Source: http://www.google.com/patents/US20020072762?dq=%22Meaning-based+advertising+and+document+relevance+determination%22
Timestamp: 2016-09-28 09:15:26
Document Index: 88245530

Matched Legal Cases: ['art 61', 'art 62', 'art 63', 'art 82', 'art 407', 'art 408']

Patent US20020072762 - Laparoscopic sealed access device - Google PatentsSearch Images Maps Play YouTube News Gmail Drive More »Sign inPatentsA hand access device for use in hand assisted laparoscopic surgery comprises a substantially tubular inflatable sleeve of pliable gas tight material having a twisted inner sleeve section and an outer sleeve section. The device has an inner O-ring for insertion through a wound opening in the abdominal...http://www.google.com/patents/US20020072762?utm_source=gb-gplus-sharePatent US20020072762 - Laparoscopic sealed access deviceAdvanced Patent SearchTry the new Google Patents, with machine-classified Google Scholar results, and Japanese and South Korean patents.Publication numberUS20020072762 A1Publication typeApplicationApplication numberUS 09/804,552Publication dateJun 13, 2002Filing dateMar 13, 2001Priority dateDec 1, 1998Also published asCA2351708A1, CN1191790C, CN1329473A, DE69915868D1, DE69915868T2, DE69920744D1, DE69920744T2, DE69937466D1, DE69937466T2, EP1135070A1, EP1135070B1, EP1135072A1, EP1135072B1, EP1498078A1, EP1498078B1, US6578577, US6623426, US20010047188, US20040092795, US20040249248, WO2000032117A1, WO2000032120A1Publication number09804552, 804552, US 2002/0072762 A1, US 2002/072762 A1, US 20020072762 A1, US 20020072762A1, US 2002072762 A1, US 2002072762A1, US-A1-20020072762, US-A1-2002072762, US2002/0072762A1, US2002/072762A1, US20020072762 A1, US20020072762A1, US2002072762 A1, US2002072762A1InventorsFrank Bonadio, Ronan McManus, Derek Young, Alan Reid, Alfred CushieriOriginal AssigneeAtropos LimitedExport CitationBiBTeX, EndNote, RefManReferenced by (116), Classifications (36), Legal Events (6) External Links: USPTO, USPTO Assignment, EspacenetLaparoscopic sealed access device
[0175] where E is the angle of twist, [0176] D1 is the tube diameter, and [0177] D2 is the diameter of the elongate object. [0178] Although depicted as of circular profile, a tube of sufficiently compliant material will conform to many non recursive profiles. For such a profile D2 is taken as the smallest diameter which can be inscribed within the profile. [0179] Twin Walled Pressure Vessel Under Internal Pressure [0180] Referring to FIGS. 44 to 50 consider a thin walled tube as shown in FIG. 45a. One end of the tube is folded back on itself as shown in FIG. 47 and the free ends conjoined. What is defined is essentially a twin wailed tube (or two coaxial tubes conjoined at their ends) with an enclosed volume between the two walls. One way of extending the thin walled tube in an axial direction is to introduce a pressurised fluid into the enclosed volume. This causes the outer tube to be subject to tensile axial stress and tensile hoop stress. The inner tube will be subject to tensile axial stress and compressive hoop stress. As a result the diameter of the lumen reduces and the lumen collapses into a nominally duck bill configuration but constrained by the outer tube, FIG. 50. [0181] Greater control of the lumen can be obtained by the introduction of a twist into the tube. The tube shown in FIG. 52 is twisted as shown in FIG. 54. One end of the tube is folded back on itself, as shown in FIG. 56, and the free ends conjoined. This configuration defines two coaxial conical vessels conjoined at their bases and at a common apex. However the common apex is not constrained to remain in this configuration. In reality, the inner and outer tubes are free to behave as individual tubes each with half of the original twist and as such the composite tube can better be defined as two coaxial hour glass tubes as shown in FIG. 59, each containing half the original total twist. As both the inner and outer tubes are necked they each are subject to compressive hoop stresses. [0182] Next a pressurised fluid is introduced into the enclosed volume. The introduction of the pressurised fluid extends the inner and outer tubes in an axial direction, reducing the lumen diameter. The outer tube is a necked hour glass tube with compressive hoop stresses. The introduction of the pressurised fluid also induces tensile hoop stresses, negating the compressive hoop stresses induced by the twist. Since, to remain in its twisted configuration, the tube must have compressive hoop stresses and since the pressurised fluid overcomes these compressive stresses the tube untwists and takes on a nominally cylindrical configuration, FIG. 61. Since the inner and outer tubes are conjoined, as the outer tube untwists the inner tube twists more in response. Since the outer tube now has no twist the inner tube must have all the twist. If the original total twist were 180� then the lumen would close totally. Additionally, the material defining the inner tube will be central within the diameter of the outer tube. This configuration will for brevity be called a Cyclops. [0183] Translation of an Elongate Object through a Cyclops [0184] Consider the arrangement depicted in FIG. 62. A shaft is passed through a Cyclops with the lumen in mutual contact with the shaft. The outer tube of the Cyclops is resting in mutual contact with a fixed surface. Consider points of contact A, between the Cyclops and the fixed surface, and B, between the shaft and the lumen of the Cyclops. As the shaft is translated, as shown in FIG. 64, point A remains fixed whilst the leading end of the lumen rolls out. Since the Cyclops does not change in overall length the trailing end of the outer tube rolls in as depicted. It will be apparent that the shaft translates to the right twice as far as the Cyclops. This is exactly the motion of a caterpillar track. From his point of view a Cyclops could be considered as a three dimensional caterpillar track. Since points A and B on the Cyclops do not move relative to their corresponding positions on the shaft and the fixed surface there is no frictional resistance to the translation of the shaft In FIG. 66, the Cyclops has translated to the right by approximately its own length. The material which had originally formed the inner tube has rolled out to become the outer tube and vice versa. In other words the Cyclops has turned inside out. Since the inner tube of the Cyclops is in a twisted configuration and since the point B remains in contact with the same point the shaft rotates about it's axis as depicted by arrow C (in this instance approx. 120�). In order to obtain this translation the resistance required to be overcome is that generated as the leading and trailing ends of the Cyclops deform as they roll our and roll in respectively. [0185] Referring to FIGS. 68 and 69 there is illustrated another access device 50 which in this case has a glove 51 integral with or attached thereto to receive a surgeons hand. [0186] Referring to FIGS. 70 to 74 there is illustrated another hand access device 55 according to the invention. The device 55 is similar to those described above except that in this case the twist is adjustable in situ. In this case the sleeve 5 has an inner ring 56 similar to the ring 30 and an outer ring assembly comprising two interengagable rings 57, 58 which are rotatable relative to one another to adjust the twist in the sleeve 5. The rings 57, 58 are snap fitted together and a seal 60 is used to present air egress. The seal 60 has a head part 61 which is housed in a female recess 62 in the ring 57 and a sealing part 62 which extends to sealingly to engage a projecting part 63 of the outer ring 58. [0187] Referring to FIGS. 75 and 78 there is illustrated another adjustable twist device 70 which is similar to the device 55 of FIGS. 70 to 74 and like parts are assigned the same reference numerals. In this case snap projections 79, 80 engage on assembly of the mounting rings 57, 58. To ensure gas tight sealing between the rings 57, 58 an elastomeric sealing ring 81 is provided. The sealing ring 81 is housed in a recess in the male part 82 of the outer mounting ring 59 and projects into the space between the two rings 57, 58, on assembly to engage against an integral projection 92 of the lower ring 58. Mounting ring seals 93, 94 are used for mounting the sleeve 5 to the outer and inner mounting rings 57, 58, respectively. [0188] In each of the devices 55, 70 the mounting ring 57 includes a side port 95 having a passageway 96 for entry of an inflation gas into the sleeve 5. The mounting rings 57, 58 are rotatable relative to one another to twist the sleeve 5 and so reduce the diameter of the lumen 25 defined by the sleeve 5. The relative rotation is effected by gripping opposed handles 97, 98 on the mounting rinas 57, 58 and turning them. This causes the sleeve S to twist from a configuration 28 where there is no twist to, for example, a 90� twist or a 180� twist in which the lumen 25 is closed. The sleeve 5 may therefore be pre-twisted or twisted during a surgical procedure. [0189] In use, the sleeve 5 is untwisted and the O-ring 56 is inserted through a wound opening 3. A surgeon then inserts his hand through the sleeve 5. The rings 57, 58 are relatively rotated to twist the sleeve 5 and so reduce the lumen diameter. The sleeve 5 is then inflated by introducing pressurised gas through the entry port 95. This causes the sleeve 5 to extend in the axial direction, and the diameter of the lumen 25 to reduce, further enhancing the seal. The surgical procedure is then carried out. On completion of the surgical procedure, a combination of deflation and/or untwisting of the sleeve 5 is used to allow a surgeon to remove his hand. In this way, if required, the gas seal may be maintained as a surgeon removes his hand and when the hand is fully removed. [0190] One advantage of his sealing device is that it is adjustable on site and in situ to suit a particular patient, surgeon and/or procedure. The mounting rings 57, 58 slide over one another as they rotate relative to one another. It is desirable to have a small frictional force acting between the surfaces as they rotate relative to one another to facilitate ease of operation of the device 55, 70 and also to maintain the desired sealing contact between the two rings 57, 58. [0191] Referring to FIGS. 79 to 81 there is illustrated another surgical device 100 according to the invention. In this case an inner ring 101 has engagement means in the form of a radially and axially extending lip seal 105 to engage an inner wall of a patient at the wound opening. This facilitates positive location and engagement of the device 100, in use. [0192] Referring to FIGS. 82 to 85, there is illustrated another device 109. In this case an inner liner or bladder 110, extending between the outer and inner rings 111, 112 is provided to ensure that the inflated sleeve 5 interior is maintained sealed while the rings 111, 112 are rotated relative to one another. [0193] Referring to FIGS. 86 to 88 there is illustrated another surgical device 20 according to the invention. The device 1 comprises a first O-ring 201, a first outer mounting means in the form of a O-ring 202 mounted in a first receiver 203, and a second mounting means in the form of a O-ring 205 mounted in a second receiver 206. The receivers 203, 206 are in this case interconnectable as illustrated and a fourth O-ring 207 is provided between the receivers 203, 206 on assembly. [0194] A sleeve 210 of flexible pliable plastics material extends from the second outer receiver 206 to the first outer receiver 203. The receivers 203, 206 are de-mountable as illustrated in FIG. 87 to facilitate relative rotation therebetween in the direction of the arrows to vary the degree of twist in the sleeve 210. [0195] Referring to FIGS. 89 and 90 there is illustrated another surgical device 220 which is similar to the device 200. In his case the O-ring 205 is de-mountable from the receiver 206 to facilitate length adjustment of the sleeve 210. On removal of the O-ring 205 the sleeve 210 is adjusted to a desired length d. In this way a single device 220 may be used for a variety of thickness of abdomens. The lumen diameter defined by the twist does not need to be changed to cater for a range of abdomen sizes. The excess sleeve may be cut off or wound around the O-ring seal 205. [0196] Referring to FIGS. 91a and 91 b there is illustrated an assembly of two surgical devices 250, 260. The device 250 is a forearm seal and the device 260 is a wound protector retractor which is assembled to an outer sealing device 250. The sealing device 250 provides an outer sealed access port through which a surgeon may insert his forearm or for insertion of an instrument or the like. [0197] Referring to FIG. 92 there is illustrated a modified hand access device 55 according to the invention. In this case an inner ring 56 is enclosed in a pocket 57 on the sleeve 5 while an outer ring 58 is free to move between the walls of the sleeve. [0198] Referring to FIGS. 93 and 94 there is illustrated another hand access device 160 in which eversion limiting rings 61, 62 are free to move axially inside the sleeve 5. The device is used as described above, the outer ring 61 engaging the outside of the abdominal wall on insertion to limit eversion into the incision. The inner ring 162 is free between the walls of the sleeve 5 when the sleeve is fully everted into the wound as illustrated in FIG. 94. On withdrawal of a surgeons arm eversion the sleeve outwardly is limited by engagement of the ring 162 against the inside of the abdominal wall. One advantage of this arrangement is that the same device may be used for a wide range of different thicknesses of abdomen. [0199] Referring to FIGS. 95 and 96 there is illustrated another hand access device 165 which is again similar to those descried above. In this case inner and outer rings 166, 167 are not attached to the sleeve 5, however a linking section 168 of pliable material extends between the rings 166, 167. [0200] Referring now to FIGS. 97 and 98 there is illustrated another hand access device 70 according to the invention. In this case an inner ring 71 is held in a desired axial position in the sleeve 5 by adhesive tapes 73. An outer ring 72 is free to move axially within the sleeve. [0201] Referring to FIG. 99 there is illustrated another medical device 700 according to the invention which is similar to those described above and like parts are assigned the same reference numerals. The device includes a shielding device to shield the existing connection between the rings 30, 31. The shield shields the sleeve section that engages with the incision from the axial tensile force. This facilitates improved conformity to the incision margins and enhanced retraction and sealing. [0202] In this case the shield is in the form of a film 701 which is of lighter gauge than that of the main sleeve 5. There is a hole 702 in the main sleeve 5 which allows air access to the chamber 706 between the main sleeve 5 and the film 701. The hole 702 may be covered by a valve such as a non return flap valve 705. [0203] The shielding film 701 is illustrated as deflated in FIG. 99a. After inflation it bulges outwardly as illustrated in FIG. 99b and a better conformity to the incision is achieved as illustrated in FIG. 99c. [0204] This arrangement may then be used to allow deflation of the inner sleeve for improved access as illustrated in FIG. 99d. [0205] Referring to FIG. 100, in this case the shield is provided by a compressible foam like sleeve 750. The foam may include stiffening means 751 as illustrated in FIG. 101. It will be appreciated that the shield may be of any suitable material. [0206] Referring to FIGS. 102 to 109 there is illustrated a sealing device 250 according to the invention. The sealing device 250 comprises a tubular sleeve 251 of pliable material mounted at a first end to a first mounting means and mounted at a second end to a second mounting means. The first mounting means is a resilient ring 252, the second mounting means is a resilient ring 253. The sleeve 251 defines a lumen 254. The rings 252, 253 are rotated relative to one another to cause the sleeve 251 to twist, thereby reducing the diameter of the lumen 254. The sleeve 251 is illustrated in a twisted, flaccid position in FIGS. 102 to 105. The rings 252, 253 are moved away from each other in the axial direction, thereby extending the sleeve 251 and reducing the lumen diameter further, FIGS. 106 to 109. [0207] The sleeve 251 is sealed around an object passing through the lumen 254; [0208] (i) by rotating the rings 252, 253 relative to one another, thereby twisting the sleeve 1 and reducing the diameter of the lumen 254; or [0209] (ii) by moving the rings 252, 253 away from one another in the axial direction, thereby extending the sleeve 1 and reducing the diameter of the lumen 254; or [0210] (iii) by a combination of (i) and (ii). [0211] Referring to FIGS. 110 to 117 there is illustrated a sealing device 300 which is similar to the sealing device 250 of FIGS. 102 to 109 and like parts are assigned the same reference numerals. In this case resilient struts 305 are connected between the first resilient ring and the second resilient ring. As the two rings are moved together, the struts 305 bend outwardly in a buckling manner. This causes the twisted sleeve to take up a flaccid configuration increasing the lumen diameter, FIGS. 114 to 117. The material properties of the struts 305 cause them to unbuckle when released. The struts 305 spring back to their straight positions parallel to the sleeve axis, FIGS. 110 to 113. The unbuckling of the struts 305 moves the two rings away from each other in the axial direction and extends the sleeve, thereby reducing the lumen diameter. In this case the sleeve is pre-twisted and the resilient rings are constrained by the struts 305 to remain in the twisted position. The resilient rings cannot rotate relative to one another. [0212] Referring to FIGS. 118 to 125 there is illustrated another medical device 400 forming a trocar seal. In this case a coiled spring 401 is positioned between two resilient rings 402, 403 with a sleeve 404 therebetween. The upper end of the coiled spring 401 bears against the underside of the first ring 402 and the lower end of the coiled spring 401 bears against the top side of the second ring 403. The coiled spring 401 and sealing sleeve 404 are enclosed within a housing. The housing comprises a rigid casing having an upper part 407 and a lower part 408 which are separable from one another and a pliable tubular elastomeric sleeve 409 extending therebetween. The elastomeric sleeve 409 is sealed to the casing upper part and the casing lower part so that it joins the upper part and the lower part together. This arrangement facilitates the movement of the coiled spring 401 from a compressed position to an extended position, with the spring 401 remaining enclosed within the housing. [0213] When the coiled spring 401 is compressed, the two rings 402, 403 move together. This causes the twisted sleeve to take up a flaccid configuration, increasing the lumen diameter. This compresses the elastomeric sleeve so that the upper and lower parts of the casing are adjacent to each other. When the coiled spring 401 is released, it moves to an extended position. This causes the two rings to move away from each other, extending the twisted sleeve and reducing the lumen diameter. The elastomeric sleeve is extended to a position in which the upper and lower parts of the casing are distal from each other. The device 400 is used for sealing a cannula. [0214] Referring to FIGS. 126 and 127 there is illustrated a sealing device 500 according to the invention. In this case a twisted tubular sleeve 501 is mounted at one end to one end of a rigid tube 502 and at the other end to the other end of the rigid tube 502, with an enclosed volume 503 between the sleeve 501 and the rigid walls of the tube 502. The sleeve 501 is inflated by passing air through a port 504 in the tube 502 and into the enclosed volume 505. The inflation of the sleeve 501 extends the sleeve 501 in the axial direction, thereby reducing the lumen diameter. [0215] Referring to FIGS. 127 and 128 there is illustrated a sealing device 600 which is similar to the sealing device 500 of FIGS. 125 and 126. One end of a twisted tubular sleeve 601 is mounted to a first rigid tube 602, the other end of the twisted sleeve 501 is mounted to a second rigid tube 603. The rigid tubes 602, 603 partially overlap and are movable in an axial direction relative to one another, so that when the sleeve is inflated and extends in the axial direction, the tubes move axially away from one another in a “trombone-type” action, reducing the lumen diameter. The tubes are constrained at the overlapping ends so that they always overlap at least partially. [0216] Reference is also made to appropriate alternatives and modifications which are outlined in our parallel applications referenced ATRO1/C, ATRO14/C/, ATRO15/C, ATRO16/C/, ATRO17/C, the entire contents of which are incorporated herein by reference. [0217] The invention is not limited to the embodiments hereinbefore described which may be varied in construction and detail. 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Ltd.Immunostimulatory nucleic acid oil-in-water formulations and related methods of useUS20100312067 *Jul 29, 2010Dec 9, 2010Tyco Healthcare Group LpSurgical hand access apparatusEP1617755A2 *Apr 26, 2004Jan 25, 2006Tyco Healthcare Group LpSurgical hand access apparatusWO2004075730A2 *Feb 25, 2004Sep 10, 2004Applied Medical Resources CorporationSealed surgical access deviceWO2004075730A3 *Feb 25, 2004Dec 23, 2004Applied Med ResourcesSealed surgical access deviceWO2004096012A2 *Apr 26, 2004Nov 11, 2004Tyco Healthcare Group LpSurgical hand access apparatusWO2004096012A3 *Apr 26, 2004Mar 24, 2005Tyco HealthcareSurgical hand access apparatus* Cited by examinerClassifications U.S. Classification606/192, 606/213International ClassificationA61M29/02, A61M25/01, A61B17/00, A61B17/22, A61B17/34, A61B1/00, A61B17/02, A61F2/06, A61F2/84, A61B1/01, A61M25/04, A61M29/00, A61B1/313, A61B19/00, A61B1/012, A61B1/32, A61M39/00Cooperative ClassificationA61B17/3498, A61M29/02, A61B2017/00477, A61M25/0119, A61B2017/3482, A61B17/3423, A61B17/3431, A61B2017/3435, A61B17/3462, A61M2025/109, A61M2025/0062, A61B2017/22051, A61B2017/00557, A61B17/0293European ClassificationA61M25/01C5, A61B17/34G4A, A61B17/34HLegal EventsDateCodeEventDescriptionMar 13, 2001ASAssignmentOwner name: ATROPOS LIMITED, IRELANDFree format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:BONADIO, FRANK;MCMANUS, RONAN BERNARD;YOUNG, DEREK WILLIAM;AND OTHERS;REEL/FRAME:011600/0292;SIGNING DATES FROM 20010302 TO 20010307Aug 5, 2003CCCertificate of correctionDec 18, 2006FPAYFee paymentYear of fee payment: 4Dec 17, 2010FPAYFee paymentYear of fee payment: 8Apr 27, 2011ASAssignmentOwner name: JNC CORPORATION, JAPANFree format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:CHISSO CORPORATION;REEL/FRAME:026187/0940Effective date: 20110412Nov 28, 2014FPAYFee paymentYear of fee payment: 12RotateOriginal ImageGoogle Home - Sitemap - USPTO Bulk Downloads - Privacy Policy - Terms of Service - About Google Patents - 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