemblies are utilized to allow the introduction of surgical instrumentation and endoscopes (or other visualization tools). These cannula assemblies maintain the pressure of the pneumoperitoneum, as they have one or more seals. Typically, a “zero-seal” in the cannula assemblies seals a cannula assembly in the absence of a surgical instrument therein, and an instrument seal seals around a surgical instrument that is inserted through the cannula assembly. Further, these cannula assemblies may include, e.g., a foam, collar configured to secure the cannula assemblies in position. 
     In surgical procedures, it is desirable to adjust or manipulate surgical instrumentation extending through the cannula assemblies without compromising pneumoperitoneum. Therefore, it would be beneficial to have a cannula assembly with improved seal capability. 
     SUMMARY 
     In accordance with the disclosure, a cannula assembly includes a cannula housing, a cannula sleeve extending distally from the cannula housing, and a suction cup assembly adjustably securable over the cannula sleeve. The suction cup assembly includes a sealing component and a locking component. The sealing component includes a neck portion and inner and outer cups extending distally from the neck portion. The inner cup is nested within the outer cup. The sealing component is formed of a compressible material to create suction when pressed against tissue to form fluid-tight seals against tissue. The locking component is disposed about the neck portion of the sealing component. The locking component includes a locking sleeve and a latch coupled to the locking sleeve to selectively compress the locking sleeve to adjustably secure the suction cup assembly at a position along the cannula sleeve. 
     In an aspect, the cannula sleeve may have an inflatable balloon disposed at a distal end portion of the cannula sleeve. 
     In another aspect, the cannula housing may include an inflation port in communication with the inflatable balloon. 
     In yet another aspect, the inner cup may include an engaging portion defining an acute angle with respect to a longitudinal axis defined by the cannula sleeve when the inner cup is in an uncompressed state. 
     In still yet another aspect, the engaging portion of the inner cup may include a planar surface configured for planar contact with tissue in a sealing relation when the inner cup is compressed against tissue. 
     In still yet another aspect, the outer cup of the sealing component may include a first portion extending from the neck portion and a second portion deflected distally from the first portion. 
     In an aspect, the second portion of the outer cup may include a planar surface configured to be in a planar contact with tissue when compressed against tissue in a sealing relation. 
     In another aspect, the second portion of the outer cup may be distal of the inner cup. 
     In yet another aspect, at least the inner cup or the outer cup may be formed of a thermoplastic elastomer. 
     In still yet another aspect, the sealing component of the suction cup assembly may be monolithically formed. 
     In an aspect, the locking sleeve may define a slit to enable enlarging of the diameter of the locking sleeve by the latch. 
     In another aspect, the second portion of the outer cup may be disposed radially outwards of the inner cup when the suction cup assembly is compressed against tissue. 
     In yet another aspect, the locking sleeve may have a flange at a distal portion thereof. The flange may be configured to engage the outer cup of the sealing component to urge the outer cup radially outwards when the suction cup assembly is compressed against tissue. 
     In accordance with another aspect of the disclosure, a cannula assembly includes a cannula housing including an inflation port, a cannula sleeve extending from the cannula housing, and a suction cup adjustably disposed over the cannula sleeve. The cannula housing and the cannula sleeve define a lumen configured to receive a surgical instrument therethrough. The suction cup has a dome shape. The suction cup is compressible to form suction, thereby forming a seal against tissue. 
     In an aspect, the suction cup may be formed of a thermoplastic elastomer. 
     In another aspect, the suction cup may define a proximal aperture dimensioned to receive the cannula sleeve in a sealing relation. 
     In yet another aspect, the suction cup may further define a distal aperture having a diameter larger than a diameter of the proximal aperture. 
     In still yet another aspect, the suction cup may be frictionally secured at a position along a length of the cannula sleeve. 
     In still yet another aspect, the cannula sleeve may include an inflatable balloon at a distal portion of the cannula sleeve. The inflatable balloon may be in communication with the inflation port of the cannula housing. 
     In still yet another aspect, the suction cup may have a lip extending radially inwards from a peripheral portion of the suction cup to establish a planar contact with tissue in a sealing relation. 
    
    
     
       BRIEF DESCRIPTION OF DRAWINGS 
       A cannula assembly is disclosed herein with reference to the drawings, wherein: 
         FIG. 1  is a perspective view of a cannula assembly including a suction cup in accordance with the disclosure; 
         FIG. 2  is a perspective view of the cannula assembly of  FIG. 1  with the suction cup separated from a cannula sleeve of the cannula assembly; 
         FIG. 3  is a perspective view of the suction cup of  FIG. 1 ; 
         FIG. 4  is a perspective view of the suction cup of  FIG. 3  taken along section line  4 - 4  of  FIG. 3 ; 
         FIG. 5  is a side view of the cannula assembly of  FIG. 1 , illustrating the suction cup disposed on a cannula sleeve of the cannula assembly; 
         FIG. 6  is a side cross-sectional view of the cannula assembly of  FIG. 5  taken along section line  6 - 6  of  FIG. 5 , illustrating displacement of the suction cup towards tissue; 
         FIG. 7  is a side cross-sectional view of the cannula assembly of  FIG. 6 , illustrating compression of the suction cup to provide a fluid-tight seal against tissue; 
         FIG. 8  is a perspective view of the cannula assembly of  FIG. 1 , illustrating securement of the cannula assembly with an opening in tissue; 
         FIG. 9  is a perspective view of a cannula assembly including a suction cup assembly in accordance with another aspect of the disclosure; 
         FIG. 10  is a bottom perspective view of the cannula assembly of  FIG. 9 ; 
         FIG. 11  is a perspective view of the cannula assembly of  FIG. 10  with the suction cup assembly separated from a cannula sleeve of the cannula assembly; 
         FIG. 12  is a perspective view of a suction cup assembly with parts separated; 
         FIG. 13  is a partial perspective view of the suction cup assembly of  FIG. 11  taken along section line  13 - 13  of  FIG. 11 ; 
         FIG. 14  is a perspective view of the cannula assembly of  FIG. 10 , illustrating use thereof in a body cavity; and 
         FIG. 15  is a side cross-sectional view of the cannula assembly of  FIG. 14  taken along section line  15 - 15  of  FIG. 14 . 
     
    
    
     DETAILED DESCRIPTION 
     A cannula assembly is described in detail with reference to the drawings, wherein like reference numerals designate corresponding elements in each of the several views. As used herein, the term “distal” refers to that portion of the instrument, or component thereof which is farther from the user while the term “proximal” refers to that portion of the instrument or component thereof which is closer to the user. In addition, the terms parallel and perpendicular are understood to include relative configurations that are substantially parallel and substantially perpendicular up to about + or −10 degrees from true parallel and true perpendicular. Further, to the extent consistent, any or all of the aspects detailed herein may be used in conjunction with any or all of the other aspects detailed herein. 
       FIGS. 1 and 2  illustrate a cannula assembly in accordance with the disclosure shown generally as a cannula assembly  10 . The cannula assembly  10  is configured to permit access to a surgical site such as, e.g., an insufflated abdominal cavity, during a laparoscopic procedure to permit the introduction of a surgical object for performing various surgical tasks on internal organs within the cavity. The surgical object may be a surgical instrument such as laparoscopic or endoscopic clip appliers, obturators, graspers, dissectors, retractors, staplers, laser probes, photographic devices, tubes, endoscopes and laparoscopes, electro-surgical devices, and the like. The cannula assembly  10  generally includes a cannula housing  100 , a cannula sleeve  200  extending from the cannula housing  100 , and a suction cup  300  adjustably disposed on the cannula sleeve  200  to form a seal against tissue, as will be discussed. 
     The cannula housing  100  is configured for engagement by the clinician. The cannula sleeve  200  includes proximal and distal end portions  206 ,  208  and defines a longitudinal axis “L-L” extending along the length of the cannula sleeve  200 . The cannula housing  100  and the cannula sleeve  200  define a lumen  12  for reception and passage of a surgical object therethrough. The cannula housing  100  includes an insufflation port  214  and associated insufflation valve  216  (e.g., a stop cock valve) for selective introduction of insufflation fluids into the cannula sleeve  200  and the abdominal cavity. The lumen  12  is in fluid communication with the insufflation port  214  to convey the insufflation fluids into the abdominal cavity to establish and/or maintain the pneumoperitoneum. 
     The cannula housing  100  defines a cavity configured to adjustably support a seal assembly therein. The seal assembly may be supported within the cannula housing  100  to provide sealed passage of the surgical instrument through the cannula assembly  100 . The cannula housing  100  may include a zero-closure valve, e.g., a duckbill valve, which is configured to close in the absence of a surgical object to prevent egress of insufflation gases. 
     The cannula assembly  10  may be configured for use with an obturator inserted through the lumen  12  of the cannula housing  100  and the cannula sleeve  200 . The obturator may have a blunt distal end, or a bladed or non-bladed penetrating distal end. The obturator may be used to incise the abdominal wall so that the cannula assembly  10  may be introduced into the abdomen. A handle of the obturator may engage or selectively lock into the cannula housing  100  of the cannula assembly  10 . 
       FIGS. 1 and 2  further illustrate the cannula sleeve  200  including a balloon anchor or an expandable member  250  at a distal end portion  202  of the cannula sleeve  200 . The balloon anchor  250  is disposed about the cannula sleeve  200 . The balloon anchor  250  is provided to secure cannula assembly  10  against body tissue, e.g., an inner surface of an abdominal wall. The cannula housing  100  includes an inflation port  150  which is in fluid communication with the balloon anchor  250 . The inflation port  150  may be connected to a fluid supply to inflate the balloon anchor  250 . It is contemplated that the cannula sleeve  200  may be without the balloon anchor  250 . For example, the cannula sleeve  200  may include a ribbed surface to facilitate securement of the cannula sleeve  200  with tissue. Alternatively, the cannula sleeve  200  may include a smooth surface. 
       FIGS. 1 and 2  further illustrate the suction cup  300  adjustably disposed on the cannula sleeve  200 . The suction cup  300  is provided to seal around an incision in the patient&#39;s abdominal wall and stabilize the cannula assembly  10  relative to the abdominal wall in conjunction with the balloon anchor  250 . The suction cup  300  is formed of a compressible material. The suction cup  300  is formed of a flexible material that creates suction when pressed against tissue and forms a seal about the incision in the abdominal wall. In particular, the suction cup  300  has a hemispherical shape defining a bore  302  ( FIG. 3 ) dimensioned to receive the cannula sleeve  200  therethrough. The suction cup  300  includes a lip  310  ( FIG. 4 ) extending radially inwards to engage tissue. Further, the lip  310  includes a planar surface to engage tissue in a sealing relation. For example, the suction cup  300  may be formed of the thermoplastic elastomer (TPE) commercially available under the tradename SANTOPRENE® from Advanced Elastomer Systems, L.P. 
       FIGS. 5 and 6  illustrate the suction cup  300  frictionally supported on the cannula sleeve  200 . Once the distal end portion  202  of the cannula sleeve  200  is inserted through an opening or an incision, the balloon anchor  250  may be inflated to secure the cannula assembly  10  to tissue “T” and to provide a seal against the opening or incision. At this time, the clinician may slide the suction cup  300  towards the balloon anchor  250 , i.e., in the direction of arrows “D” such that the opening or the incision is closed by the balloon anchor  250  and the suction cup  300 . 
       FIGS. 7 and 8  illustrate the suction cup  300  forming a seal against tissue “T”. The clinician presses the suction cup  300  towards the balloon anchor  250  in the direction of arrows “I”. In this manner, the suction cup  300  is compressed and creates suction against tissue “T” such that the suction cup  300  seals around the opening or incision in tissue “T” and facilitates securement of the cannula assembly  10  in the opening or incision in tissue “T”. Under such a configuration, the suction cup  300  and balloon anchor  250  enable off-axis movement of the cannula sleeve  200  while maintaining the pneumoperitoneum. 
       FIG. 9  illustrates a cannula assembly  1000  including a suction cup assembly  1300  in accordance with another aspect of the disclosure. Parts of the cannula assembly  1000  substantially identical to the parts of the cannula assembly  10  ( FIG. 1 ) will only be described herein to the extent necessary to identify differences in construction and/or operation. The suction cup assembly  1300  is formed of a flexible material that creates suction when pressed against tissue and forms a seal about the incision in the abdominal wall. The suction cup assembly  1300  includes a sealing component  1320  and a locking component  1380 . The sealing component  1320  and the locking component  1380  may be detachably coupled to each other. The sealing component  1320  may be formed as a single construct. The suction cup assembly  1300  is adjustably securable at a position along a length of a cannula sleeve  1200 . 
       FIGS. 10-12  illustrate the suction cup assembly  1300  that is adjustably securable on the cannula sleeve  1200 . In particular, the sealing component  1320  of the suction cup assembly  1300  includes an inner cup  1330 , an outer cup  1340 , and a neck portion  1370  configured to support the locking component  1380 . The inner and outer cups  1330 ,  1340  extend distally from the neck portion  1370 . The inner cup  1330  is nested within the outer cup  1340 . At least the inner cup  1330  and the outer cup  1340  are formed a compressible material such as, e.g., the thermoplastic elastomer (TPE) commercially available under the tradename SANTOPRENE® from Advanced Elastomer Systems, L.P. The sealing component  1320  may be monolithically formed. However, it is contemplated that the inner and outer cups  1330 ,  1340  may be formed of different materials to provide different compressibilities. Alternatively, the inner and outer cups  1330 ,  1340  may be formed of the same material, but have different thicknesses to provide different compressibilities. For example, the outer cup  1340  may be more compressible than the inner cup  1330  or vice versa. 
       FIG. 13  illustrates the suction cup assembly  1300  defining a bore  1350  to receive the cannula sleeve  1200  ( FIG. 1 ) in a sealing relation. The bore  1350  defines a longitudinal axis “M-M.” The inner and outer cups  1330 ,  1340  may define an arcuate profile. The outer cup  1340  is disposed about the inner cup  1330 . The inner cup  1330  includes an engaging portion  1322  configured to engage tissue in a sealing relation. The engaging portion  1322  defines an acute angle α with respect to the longitudinal axis “M-M” when the inner cup  1330  is uncompressed. However, when the inner cup  1330  is compressed, the engaging portion  1322  is configured to provide, e.g., a planar contact with tissue, to form a fluid-tight seal against tissue. The outer cup  1340  is disposed about the inner cup  1330  and extends radially outwards from the neck portion  1370 . In particular, the outer cup  1340  includes a first portion  1342  that extends radially outwards from the neck portion  1370  and a second portion  1344  that deflects distally from the first portion  1342 . At least the second portion  1344  may be distal of the inner cup  1330 . Further, at least the second portion  1344  may be radially outwards of the inner cup  1330 . 
       FIGS. 11 and 12  further illustrate the locking component  1380  of the suction cup assembly  1300 . The locking component  1380  includes a locking sleeve  1382  defining a bore  1384  dimensioned to receive the neck portion  1370  of the sealing component  1320 . The locking sleeve  1382  defines a slit  1382   a . The locking mechanism  1386  includes a latch  1387  coupled to the locking sleeve  1382  on opposing slides of the slit  1382   a  to compress the locking sleeve  1382  and the neck portion  1370  of the sealing component  1320  radially inwards and against the cannula sleeve  1200  to secure the suction cup assembly  1300  against an outer surface of an abdominal wall. 
       FIG. 11  illustrates the suction cup assembly  1300  separated from the cannula assembly  1000  prior to use. The latch  1387  of the locking mechanism  1386  may be opened to enlarge the diameter of the locking sleeve  1382 . The suction cup assembly  1300  is then placed over the cannula sleeve  1200 . Thereafter, and with additional reference to  FIG. 15 , the distal end portion  1202  of the cannula sleeve  1200  is inserted through an incision or an opening and into a body cavity “BC.” At this time, the balloon anchor  1250  may be inflated with a fluid introduced through an inflation port  1150  of the cannula housing  1100  such that the balloon anchor  1250  secures the cannula assembly  1000  in a sealing relation against tissue “T”. At this time, the clinician may slide the suction cup assembly  1300  towards the balloon anchor  1250  such that tissue “T” is clamped between the balloon anchor  1250  and the suction cup assembly  1300 , thereby the sealing component  1320  engages tissue “T” in a sealing relation. In particular, the inner cup  1330  makes, e.g., a planar contact, with tissue “T” to form a seal against tissue “T”, and at least the second portion  1344  of the outer cup  1340  forms, e.g., a planar contact, with tissue “T” to form a seal against tissue “T” when the suction cup assembly  1300  is pressed against tissue “T”. In this manner, the sealing component  1320  creates suction against tissue “T” and establishes a fluid-tight seal against tissue “T”. At this time, the clinician may secure the suction cup assembly  1300  to the position by using the latch  1387  of the locking mechanism  1386 . In this manner, the suction created by the compressed suction cup assembly  1300  maintains the seal against tissue “T”, and thus pneumoperitoneum in the abdominal cavity. 
     In use, initially, an incision is made in a body wall to gain entry to a body cavity, such as the abdominal cavity. The distal end portion  1208  of the cannula sleeve  1200  is inserted through the incision until at least the balloon anchor  1250  is within the body cavity. At this time, the balloon anchor  1250  is inflated. Thereafter, the suction cup assembly  1300  is moved distally such that tissue “T” is clamped between the balloon anchor  1250  and the suction cup assembly  1300 . However, it is contemplated that the suction cup assembly  1300  may be utilized without the balloon anchor  1250 . At this time, the clinician may compress the suction cup assembly  1300  against tissue “T” to create suction, thereby forming a fluid-tight seal against tissue “T”. In order to maintain suction and the seal against tissue “T”, the latch  1387  the locking mechanism  1386  is utilized to lock the position of the suction cup assembly  1300  relative to the cannula sleeve  1200 . With the incision sealed, the body cavity may be insufflated with CO 2 , a similar gas, or another insufflation fluid. Surgical instruments may be inserted through the cannula assembly  1000  to perform desired surgical procedures. The method of use of the cannula assembly  10  is substantially similar to the method of use of the cannula assembly  1000 , and thus, will not be described herein. 
     It is further contemplated that the cannula assembly  10  may be used with an obturator. The obturator generally includes a head portion having latches configured to engage respective notches defined in the cannula housing  100  of the cannula assembly  10  to enhance securement therewith, an elongate shaft extending from the head portion, and an optical penetrating tip coupled to a distal end of the elongate shaft. The optical penetrating tip may be used to penetrate the skin and access the body cavity. By applying pressure against the proximal end of the obturator, the tip of the obturator is forced though the skin and the underlying tissue layers until the cannula and obturator enter the body cavity. 
     Persons skilled in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are non-limiting. It is envisioned that the elements and features may be combined with the elements and features of another without departing from the scope of the disclosure. As well, one skilled in the art will appreciate further features and advantages of the disclosure.