Abstract:
A surgical portal apparatus for use during a surgical procedure involving at least one suture is provided. The surgical portal apparatus includes a portal member defining a longitudinal axis and having a longitudinal opening therethrough for receiving a surgical object, and a suture management device associated with the portal member. The suture management device includes a base segment and at least one spring element mounted to the base segment. The at least one spring is configured to selectively retain at least one suture in predetermined relation relative to the portal member.

Description:
CROSS REFERENCE TO RELATED APPLICATION 
       [0001]    The present application claims the benefit of and priority to U.S. Provisional Application Ser. No. 61/148,139 filed on Jan. 29, 2009, the entire contents of which are incorporated herein by reference. 
     
    
     BACKGROUND 
       [0002]    1. Technical Field 
         [0003]    The present disclosure relates to trocars and other surgical portal apparatus, and more particularly, relates to surgical portal apparatus including a suture management system that includes a spring. 
         [0004]    2. Background of Related Art 
         [0005]    Trocars and other surgical portal apparatus are known, as are myriad procedures that may be preformed using such assemblies. Many of the minimally invasive procedures performed through access assemblies necessitate or are simplified by the use of one or more sutures passing through the surgical portal apparatus. Sutures extending into a body cavity through a surgical portal apparatus may be used to, for example, temporarily retain tissue, manipulate tissue, anchor tissue or operate peripheral devices. In an attempt to reduce the number of incision sites required to complete a given surgical procedure, a single surgical portal apparatus may be used to pass one or more sutures into a body cavity, in addition to providing access for one or more devices. A single anchor device may have numerous suture ends that extend therefrom and through the surgical portal apparatus. The sutures extending through the surgical portal apparatus may become tangled as each is manipulated or as one or more instruments are inserted and withdrawn from the assembly. Also, a surgeon may confuse the suture ends during the course of a surgery. Tangling or confusion of the suture ends may unnecessarily complicate the procedure and increase time necessary to complete the procedure. 
         [0006]    Therefore, it would be beneficial to have a surgical portal apparatus that includes a suture management system. 
       SUMMARY 
       [0007]    Accordingly, a surgical portal apparatus for use during a surgical procedure involving at least one suture is provided. The surgical portal apparatus includes a portal member defining a longitudinal axis and having a longitudinal opening therethrough for receiving a surgical object, and a suture management device associated with the portal member. The suture management device includes a base segment and at least one spring element mounted to the base segment. The at least one spring is configured to selectively retain at least one suture in predetermined relation relative to the portal member. The base segment may include markings to identify the at least one spring element. The at least one spring element may include a coating to facilitate engagement with the at least one suture. The at least one spring element may be a coil spring. The coil spring may include a plurality of coil segments, whereby the at least one suture is selectively secured within adjacent coil segments. A plurality of coil springs may be radially spaced about the base segment. 
         [0008]    In one embodiment, the base segment of the suture management device may be selectively releasable from the portal member. In the alternative, the base segment of the suture management device may be monolithically formed with the portal member. The base segment may define an opening in alignment with the longitudinal opening of the portal member. The portal member may include a housing and a sleeve extending from the housing. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0009]    The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments of the disclosure and, together with a general description of the disclosure given above, and the detailed description of the embodiment(s) given below, serve to explain the principles of the disclosure, wherein: 
           [0010]      FIG. 1  is a perspective side view of a surgical portal apparatus according to an embodiment of the present disclosure; 
           [0011]      FIG. 2  is a top view of the surgical portal apparatus of  FIG. 1 ; 
           [0012]      FIG. 3A and 3B  are perspective views of the surgical portal apparatus of  FIGS. 1 and 2  as a suture “S” engages ( FIG. 3A ) and disengages ( FIG. 3B ) the surgical portal apparatus; and, 
           [0013]      FIG. 4  is a perspective side view of a suture management system according to another embodiment of the present disclosure. 
       
    
    
     DETAILED DESCRIPTION 
       [0014]    Referring now to the drawings wherein like reference numerals illustrate similar components throughout the several views, there is illustrated surgical portal apparatus  100  in accordance with the principles of the present disclosure. As shown in the drawings and as described throughout the following description, as is traditional when referring to relative positioning on an object, the term “proximal” refers to the end of the apparatus which is closer to the user and the term “distal” refers to the end of the apparatus which is further from the user. The surgical portal apparatus herein disclosed may be configured for use in various surgical procedures, including laparoscopic, endoscopic, arthroscopic and orthopedic surgery. 
         [0015]    Referring initially to  FIGS. 1 and 2 , an embodiment of a surgical portal apparatus of the present disclosure is shown generally as surgical portal apparatus or surgical portal device  100 . Surgical portal apparatus  100  includes a portal member  102  and a sleeve  104  extending distally from portal member  102 . Surgical portal apparatus  100  may be configured for use with any known endoscopic, laparoscopic, arthroscopic, orthopedic or other suitable instrument. Sleeve  104  is configured to be inserted through the skin of a patient and into a body cavity with the aid of an obturator (not shown). Sleeve  104  may instead include a blade or piercing tip for penetrating through the skin and into the body cavity. Sleeve  104  may be integral formed with portal member  102 . Alternatively, sleeve  104  may be configured for selectable engagement with portal member  102 . 
         [0016]    Sleeve  104  forms a substantially tubular member having proximal and distal ends  104   a,    104   b  and defining a longitudinal passage  103  extending therebetween. Sleeve  104  may be composed of plastic, metal, polymers or the like. Sleeve  104  may be disposable, or in the alternative, reusable. Sleeve  104  may be rigid, or alternatively, sleeve  104  may be flexible. Sleeve  104  may be open, or instead, may be configured to include one or more seal members  105 , having any seal arrangement, for sealed reception of an instrument (not shown). Sleeve  104  may be of any configuration and of any length or diameter. Thus, it is appreciated that the embodiments of the present disclosure are not limited by the configuration of sleeve  104  and may be configured for use with any conceivable surgical portal apparatus configuration. 
         [0017]    Still referring to  FIGS. 1 and 2 , portal member  102  includes a substantially cylindrical housing  106  and a suture management system  110  operably connected to housing  106 . Housing  106  may be composed of plastic, metal polymers or the like. As discussed above, housing  106  is in operable connection with sleeve  104 . Housing  106  defines a longitudinal passage  107  and includes a tapered portion  107   a  for directing one or more instruments (not shown) into passage  103  of sleeve  104 . Housing  106  may include one or more seal members  105   b  having any seal arrangement. Housing  106  may further include an insufflation valve or port (not shown) configured to fill the body cavity of a patient with insufflation gas, saline or other suitable fluid. 
         [0018]    With reference still to  FIGS. 1 and 2 , surgical portal apparatus  100  further includes a suture management system  110 . Suture management system  110  includes a base segment  108  operably connected to a proximal end of housing  106 . As shown, base segment  108  is integrally formed with housing  106 . Alternatively, base segment  108  may be securely affixed to housing  106  with adhesives, welding or other suitable methods, or instead, base segment  108  may be selectively secured to housing  106  through friction fit, threading, mechanical fasteners or other suitable means. A series of arcuate slots  111  are formed between base segment  108  and housing  106 . Each of arcuate slots  111  are configured to permit a spring element  112  to be received about base segment  108 . 
         [0019]    Still referring to  FIGS. 1 and 2 , spring element  112  may include a coil spring having a plurality of coil segments. Alternatively, a single spring (not shown) may extend partially or entirely around base segment  108 . Springs  112  are configured to engage and retain one or more sutures “S” ( FIGS. 3A and 3B ) extending through surgical portal apparatus  100 . Springs  112  may be composed of plastic, metal, polymer or other suitable material. Depending on the diameter of the sutures “S”, spring  112  may require a tighter or looser coils to ensure secure engagement of suture “S” with spring  112 . Springs  112  may be coated (not shown) with rubber, polymer or other like material to increase the frictional engagement with suture “S” and/or to prevent damage to suture “S”. A color coating (also not shown) may be added to springs  112  to assist in differentiating between the various sutures “S” retained therein. Alternatively, base segment  108  may include reference numerals or other markings  109  to differentiate springs  112  and sutures “S” secured therein. Markings  109  may be letters, numbers, symbols, colors or other identifying feature. 
         [0020]    With reference now to  FIGS. 3A and 3B , in operation, surgical portal apparatus  100  functions similar to conventional access assemblies. As discussed above, sleeve  104  may be inserted into a body cavity through an incision with the aid of an obturator (not shown), or alternatively, sleeve  104  may be fitted with a blade to create the incision. Once surgical portal apparatus  100  is properly received within the body cavity, the body cavity may be filled with insufflation gas, saline or other suitable fluid to permit greater access to the tissue therein. Surgical portal apparatus  100  is then ready to receive one or more sutures “S” and/or one or more endoscopic, laparoscopic, arthroscopic, orthopedic or other suitable device (not shown). 
         [0021]    Referring initially to  FIG. 3A , suture “S” extends through surgical portal apparatus  100  and is pulled taut against one of springs  112 . By pulling suture “S” taut against spring  112 , a portion of suture “S” is forced between adjacent coils of spring  112 . Engagement of suture “S” within the coils of spring  112  locks suture “S” in place against base segment  108 . One or more sutures “S” may be secured in this manner utilizing the same or alternate springs  112 . At any time during the procedure, an instrument (not shown) may be inserted through passage  107  ( FIGS. 1 and 2 ) of surgical portal apparatus  100  without interfering with or tangling sutures “S”. Turning now to  FIG. 3B , suture “S” may be released from between the coils of spring  112  by lifting suture “S” away from base segment  108 . Suture “S” may be re-secured to base segment  108  in the manner described above. 
         [0022]    The use of suture management system  110  enables a clinician to actively organize and maintain one or more sutures “S” during a surgical procedure. Suture management system  110  reduces tangling of sutures “S” and prevents a clinician from becoming confused as to which suture “S” is which. Suture management system  110  further acts as a third hand for a clinician, maintaining tension on suture “S” extending from the body cavity. In this manner, suture “S” may be used to assist in retracting tissue or otherwise manipulating the tissue within the body cavity. 
         [0023]    With reference now to  FIG. 4 , an embodiment of a suture management system configured for use with a surgical portal apparatus is shown generally as suture management system  200 . Suture management system  200  defines a substantially annular portal member  204  including a housing  206  and a base segment  208  extending about a proximal end of housing  206 . Base segment  208  is substantially similar in form and function to base segment  108  described hereinabove. Base segment  208  includes a plurality of springs  212  spaced thereabout for engaging one or more sutures “S” ( FIGS. 3A and 3B ). As shown, housing  206  is configured to be selectively received on a proximal end  10   a  of a surgical portal apparatus  10 . Housing  206  may be configured for use with a conventional surgical portal apparatus. Housing  206  may be frictionally fit, threaded, mechanically fastened, or otherwise secured to surgical portal apparatus  10 . Suture management system  210  is configured to operate as surgical portal apparatus  10 , with the added capability of managing multiple sutures “S” passing therethrough. 
         [0024]    Although the illustrative embodiments of the present disclosure have been described herein with reference to the accompanying drawings, it is to be understood that the disclosure is not limited to those precise embodiments, and that various other changes and modifications may be effected therein by one skilled in the art without departing from the scope or spirit of the disclosure.