US20140058205A1 - Methods, Systems, and Devices for Surgical Access and Insertion - Google Patents
Methods, Systems, and Devices for Surgical Access and Insertion Download PDFInfo
- Publication number
- US20140058205A1 US20140058205A1 US13/738,706 US201313738706A US2014058205A1 US 20140058205 A1 US20140058205 A1 US 20140058205A1 US 201313738706 A US201313738706 A US 201313738706A US 2014058205 A1 US2014058205 A1 US 2014058205A1
- Authority
- US
- United States
- Prior art keywords
- port
- seal
- canister
- ring
- top cap
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
Links
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
- A61B17/3423—Access ports, e.g. toroid shape introducers for instruments or hands
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/0218—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for minimally invasive surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/40—Apparatus fixed or close to patients specially adapted for providing an aseptic surgical environment
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3498—Valves therefor, e.g. flapper valves, slide valves
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00283—Type of minimally invasive operation with a device releasably connected to an inner wall of the abdomen during surgery, e.g. an illumination source
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
- A61B17/3439—Cannulas with means for changing the inner diameter of the cannula, e.g. expandable
- A61B2017/3441—Cannulas with means for changing the inner diameter of the cannula, e.g. expandable with distal sealing means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
- A61B2017/3445—Cannulas used as instrument channel for multiple instruments
- A61B2017/3447—Linked multiple cannulas
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3462—Trocars; Puncturing needles with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals
- A61B2017/3464—Trocars; Puncturing needles with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals with means acting on inner surface of valve or seal for expanding or protecting, e.g. inner pivoting fingers
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3462—Trocars; Puncturing needles with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals
- A61B2017/3466—Trocars; Puncturing needles with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals for simultaneous sealing of multiple instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/30—Surgical robots
- A61B2034/302—Surgical robots specifically adapted for manipulations within body cavities, e.g. within abdominal or thoracic cavities
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/06—Measuring instruments not otherwise provided for
- A61B2090/062—Measuring instruments not otherwise provided for penetration depth
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/50—Supports for surgical instruments, e.g. articulated arms
Definitions
- the various embodiments herein relate to systems, devices, and/or methods relating to surgical procedures, and more specifically for accessing an insufflated cavity of a patient and/or positioning surgical systems or devices into the cavity.
- Invasive surgical procedures are essential for addressing various medical conditions. When possible, minimally invasive procedures such as laparoscopy are preferred.
- a surgical insertion device comprises a canister defining a lumen, a top cap coupled to a proximal end of the canister, and an incision port removably coupled to a distal end of the canister.
- the canister is sized to receive a surgical device in the lumen.
- the top cap comprises at least one lumen defined in the top cap, wherein the at least one lumen is configured to receive a support rod.
- the incision port comprises a fluidic sealing component configured to maintain a fluidic seal.
- Example 2 relates to the surgical insertion device according to Example 1, wherein the lumen is fluidically sealed in relation to ambient air.
- Example 3 relates to the surgical insertion device according to Example 1, wherein the canister comprises a flexible material or a substantially rigid material.
- Example 4 relates to the surgical insertion device according to Example 1, wherein the canister comprises a flexible portion and a substantially rigid portion.
- Example 5 relates to the surgical insertion device according to Example 1, wherein the canister has a cylindrical shape, a spherical shape, or a conical shape.
- Example 6 relates to the surgical insertion device according to Example 1, wherein the canister comprises at least one rib structure.
- Example 7 relates to the surgical insertion device according to Example 1, wherein the fluidic sealing component comprises a sealable sleeve device, a flexible seal component, a removable lid seal component, or a flap seal component.
- the fluidic sealing component comprises a sealable sleeve device, a flexible seal component, a removable lid seal component, or a flap seal component.
- Example 8 relates to the surgical insertion device according to Example 1, wherein the top cap comprises at least one of a pressure relief valve, at least one threaded lumen, a detachable cable harness, and a clamp projection.
- Example 9 relates to the surgical insertion device according to Example 1, further comprising an outer handle set coupleable to the top cap.
- Example 10 relates to the surgical insertion device according to Example 1, further comprising at least one measurement mechanism coupled to the top cap or the incision port.
- Example 11 relates to the surgical insertion device according to Example 1, wherein the canister comprises at least one access port, wherein the at least one access port is a hand access port or a side access port.
- a surgical insertion device comprises a flexible canister defining a lumen, a top cap coupled to a proximal end of the canister, an incision port removably coupled to a distal end of the canister, and a first measurement mechanism coupled with the top cap or the incision port.
- the canister is sized to receive a surgical device in the lumen.
- the top cap comprises at least one lumen defined in the top cap, wherein the at least lumen is configured to receive a support rod.
- the incision port comprising a fluidic sealing component is configured to maintain a fluidic seal.
- the first measurement mechanism is configured to measure the insertion depth of the surgical device.
- Example 13 relates to the surgical insertion device according to Example 12, wherein the first measurement mechanism comprises a sensor, a string measurement system, a substantially rigid structure system, or a camera.
- Example 14 relates to the surgical insertion device according to Example 12, wherein the fluidic sealing component comprises a sealable sleeve device, a flexible seal component, a removable lid seal component, or a flap seal component.
- the fluidic sealing component comprises a sealable sleeve device, a flexible seal component, a removable lid seal component, or a flap seal component.
- Example 15 relates to the surgical insertion device according to Example 12, wherein wherein the top cap comprises at least one of a pressure relief valve, at least one threaded lumen, a detachable cable harness, and a clamp projection.
- Example 16 relates to the surgical insertion device according to Example 12, further comprising a second measurement mechanism coupled to the top cap or the incision port, the second measurement mechanism configured to measure any tilt of the flexible canister.
- a surgical insertion device comprises a canister defining a lumen, a top cap coupled to a proximal end of the canister, and an incision port removably coupled to a distal end of the canister.
- the canister is sized to receive a surgical device in the lumen, wherein the surgical device is a robotic surgical device comprising two arms.
- the top cap comprises a pressure relief valve and at least one lumen defined in the top cap, wherein the at least one lumen is configured to receive a support rod.
- the incision port comprises a fluidic sealing component configured to maintain a fluidic seal.
- Example 18 relates to the surgical insertion device according to Example 17, wherein the fluidic sealing component comprises a sealable sleeve device, a flexible seal component, a removable lid seal component, or a flap seal component.
- the fluidic sealing component comprises a sealable sleeve device, a flexible seal component, a removable lid seal component, or a flap seal component.
- Example 19 relates to the surgical insertion device according to Example 17, wherein the top cap comprises at least one of at least one threaded lumen, a detachable cable harness, and a clamp projection.
- Example 20 relates to the surgical insertion device according to Example 17, further comprising at least one measurement mechanism coupled to the top cap or the incision port.
- FIG. 1A is a side view of an external pressurized system or apparatus, according to one embodiment.
- FIG. 1B is a perspective view of the external pressurized system or apparatus of FIG. 1A with a surgical device positioned therein.
- FIG. 2A is an exploded side view of the external pressurized system or apparatus of FIG. 1A .
- FIG. 2B is an exploded perspective view of the external pressurized system or apparatus of FIG. 1A .
- FIG. 3A is an exploded side view of a top cap, according to one embodiment.
- FIG. 3B is an exploded perspective view of the top cap of FIG. 3A .
- FIG. 4A is an exploded perspective view of a port, according to one embodiment.
- FIG. 4B is an exploded side view of the port of FIG. 4A .
- FIG. 5A is an upper perspective view of a base ring and port ring, according to one embodiment.
- FIG. 5B is a lower perspective view of the base ring and port ring of FIG. 5A .
- FIG. 6A is a top schematic view of a sealable sleeve device being positioned in an incision, according to one embodiment.
- FIG. 6B is a top schematic view of the sealable sleeve device of FIG. 6A being positioned in an incision, according to one embodiment.
- FIG. 6C is a top schematic view of the sealable sleeve device of FIG. 6A being positioned in an incision, according to one embodiment.
- FIG. 6D is a top schematic view of the sealable sleeve device of FIG. 6A being positioned in an incision, according to one embodiment.
- FIG. 7A is a side view of a fully assembled port, according to one embodiment.
- FIG. 7B is a perspective view of the fully assembled port of FIG. 7A .
- FIG. 8A is a side view of the coupling of a canister and connector ring, according to one embodiment.
- FIG. 8B is a side view of the coupling of the canister and connector ring of FIG. 8A .
- FIG. 9 is a side view of an external pressurized system or apparatus with a surgical device positioned therein, according to one embodiment.
- FIG. 10 is a perspective view of the external pressurized system or apparatus of FIG. 9 , in which the surgical device has been urged out of the system or apparatus and into the patient's cavity.
- FIG. 11 is a perspective view of the external pressurized system or apparatus of FIG. 10 , in which the canister has been removed.
- FIG. 12 is a perspective view of an balloon seal insertion system or apparatus, according to one embodiment.
- FIG. 13A is a perspective view of an balloon seal insertion system or apparatus, according to one embodiment.
- FIG. 13B is an exploded perspective view of the balloon seal insertion system or apparatus of FIG. 13A .
- FIG. 14A is a perspective view of a port housing, according to one embodiment.
- FIG. 14B is a cutaway perspective view of the port housing of FIG. 14A .
- FIG. 14C is a cutaway perspective view of the port housing of FIG. 14A .
- FIG. 15 is a perspective view of a standard sealable sleeve device, according to one embodiment.
- FIG. 16A is a cutaway side view of a balloon seal insertion system or apparatus, according to one embodiment.
- FIG. 16B is a cutaway perspective view of the balloon seal insertion system or apparatus of FIG. 16A .
- FIG. 17A is a cutaway perspective view of a balloon seal insertion system or apparatus with a first arm of a surgical device disposed therethrough, according to one embodiment.
- FIG. 17B is a cutaway perspective view of the balloon seal insertion system or apparatus of FIG. 17A in which the first arm is positioned using a connection rod.
- FIG. 18 is a cutaway perspective view of a rubber seal access/insertion device, according to one embodiment.
- FIG. 19A is an exploded side view of a rubber seal access/insertion device, according to one embodiment.
- FIG. 19B is an exploded perspective view of the rubber seal access/insertion device of FIG. 19A .
- FIG. 20 is an exploded perspective view of the separate rubber seals of a rubber seal access/insertion device, according to one embodiment.
- FIG. 21 is a top view of a rubber seal access/insertion device, according to one embodiment.
- FIG. 22 is a base ring of a rubber seal access/insertion device, according to one embodiment.
- FIG. 23 is a side view of a rubber seal access/insertion device, according to one embodiment.
- FIG. 24A is a side view of an external pressurized system or apparatus having one or more additional access ports, according to one embodiment.
- FIG. 24B is another side view of the external pressurized system or apparatus of FIG. 24A .
- FIG. 24C is a top view of the external pressurized system or apparatus of FIG. 24A .
- FIG. 24D is a perspective view of the external pressurized system or apparatus of FIG. 24A .
- FIG. 24E is another top view of the external pressurized system or apparatus of FIG. 24A .
- FIG. 24F is a cutaway side view of the external pressurized system or apparatus of FIG. 24A along the cross-section shown with the dotted line in FIG. 24E .
- FIG. 25 is a perspective view of an access port with a hand disposed therethrough, according to one embodiment.
- FIG. 26 is a top view of another access port, according to another embodiment.
- FIG. 27A is a perspective view of a port adaptor ring coupling an access port to a tube, according to one embodiment.
- FIG. 27B is a perspective view of a device access port having a device attachment component, according to one embodiment.
- FIG. 28A is a perspective view of a glove port, according to one embodiment.
- FIG. 28B is a perspective view of the glove port in FIG. 28A in use.
- FIG. 29A is a top schematic view of a sealable sleeve device being positioned in an incision, according to one embodiment.
- FIG. 29B is a top schematic view of the sealable sleeve device of FIG. 29A being positioned in an incision, according to one embodiment.
- FIG. 30 is a cutaway side view of an incision port, according to one embodiment.
- FIG. 31A is a top view of a base ring of an incision port, according to one embodiment.
- FIG. 31B is a perspective view of the base ring of FIG. 31A .
- FIG. 32 is a perspective view of a tube bracket, according to one embodiment.
- FIG. 33 is a perspective view of a tube bracket coupling a main tube to a base ring, according to one embodiment.
- FIG. 34 is a perspective view of a sleeve clamp, according to one embodiment.
- FIG. 35 is a cutaway side view of an incision port, according to one embodiment.
- FIG. 36 is a perspective view of an incision port with an internal coupling component, according to one embodiment.
- FIG. 37A is a cutaway side view of an incision port coupled to a port seal, according to one embodiment.
- FIG. 37B is a cutaway perspective view of the incision port and the port seal of FIG. 37A .
- FIG. 37C is a perspective view of the underside of a base seal ring, according to one embodiment.
- FIG. 38A is a cutaway side view of an incision port having a flap seal component, according to one embodiment.
- FIG. 38B is a cutaway side view of an incision port having a flap seal component and coupled to a port seal, according to one embodiment.
- FIG. 38C is a perspective top view of the incision port and a port seal of FIG. 38B .
- FIG. 39A is a perspective side view of an external pressurized device, according to another embodiment.
- FIG. 39B is a perspective side view of the external pressurized device of FIG. 39A .
- FIG. 40 is a side view of an external pressurized device having two slots, according to a further embodiment.
- FIG. 41A is a side view of a positioning tube, according to one embodiment.
- FIG. 41B is a top view of the positioning tube of FIG. 41A .
- FIG. 42 is a perspective view of a stacked incision port, according to one embodiment.
- FIG. 43 is a perspective view of an incision port having two seals, according to one embodiment.
- FIG. 44 is a perspective view of an incision port having two seals, according to another embodiment.
- FIG. 45A is a top view of an incision port, according to a further embodiment.
- FIG. 45B is a perspective view of the incision port of FIG. 45A .
- FIG. 46A is a top view of an air barrier incision port system, according to one embodiment.
- FIG. 46B is a top view of the air barrier port of the port system of FIG. 46A .
- FIG. 47 is a perspective side view of a rubber seal incision port, according to one embodiment.
- FIG. 48A is a perspective side view of a dual brush incision port, according to one embodiment.
- FIG. 48B is another perspective side view of the dual brush incision port of FIG. 48A .
- FIG. 49A is a perspective top view of a triple brush incision port, according to one embodiment.
- FIG. 49B is a perspective side view of the triple brush incision port of FIG. 49A .
- FIG. 50A is a side view of an insertion device, according to one embodiment.
- FIG. 50B is another side view of the insertion device of FIG. 50A .
- FIG. 50C is another side view of the insertion device of FIG. 50A .
- FIG. 51A is a side view of an insertion device, according to another embodiment.
- FIG. 51B is a top view of the insertion device of FIG. 51A .
- FIG. 52 is a side view of an insertion device, according to a further embodiment.
- FIG. 53 is a side view of a surgical device positioned in a positioning rod, according to one embodiment.
- FIG. 54A is a side view of an internal pressurized bag device, according to one embodiment.
- FIG. 54B is another side view of the internal pressurized bag device of FIG. 54A .
- FIG. 55 is a side view of another external pressurized system or apparatus, according to one embodiment.
- FIG. 56A is a perspective side view of a top cap, according to one embodiment.
- FIG. 56B is another perspective side view of the top cap of FIG. 56A .
- FIG. 57A is a perspective side view of a top cap and a canister, according to one embodiment.
- FIG. 57B is another perspective side view of the top cap and canister of FIG. 57A .
- FIG. 58A is a perspective view of a top cap with a portion of a device assembly positioned therethrough, according to one embodiment.
- FIG. 58B is a perspective view of the underside of the top cap of FIG. 58A .
- FIG. 59A is a perspective view of a top cap with a portion of a device assembly positioned therethrough, according to one embodiment.
- FIG. 59B is a another perspective view of the top cap of FIG. 59A .
- FIG. 60 is a cutaway perspective view of a top cap, according to one embodiment.
- FIG. 61A is a perspective side view of a top cap coupled to a canister with a portion of a device assembly positioned therethrough, according to one embodiment.
- FIG. 61B is another perspective side view of the top cap of FIG. 61A .
- FIG. 62A is a perspective side view of a base coupling component, according to one embodiment.
- FIG. 62B is another perspective side view of the base coupling component of FIG. 62A .
- FIG. 63A is a perspective side view of a base coupling component and an access port, according to one embodiment.
- FIG. 63B is another perspective side view of the base coupling component and the access port of FIG. 63A .
- FIG. 63C is a perspective side view of a portion of the base coupling component and the access port of FIG. 63A .
- FIG. 63D is another perspective side view of a portion of the base coupling component and the access port of FIG. 63A .
- FIG. 63E is a cutaway side view of the base coupling component and the access port of FIG. 63A .
- FIG. 64A is side view of an external pressurized system or apparatus with a base coupling component and access port, according to one embodiment.
- FIG. 64B is a top view of the external pressurized system of FIG. 64A .
- FIG. 65A is a side view of an external pressurized system or apparatus with a base coupling component and access port, according to one embodiment.
- FIG. 65B is another side view of the external pressurized system or apparatus of FIG. 65A .
- FIG. 66A is a side view of an external pressurized system or apparatus when the robotic device is lowered through an opening created by an access port, according to one embodiment.
- FIG. 66B is another side view of the external pressurized system or apparatus of FIG. 66A .
- FIG. 67A is a side view of an external pressurized system or apparatus in which the forearms of the robotic device are positioned at an angle of or near 45° in relation to the upper arms, according to one embodiment.
- FIG. 67B is another side view of the external pressurized system or apparatus of FIG. 67A .
- FIG. 68A is a side view of an external pressurized system or apparatus in which the forearms of the robotic device are positioned in a particular position, according to one embodiment.
- FIG. 68B is another side view of the external pressurized system or apparatus of FIG. 67A .
- FIG. 69A is a side view of an external pressurized system or apparatus in which the forearms of the robotic device are positioned in an appropriate starting position for a procedure, according to one embodiment.
- FIG. 69B is another side view of the external pressurized system or apparatus of FIG. 67A .
- FIG. 70 is a side view of an external pressurized system or apparatus having a flexible container, according to another embodiment.
- FIG. 71A is a perspective side view of a base coupling component, according to one embodiment.
- FIG. 71B is another perspective side view of the base coupling component of FIG. 71A .
- FIG. 72A is a perspective side view of a port attachment having a removable lid and an access port, according to one embodiment.
- FIG. 72B is another perspective side view of the port attachment and access port of FIG. 72A .
- FIG. 73A is a perspective side view of a port attachment having a removable lid and an access port, according to one embodiment.
- FIG. 73B is another perspective side view of the port attachment and access port of FIG. 73A .
- FIG. 74A is a cutaway side view of a port attachment having a removable lid and an access port, according to one embodiment.
- FIG. 74B is another cutaway side view of the port attachment and access port of FIG. 74A .
- FIG. 75A is a perspective side view of an external pressurized insertion device having a port attachment with a removable lid, according to one embodiment.
- FIG. 75B is another perspective side view of the external pressurized insertion device of FIG. 75A .
- FIG. 75C is another perspective side view of the external pressurized insertion device of FIG. 75A .
- FIG. 76 is a perspective side view of a top cap having a pressure relief valve, according to one embodiment.
- FIG. 77A is a perspective side view of a top cap having a pressure relief valve and port seal, according to one embodiment.
- FIG. 77B is a perspective cutaway view of the top cap of FIG. 77A .
- FIG. 78A is a side view of an insertion device having an actuator and sensor package.
- FIG. 78B is another side view of the insertion device of FIG. 78A .
- FIG. 78C is another side view of the insertion device of FIG. 78A .
- FIG. 79 is a side cutaway view of an insertion device having a measurement mechanism associated with the top cap, according to one embodiment.
- FIG. 80 is a side cutaway view of an incision port of an insertion device having a measurement mechanism associated with the incision port, according to one embodiment.
- FIG. 81 is a top view of a top cap of an insertion device having a string measurement system, according to one embodiment.
- FIG. 82A is a top view of a top cap of an insertion device having a substantially rigid structure measurement mechanism, according to one embodiment.
- FIG. 82B is an underside view of the top cap of FIG. 82A .
- FIG. 82C is an underside view of an incision port of the insertion device of FIG. 82A .
- FIG. 82D is a perspective view of the substantially rigid structure having a pegged ball of the insertion device of FIG. 82A .
- FIG. 82E is a top view of the incision port of FIG. 82C .
- FIG. 83 is a cutaway side view of an incision port having an insufflations port, according to one embodiment.
- FIG. 84A is a cutaway side view of an insertion device having a spherically shaped canister, according to one embodiment.
- FIG. 84B is a cutaway side view of an insertion device having a conically shaped canister, according to one embodiment.
- FIG. 85A is a cutaway side view of an insertion device having a canister with vertical rib structures, according to one embodiment.
- FIG. 85B is a cutaway side view of an insertion device having a canister with horizontal rib structures, according to one embodiment.
- FIG. 85C is a cutaway side view of an insertion device having a canister with spiral-shaped rib structures, according to one embodiment.
- FIG. 86A is a side view of a base coupler that can be releasably coupled to a canister, according to one embodiment.
- FIG. 86B is another side view of the base coupler and canister of FIG. 86A .
- FIG. 86C is another side view of the base coupler and canister of FIG. 86A .
- FIG. 86D is another side view of the base coupler and canister of FIG. 86A .
- FIG. 87A is a perspective side view of a top cap and outer handle set, according to one embodiment.
- FIG. 87B is a cutaway side view of the top cap and outer handle set of FIG. 87A .
- FIG. 87C is a perspective cutaway view of the top cap and outer handle set of FIG. 87A .
- FIG. 88A is a side view of an insertion device, according to one embodiment.
- FIG. 88B is a perspective view of a top cap of the insertion device of FIG. 88A .
- FIG. 88C is a perspective view of a mobile seal and outer handle set of the insertion device of FIG. 88A .
- FIG. 88D is a perspective view of an incision port of the insertion device of FIG. 88A .
- FIG. 89 is a side view of an insertion device having a substantially non-flexible canister portion and a substantially flexible canister portion, according to one embodiment.
- the various embodiments described herein relate to systems, devices, and/or methods for accessing an insufflated cavity of a patient and/or positioning surgical systems or devices into the cavity.
- Certain embodiments provide for insertion of the surgical systems/devices into the cavity while maintaining sufficient insufflation of the cavity. Further embodiments minimize the physical contact of the surgeon or surgical users with the surgical devices/systems during the insertion process. Other implementations enhance the safety of the insertion process for the patient and the systems/devices. For example, some embodiments provide visualization of the system/device as it is being inserted into the patient's cavity to ensure that no damaging contact occurs between the system/device and the patient. In addition, certain embodiments allow for minimization of the incision size/length. Further implementations reduce the complexity of the access/insertion procedure and/or the steps required for the procedure. Other embodiments relate to devices that have minimal profiles, minimal size, or are generally minimal in function and appearance to enhance ease of handling and use.
- any of the various embodiments disclosed herein could also be automated or made into fully automatic devices/systems and thus could be used by lightly-trained users, such as on the battlefield or during a space mission or the like.
- FIG. 1A One embodiment relates to an external pressurized system or apparatus.
- the apparatus 10 has a canister 12 with a top cap 14 coupled to a top portion 16 of the canister 12 .
- the canister 12 has a port 18 that is coupled to the canister 12 at a base portion 20 of the canister 12 .
- the port 18 is positioned in an incision in the skin 22 of the patient, thereby providing access to a cavity 24 of the patient.
- the apparatus 10 is configured to receive a surgical device 26 such that the device 26 can be inserted into the patient cavity 24 through the port 18 of the apparatus 10 .
- the canister 12 is made of a hard plastic, such as, for example, poly(methyl methacrylate) (“PMMA”).
- PMMA poly(methyl methacrylate)
- the canister 12 can be made of any known rigid material that can be used in medical devices. It is understood that certain embodiments of the canister 12 are transparent, such as those depicted in the figures provided. The transparent canister 12 allows for the user to see the surgical device 26 during insertion. Alternatively, the canister 12 is not transparent and the device 26 can be inserted without being able to view the device 26 in the canister 12 .
- FIGS. 2A and 2B provide an exploded view of the external pressurized apparatus 10 according to one embodiment.
- the top cap 14 also depicted in FIGS. 3A and 3B , is coupled to the top portion 16 of the canister 12 .
- the top cap 14 has a seal 30 that is held in place with a cover 32 .
- the cover is coupled to the top cap 14 with bolts, other similar mechanical fasteners, or any other known mechanism, device, or method for coupling two such components together.
- the seal 30 has an orifice 34 defined in the seal 34 .
- the orifice 34 is configured to receive a positioning rod 28 , as described in further detail below.
- the seal 30 is made of some type of rubber.
- the seal 30 can be made of any number of known materials that can be used to provide a fluid seal around a smooth rod, including a gel material or the like.
- the top cap 14 can have any known configuration that provides a seal having an orifice or other type of access for a positioning rod 28 or the like.
- the port 18 (also referred to herein as an “incision port”), in accordance with one implementation, has multiple components.
- the port 18 has a connector ring 40 , a base ring 42 , a port ring 44 , and a sealable sleeve device 46 .
- the sealable sleeve device 46 has an upper sleeve ring 46 A and a lower sleeve ring 46 B, both of which are coupled together by a flexible sleeve 46 C.
- the flexible sleeve 46 C has elastic properties. As best shown in FIGS.
- the port ring 44 has multiple teeth or protrusions 44 A defined in a top portion of the ring 44 in a circular configuration around a hole 50 .
- the ring 44 has a lip 52 extending from the bottom portion of the ring 44 and defining an outer edge of the hole 50 . As described below, this lip 52 can be positioned within the incision made in the patient, thereby defining the smallest circumference of the incision.
- the port ring 44 has three guide projections 54 extending from the top portion of the ring 44 , which can aid in keeping the base ring 42 positioned appropriately when it is placed on top of the port ring 44 as described below.
- the port ring 44 can also have indentations 60 around its circumference that allow a user to grasp the port ring 44 during use as described below.
- the port ring 44 can have any exterior feature or mechanism that a user can use to better grasp the ring 44 .
- the base ring 42 has an underside that has multiple indentations 42 B defined in the ring 42 .
- the indentations 42 B correspond to the protrusions 44 A in the port ring 44 such that the base ring 42 and port ring 44 can be coupled and rotational force can be transferred from one to the other, as described in further detail below.
- the features on the base ring 42 and the port ring 44 can be ridges that can easily couple together.
- the features can be any known features or physical components that can be coupled together to allow for transmission of rotational force as described herein.
- the underside of the base ring 42 has an exterior lip or ridge 62 , according to one embodiment.
- the ridge 62 is in slidable contact with the port ring 44 .
- the contact of the ridge 62 with the port ring 44 can provide a better seal that the ridges 42 B, 44 A provide alone. As such, this seal can be a secondary seal that can actually be strengthened as the sleeve device 46 is rotated and the two rings 42 , 44 are urged together.
- the connector ring 40 is configured to be coupleable with the canister 12 , as will be described in further detail below.
- the connector ring 40 is coupleable to the rest of the port 18 by being configured to be coupleable to the base ring 42 .
- the connector ring 40 has multiple threaded holes 40 A defined through the ring 40 that correspond to multiple threaded holes 42 A defined through the base ring 42 , such that screws, bolts, or the like can be inserted into and through the threaded holes 40 A, 42 A of the two rings 40 , 42 , thereby coupling the two rings 40 , 42 together.
- any known coupling components or methods can be used to couple the two rings 40 , 42 .
- the base ring 42 is coupleable to the port ring 44 .
- the protrusions 44 A are positioned in the indentations 42 B and rotational friction is established such that any rotational force applied to the base ring 42 will be transmitted to the port ring 44 (or vice versa) without any slippage between the two rings 42 , 44 .
- the base ring 42 and port ring 44 are coupled such that the holes 48 , 50 in each ring 42 , 44 correspond as well.
- any known coupling components or methods can be used to couple the two rings 42 , 44 in the same fashion.
- the external pressurized system 10 can be used to insert a surgical device or system into a cavity of a patient.
- One method of insertion will now be described, but it is understood that the embodiments disclosed herein are not limited to a single procedure and instead can be used in any procedure that falls within the spirit of the various implementations contemplated herein.
- the port 18 is placed in an incision in the following manner to create a seal for the incision that fluidly seals the patient's cavity from the ambient air outside the patient.
- an incision is made in the patient that provides access to the patient's target cavity.
- the cavity is the peritoneal cavity, but the target could be any known cavity.
- the sealable sleeve device 46 is positioned in the incision, for example as shown in FIGS. 6A , 6 B, 6 C, and 6 D.
- the device 46 is positioned through incision 58 .
- the device 46 is positioned in the incision by inserting the lower sleeve ring 46 B (not shown in FIGS.
- the lower sleeve ring 46 B of the device 46 is a flexible ring 46 B that can be deformed such that the ring 46 B can be inserted through the incision 58 .
- the device 46 prior to positioning the sealable sleeve device 46 in the incision 58 as described above, the device 46 is first positioned in a similar fashion through the hole 50 in the port ring 44 and the hole 48 in the base ring 42 . That is, the lower sleeve ring 46 B is deformed and inserted through the hole 50 and the hole 48 , thereby resulting in the upper sleeve ring 46 A being positioned on the top portion of the base ring 42 (which is positioned on the top portion of the port ring 44 ) and the lower sleeve ring 46 B being positioned on the bottom portion of the port ring 44 . The lower sleeve ring 46 B is then inserted through the incision 58 in the patient as described above.
- the sealable sleeve device 46 can be positioned through the hole 50 in the port ring 44 and the hole 48 in the base ring 42 after the device 46 has been positioned through the incision 58 .
- the upper ring 46 A is positioned over the incision 58 such that the incision 58 is centered within the ring 46 A, as shown in FIG. 6B .
- the port ring 44 is not depicted in these figures.
- the sealable sleeve 46 is then tightened to create a seal and position the lower ring 46 B snugly to the underside of the incision 58 and the upper ring 46 A snugly to the top portion of the base ring 42 . This tightening occurs by rotating the upper ring 46 A.
- the upper ring 46 A is less flexible (more rigid) than the lower ring 46 B, thereby allowing a user to grasp it and rotate it.
- FIG. 6C depicts the sealable sleeve device 46 after the ring 46 A has been rotated, thereby causing the sleeve 46 C to gather and begin to close the opening in the sleeve 46 C (or “collapse on itself”).
- FIG. 6D shows the sleeve device 46 after the user has successfully rotated the ring 46 A to the point that a seal is formed in the sleeve 46 C by closing the opening therein.
- the base ring 42 and the port ring 44 are intended to be generally rotatable relative to each other during the process of positioning the port 18 and thereby sealing the incision 58 . That is, when the base ring 42 is initially positioned on the port ring 44 , the two rings 42 , 44 are rotatable in relation to each other. This relative rotation of the two rings 42 , 44 allows for rotation of the sleeve device 46 , thereby resulting in the seal created by the sleeve device 46 when it is sufficiently constricted.
- the elasticity of the sleeve 46 C urges the base ring 42 and port ring 44 together as described above, causing the bottom surface of the base ring 42 and the top surface of the port ring 44 to come into contact such that the ridges 44 A on the port ring 44 couple with the ridges 42 B on the base ring 42 as described above.
- the interfacing ridges 44 A, 42 B provide an interface or coupling that will result in rotational coupling of the rings 42 , 44 when the rings are in contact, but also is releasable when desired. It is understood that the more force applied to urge the two rings 42 , 44 together (the more that the sleeve device 46 is rotated), the more secure the coupling of the ridges 44 A, 44 B becomes.
- the connector ring 40 is coupled to the base ring 42 .
- the connector ring 40 is coupled to the base ring 42 via nuts or bolts. Alternatively, any standard coupling device or method can be used.
- the coupling of the connector ring 40 to the base ring 42 as shown in FIG. 7A in combination with the tightening of the sleeve device 46 as described above, creates a fluid seal that seals the patient's cavity from the ambient air outside the patient. More specifically, at this point the sealable sleeve device 46 provides a seal as best shown in FIG. 6D .
- this fluidic seal is sufficient to maintain the increased air pressure of the insufflated cavity of the patient.
- the canister 12 with the medical device/system 26 positioned inside can be coupled to the connector ring 40 as best shown in FIG. 1B such that the device/system 26 can then be inserted into the insufflated cavity 24 of the patient.
- the device/system 26 (coupled to a positioning rod 28 ) must be positioned in the canister 12 . While it is understood that any number of known procedures within the spirit of the embodiments contemplated herein could be used to position the device/system 26 in the canister 12 , one implementation provides for—prior to coupling the canister 12 to the port 18 —inserting the device/system 26 through the open end (not shown) at the base portion 20 of the canister 12 (as best depicted in FIG.
- the positioning rod 28 in accordance with some embodiments, can have one or more lumens therein that can contain one or more connection components (such as wires, cords, or the like) that connect the device/system 26 to an external controller of some kind, thereby allowing for the controller to control the device/system 26 via the connection component(s).
- connection components such as wires, cords, or the like
- the canister 12 can be coupled to the connector ring 40 .
- the base portion 20 of the canister 12 has at least 2 projections 12 A extending from the canister 12 that correspond to the slots 40 B in the connector ring 40 .
- the canister 12 has 4 projections 12 A (one of which is not shown) that correspond to 4 slots 40 B in the connector ring 40 .
- the four projections 12 A are inserted into the slots 40 B and the canister 12 is rotated in a counterclockwise fashion to position the projections 12 A in the fully coupled position in the slots 40 B as shown in FIG. 8B .
- any known coupling mechanism, device, or procedure can be used to couple the canister 12 to the ring 40 .
- the canister 12 Once the canister 12 is coupled to the port 18 as best shown in FIG. 9 , a seal has been achieved that fluidically separates and seals fluid within the canister 12 from fluid outside the canister 12 . At this point, the pressure inside the canister 12 is increased until it matches the pressure of the insufflated cavity 24 . By equalizing the pressure in the canister 12 to the pressure in the insufflated cavity 24 , the device/system 26 positioned in the canister 12 can then be inserted into the cavity 24 through the seal created by the sealable sleeve device 46 without causing a loss of pressure or loss of insufflation in the cavity 24 .
- the fluidic seal is maintained in the canister 12 by the seal created between the canister 12 and the port 18 and further by the seal created between the positioning rod 28 and the seal 30 . More specifically with respect to the positioning rod 28 and the seal 30 , it is understood that the rod 28 is sized to contact the inner circumference of the orifice 34 in the seal 30 , thereby resulting in an airtight fluidic seal between the rod 28 and the seal 30 . It is understood that, at this point, if a user wants to adjust the positioning of the device/system 26 , the user can do so using the positioning rod 28 .
- the device/system 26 is moved out of the canister 12 , through the port 18 and the incision 58 , and into the patient's cavity 24 .
- the device/system 26 can be moved through the port 18 and into the cavity 24 using the positioning rod 28 , which is coupled at its distal end to the device/system 26 . That is, a user can grasp a proximal end of the rod 28 and move the rod 28 in a distal direction as desired to move the device/system 26 distally out of the canister 12 and into the cavity 24 .
- the device in those implementations in which the device/system is a robotic device having operational arms, the device, including the arms, can be advanced through the port 18 and into the insufflated cavity 24 . It is understood that the user can also turn the rod 28 to turn the device/system 26 as needed/desired as well. In this fashion, the user can position the device/system 26 as desired within the patient's cavity 24 in order to perform a procedure.
- the positioning rod 28 can be a larger rod than that depicted in these figures such that the rod 28 can have multiple lumens defined within the rod 28 , including one or more larger lumens that could be used for tool and/or camera insertion. Insufflation after removal of the canister 12 could also be accomplished through such a rod 28 .
- a port such as a known SILS port could be used instead of a rod.
- the fluidic seal is re-established between the insufflated cavity 24 and the interior of the canister 12 via the sealable sleeve device 46 .
- the pressure inside the canister 12 can be lowered until it is substantially equal to the ambient pressure.
- the canister 12 can be de-coupled from the connector ring 40 . That is, according to one embodiment, the canister 12 is rotated in the clockwise direction, thereby urging the projections 12 A out of the slots 40 B in the ring 40 .
- the port 18 itself remains with the fluidic seal established by the combination of the port 18 components, including the sealable sleeve device 46 as described above.
- the user can freely position and operate the device/system using the positioning rod 28 (and, in some embodiments, the external controller (not shown) connected to the device/system via the connection component(s)).
- the removal of the canister 12 can provide for additional accessibility and freedom of movement for the rod 28 .
- the medical procedure using the system/device 26 is typically performed once the canister 12 is removed as shown in FIG. 11 .
- FIG. 12 One example of a balloon seal insertion device 100 being used to position and operate a surgical device 102 in a patient's insufflated cavity 106 is depicted in FIG. 12 . As depicted, the insertion device 100 is positioned on the patient's skin (schematically depicted as 106 ) and through the incision in the skin (not shown). The connecting rod 104 coupled to the device 102 is positioned through the insertion device 100 , with the surgical device 102 positioned within the patient's insufflated cavity 108 .
- the insertion device 100 can maintain a fluidic seal during a surgical procedure because the device 100 has an expandable seal 114 (also referred to as an “expandable balloon” or “balloon” herein) disposed through a hole 112 defined in the port housing 110 of the device 100 .
- the balloon 114 provides a fluidic seal around any surgical device positioned through the hole 112 because the balloon 114 is flexible, expandable, and elastic.
- the balloon 114 is inflated, it provides “odd geometry molding,” which means it can be expanded around, come into contact with, and conform to the shape of any object positioned through the hole 112 , thereby creating a fluidic seal around that object, regardless of its shape.
- the insertion device 100 comprises a port housing 110 that defines a hole 112 as discussed above.
- the balloon 114 is positioned within the hole 112 .
- the housing 110 further has two balloon inflation/deflation ports 116 A, 116 B and a cavity insufflation/deflation port 118 .
- the housing 110 has two attachment components 120 configured to allow for the attachment of the coupling components 122 .
- the coupling components 122 are used to couple the housing 110 to a standard sealable sleeve 46 as will be discussed below.
- the ports 116 A, 116 B, 118 are configured to receive various types of standard valves and/or connections such as Luer locks, each of which is configured to provide an interface for external tubes, hoses, or the like for providing inflation or deflation as desired/needed.
- two connections 124 , 126 are Luer locks and one connection 128 is a Schrader valve.
- a Schrader valve is used for connection 128 in port 116 B to accommodate connection to a standard air pump while also providing a release valve to deflate the balloon seal 114 when necessary.
- any other known valves or connections used with medical devices such as, for example, any connections using standard UNF or NPT size fittings—can be used in place of connections 124 , 126 , 128 with various implementations of this device 100 .
- the various ports 116 A, 116 B, 118 are intended to couple to external hoses, tubes, or the like, one or more of which are in turn coupled to external air pressure sources. It is further understood that one or all of the external air pressure sources can be an insufflation device or an air pump typically used for inflation of a medical device. In one embodiment, the external air pressure source is a self-regulating device that self-regulates the level of the air pressure. Alternatively, the external air pressure source can be any known air pressure source that is used with inflatable medical devices.
- the balloon 114 has a top ring 140 , a bottom ring 144 , and an expandable body 142 connecting the two rings 140 , 144 . It is understood that these parts of the balloon 114 can be part of a single integral piece that makes up the balloon 114 . Alternatively, the balloon 114 can be made up of separate components.
- the top ring 140 is positioned on and coupled to the top lip 130 on the top portion of the hole 112
- the bottom ring 144 is positioned on and coupled to the bottom lip 132 on the bottom portion of the hole 112 , as best shown in FIGS. 14B and 14C .
- the rings 140 , 144 can be coupled to the lips 130 , 132 chemically (a glue or other type of adhesive) or mechanically (clamps, screws, or any other known mechanical attachment mechanisms).
- the expandable seal 114 can be any known expandable device or component that is used with medical devices and can provide a fluidic seal via odd geometry molding.
- the balloon 114 is comprised of latex or some type of rubber.
- the balloon 114 can be made of any known material used in medical devices that is expandable, elastic, and can provide a fluidic seal via odd geometry molding.
- the thickness of the seal 114 can be modified to influence how the seal 114 operates.
- various parts of the seal 114 can have different thicknesses to influence the way in which the seal 114 expands when it is inflated.
- the seal 114 can have a single thickness that can be varied to influence the resistance of the seal 114 when an object is inserted through it.
- the thickness can be varied for other reasons as well.
- an additional material or materials can be added to the seal 114 .
- a fabric or other type of material that is less elastic and/or less expandable can be included in the seal 114 to influence or control the way the seal 114 expands when it is inflated.
- a fabric could be included in a top and bottom portion of the seal 114 to prevent the seal 114 from expanding vertically (up or down) and thereby influence the seal 114 to expand horizontally.
- the attachment components 120 are threaded holes configured to receive screws or bolts or the like. Further, in this implementation, the threaded holes 120 are positioned on opposite sides of the housing 110 .
- any appropriate known attachment component 120 can be used to allow for attachment of the coupling components 122 to the housing 110 . Further, it is understood by one of ordinary skill that the number and positioning of the attachment components 120 on the housing can vary as desired to allow for different configurations and different types of coupling components 122 .
- FIGS. 14A , 14 B, and 14 C depict additional details about the configuration of the port housing 110 , according to one embodiment. More specifically, as best shown in FIG. 14B (which depicts a cross-section of the housing 110 ), the port housing 110 has two balloon inflation/deflation lumens 150 A, 150 B defined in the housing 110 .
- the balloon inflation/deflation lumen 150 A provides a fluid connection between the balloon inflation/deflation port 116 A and the hole 112 , thereby allowing for inflation or deflation of the expandable seal 114 via the port 116 A.
- the balloon inflation/deflation lumen 150 B provides a fluid connection between the balloon inflation/deflation port 116 B and the hole 112 , thereby also allowing for inflation or deflation of the expandable seal 114 via the port 116 B.
- the port housing 110 also has a cavity insufflation/deflation lumen 152 defined in the housing 110 that provides a fluid connection between the cavity insufflation/deflation port 118 and patient's cavity 108 which is in fluid communication with the underside of the housing 110 when the housing is positioned on the incision in the patient.
- This lumen 152 thus allows for insufflation or deflation of the patient's cavity 108 via the port 118 .
- the device 100 is positioned on the incision 160 in the patient in combination with a standard sealable sleeve device 162 as best shown in FIGS. 16A and 16B .
- the standard sealable sleeve device 162 is shown in FIG. 15 . It has an upper ring 164 and a lower ring 166 that are coupled together by a flexible sleeve 168 .
- the device 162 is substantially similar to the sealable sleeve device described above with respect to FIGS. 2A , 2 B, 6 A, 6 B, 6 C, and 6 D.
- the sealable sleeve device 162 is first positioned in the incision 160 . It is understood that the sleeve device 162 can be inserted using steps similar to those described above. Alternatively, any known insertion steps can be used to insert the device 162 into the incision such that the upper ring 164 is positioned outside of the incision 160 and the lower ring 166 is positioned inside the patient's cavity, with the sleeve 168 disposed through the incision 160 itself, as best shown in FIG. 16A .
- the housing 110 is coupled to the sleeve device 162 as best shown in FIGS. 16A and 16B . More specifically, according to one implementation, the housing 110 is positioned over the upper ring 164 of the sleeve device 162 such that the upper ring 164 is positioned into the circular indentation or notch 170 defined in the bottom of the housing 110 .
- the configuration of the notch 170 corresponds to the configuration of the upper ring 164 and thus is configured to receive the upper ring 164 such that the ring 164 fits snugly into the notch 170 .
- the coupling components 122 are coupled to the attachment components 120 on the housing 110 and thereby firmly couple the housing 110 to the sleeve device 162 .
- the coupling components 122 in this embodiment are components having a vertical piece 122 A and a horizontal piece 122 B.
- the vertical pieces 122 A are coupled to the attachment components 120 using a screw or bolt or similar mechanism.
- the horizontal pieces 122 B are positioned under the housing 110 such that they are also positioned under the upper ring 164 disposed in the notch 170 .
- the coupling components 122 operate to retain or lock the upper ring 164 in the notch 170 .
- the retention of the upper ring 164 into the notch 170 can provide a fluidic seal between the housing 110 and sleeve device 162 .
- any appropriate known interface between the housing 110 and sleeve device 162 that provides a fluidic seal can be used.
- the balloon 114 can be inflated using either port 116 A or port 116 B or both.
- the balloon 114 has been sufficiently inflated such that the expandable body 142 of the balloon 114 contacts itself, a fluidic seal is created between the patient's cavity and the ambient air outside the patient's body. Once this fluidic seal is established, the patient's cavity 108 can be insufflated using port 118 to the desired pressure inside the cavity 108 and the appropriate devices and/or instruments can be inserted into the cavity 108 through the expanded balloon 114 seal with loss of pressure inside the cavity 108 .
- a device/system having two robotic arms 180 , 182 are positioned in the patient's cavity 108 through the expanded balloon 114 seal. More specifically, the first robotic arm 180 is inserted into the expanded balloon 114 seal in FIG. 17A . Due to the odd geometry formation of the expanded balloon 114 , the fluidic seal is maintained even as the first arm 180 is being inserted through the balloon 114 . Once the first arm 180 is successfully inserted into the cavity 108 and positioned as desired as shown in FIG. 17B using a connection rod 184 , the second arm 182 is inserted into the balloon 114 seal. Again, the odd geometry formation of the balloon 114 allows this to occur without losing the fluidic seal and thus without losing the higher pressure of the insufflated cavity 108 .
- this figure depicts a final position of the robotic system having two arms 180 , 182 .
- the system can now be operated by a user or surgeon to perform the desired procedure.
- balloon seal devices could have more than one balloon seal provided in a single device.
- Those two or more balloon seals could be provided in various configurations.
- a second seal could be provided off to one side of the first seal and positioned at an angle so that any device or object inserted through the second seal would be inserted at an angle.
- these two or more balloon seals could be pneumatically connected to the same air pressure source(s), or, alternatively, each seal could be pneumatically separate so that each has its own pressure source and can be set at its own independent level of air pressure.
- Another access and insertion embodiment relates to a rubber seal insertion method and device for inserting a surgical device/system into a patient's cavity and performing a surgical procedure using a rubber seal access/insertion device that operates to maintain a fluidic seal at the incision such that the higher air pressure of the insufflated cavity is not lost during the procedure.
- a rubber seal access/insertion device 200 is depicted in cross-sectional view in FIG. 18 . As depicted, the access/insertion device 200 is positioned on the patient's skin (schematically depicted as 202 ) over the incision 206 in the skin 202 and is coupled to a standard sealable sleeve device 204 , which is disposed through the incision 206 .
- the access/insertion device 200 has a base ring 210 that is coupleable to the sleeve device 204 .
- the device 200 also has three seals 212 A, 212 B, 212 C positioned between the base ring 210 and the first top ring 214 .
- the device 200 has only the first set of seals ( 212 A, 212 B, 212 C) and the first top ring 214 .
- the device 200 also has a second set of three seals 216 A, 216 B, 216 C positioned between the first top ring 214 and a second top ring 218 .
- first and second top rings 214 , 126 are coupled to the base ring 210 , thereby maintaining the first set of seals 212 A, 212 B, 212 C and second set of seals 216 A, 216 B, 216 C in place such that each of the sets of seals 212 , 216 and the two top rings 214 , 218 maintain a fluidic seal.
- a set of screws or bolts are positioned through the holes 210 A, 214 A, 218 A defined in the outer circumference of each of the base ring 210 , the first top ring 214 , and the second top ring 218 , respectively, and fastened to fix the rings 210 , 214 , 218 in place.
- any known device or mechanism for holding or fixing the rings 210 , 214 , 218 (and thus the seals 212 , 214 ) in place can be used.
- the fluidic seal created by the set of seals is created by providing separate rubber seals having different types of openings defined in each such seal.
- the seals 212 A, 212 B, 212 C each have two different openings formed through them that are different from the corresponding openings in the other seals.
- Seal 212 A has two substantially circular holes 230 A, 230 B formed through the seal 212 A. The hole 230 A is larger, is positioned more centrally on the seal 212 A, and is intended to receive a surgical device or system such as a robotic surgical device.
- the hole 230 B is smaller, is positioned closer to an edge of the seal 212 A, and is intended to receive a peripheral device or component such as a trocar, a camera, or some other accessory tool. These holes 230 A, 230 B are intended to provide a fluidic seal around the perimeter of any object(s) passed through them.
- seal 212 B has two slits 232 A, 232 B formed through the seal 212 B.
- the slit 232 A is larger and is positioned in a location that corresponds to hole 230 A
- slit 232 B is smaller and is positioned in a location that corresponds to hole 230 B.
- seal 212 C has a larger slit 234 A positioned in a location corresponding to hole 230 A and slit 232 A and further has a smaller slit 234 B positioned in a location corresponding to hole 230 B and slit 232 B.
- the slits 234 A, 234 B in seal 212 C are positioned at a 90 degree angle with respect to the slits 232 A, 232 B in seal 212 B. According to one implementation, the combination of the slits 232 A, 232 B in seal 212 B with the slits 234 A, 234 B in seal 212 C results in a stronger fluid seal that can withstand the increased pressure of the insufflated cavity 208 of the patient without the slits opening and allowing that increased pressure to be lost.
- the first top ring 214 defines a hole 214 B at its center.
- the hole 214 B in the first top ring 214 creates a cavity between the two sets of seals 212 , 214 .
- any loss of the fluidic seal in one set of the seals will not cause a loss of the overall fluidic seal or leak pressure directly from the patient's cavity 208 into the ambient air outside the patient.
- the cavity created by the first top ring 214 can minimize the overall pressure loss from any such leak.
- each of the seals 212 A, 212 B, 212 C, 216 A, 216 B, 216 C is a relatively thin sheet of rubber.
- each of the seals can be made of any known flexible material that can serve as a seal in a medical device.
- each of the seals is about 0.125 inches thick.
- the thickness of each of the seals can vary between about 0.0625 and about 0.25 inches thick.
- each set of three seals 212 , 216 can be replaced with a single seal having a thickness ranging from about 0.1875 inches to about 0.75 inches. This thickness in a single seal, according to some embodiments, can provide substantially the same type of fluidic seal strength as the set of three thin seals.
- the device 200 has only one set of seals 212 A, 212 B, 212 C and only the first top ring 214 . While such embodiments do not have the cavity created by the first top ring 214 as described above, the device 200 with a single set of seals 212 can still provide a sufficient fluidic seal. For example, such a device 200 would provide a sufficient fluidic seal for insertion of any robotic device having sufficiently smooth external features and surfaces. In addition, a device 200 with a single set of seals 212 can reduce the size of the overall device 200 and can potentially reduce any trauma to the surgical device inserted through the device 200 as a result of only having to pass through a single set of seals 212 .
- FIG. 21 depicts a top view of the device 200 . More specifically, FIG. 21 shows the second top ring 218 positioned over the seal 216 A. The holes 236 A, 236 B in the seal 216 A are visible as well.
- the rubber seal access/insertion device 200 can be positioned for use in the following manner.
- the sealable sleeve device 204 is first positioned in the incision 206 . It is understood that the sleeve device 204 can be inserted using steps similar to those described above. Alternatively, any known insertion steps can be used to insert the device 204 into the incision such that the upper ring 240 is positioned outside of the incision 206 and the lower ring 242 is positioned inside the patient's cavity, with the sleeve 244 disposed through the incision 206 itself, as best shown in FIG. 18 .
- the base ring 210 (and thus the entire device 200 ) is coupled to the sleeve device 204 as best shown in FIGS. 18 and 22 . More specifically, according to one implementation, the base ring 210 is positioned over the upper ring 240 of the sleeve device 204 such that the upper ring 240 is positioned into the circular indentation or notch 250 defined in the bottom of the base ring 210 .
- the configuration of the notch 250 corresponds to the configuration of the upper ring 240 and thus is configured to receive the upper ring 240 such that the ring 240 fits snugly into the notch 250 .
- the coupling components 220 are coupled to the attachment components 252 on the base ring 210 and thereby firmly couple the base ring 210 to the sleeve device 204 .
- the coupling components 220 in this embodiment are components having a vertical piece 220 A and a horizontal piece 220 B as best shown in FIG. 19A or 22 .
- the vertical pieces 220 A are coupled to the attachment components 252 using a screw or bolt or similar mechanism.
- the horizontal pieces 220 B are positioned under the base ring 210 such that they are also positioned under the upper ring 240 disposed in the notch 250 .
- the coupling components 220 operate to retain or lock the upper ring 240 in the notch 250 .
- the retention of the upper ring 240 into the notch 250 can provide a fluidic seal between the base ring 210 and sleeve device 204 .
- any appropriate known interface between the base ring 210 and sleeve device 204 that provides a fluidic seal can be used.
- a fluidic seal has been established between the patient's cavity 208 and the external air outside of the patient.
- the patient's cavity can be insufflated to the desired amount of air pressure.
- one or more surgical devices can be inserted through the seals 212 , 216 at the appropriate holes/slits and into the patient's insufflated cavity 208 .
- each arm of a robotic surgical device can be separately and consecutively inserted through the larger hole (and larger slits) of the seals and into the cavity 208 .
- any known devices can be inserted into the cavity 208 so long as they fit through the holes and slits as contemplated herein.
- an access/insertion device relates to another external pressurized system or apparatus similar to the system or apparatus depicted in FIGS. 1-11 and described in detail above.
- the instant device is coupled to a port that is positioned over and/or in an incision in the skin of the patient, thereby providing access to a cavity of the patient.
- the external pressurized system/apparatus has a external body having one or more access ports for the insertion of not only surgical devices, but also additional equipment and/or the hands of one or more users or medical professionals, providing access to the interior of the pressurized system/apparatus without loss of the higher pressure inside the system/apparatus.
- FIGS. 24A-24F one implementation of such an external pressurized system or apparatus 300 is depicted in FIGS. 24A-24F .
- the device 300 has an external body 302 having a main tube (also referred to as the “canister”) 304 , a left hand tube 306 with a left hand access port 308 , a right hand tube 310 with a right hand access port 312 , and a side access tube 314 with a side access port 316 .
- the main tube 304 has a device port 318 coupled to a top portion of the tube 304 .
- the bottom portion of the main tube 304 is coupleable to an incision port 320 , as best shown in FIGS. 24A and 24B .
- the incision port 320 is coupleable to a standard sealable sleeve device 322 , which can be positioned in the incision 324 made in the patient's skin 326 to access a target cavity 328 of the patient.
- the incision port 320 and its coupling to both the main tube 304 and the sealable sleeve device 322 are described in detail below.
- the left and right hand access ports 308 , 312 can be configured to allow a user or medical professional to insert her or his hands through the ports 308 , 312 and into the interior of the body 302 .
- the side access tube 314 with access port 316 can be used for storage of equipment and/or for assistance of another user by inserting her or his hand through the port 316 .
- the device access port 318 can be configured such that various medical devices/systems can be inserted into the body 302 through the port 318 .
- any of the access ports 308 , 312 , 316 , 318 can be configured to allow for insertion of hands and/or equipment/devices.
- the body 302 could have a main tube 304 with one, two, or more than three additional tubes with access ports for various uses, including any of those discussed above. It is also understood that various embodiments contemplated herein include tubes and/or ports that are different sizes or shapes than those depicted. For example, in some implementations, the tubes and/or ports could be square or oval in shape.
- the external body 302 (the main tube 304 and the access tubes 306 , 310 , 314 ) is made of a hard plastic, such as, for example, poly(methyl methacrylate) (“PMMA”).
- PMMA poly(methyl methacrylate)
- the body 302 can be made of any known rigid material that can be used in medical devices. It is understood that certain embodiments of the body 302 are transparent, such as those depicted in the figures provided. The transparent body 302 allows for the user to see the interior of the tubes 304 , 306 , 310 , 314 including any equipment or devices being inserted during the procedure. Alternatively, the body 302 is not transparent and the equipment/devices can be inserted without being able to view them in the device 300 .
- the sealable sleeve device 322 can be a standard, commercially available device as described in the various embodiments above.
- the device 322 has an upper ring 420 and a lower ring 422 that are coupled together by a flexible sleeve 424 .
- the device 322 is substantially similar to the sealable sleeve device described above with respect to FIGS. 2A , 2 B, 6 A, 6 B, 6 C, and 6 D.
- the access ports 308 , 312 , 316 , 318 are standard commercially-available ports that allow various objects, including devices or hands, to be inserted through them and into a surgical space.
- One example of an access port 340 in use is depicted in FIG. 25 . As shown in that figure, the port 340 allows for insertion of a hand through the port 340 .
- Another exemplary access port 342 is depicted in FIG. 26 . This port 342 is the GelSeal® port that is commercially available from Applied Medical in Rancho Santa Margarita, Calif.
- the port 342 has a body 344 , a rigid support ring 346 , and a moveable clamp lever 348 that can be used to tighten the port 342 and thus secure the port 342 to any ringed object to which it is attached. More specifically, the clamp lever 348 is depicted in three different positions. In position A, the lever 348 is in the open position A and the port 342 thus has its widest circumference. In position B, the lever 348 is midway between the open position A and the closed position C and the port 342 has a circumference that is less than when it is in the open position A. Finally, in position C, the lever 348 is positioned against the port 342 in the closed position C and the port 342 has its smallest circumference.
- the lever 348 is typically in position A when the port 342 is positioned and then the lever 348 is moved to position C to clamp the port 342 in place.
- the body 344 is made of the soft, gel-like material in the product as provided by Applied Medical.
- the body 344 can be made of any material that allows for objects and/or hands to be inserted through the material such that the fluidic seal is maintained so that the higher pressure of the surgical cavity is not lost when an object is inserted through the material.
- the access ports 308 , 312 , 316 , 318 are coupled to the tubes 304 , 306 , 310 , 314 via a port adaptor ring 350 .
- the port adaptor ring 350 has a first ring portion 352 that is sized to mate with any one of the tubes 304 , 306 , 310 , 314 of the body 302 . (In this particular depiction, the left hand access tube 306 is used as an example.)
- the ring 350 also has a second ring portion 354 that is sized to mate with a port—in this case the left hand access port 308 .
- the first ring portion 352 is coupled to the tube 306 by positioning the first ring portion 352 over the end of the tube 306 and holding the first ring portion 352 in place using thumb screws 356 that are inserted through threaded holes 358 A in the first ring portion 352 and into threaded holes 358 B in the tube 306 .
- any attachment devices or mechanisms such as bolts, clamps, or the like, can be used to attach the first ring portion 352 to the tube 306 (and, by extension, to any of the tubes 304 , 306 , 310 , 314 ).
- a gasket (not shown), such as a foam or rubber gasket, is positioned between the tube 306 and the first ring port 352 to ensure that a fluidic seal is established between the two components.
- the access port 308 is coupled to the second ring portion 354 in a fashion similar to that described above. That is, the clamp lever 308 A on the port 308 is placed in position A, and the port 308 is positioned over the second ring portion 354 . Then the lever 308 A is moved into the closed position—position C—such that the port 308 is clamped onto the second ring portion 354 .
- any known mechanism or method for coupling a port similar to port 308 to a device component can be used.
- the device access port 318 can have one or more additional structures to allow a user to easily stabilize or position a surgical device within the body 302 of the device 300 prior to or during use. More specifically, the device access port 318 in certain implementations has one or more device attachment components 357 (also referred to as “device clips”) positioned along the inner lumen of the port 318 .
- the device clip 357 is configured to retain a device such as a positioning rod 359 within the clip 357 , thereby providing a way to couple a portion of the surgical device being used for the intended procedure to the interior of the body 302 .
- the attachment component 357 is an actual clip as shown in FIG. 27B .
- the component 357 can be a notch or other type of specifically configured indentation 357 defined in the inner lumen of the port 318 that is configured to receive a medical device such as a positioning rod 359 or the like.
- the attachment component 357 can be any mechanical or structural mechanism or component that allows for coupling to a medical device.
- such attachment components 357 can be positioned elsewhere in the body 302 , such as, for example, on an interior port of another access port or elsewhere on an interior portion of one of the tubes.
- one or more glove ports can be used such as the glove port 360 depicted in FIGS. 28A and 28B .
- the glove port 360 has a glove component 362 coupled to a glove port ring 364 .
- the glove port 360 could be coupled at the glove port ring 362 to one or more of the tubes 304 , 306 , 310 , 314 on the body 302 .
- the glove port ring 362 is coupled to the tube via a clamp lever similar to the clamp lever described with respect to FIG. 26 .
- any known coupling mechanism can be used.
- the glove port 360 does not require that a fluidic seal be established around the surgeon's arm or whatever object is inserted through it. As such, the glove port 360 can help to ensure that the pressure differential between the patient's cavity and the ambient air outside the patient will be maintained.
- the glove port 360 has a pressure relief valve (not shown) that can be used to adjust the volume, thereby accounting for the volume change caused when a user inserts her or his hand into the body 302 using the glove component 362 .
- FIG. 28B depicts the glove port 360 in use.
- the incision port 320 is configured to be coupleable to both the main tube 304 and to the sealable sleeve device 322 , as shown in FIGS. 24F and 29 .
- the incision port 320 has a base ring 370 .
- the upper portion of the base ring 370 can be coupled to an internal coupling component 372 , which can couple to the port seal 450 as described in further detail below.
- the lower portion of the base ring 370 can be coupled to external coupling components 374 (also referred to in certain embodiments as “sleeve clamps”), which couple the ring 370 to the sealable sleeve device 322 .
- the base ring 370 can also be coupled to coupling components 376 (also referred to in certain embodiments as “tube brackets”), which couple the ring 370 to the main tube 304 of the device 300 .
- FIGS. 31A and 31B depict the base ring 370 , according to one implementation.
- the ring 370 has a curved indentation or notch 378 configured to receive and couple with the bottom portion of the main tube 304 .
- the ring 370 has three bracket receiving components 380 configured to receive the tube brackets 376 .
- the bottom portion of the ring 370 defines a circular indentation or lumen 381 that is configured to be positioned over and receive the upper ring 420 of the sleeve device 322 .
- the ring 370 also has multiple holes 384 defined in an interior ring 382 .
- the multiple holes 384 correlate to holes 436 in the base plate 430 of the internal coupling component 372 , as described in detail below.
- Each of the bracket receiving components 380 have a projection 386 and horizontal portion 388 on which the tube bracket 376 is positioned and a hole 390 that corresponds to the hole 394 in the tube bracket 376 as described in detail below.
- a gasket (not shown), such as a silicon, foam or rubber gasket, is provided between the notch 378 and the bottom portion of the main tube 304 to strengthen the fluidic seal between the two components.
- FIG. 32 depicts a tube bracket 376 , according to one embodiment.
- the tube bracket 376 has a base portion 392 having a hole 394 defined therein that corresponds to the hole 390 in the bracket receiving component 380 on the base ring 370 .
- the bracket 376 also has a tube contacting portion 396 having two holes 398 defined therein that correspond to the holes 404 in the bottom portion of the main tube 302 , as described below.
- the tube bracket 376 is used to couple the main tube 302 to the base ring 370 , as shown in FIG. 33 . More specifically, the tube bracket 376 is positioned on the bracket receiving components 380 , with the base portion 392 of the bracket 376 positioned on the horizontal portion 388 and the tube contacting portion 396 positioned on the projection 386 . In that position, the bracket 376 is coupled to the base ring 370 by inserting a threaded screw 400 through hole 394 in the bracket 376 and into hole 390 in the ring 370 . Further, the bracket 376 is coupled to the main tube 302 by inserting two threaded screws 402 through holes 398 in the bracket 376 and into holes 404 in the tube 302 .
- the tube 302 is attached in position against the incision port 320 and specifically the base ring 370 using the brackets 376 .
- brackets 376 there are three tube brackets 376 —spaced about 120 degrees from each other around the circumference of the port 320 —that are used to couple the tube 302 to the port 320 .
- two brackets or more than three brackets could be used in different positions around the port 320 .
- any known type of coupling mechanism could be used to keep the tube 302 coupled to the port 320 .
- FIG. 34 depicts one embodiment of a sleeve clamp 374 .
- the clamp 374 has a hole 406 defined in a top portion of the clamp 374 , projections 408 configured to fit into the notches 410 defined under the bracket receiving components 380 on the base ring 370 (as best shown in FIG. 31B ), and a projection 412 configured to help retain the upper ring 420 of the sealable sleeve device 322 in position on the clamp 374 , as discussed below.
- the hole 406 corresponds to the hole 394 in the bracket 376 and the hole 390 in the base ring 370 such that when the sleeve clamp 374 is positioned under the bracket receiving component 380 of the base ring 370 and the threaded screw is inserted through hole 394 and hole 390 , it is also threaded into hole 406 such that the sleeve clamp 374 is coupled to the base ring 370 .
- the sleeve clamp 374 can be coupled to the base ring 370 as described and the upper ring 420 of the sealable sleeve device 322 is contacted by the clamp 374 and thereby retained in its desired position as shown. Further, the notch 412 in the clamp 374 can further help to retain the upper ring 420 .
- a gasket (not shown), such as a foam, rubber, or silicone gasket, is placed between the upper ring 420 and the underside of the base ring 370 , thereby providing a stronger fluidic seal between the two components.
- the upper portion of the base ring 370 can be coupled to an internal coupling component 372 , as best shown in FIGS. 24A , 30 , and 36 .
- the internal coupling component 372 has a base plate 430 and a male component 432 projecting from the base plate 430 .
- the base plate 430 has multiple holes 436 defined in the plate 430 . These holes 436 correspond to the holes 384 defined in the interior ring 382 of the base ring 370 such that screws 438 (or bolts or any other known coupling mechanisms) can be used to couple the base plate 430 to the interior ring 382 of the base ring 370 as shown.
- the interior portion of the male component 432 has two device attachment components 440 (also referred to herein as “device clips”) (only one such clip 440 is shown in FIG. 36 ).
- Each device clip 440 is configured to be able to allow a user to couple a positioning rod (as described elsewhere herein) or some other device component to the clip 440 before or during a surgical procedure, thereby stabilizing or maintaining the position of the device.
- the male component 432 has three notches 434 formed or engineered on its outer circumference (one of which is fully depicted in FIG. 36 ).
- the notches 434 have a vertical portion 434 A and a horizontal portion 434 B in communication with the vertical portion 434 A.
- Each notch 434 is configured to received a corresponding projection formed on an internal circumference of any device intended to couple with the male component 432 .
- the device is positioned over the male component 432 with the projections on the device positioned over the corresponding notches 434 on the male component 432 .
- the device is then positioned onto the male component 432 such that each projection moves along the vertical portion 434 A of the notch 434 until it reaches the horizontal portion 434 B. At that point, the device can be rotated and thereby move each projection circumferentially along the horizontal portion 434 B of the notch 434 , thereby coupling the device to the male component 432 of the internal coupling component 372 .
- one of the components that can be coupled to the internal coupling component 372 is a port seal 450 .
- the port seal 450 has a seal clamp 452 coupled to a base seal ring 454 .
- a seal component 456 is positioned between the clamp 452 and the ring 454 so that the coupling of the clamp 452 to the ring 454 fixes the seal component 456 in place in the port seal 450 .
- the seal clamp 452 has multiple holes 458 defined in the clamp 452 that correspond to holes (not shown) in the base seal ring 454 such that threaded screws 460 (or bolts, or the like) can be inserted through the holes 458 and into the holes in the ring 454 to couple the two components together.
- a gasket (not shown), such as a foam, silicone, or rubber gasket, can be positioned between the male component 432 and the base seal ring 454 to strengthen the fluidic seal between the two components.
- the seal clamp 452 in one embodiment, has multiple projections 464 extending from the top surface of the clamp 424 . These projections 464 can be easily grasped by a user to place the port seal 450 on the male component 432 or remove it therefrom. Further, as best shown in FIG. 37C , the underside of the base seal ring 454 has three projections 462 disposed on the inner circumference of the ring 454 . The three projections 462 correspond to the three notches 434 defined in the outer circumference of the male component 432 such that the base seal ring 454 can be coupled to the male component 432 as described above.
- the seal component 456 (also referred to herein as a “flexible seal component” or an “elastic seal component”) is a circular sheet of flexible or elastic material that is configured to allow a device or other equipment to be inserted through the seal component 456 (or to allow the seal component 456 to be positioned over such equipment, like a positioning rod, as described in further detail below).
- the seal component 456 is a circular rubber sheet having a small hole (not shown) in the sheet through which equipment can be inserted.
- the seal component 456 can be any known material configured to maintain a fluidic seal when a device or equipment is inserted through the seal component 456 .
- a different type of seal component can also be incorporated into the device 300 .
- a flap seal component 470 is provided.
- the flap seal component 470 has two flaps—a first flap 472 and a second flap 474 —that contact each other at a midpoint in the component 470 .
- Each of the flaps 472 , 474 has ridges or teeth 472 A, 474 A on the surfaces that are in contact such that the ridges 472 A on flap 472 correspond to the ridges 474 A on flap 474 and thus interface or couple with each other.
- the flap seal component 470 is positioned between the base ring 370 and the internal coupling component 372 .
- the configuration of the flaps 472 , 474 extended downward toward the patient's cavity and the coupled ridges 472 A, 474 A can provide structural strength to prevent a mechanical failure (also referred to as a “blowout”) in which the flaps 472 , 474 are forced outward by the higher air pressure until the flaps 472 , 474 are extending outward away from the patient's cavity and the fluidic seal is lost.
- a mechanical failure also referred to as a “blowout”
- the flap seal component 470 can be incorporated into the incision port 320 and used when the port seal 450 is not coupled to the port 320 .
- the flap seal component 470 can be incorporated into the incision port 320 and used when the port seal 450 is coupled to the port 320 .
- the various embodiments disclosed or contemplated herein relating to access and insertion systems, devices, and methods that relate specifically to an external device having one or more ports for the insertion of not only medical devices, but also related equipment and/or the hands of one or more medical professionals to access the interior of the device during medical procedures while being able to maintain a higher air pressure within the device that is substantially the same as the insufflated cavity of the patient.
- the high pressure is around 18 mmHg above atmospheric pressure, which is around the amount of pressure that is used to insufflate a patient's abdominal cavity during a laparoscopic procedure.
- any known higher pressure amount that is used during medical procedures can be used.
- the method of using the device 300 includes at least some of the following steps.
- the sealable sleeve device 322 is first positioned in the incision 324 (see FIGS. 24F , 29 A, 29 B, and 30 ). It is understood that the sleeve device 322 can be inserted using steps similar to those described above. Alternatively, any known insertion steps can be used to insert the device 322 into the incision 324 such that the upper ring 420 is positioned outside of the incision 324 and the lower ring 422 is positioned inside the patient's cavity, with the sleeve 424 disposed through the incision 324 itself, as best shown in FIG. 30 .
- the incision port 320 and the device 300 are coupled to the sealable sleeve device 322 .
- the base ring 370 of the incision port 320 is positioned over the upper ring 420 of the sleeve device 322 such that the upper ring 420 is positioned in the lumen 381 on the bottom portion of the base ring 370 .
- the bottom portion of the main tube 304 of the device body 302 can be positioned in the curved notch 378 on the base ring 370 .
- both the device 300 and the sleeve device are positioned as desired with respect to the incision port 320 and must be coupled to the port 320 .
- the tube brackets 376 and the sleeve clamps 374 are positioned on the base ring 370 as described above and fixed in place using the threaded screws 400 . Then the threaded screws 402 are placed as well. As such, the incision port 320 is coupled to both the device 300 and the sleeve device 322 and a fluidic seal is created between the interior of the body 302 and the exterior.
- At least one medical device or piece of equipment that will be used during the procedure can be placed in the body 302 prior to coupling the body 302 to the incision port 320 .
- the device 480 disposed within the body 302 as best shown in FIGS. 24A , 24 B, 24 D, and 24 F can be positioned within the body 302 and, in some implementations, secured to a device clip 357 (as shown in FIG. 27B ). More specifically, in the particular embodiment depicted in FIGS. 24A , 24 B, 24 D, and 24 F, the device 480 is made up of two arms 482 A, 482 B that are positioned within the body 302 . Alternatively, any medical device that will be used for the surgical procedure could be positioned within the body 302 in the same or a similar fashion.
- the port seal 450 is not coupled to the internal coupling component 372 (which is coupled to the incision port 320 ) at this point during the placement of the device 300 .
- the port seal 450 is stored in the side access tube 314 while the body 302 is being coupled to the port 320 , as best shown in FIGS. 24B , 24 C, and 24 D.
- the port seal 450 can be uncoupled from the internal coupling component 372 and placed in the side access tube 314 prior to positioning the medical device inside the body 302 and coupling the body 302 to the incision port 320 .
- the fluidic seal within the device 300 has been established, and the patient's cavity can be insufflated. This insufflation will result in an increase in air pressure within the patient's cavity and within the device 300 (because neither the port seal 450 nor the flap seal 470 is nt coupled to the internal coupling component 372 ).
- the device 480 is positioned through the incision port 320 and into the patient's cavity. More specifically, the user or medical professional inserts her or his hands into the left and right hand access ports 308 , 312 and moves the medical device through the incision port 320 and into position within the cavity. At this point, if the medical device has a positioning rod 359 , that rod 359 can be coupled to a device clip 440 on the interior of the male component 432 of the internal coupling component 372 of the port 320 , thereby establishing, maintaining, or fixing the position of the medical device within the patient's cavity. Alternatively, the device can be positioned and maintained in that position using any type of mechanism or method, including some type of device or method independent of the device 300 .
- the port seal 450 can be positioned in place over the device (or the positioning rod 359 —or rods—of the device). That is, the user reaches in through the hand access ports 308 , 312 and removes the seal 450 from the side access tube 314 and placed over the device/rod 359 so that the device and/or rod 359 is inserted through the seal component 456 of the seal 450 and then coupled to the male component 432 of the internal coupling component 372 as described above.
- the body 302 can be removed from the incision port 320 . More specifically, the user can remove the threaded screws 402 and then remove the main tube 304 from the port 320 . The fluidic seal between the patient's cavity and the ambient air outside the patient's body is maintained by the port seal 450 .
- the user/medical professional can then begin performing the medical procedure.
- the device 500 is a single tube 502 having a single access port 504 disposed at the top of the tube 502 .
- the access port 504 serves to establish a fluidic seal when a medical device or a surgeon's hand is inserted through the port 504 .
- the tube 502 also has two camera ports 506 extending from a bottom portion of the tube 502 .
- the tube 502 is configured to couple to an incision port, including any incision port disclosed elsewhere herein or any known incision port.
- a further embodiment depicted in FIG. 40 is another alternative external pressurized device 510 .
- the device 510 has a tube 514 that is coupleable to an incision port 516 and has two slots 511 , 513 formed on opposite sides of the tube 514 . These slots 511 , 513 provide fluid communication between the interior of the tube 514 and the exterior of the tube 514 .
- the rod slots 512 are each configured to receive a positioning rod.
- the device 510 further has two slot seals 512 , with one seal 512 positioned in each of the slots 511 , 513 .
- the tube 514 also has two sets of device attachment components 518 A, 518 B (also referred to as “rod clips”). Each set of rod clips 518 A, 518 B has two device clips—a horizontal clip 515 A and an angled clip 515 B.
- a device in use, can be positioned within the tube 514 such that a positioning rod coupled to the device extends out of the tube 514 through one of the slots 511 , 513 .
- the device can be fixed in position in the tube 514 by coupling the positioning rod to the horizontal clip 515 A.
- the patient's cavity can then be insufflated.
- the positioning rod can be moved down the slot ( 511 or 513 ) such that the device is being moved down the interior of the tube 514 and inserted through the port 516 and into the patient's cavity.
- the positioning rod is angled upward and clipped to the angled clip 515 B, thereby fixing the positioning of the device inside the patient's cavity.
- FIGS. 41A and 41B Another implementation relates to a positioning tube 520 as depicted in FIGS. 41A and 41B .
- the positioning tube 520 can also act as a large positioning rod.
- the tube 520 has two guide slots 522 defined in or attached to an inner portion of the tube 520 .
- the guide slots 522 are each configured to receive a positioning rod 524 .
- each device 526 (or device arm) is coupled to an end of one of the positioning rods 524 and can be inserted through the tube 520 and into the patient's cavity. Due to the size of the tube 520 , the devices 526 must be inserted one at a time. Alternatively, the tube 520 can be sized so that both devices 526 can be inserted at the same time.
- the tube 520 also has an air lock 528 disposed in the tube 520 .
- the air lock 528 is configured to be capable of fluidically dividing the tube 520 into two fluidically separate compartments when the air lock 528 is closed.
- the positioning tube 520 (having a robotic arm 526 disposed within the tube 520 ) can be inserted through any of the various incision ports described elsewhere herein.
- a seal is created at the top of the top by placing a seal cap (not shown) on the top of the tube 520 .
- the positioning rod 524 can be urged distally and thereby the arm 526 is urged out of the tube 520 and into the patient's cavity. If a second arm 526 is going to be inserted, the air lock 528 is then closed.
- the air lock 528 is closed to create a fluidic seal between the top of the tube 520 and the bottom of the tube 520 .
- the seal cap is removed, and the second arm 526 can be positioned in the tube 520 .
- the seal cap can be replaced, the air lock 528 can be released, and the second arm 526 can be inserted into the patient's cavity.
- FIG. 42 depicts a stacked incision port 540 .
- the port 540 actually has two access ports 542 , 544 that are coupled together, with a cavity 546 between the two access ports 542 , 544 .
- the access ports 542 , 544 are commercially available GelSeal® ports.
- the cavity 546 between the two access ports 542 , 544 strengthens the overall fluidic seal of the port 540 . In other words, the cavity 546 reduces the amount of air pressure loss because any air pressure loss is lost in the cavity and not lost to the ambient air, thereby reducing the overall loss.
- FIG. 43 Another incision port embodiment is depicted in FIG. 43 .
- This incision port 550 actually has two seals combined in the port: a rubber seal 552 and a flap seal 554 .
- the port 550 also has two camera ports 556 extending out from the port 550 .
- the rubber seal 552 has three different rubber disks (not shown) similar to the different disks depicted in FIG. 20 and described above.
- the disks in this rubber seal 552 can have openings/incisions that differ for each disk in the same fashion as the disks shown in FIG. 20 .
- the rubber seal 552 can be similar to any rubber or flexible seal described elsewhere herein.
- the flap seal 554 is similar to the flap seal depicted in FIGS. 38A-38C .
- FIG. 44 depicts another incision port embodiment. More specifically, this port is a two-seal port 560 having a first rubber seal 562 and a second rubber seal 564 .
- the port 560 also has a base ring 570 , a middle ring 568 , and a top ring 566 .
- the middle ring 568 creates a cavity (not shown) between the two seals 562 , 564 that is configured to compartmentalize any lose of pressure by either of the seals 562 , 564 .
- the presence of the cavity makes this embodiment fairly similar to the incision port depicted in FIG. 42 .
- each sheet of rubber 562 , 564 is about 0.5 inches thick and has a single slit (not shown) formed through the middle of it.
- each sheet 562 , 564 can have two openings (not shown) formed through the middle of it.
- FIGS. 45A and 45B depict a further incision port embodiment.
- This port is a three-sheet rubber seal port 580 having a single ring 582 in which three sheets of rubber (only the top sheet 584 is shown).
- each of the three sheets has an opening in it that corresponds to the openings in the other two sheets.
- the openings are similar to those depicted in FIG. 20 and described.
- each sheet can have two corresponding openings.
- FIGS. 46A and 46B depict a further incision port system embodiment.
- This system is an air barrier port system 590 having an air barrier port 592 .
- This port 592 is coupled to four air tubes 596 A, 596 B, 596 C, 596 D that are coupled to an air intake port 594 .
- high pressure air is provided at the air intake port 594 and is forced through the four tubes 596 A-D and into the port 592 .
- the four tube connections 598 A, 598 B, 598 C, 598 D are positioned on the port 592 such that the air is forced into a channel (not shown) that encircles the hole 600 in the port 592 .
- the air is then forced through a circular nozzle (not shown) in communication with the channel (not shown) that projects the air out of the nozzle and across the hole 600 .
- the air flow projected across the hole 600 is both directed and has a high velocity—both of which have an impact on the creation of an air barrier.
- an air barrier is created in the hole 600 defined in the port 592 . That is, the high velocity air movement across or within the hole 600 creates a fluidic seal that is sufficient to maintain the insufflation of a patient's cavity.
- FIG. 47 depicts another incision port embodiment—in this case, a one-sheet rubber seal port 610 having a single sheet of rubber 612 (other flexible seal material) positioned between a base ring 614 and a top ring 616 .
- the sheet has slit (not shown) formed in it through which a surgical device or other equipment can be inserted.
- the sheet can have two slits or other types of openings.
- FIGS. 48A and 48B Another incision port embodiment is shown in FIGS. 48A and 48B .
- This port is a dual brush port 620 .
- This port 620 has a body 622 with a first brush holder 624 and a second brush holder 626 .
- the first brush 628 is positioned in the first brush holder 624 and the second brush 630 is positioned in the second brush holder 626 .
- the body 622 has an opening 632 formed in a bottom portion of the body 622 that can provide access to the patient's cavity.
- the brush bristles of the two brushes 628 , 630 are mingled and meshed together at the brush seal 634 such that the mesh of bristles creates a fluidic seal that is sufficient to maintain a patient's insufflated cavity.
- FIGS. 49A and 49B depict another brush port—in this case, a triple brush port 640 .
- This port 640 has a body 642 with first, second, and third brush holders 644 , 646 , 648 .
- the first brush 650 is positioned in the first brush holder 644
- the second brush 652 is positioned in the second brush holder 646
- the third brush 654 is positioned in the third brush holder 648 .
- the body 642 has an opening (not shown) formed in a bottom portion of the body 642 that can provide access to the patient's cavity.
- the brush bristles of the three brushes 650 , 652 , 654 are mingled and meshed together at the brush seal 656 such that the mesh of bristles creates a fluidic seal that is sufficient to maintain a patient's insufflated cavity.
- FIGS. 50A , 50 B, and 50 C depict an insertion device 670 that can be used to insert both arms of a robotic surgical device into a patient's cavity.
- the insertion device 670 has an insertion tube 672 through which an insertion rod 674 is slidably disposed.
- the device has a first arm 676 A and a second arm 676 B, both of which are coupled to the distal end of the tube 672 .
- the first arm 676 A is coupled to an end bracket 680 A coupled to an end of the first device body 682 A, while the second arm 676 B is coupled to an end bracket 680 B coupled to an end of the second device body 682 B.
- the insertion rod 674 is coupled to two center brackets (only bracket 678 A is visible in the figures)—one center bracket 678 A coupled to a middle portion of the first body 682 A and a second center bracket (not shown) coupled to a middle portion of the second body 682 B.
- the insertion device 670 can be used to insert a two-armed surgical device through a hole (such as an incision, a port, or the like) and into a patient's cavity prior to operating the device within the cavity.
- a hole such as an incision, a port, or the like
- the insertion device 670 initially maintains an insertion configuration (as best shown in FIG. 50A ) such that the surgical device has its smallest circumferential profile, thereby allowing it to pass through smaller holes.
- the insertion device 670 can be moved into its deployed configuration (as best shown in FIG. 50C ) such that the surgical device is in its operational configuration.
- a user or surgeon retracts the insertion rod 674 in a proximal direction (away from the surgical device.
- This retraction of the rod 674 urges the two center brackets (with only center bracket 678 A of body 682 A depicted) in the same proximal direction.
- the two end brackets 680 A, 680 B are retained in substantially the same position by the two arms 676 A, 676 B, the result is that the two device bodies 682 A, 682 B move through a transition depicted in FIG. 50B and into the operational configuration depicted in FIG. 50C .
- the user or surgeon can use the surgical device, including its two arms 684 A, 684 B to perform the planned surgery or procedure.
- FIGS. 51A and 51B depict an alternative embodiment of an insertion device 690 (in the same spirit as the insertion device depicted in FIGS. 50A-C ). While the above embodiment in FIGS. 50A-C depict an insertion device for use with a two-armed device, this insertion device 690 is used with a single arm 704 or with two arms that are inserted separately. That is, in this embodiment, a single device arm 704 is coupled to the insertion device 690 . As shown, this device is positioned through an insertion tube 692 (which can also be a positioning or support rod). The device has two moveable rods 694 , 696 slidably disposed within the support rod 692 .
- the first moveable rod 694 is coupled at its distal end to a first robotic arm 704 and at its proximal end to a control lever 698 .
- the second moveable rod 696 is coupled at its distal end to a coupling link 700 (that is coupled to the arm 704 ) and at is proximal end to a coupling link 702 (that is coupled to the lever 698 ).
- the lever 698 can be actuated to cause the first and second rods 694 , 696 to move in relation to each other. This movement of the rods 694 , 696 can be used to move the arm 704 and thereby position the arm 704 as desired or needed inside the patient's cavity.
- FIG. 51B which is a cross-section of the support rod 692 , showing that the support rod 692 can have two separate lumens 706 , 708 or slots, one for each of the moveable rods 694 , 696 .
- the first moveable rod 694 is positioned in the first lumen 706 and the second moveable rod 696 is positioned in the second lumen 708 .
- this support rod 692 could have two halves—a right half 710 and a left half 712 —that are coupleable at the mating feature 714 .
- the two halves can be coupleable by any known mechanical means.
- the right half 710 is configured to hold the first and second rods 694 , 696 relating to the first (or right) arm 704
- the left half is configured to hold the first and second rods 716 , 718 relating to a second (or left) arm (not shown).
- This embodiment can thus be used with two arms, with each arm being inserted and positioned separately.
- FIG. 52 depicts another embodiment in which two separate arms can be inserted and positioned separately by using an overtube 722 .
- the first moveable rod 724 and second moveable rod 726 are still positioned within a support rod 728 .
- the support rod 728 is positioned within an overtube 722 .
- the overtube 722 can be pass over the top of the support rod 728 in order to couple the support rod 728 to a second support rod (not shown) or another half of a support rod.
- This embodiment is another way to couple the two support rods or two halves of a support rod just as the mating feature 714 accomplishes that task in the prior embodiment.
- the surgical device or robotic arm has a motor 740 provided that can be positioned in the positioning or support rod 744 and is coupled to the robotic arm 742 , there is no need for a separate insertion device. Instead, the arm 742 can easily be positioned by actuating the motor 740 and transfer the motive force through the beveled gears 746 and to the arm 742 .
- FIGS. 54A and 54B depict a different type of access/insertion device in comparison to the devices described above.
- the internal pressurized bag device 750 shown in these two figures is initially positioned in the patient's cavity.
- the device 750 has a port seal 752 , an outer sleeve 754 , and an inner sleeve 756 .
- the outer sleeve 754 is releasably sealed at the distal end 758 . That is, the outer sleeve 754 has a releasable seal that can be intentionally broken or released at a desired time during the procedure, as described below.
- the entire device 750 can be positioned through an incision port such that the inner and outer sleeves 754 , 756 are positioned inside the patient's cavity with the port seal 752 coupled to the incision port (thereby creating a fluidic seal).
- the patient's cavity can be insufflated, and the outer sleeve 754 can be pressurized to a pressure that is greater than the pressure of the insufflated cavity, thereby expanding the outer sleeve 754 to its maximum expansion (and, in some cases, making the outer sleeve 754 substantially rigid).
- the surgical device can be inserted through the incision port and into the outer sleeve 754 and positioned as desired.
- the outer sleeve 754 can be removed by releasing the releasable seal at the distal end of the sleeve 754 .
- the releasable seal could be a chemical seal such as an adhesive that can be deactivated by applying a different composition to it.
- the releasable seal could be a mechanical release such as a pull cord or something of the like.
- the releasable seal could be any known mechanism or method for being able to release the seal.
- FIG. 55 depicts another implementation of an external pressurized system or apparatus 800 .
- the apparatus 800 has a container 802 with a top cap 804 coupled to a top portion of the container 802 .
- the container 802 has a port 806 that is coupled to the container 802 at a base portion of the container 802 .
- the port 806 is configured to be positionable in an incision in the skin of the patient, thereby providing access to a cavity of the patient.
- the apparatus 800 is configured to receive a surgical device 808 such that the device 808 can be inserted into the patient cavity through the port 806 of the apparatus 800 .
- the container 802 in this device 800 is made of a flexible material such as, for example, polyethylene plastic, latex, nylon, or silicone rubber.
- the container 802 can be manipulated and configurable with respect to the shape of the container 802 , and more specifically can be compressed longitudinally such that the height of the container 802 can be reduced during insertion of a robotic device into a patient's cavity. This will be described in further detail herein.
- the top cap 804 is depicted in further detail in FIGS. 56A-61B .
- the top cap 804 has a cap body 810 , a detachable cable harness 812 , an access lumen 814 , support rod lumens 816 , threaded lumens 818 , and a clamp projection 820 .
- the cap 804 has a notch 822 defined in the cap 804 that is configured to receive the harness 812 .
- the notch 822 has five channels 824 A defined or formed in the notch 822 .
- the channels 824 A match with the channels 824 B defined in the detachable harness 812 such that when the harness 812 is positioned in the notch 822 and thus coupled with the cap body 810 , the channels 824 A and the channels 824 B match up to form lumens 824 as best shown in FIG. 56B .
- the lumens 824 can be formed in different sizes and configured to receive various cables and/or suction/irrigation tubes the extend from an external controller through the top cap 804 to the surgical device 808 .
- the cap body 810 has a groove 826 formed or defined around the outer edge of the body 810 , including the outer edge of the harness 812 , such that when the harness 812 is coupled to the body 810 , an O-ring can be positioned around the outer edge of the body 810 in the groove 826 .
- FIGS. 57A and 57B depict the top cap 804 being coupled to the canister 802 .
- the flexible canister 802 is positioned over the peripheral edge of the body 810 as best shown in FIG. 57B and an elastic ring (also referred to as an “O-ring”) 828 is positioned around the canister 802 at the groove 826 such that a portion of the canister 802 is positioned between the body 810 and the ring 828 in the groove 826 and the ring 828 urges the canister 802 into the groove 826 , thereby creating a fluidic seal between the canister 802 and the top cap 804 .
- silicone sealant can be applied to the groove 826 to enhance the strength of the fluidic seal.
- the O-ring 828 can also help to secure the cap body 810 and the harness 812 together.
- the O-ring 828 can be any elastic member that can be used to maintain a fluidically sealed coupling of the canister 802 and the top cap 804 .
- any coupling mechanism can be used.
- FIGS. 58A and 58B depict a portion of the device assembly 808 being positioned through the top cap 804 . More specifically, the support rods 830 coupled to the device 808 are slidably positioned through the lumens 816 in the cap body 810 . Further, according to one implementation, a portion of the device 808 also couples to or mates with the top cap 804 . More specifically, a stabilization protrusion 832 on the device 808 is coupleable with a mating hole 834 defined or formed in an underside of the body 810 as best shown in FIG. 58B . The positioning of the stabilization protrusion 832 in the mating hole 834 creates a pathway from lumen 814 into and through the stabilization protrusion 832 , thereby allowing for passage of additional tools or cameras through the device 800 without losing pressure.
- the top cap 804 is coupled to the support rods 830 with two threaded set screws 840 .
- the set screws 840 are threaded through lumens 818 as best shown in FIG. 59B . More specifically, the set screws 840 can be screwed into the threaded lumens 818 until the screws 840 contact the support rods 830 .
- the set screws 840 are configured to exert pressure on the support rods 830 , thereby creating frictional resistance that helps to secure the support rods 830 and thus the device 808 to the top cap 804 .
- a connection cable 842 that is coupled at its distal end to the robotic device 808 is positioned through one of the lumens 824 . It is understood that other cables can be positioned through the additional lumens 824 as well. In accordance with one embodiment, the cables are positioned in the channels 824 A or 824 B prior to coupling the harness 812 to the body 810 . Alternatively, one or more of the cables can be inserted through one of the lumens 824 after the body 810 and harness 812 are coupled together.
- FIGS. 61A and 61B show the container 802 coupled to the top cap 804 .
- FIGS. 62A and 62B depict the base coupling component (also referred to as the “base coupler”) 850 that is coupled to a bottom portion of the container 802 .
- the base coupler 850 has an upper groove 852 , a lower groove 854 , and three coupling protrusions (also referred to as “coupling notches”) 856 that extend from a portion of the coupler 850 between the upper and lower grooves 852 , 854 .
- the container 802 is coupled to the base coupler 850 using an O-ring 858 . More specifically, the container 802 is positioned over the upper portion of the coupler 850 such that the container 802 is positioned over the upper groove 852 and adjacent to or against the three protrusions 856 .
- the O-ring 858 is positioned over the container 802 at the upper groove 852 such that the O-ring 858 urges a portion of the container 802 into the groove 852 , thereby creating a fluidic seal between the container 802 and the base coupler 850 .
- FIGS. 63A , 63 B, 63 C, 63 D, and 63 E depict the coupling of the base coupler 850 to the access port 806 .
- the access port 806 has a top portion (or “top ring”) 860 , a bottom portion (or “bottom ring”) 862 , and a middle portion (or “neck”) 864 .
- the top ring 860 has three coupling protrusions (also referred to as “coupling tabs”) 866 that extend from a portion of the top ring 860 and are configured to mate with the coupling notches 856 .
- the access port 806 is a known standard device used in hand-assisted laparoscopic surgery. As is understood in the art, the access port 806 provides a structured open pathway through the cavity wall, such as the abdominal wall. at the incision site. In one particular example, the access port 806 is a commercially available retractor port 806 called the DEXTRUS® Retractor, which is available from Ethicon Endo-Surgery.
- the base coupler 850 is coupled to the access port 806 using an O-ring 868 . More specifically, the O-ring 868 is positioned in the lower groove 854 of the coupler 850 and the top ring 860 is positioned over the lower portion of the coupler 850 and the O-ring 868 in the groove 854 such that the O-ring 868 is compressed between the coupler 850 and the top ring 860 , thereby creating a fluidic seal between those two components.
- the coupling tabs 866 of the access port 806 are coupled with the coupling notches 856 of the base coupler 850 , thereby enhancing the stability of the coupling of the coupler 850 and the access port 806 .
- FIG. 63E depicts the entire coupling of the container 802 to the access port 806 via the coupler 850 as described above. Further, FIGS. 64A and 64B depict the external pressurized insertion device 800 in use, with the device 800 coupled to an access port 806 that is positioned in an incision in a patient's skin 870 .
- the access port 806 and the external pressurized device 800 are positioned for a surgical procedure in the following manner.
- the robotic device 808 is positioned inside the insertion device 800 prior to placing the port 806 and the device 800 in the appropriate surgical position. That is, the robotic device 808 is positioned inside the container 802 , the support rods 830 coupled to the device 808 are secured to the top cap 804 with the set screws 840 , any connection cables coupled to the device 808 are positioned through the lumens 824 in the top cap 804 , and the flexible container 802 is coupled and fluidically sealed to the top cap 804 and the base coupler 850 via the O-rings 828 , 858 .
- the robotic device 808 is positioned inside the insertion device 800 after positioning the port 806 and device 800 .
- the port 806 is positioned first in certain implementations. That is, in one embodiment, the bottom ring 862 is first inserted through the incision previously made in the patient's cavity wall. Once the ring 862 is positioned through the incision and inside the cavity, the ring 862 can help constrain the entire port 806 within the incision by expanding to a diameter that is greater than the diameter of the incision, as best shown in FIG. 64A .
- the container 802 and the coupler 850 are coupled to the access port 806 prior to positioning the port 806 in the incision.
- the port 806 is first positioned in the incision, and then the coupler 850 and the container are coupled to the port 806 . Regardless, once the access port 806 and insertion device 800 are positioned, the patient's cavity can then be insufflated. Due to the fluidic communication between the cavity and the interior of the container 802 that is created by the access port 806 , the entire interior of the insertion device 800 will be under the same pressure as the cavity.
- the process of inserting the robotic device 808 into the patient's insufflated cavity can take place in the following manner as best shown in FIGS. 65A-69B .
- the robotic device 808 begins with both arms parallel and vertical to the incision, as best shown in FIGS. 65A and 65 B.
- the robot 808 is lowered through the opening created by the access port 806 as shown in FIGS. 66A and 66B .
- FIGS. 65A and 65B As best shown by comparing FIGS. 65A and 65B with FIGS.
- the flexible container 802 shrinks in height by allowing portions of the flexible material of the container 802 to “crumple” or begin forming folds such that the top cap 804 moves closer to the access port 806 .
- the forearms are rotated at the elbow joints until the forearms are positioned at an angle of or near 45° in relation to the upper arms (as best shown in FIG. 67A ).
- the “upper arms” are rotated at the “shoulder joints” until the upper arms are positioned at an angle of or near 20°, as best shown in FIG. 67B .
- This rotation of the forearms and upper arms can help to ensure that the device 808 will fit within the patient's target cavity so that any contact of the robotic device 808 with any internal tissues or organs is minimized or eliminated.
- the forearms and upper arms can be rotated to any angle that minimizes the risk of contact with tissues or organs.
- the device 808 can be inserted further into the patient's cavity by further positioning the arms of the device 808 while the container 802 continues to crumple, thereby resulting in further shrinkage of the insertion device 800 . More specifically, the upper arms can be rotated further until they are positioned at an angle of or near 45°, as best shown in FIG. 68B . This process of moving the device 808 further into the cavity while positioning the arms to avoid contact with organs or tissues and causing the container 802 to crumple is continued until the shoulder joints of the device 808 have cleared the cavity wall and access port 806 .
- the forearms can be rotated back to center and the upper arms can be further rotated up, leaving the arms in an appropriate starting position for a surgical procedure.
- the device 808 can be locked or otherwise stabilized in place using a known external clamping mechanism such as, for example, an Iron Intern®, which is commercially available from Automated Medical Products Corp.
- FIG. 70 depicts another implementation of an external pressurized system or apparatus 900 .
- the apparatus 900 has a container 902 with a top cap 904 coupled to a top portion of the container 902 .
- the container 902 has a port 906 that is coupled to the container 902 at a base portion of the container 902 .
- the port 906 is configured to be positionable in an incision in the skin of the patient, thereby providing access to a cavity of the patient.
- the apparatus 900 is configured to receive a surgical device 908 such that the device 908 can be inserted into the patient cavity through the port 906 of the apparatus 900 .
- the container 902 in this device 900 is made of a flexible material such as, for example, polyethylene plastic, latex, nylon, or silicone rubber.
- top cap 904 , the container 902 , and the robotic device 908 are substantially similar to the top cap 804 and container 802 depicted and described above. All the various features and components described above apply to these top cap 904 , container 902 , and device 908 embodiments as well.
- FIGS. 71A and 71B depict the base coupling component (also referred to as the “base coupler”) 920 that is coupled to a bottom portion of the container 902 .
- the base coupler 920 has a groove 922 and three coupling protrusions 924 that extend from the coupler 920 .
- each of the coupling protrusions 924 has a lumen 926 configured to receive a thumb screw 928 .
- the container 902 is coupled to the base coupler 920 using an O-ring 930 . More specifically, the container 902 is positioned over the upper portion of the coupler 920 such that the container 902 is positioned over the groove 922 and adjacent to or against the three protrusions 924 .
- the O-ring 930 is positioned over the container 902 at the groove 922 such that the O-ring 930 urges a portion of the container 902 into the groove 922 , thereby creating a fluidic seal between the container 902 and the base coupler 920 .
- the insertion device 900 has a port attachment 940 that is coupleable to the base coupler 920 and the access port 906 such that the port attachment 940 is positioned between the coupler 920 and the port 906 .
- the port attachment 940 has a removable lid 944 that maintains a fluidic seal when the lid 944 is in place on the port attachment 940 , thereby making it possible to maintain insufflation of the patient's cavity even when the insertion device 900 is not yet coupled to the access port 906 .
- FIGS. 72A and 72B depict the coupling of the port attachment 940 to the access port 906 .
- the port attachment 940 has three coupling notches 942 similar to the coupling notches 856 described and depicted above.
- the port attachment 940 has a removable lid 944 (also referred to as a “removable seal component,” “removable lid seal component,” or “removable seal component”) that provides a fluidic seal when it is positioned in its closed position in relation to the port attachment 940 .
- the removable lid 944 is a slidable lid 944 .
- this access port 906 (as best shown in FIG. 72A ) has a top ring 946 that has three coupling protrusions (also referred to as “coupling tabs”) 948 that extend from a portion of the top ring 946 and are configured to mate with the coupling notches 942 in the port attachment 940 .
- coupling tabs also referred to as “coupling tabs”
- the port attachment 940 has an O-ring 950 that can be positioned between the port attachment 940 and the access port 906 such that the O-ring 950 creates a fluidic seal when the two components are coupled together.
- the port attachment 940 can be coupled to the access port 906 by positioning the bottom portion of the port attachment 940 in the top portion of the top ring 946 with the O-ring 950 positioned between the two components, with the coupling notches 942 on the port attachment 940 mating with the coupling protrusions 948 on the top ring 946 .
- the port attachment 940 also has another O-ring 952 that is configured to be positioned in the groove 954 formed in the top of the port attachment 940 .
- the O-ring 952 can be placed in the groove 954 to help create an airtight seal when the port attachment 940 is coupled to the base coupler 920 .
- the port attachment 940 also has three threaded lumens 956 in the top of the attachment 940 .
- these lumens 956 are configured to receive the thumb screws 928 that are positioned through the lumens 926 in the base coupler 920 , thereby allowing for coupling the base coupler 920 to the port attachment 940 via the screws 928 .
- thumb screws besides thumb screws
- any known attachment or coupling mechanism or component can be used. Some non-limiting examples include magnets, quick clamps, quarter turn features, snap-in features, and the like.
- the slidable lid 944 can be moved between a closed position (as shown in FIG. 73B ) and an open position (as shown in FIG. 73A ).
- the slidable lid 944 is positioned in the port attachment 940 via a lid slot 958 in the port attachment 940 .
- tools or robotic devices can be passed through the port attachment 940 and the access port 906 .
- the closed position a fluid seal is established between the lid 944 and the port attachment 940 , which makes it possible to insufflate the patient's cavity prior to attaching the insertion assembly 900 .
- removable lid 944 is a slidable lid 944
- any other known method or device for establishing a fluidic seal could be used.
- Non-limiting examples include a mechanical iris, leaf shutter, or any other known method of providing a removable fluidic seal.
- FIGS. 74A and 74B depict cross-sectional views of the entire lower subassembly as described above, including the base coupler 920 , the port attachment 940 , and the access port 906 . More specifically, FIG. 74A shows the port attachment 940 coupled to the access port 906 , with the slidable lid 944 fully inserted into the port attachment 940 in the closed position, thereby creating a fluidic seal. FIG. 74B shows all three components coupled together, including the base coupler 920 , the port attachment 940 , and the access port 906 .
- FIGS. 75A , 75 B, and 75 C depict the external pressurized insertion device 900 in use, according to one embodiment.
- the port attachment 940 can be coupled to the port 906 , as best shown in FIG. 75A .
- a fluidic seal is established between the port attachment 940 and the port 906 such that the patient's cavity can be insufflated to the desired Insufflation pressure.
- the insertion device 900 can then be coupled to the port attachment 940 as best shown in FIG. 75B .
- the slidable lid 944 can then be moved to its open position (or fully remove) as best shown in FIG. 75C , thereby providing fluidic communication between the patient's cavity and the interior of the insertion device 900 , resulting in equalized pressure in the device 900 and the cavity.
- the robotic device 908 can be inserted via any of the same steps as described previously. If the device 908 completes the desired surgical procedure and a different robotic device or other type of tool needs to be used, the robotic device 908 can be removed from the cavity, the slidable lid 944 can be replaced in the closed position, and the base coupler 920 can be removed from port attachment 940 . This allows pressure to be maintained within the cavity, even during tool changes.
- FIG. 76 depicts an alternative embodiment having a top cap 960 that has a pressure relief valve 962 .
- the pressure relief valve 962 can be configured to release pressure if the internal insufflation pressure increases above a typical value, thereby aiding the process of inserting the robotic device 808 , 908 such that the attendant will not need to wait for the pressure to equalize between the cavity and the insertion device 800 , 900 .
- FIGS. 77A and 77B Another implementation of a top cap 1000 having a pressure relief valve 1002 is depicted in FIGS. 77A and 77B .
- This cap 1000 also has a dual port seal component 1004 that can be configured to receive one or more surgical instruments or devices such as a standard laparoscopic tool.
- a top cap can have only one of the pressure relief valve 1002 or the dual seal component 1004 .
- the pressure relief valve 1002 has an adjustment component (also referred to as an adjustment “door,” “wall,” or “button,” or “block”) 1006 that is operably coupled to (or positioned against) one end of a tension spring 1008 and has two holes 1010 A, 1010 B that are configured to receive retention mechanisms such as bolts, screws, or other such standard devices or components configured to hold the adjustment component 1006 in place.
- the other end of the spring 1008 is coupled to a valve ball 1012 that is positioned against a rim 1016 of an opening 1014 on the underside of the top cap 1000 .
- the spring 1008 is configured to urge the ball 1012 toward the opening 1014 such that the ball 1012 (which has a larger outer diameter than the inner diameter of the rim 1016 ) contacts the rim 1016 of the opening 1014 and thereby establishes a fluidic seal between the ball 1012 and the rim 1016 .
- the adjustment block 1006 is adjusted using the retention mechanisms to move the block 1006 toward or away from the ball 1012 , thereby increasing or decreasing, respectively, the force applied by the spring 1008 against the ball 1012 (and thereby increasing or decreasing, respectively, the strength of the seal between the ball 1012 and the rim 1016 of the opening 1014 ).
- the adjustment block 1006 can be used to adjust the strength of the seal based on the target maximum pressure threshold such that when the target maximum pressure threshold is reached (such as while lowering either of the robotic devices 808 , 908 out of the insertion device embodiments 800 , 900 as described above), the ball 1012 is urged away from the rim 1016 and the seal between the rim 1016 and the ball 1012 is broken such that the pressure is reduced by the gas escaping through the valve 1002 .
- any known pressure relief valve for use in medical devices can be incorporated into the top cap 1000 .
- the dual port seal component 1004 in this embodiment has two seal components: an elastic circular seal 1018 defining an opening 1020 and a flap seal 1022 in fluid communication with the circular seal 1018 .
- the elastic circular seal 1018 is configured to form a strong seal around the smooth surfaces of a standard laparoscopic tool positioned through the opening 1020 .
- the flap seal 1022 is a secondary seal that provides a fluid seal when no tool is positioned through the dual port seal component 1004 . That is, when no tool is positioned therethrough, the two flaps 1024 A, 1024 B are urged into contact with each other by the pressure in the patient's insufflated cavity such that the two flaps 1024 A, 1024 B form a fluidic seal.
- any known port seal component for use in establishing a fluidic seal with a laparoscopic tool positioned therethrough can be used.
- the insertion devices disclosed or contemplated herein can have one or more sensors or other types of measurement mechanisms for measuring the insertion depth of the surgical device being inserted into the patient's cavity.
- FIGS. 78A , 78 B, and 78 C depict an automatic insertion device 1030 having a flexible container 1038 and an actuator and sensor package 1032 .
- the actuator can be any known actuation device, including, for example, motor and gears, motor and timing belts, linear screw, pneumatics, hydraulics, or the like.
- the sensor could be any known sensing device, including, for example, a potentiometer, an encoder, optical sensors, or the like.
- the actuator and sensor package 1032 lowers the surgical device 1034 through the incision. That is, as shown in FIG.
- the top portion of the device 1030 is urged toward the bottom portion of the device 1030 such that the overall height of the device 1030 is reduced and the surgical device 1034 is moved distally out of the bottom portion of the insertion device 1030 .
- the sensor in the package 1032 is configured to read the distance the surgical device 1034 has been inserted into the patient's cavity. Based on this distance, in one embodiment, the control program of the surgical device 1034 can actuate the motors of the surgical device 1034 to move the arms into desirable positions so as to avoid making contact with any organs or a cavity wall. The process can then be reversed to remove the surgical device 1034 from the incision.
- an additional actuator 1036 could be used to grossly position the surgical device 1034 during the insertion process or during the surgery in order to access multiple quadrants of the patient's cavity.
- This actuator 1034 rotates the upper portion of the insertion device 1030 relative to the access port. This rotation is possible because of the flexible nature of the container 1038 .
- FIG. 79 depicts another embodiment of an insertion device 1050 having one or more measurement mechanisms 1054 for measuring the insertion depth of the surgical device that is being inserted into the patient's cavity using the insertion device 1050 .
- the insertion depth of the surgical device is determined by measuring the relative distance between the top cap 1052 and the port 1056 .
- the measurement mechanism 1054 is a sensor 1054 that is coupled to, integrated into, or otherwise associated with the top cap 1052 .
- the top cap 1052 can have two or more sensors 1054 .
- the sensor 1054 uses ultrasonic or infrared energy and transmits the energy toward the port 1056 . The energy is reflected by the port 1056 back to the sensor 1054 .
- the senor 1054 is a range finder that can utilize the energy reflected back from the port 1056 to determine the distance between the top cap 1052 and the port 1056 . The distance between the top cap 1502 and the port 1056 can then be used to calculate the insertion depth of the surgical device.
- the insertion device 1050 has not only the sensor 1054 associated with the top cap 1052 , but also a sensor (not shown) associated with the port 1056 .
- the sensor 1054 emits energy that is received by the sensor associated with the port 1056 , which triggers the sensor associated with the port 1056 to transmit energy back to the sensor 1054 associated with the top cap 1052 .
- the sensor 1054 or a separate controller can then calculate the distance between the top cap 1052 and the port 1056 , which can then be used to calculate the insertion depth of the surgical device.
- the measurement mechanism 1054 in the top cap 1052 is a camera 1054 .
- the camera 1054 can utilize known image processing techniques on known features of the surgical device to determine the insertion depth of the device.
- FIG. 80 depicts another embodiment relating to a port 1060 of an insertion device having one or more measurement mechanisms 1062 for measuring the insertion depth of a surgical device.
- the measurement mechanism 1062 is a camera 1062 that can use image processing to capture and recognize the portion of the surgical device that is passing through the opening 1064 in the port 1060 .
- the surgical device can be marked with some type of markers that are easily recognized by the image processing technology. Upon recognition of the device portion or the marker, the camera 1062 or a separate processor or controller can calculate the insertion depth of the surgical device based on that information.
- the measurement mechanism 1062 is an RFID sensor 1062 that can sense one or more RFID markers (not shown) that are coupled to or implanted in the surgical device (not shown) passing through the port 1060 .
- the RFID markers in this embodiment could also contain extra information that could be used in a two-way communication system. That is, one or more of the markers associated with the surgical device could be configured to transmit information through the same RF link to the sensor and/or a controller.
- FIG. 81 depicts another embodiment of an insertion device having a measurement mechanism that measures the relative distance between the top cap and the port to determine the insertion depth of the surgical device.
- This embodiment relates to a top cap 1070 that has a string measurement system 1072 , which, in some embodiments, is a string potentiometer system 1072 .
- the string measurement system 1072 is a system in which a string is extended from the top cap 1070 to the port (not shown) at the bottom of the insertion device (not shown) and the amount of string that extends from a rotatable drum is measured.
- the system 1072 has a rotatable sensor 1074 , a rotatable drum 1076 , a spring-loaded string dispenser 1078 , and string (not shown) extending from the dispenser and around the drum 1076 .
- the sensor 1074 is a potentiometer 1074 , and in some specific embodiments, the sensor 1074 is a multiple-turn potentiometer 1074 .
- the rotatable sensor 1074 is coupled to the rotatable drum 1076 such that the sensor 1074 rotates when the drum 1076 rotates.
- the drum 1076 is a dual drum 1076 having a measurement string drum half 1076 A and a spring-loaded string drum half 1076 B.
- the string that extends down to the port (not shown) of the insertion device (not shown) wraps around the measurement string drum half 1076 A, while a separate spring-loaded string (not shown) that is coupled at the other end to the spring-loaded string dispenser 1078 wraps around the spring-loaded string drum half 1076 B.
- the system 1072 can have a single string (not shown).
- a string (not shown) is coupled directly to the rotatable sensor 1074 .
- the string measurement system 1072 can be used to measure the tilt of the insertion device (or the canister of the insertion device). According to one implementation, the string measurement system 1072 uses three strings to measure the tilt.
- the senor 1074 can detect the distance between the top cap 1070 and the port (not shown) by sensing the number of turns of the drum 1076 , as the number of turns is directly related to the length of the string extending down to the port (not shown) and thus directly related to the distance between the top cap 1070 and the port (not shown). This information can be used to calculate the insertion depth of the surgical device.
- more than one measurement mechanism can be incorporated into an insertion device. That is, a first measurement mechanism can be incorporated into the insertion device to measure the insertion depth of the surgical device while a second measurement mechanism can be incorporated to measure the amount of “tilt” in the insertion device. It is understood that this could be any combination of the measurement devices that are capable of measuring depth and/or tilt. It is further understood that any known device for measuring tilt as described herein can be used within the insertion devices contemplated herein. In this context, “tilt” is intended to mean the angle of the longitudinal axis of the canister in relation to the plane parallel to the radius of the incision port. Several embodiments of the canisters and insertion devices herein are configured to allow for such tilt, which can be utilized to better position the surgical device in the cavity once it has exited the interior of the canister prior to or during a procedure.
- FIGS. 82A , 82 B, 82 C, 82 D, and 82 E depict yet another implementation of an insertion device having a measurement mechanism that measures the relative distance between the top cap and the port to determine the insertion depth of the surgical device.
- This embodiment relates to a top cap 1090 that has a substantially rigid structure measurement system 1092 .
- the measurement system 1092 is a system in which a substantially rigid structure 1094 extends from the top cap 1090 to the port 1096 at the bottom of the insertion device and the displacement of the structure 1094 is measured to determine the distance between the top cap 1090 and the port 1096 , which can be used to calculate the insertion depth of the surgical device.
- the substantially rigid structure is a square bar 1094 that has a coupler 1098 at the top of the bar 1094 .
- the bar 1094 extends through a seal 1100 in the top cap 1090 (as best shown in FIG. 82A ), through a hole 1102 in the underside of the top cap 1090 (as best shown in FIG. 82B ), and through a hole 1104 in the port 1096 (as best shown in FIG. 82E ).
- the hole 1102 in the top cap 1090 is square and thus the square bar 1094 cannot rotate in relation to the top cap 1090 (and thus can't rotate in relation to the insertion device).
- the seal 1100 in the top cap 1090 is an elastomeric seal 1100 .
- the seal 1100 is any seal that can maintain the pressure in the insertion device with the bar 1094 disposed therethough.
- the actual measurement of the displacement of the square bar 1094 is accomplished using a string measurement system such as the system described above with respect to FIG. 81 .
- the coupler 1098 on the top end of the square bar 1094 is configured to be coupleable to a string (not shown) that is coupled in turn to the drum 1106 of the string measurement system 1108 .
- the string measurement system 1108 operates in the same fashion as the similar system above.
- the bottom of the square bar 1094 is constrained in the port 1096 via a pegged ball 1110 having four pegs that is positioned in a cavity 1112 defined in the underside of the port 1096 , wherein the cavity 1112 is in fluid communication with the hole 1104 in the top side of the port 1096 .
- the cavity 1112 is configured to match the configuration of the pegged ball 1110 as shown (with the four slots in the cavity 1112 matching with the four pegs of the ball 1110 ) such that the ball 1110 can move within the cavity 1112 in a way that allows angular offset but not rotation about the longitudinal axis of the bar 1094 .
- the combination of this constraint and the rotational constraint at the top cap 1090 allows the surgical device to be maneuvered into the body (that is, the insertion device can be tilted as described elsewhere herein and thereby maneuver and position the surgical device), but will maintain the centerline of the robot lined up with the insertion point.
- the substantially rigid structure is another shape other than square.
- the structure can have any shape that can match with a hole in the top cap such that the structure cannot rotate in relation to the top cap.
- the substantially rigid structure can be made up of more than one bar.
- measurement mechanisms can be envisioned that fall within the scope and spirit of the embodiments disclosed herein.
- various embodiments discussed above relate to measurement of the relative distance between the top cap and the port
- other alternative embodiments can measure the relative angular and linear displacement between the top and bottom of the insertion device.
- sensors configured to emit and/or sense particular types of energy (such as infrared or ultrasonic energy), it is understood than any type of wireless technology that would work with a sensor can be used.
- FIG. 83 depicts an alternative embodiment of an incision port 1120 that can be used with any of the insertion devices described above.
- the incision port 1120 has a slidable lid 1122 similar to the lid depicted in FIGS. 72A-75C .
- the port 1120 also has an insufflation port 1124 that is in fluidic communication with the interior lumen or opening of the incision port 1120 .
- the insufflation port 1124 is a flow valve port 1124 that is positioned on the port 1120 such that it is below the slidable lid 1122 .
- the insufflation port 1124 is used to insufflate the patient's cavity or to provide supplemental insufflation during a procedure.
- the lid 1122 is positioned in the closed position to establish a fluid seal in the cavity (and in the insertion device, as described elsewhere above), and then gas is added to the patient's cavity via the insufflation port 1124 .
- FIGS. 84A and 84B depict alternative insertion device embodiments that, unlike the cylindrical canisters described above, have canisters with different shapes. More specifically, FIG. 84A is an insertion device 1130 with a flexible canister 1132 that is spherical in shape. Further, FIG. 84B is an insertion device 1140 with a flexible canister 1142 that is conical in shape. According to one embodiment, during compression, the spherical and conical canisters 1132 , 1142 collapse or compress or otherwise allow the top cap to be moved toward the incision port such that the walls of the canisters 1132 , 1142 expand or move outward. That is, the canisters 1132 , 1142 do not bend inward and thereby interfere with the surgical device disposed within the canisters 1132 , 1142 during collapse or compression of the canisters 1132 , 1142 .
- FIGS. 85A , 85 B, and 85 C depict alternative insertion device embodiments that have canisters that are reinforced with rib structures. More specifically, FIG. 85A is an insertion device 1150 with a flexible canister 1152 having vertical rib structures 1154 .
- FIG. 85B is an insertion device 1160 with a flexible canister 1162 having horizontal rib structures 1164 .
- FIG. 85C is an insertion device 1170 with a flexible canister 1172 having spiral-shaped rib structures 1174 .
- the rib structures in these exemplary embodiments create the structure of each canister while the flexible material in the canisters maintain the pressure therein.
- any combination of the rib structures can also be incorporated into a canister.
- the rib structures provide reinforcement for each canister such that the structures reduce the amount of undesired bending or collapsing of the canister during use.
- FIGS. 86A , 86 B, 86 C, 86 D depict an embodiment of a base coupler 1182 (of an incision port 1180 ) that is releasably coupled to the canister 1184 of the incision device.
- the surgical device (not shown) can be positioned in the canister 1184 prior to the procedure and then releasably coupled to the incision port 1180 .
- the coupler 1182 has at least one fixed support 1186 and at least one releasable latch 1188 . According to one embodiment, there are two fixed supports 1186 (one is not visible).
- the canister 1184 has a lip 1190 on the bottom of the canister that can couple with the coupler 1182 .
- the canister 1184 is positioned against the top of the coupler 1182 in a tilted position as shown in FIGS. 86B and 86C such that the lip 1190 is positioned under the two fixed supports 1186 . Then the entire bottom of the canister 1184 is placed into contact with the coupler 1182 , thereby creating a seal between the lip 1190 and the coupler 1182 .
- the latch 1188 is moved into the latched position such that the lip 1190 is retained in its position against the coupler 1182 via the two fixed supports 1186 and the latch 1188 as best shown in FIG. 86D .
- FIGS. 87A , 87 B, and 87 C depict an embodiment of an insertion device having top cap 1200 that is coupled to an outer handle set 1202 such that the top cap 1200 and handle set 1202 can be moved relative to the flexible canister 1204 .
- the outer handle set 1202 has an outer ring 1206 that is positioned around the outer circumference of the top cap 1200 such that there is a fluid seal established between the two components.
- the fluidic seal is enhanced by a rubber seal 1210 disposed between the top cap 1200 and outer ring 1206 .
- the set 1202 also has two handles 1208 coupled to the ring 1206 such that a user or medical professional can easily grasp the set 1202 . More specifically, as best shown in FIG.
- the top cap 1200 and outer handle set 1202 are moved down over the walls of the flexible canister 1204 such that the canister 1204 walls are disposed between the top cap 1200 and the handle set 1202 .
- the top cap 1200 is not fixed to the top of the canister 1204 , but rather can be moved distally toward the bottom of the canister 1204 while pulling the walls of the canister 1204 through the seal of the top cap 1200 and outer handle set 1202 so as to reduce any bunching of the canister walls 1204 during compression of the device.
- the top cap 1200 is free to slide within the flexible canister 1204 and is controlled via the outer handle set 1202 , which has handles 1208 that provide direct control of the position and orientation of the top cap 1200 .
- FIGS. 88A , 88 B, 88 C, and 88 D depict an alternative embodiment of an insertion device 1220 having top cap 1222 (as best shown in FIGS. 88A and 88B , a mobile seal 1224 (as best shown in FIG. 88C , an outer handle set 1226 (as best shown in FIGS. 88A and 88C ) coupled to the mobile seal 1224 , and an incision port 1228 (as best shown in FIGS. 88A and 88D ).
- This embodiment differs from the previous embodiment in that the top cap 1222 in this device 1220 is not mobile and instead is coupled to the proximal end of the device 1220 as shown in FIG. 88A .
- this embodiment has a mobile seal 1224 that is capable of moving along the length of the device 1220 in the same fashion as the top cap 1200 described above and depicted in FIGS. 87A-87C . Further, the outer handle set 1226 is coupled to the mobile seal 1224 , instead of the top cap 1222 .
- the top cap 1222 in this device 1220 is the primary seal of the device 1220 such that it is not essential that the mobile seal 1224 maintains a fluidic seal as it is moved along the length of the device 1220 .
- the top cap 1222 can have all the sealing features and components of any of the top cap embodiments described above, including seals and access openings for wires, suction, irrigation, and auxiliary tools.
- the mobile seal 1224 is used primarily, along with the outer handle set 1226 , to position the surgical device into the patient's cavity.
- the mobile seal 1224 and the outer handle set 1226 are coupled together, according to one embodiment, in a similar fashion and with similar components as the outer handle set 1202 and the top cap 1200 described above.
- the mobile seal 1224 moves as well, and the handle set 1226 and seal 1224 can be moved relative to the canister walls in the same way as the top cap 1200 and handle set 1202 above.
- the external circumference of the mobile seal 1224 is non-circular such that coupling the seal 1224 to the outer handle set 1226 restrains the mobile seal 1224 from any axial movement in relation to the handle set 1226 .
- the outer circumference of the seal 1224 can have the shape of a hexagon or an ellipse. Alternatively, any mechanism or component to restrain such axial movement can be used.
- the additional mechanisms or components such as ball bearings or surfaces conducive to movement can be incorporated into the interface, thereby enhancing the ability of the canister wall to pass through the interface easily. It is understood that these mechanisms or components can be incorporated into the seal 1224 or the handle set 1226 or both.
- FIG. 89 depicts an alternative embodiment of an insertion device 1240 having a substantially non-flexible canister portion 1242 that is coupled to a flexible canister portion 1244 , which in turn is coupled to the incision port 1246 .
- the top cap (not shown) can be coupled to an outer handle set similar to that described above such that the top cap can move along the non-flexible canister portion 1242 with ease.
- the flexible canister portion 1244 provides a flexible connection or interface (which could also be described as a “ball joint like” interface) that allows the movement of the surgical device as needed. That is, the flexible canister portion 1244 enhances the ability to tilt the insertion device 1240 as described above, thereby enhancing the ability to move the surgical device during insertion and during any procedure being performed.
- the coupling of the top cap and the outer handle set can be a magnetic connection so as to avoid the necessary sealing.
- different canister shapes and sizes can be envisioned.
- the flexible canister portion can be located elsewhere on the device. In a further alternative, more than one flexible canister portion can be provided.
- the medical devices being inserted into the patient are any known medical or surgical devices for performing procedures within a cavity of a patient.
- the medical devices are robotic surgical devices having one or two arms.
- the robotic surgical devices or systems can have or use three or more arms.
- the devices (or additional devices) can be cameras or camera systems.
- helper tools that can be inserted along with one or more medical devices or robotic devices.
Abstract
The various embodiments herein relate to systems, devices, and/or methods relating to surgical procedures, and more specifically for accessing an insufflated cavity of a patient and/or positioning surgical systems or devices into the cavity.
Description
- This application claims priority to Provisional Application No. 61/584,947, filed Jan. 10, 2012; and Provisional Application No. 61/683,483, filed Aug. 15, 2012, both of which are hereby incorporated herein by reference in their entireties.
- The various embodiments herein relate to systems, devices, and/or methods relating to surgical procedures, and more specifically for accessing an insufflated cavity of a patient and/or positioning surgical systems or devices into the cavity.
- Invasive surgical procedures are essential for addressing various medical conditions. When possible, minimally invasive procedures such as laparoscopy are preferred.
- However, known minimally invasive technologies such as laparoscopy are limited in scope and complexity due in part to 1) mobility restrictions resulting from using rigid tools inserted through access ports, and 2) limited visual feedback. Further, the technologies are also limited due to difficulties relating to maintaining access to the surgical cavity while also maintaining insufflations of the cavity.
- There is a need in the art for improved surgical methods, systems, and devices.
- Discussed herein are various surgical access and insertion devices and methods.
- In Example 1, a surgical insertion device comprises a canister defining a lumen, a top cap coupled to a proximal end of the canister, and an incision port removably coupled to a distal end of the canister. The canister is sized to receive a surgical device in the lumen. The top cap comprises at least one lumen defined in the top cap, wherein the at least one lumen is configured to receive a support rod. The incision port comprises a fluidic sealing component configured to maintain a fluidic seal.
- Example 2 relates to the surgical insertion device according to Example 1, wherein the lumen is fluidically sealed in relation to ambient air.
- Example 3 relates to the surgical insertion device according to Example 1, wherein the canister comprises a flexible material or a substantially rigid material.
- Example 4 relates to the surgical insertion device according to Example 1, wherein the canister comprises a flexible portion and a substantially rigid portion.
- Example 5 relates to the surgical insertion device according to Example 1, wherein the canister has a cylindrical shape, a spherical shape, or a conical shape.
- Example 6 relates to the surgical insertion device according to Example 1, wherein the canister comprises at least one rib structure.
- Example 7 relates to the surgical insertion device according to Example 1, wherein the fluidic sealing component comprises a sealable sleeve device, a flexible seal component, a removable lid seal component, or a flap seal component.
- Example 8 relates to the surgical insertion device according to Example 1, wherein the top cap comprises at least one of a pressure relief valve, at least one threaded lumen, a detachable cable harness, and a clamp projection.
- Example 9 relates to the surgical insertion device according to Example 1, further comprising an outer handle set coupleable to the top cap.
- Example 10 relates to the surgical insertion device according to Example 1, further comprising at least one measurement mechanism coupled to the top cap or the incision port.
- Example 11 relates to the surgical insertion device according to Example 1, wherein the canister comprises at least one access port, wherein the at least one access port is a hand access port or a side access port.
- In Example 12, a surgical insertion device comprises a flexible canister defining a lumen, a top cap coupled to a proximal end of the canister, an incision port removably coupled to a distal end of the canister, and a first measurement mechanism coupled with the top cap or the incision port. The canister is sized to receive a surgical device in the lumen. The top cap comprises at least one lumen defined in the top cap, wherein the at least lumen is configured to receive a support rod. The incision port comprising a fluidic sealing component is configured to maintain a fluidic seal. The first measurement mechanism is configured to measure the insertion depth of the surgical device.
- Example 13 relates to the surgical insertion device according to Example 12, wherein the first measurement mechanism comprises a sensor, a string measurement system, a substantially rigid structure system, or a camera.
- Example 14 relates to the surgical insertion device according to Example 12, wherein the fluidic sealing component comprises a sealable sleeve device, a flexible seal component, a removable lid seal component, or a flap seal component.
- Example 15 relates to the surgical insertion device according to Example 12, wherein wherein the top cap comprises at least one of a pressure relief valve, at least one threaded lumen, a detachable cable harness, and a clamp projection.
- Example 16 relates to the surgical insertion device according to Example 12, further comprising a second measurement mechanism coupled to the top cap or the incision port, the second measurement mechanism configured to measure any tilt of the flexible canister.
- In Example 17, a surgical insertion device comprises a canister defining a lumen, a top cap coupled to a proximal end of the canister, and an incision port removably coupled to a distal end of the canister. The canister is sized to receive a surgical device in the lumen, wherein the surgical device is a robotic surgical device comprising two arms. The top cap comprises a pressure relief valve and at least one lumen defined in the top cap, wherein the at least one lumen is configured to receive a support rod. The incision port comprises a fluidic sealing component configured to maintain a fluidic seal.
- Example 18 relates to the surgical insertion device according to Example 17, wherein the fluidic sealing component comprises a sealable sleeve device, a flexible seal component, a removable lid seal component, or a flap seal component.
- Example 19 relates to the surgical insertion device according to Example 17, wherein the top cap comprises at least one of at least one threaded lumen, a detachable cable harness, and a clamp projection.
- Example 20 relates to the surgical insertion device according to Example 17, further comprising at least one measurement mechanism coupled to the top cap or the incision port.
- While multiple embodiments are disclosed, still other embodiments of the present invention will become apparent to those skilled in the art from the following detailed description, which shows and describes illustrative embodiments of the invention. As will be realized, the invention is capable of modifications in various obvious aspects, all without departing from the spirit and scope of the present invention. Accordingly, the drawings and detailed description are to be regarded as illustrative in nature and not restrictive.
-
FIG. 1A is a side view of an external pressurized system or apparatus, according to one embodiment. -
FIG. 1B is a perspective view of the external pressurized system or apparatus ofFIG. 1A with a surgical device positioned therein. -
FIG. 2A is an exploded side view of the external pressurized system or apparatus ofFIG. 1A . -
FIG. 2B is an exploded perspective view of the external pressurized system or apparatus ofFIG. 1A . -
FIG. 3A is an exploded side view of a top cap, according to one embodiment. -
FIG. 3B is an exploded perspective view of the top cap ofFIG. 3A . -
FIG. 4A is an exploded perspective view of a port, according to one embodiment. -
FIG. 4B is an exploded side view of the port ofFIG. 4A . -
FIG. 5A is an upper perspective view of a base ring and port ring, according to one embodiment. -
FIG. 5B is a lower perspective view of the base ring and port ring ofFIG. 5A . -
FIG. 6A is a top schematic view of a sealable sleeve device being positioned in an incision, according to one embodiment. -
FIG. 6B is a top schematic view of the sealable sleeve device ofFIG. 6A being positioned in an incision, according to one embodiment. -
FIG. 6C is a top schematic view of the sealable sleeve device ofFIG. 6A being positioned in an incision, according to one embodiment. -
FIG. 6D is a top schematic view of the sealable sleeve device ofFIG. 6A being positioned in an incision, according to one embodiment. -
FIG. 7A is a side view of a fully assembled port, according to one embodiment. -
FIG. 7B is a perspective view of the fully assembled port ofFIG. 7A . -
FIG. 8A is a side view of the coupling of a canister and connector ring, according to one embodiment. -
FIG. 8B is a side view of the coupling of the canister and connector ring ofFIG. 8A . -
FIG. 9 is a side view of an external pressurized system or apparatus with a surgical device positioned therein, according to one embodiment. -
FIG. 10 is a perspective view of the external pressurized system or apparatus ofFIG. 9 , in which the surgical device has been urged out of the system or apparatus and into the patient's cavity. -
FIG. 11 is a perspective view of the external pressurized system or apparatus ofFIG. 10 , in which the canister has been removed. -
FIG. 12 is a perspective view of an balloon seal insertion system or apparatus, according to one embodiment. -
FIG. 13A is a perspective view of an balloon seal insertion system or apparatus, according to one embodiment. -
FIG. 13B is an exploded perspective view of the balloon seal insertion system or apparatus ofFIG. 13A . -
FIG. 14A is a perspective view of a port housing, according to one embodiment. -
FIG. 14B is a cutaway perspective view of the port housing ofFIG. 14A . -
FIG. 14C is a cutaway perspective view of the port housing ofFIG. 14A . -
FIG. 15 is a perspective view of a standard sealable sleeve device, according to one embodiment. -
FIG. 16A is a cutaway side view of a balloon seal insertion system or apparatus, according to one embodiment. -
FIG. 16B is a cutaway perspective view of the balloon seal insertion system or apparatus ofFIG. 16A . -
FIG. 17A is a cutaway perspective view of a balloon seal insertion system or apparatus with a first arm of a surgical device disposed therethrough, according to one embodiment. -
FIG. 17B is a cutaway perspective view of the balloon seal insertion system or apparatus ofFIG. 17A in which the first arm is positioned using a connection rod. -
FIG. 18 is a cutaway perspective view of a rubber seal access/insertion device, according to one embodiment. -
FIG. 19A is an exploded side view of a rubber seal access/insertion device, according to one embodiment. -
FIG. 19B is an exploded perspective view of the rubber seal access/insertion device ofFIG. 19A . -
FIG. 20 is an exploded perspective view of the separate rubber seals of a rubber seal access/insertion device, according to one embodiment. -
FIG. 21 is a top view of a rubber seal access/insertion device, according to one embodiment. -
FIG. 22 is a base ring of a rubber seal access/insertion device, according to one embodiment. -
FIG. 23 is a side view of a rubber seal access/insertion device, according to one embodiment. -
FIG. 24A is a side view of an external pressurized system or apparatus having one or more additional access ports, according to one embodiment. -
FIG. 24B is another side view of the external pressurized system or apparatus ofFIG. 24A . -
FIG. 24C is a top view of the external pressurized system or apparatus ofFIG. 24A . -
FIG. 24D is a perspective view of the external pressurized system or apparatus ofFIG. 24A . -
FIG. 24E is another top view of the external pressurized system or apparatus ofFIG. 24A . -
FIG. 24F is a cutaway side view of the external pressurized system or apparatus ofFIG. 24A along the cross-section shown with the dotted line inFIG. 24E . -
FIG. 25 is a perspective view of an access port with a hand disposed therethrough, according to one embodiment. -
FIG. 26 is a top view of another access port, according to another embodiment. -
FIG. 27A is a perspective view of a port adaptor ring coupling an access port to a tube, according to one embodiment. -
FIG. 27B is a perspective view of a device access port having a device attachment component, according to one embodiment. -
FIG. 28A is a perspective view of a glove port, according to one embodiment. -
FIG. 28B is a perspective view of the glove port inFIG. 28A in use. -
FIG. 29A is a top schematic view of a sealable sleeve device being positioned in an incision, according to one embodiment. -
FIG. 29B is a top schematic view of the sealable sleeve device ofFIG. 29A being positioned in an incision, according to one embodiment. -
FIG. 30 is a cutaway side view of an incision port, according to one embodiment. -
FIG. 31A is a top view of a base ring of an incision port, according to one embodiment. -
FIG. 31B is a perspective view of the base ring ofFIG. 31A . -
FIG. 32 is a perspective view of a tube bracket, according to one embodiment. -
FIG. 33 is a perspective view of a tube bracket coupling a main tube to a base ring, according to one embodiment. -
FIG. 34 is a perspective view of a sleeve clamp, according to one embodiment. -
FIG. 35 is a cutaway side view of an incision port, according to one embodiment. -
FIG. 36 is a perspective view of an incision port with an internal coupling component, according to one embodiment. -
FIG. 37A is a cutaway side view of an incision port coupled to a port seal, according to one embodiment. -
FIG. 37B is a cutaway perspective view of the incision port and the port seal ofFIG. 37A . -
FIG. 37C is a perspective view of the underside of a base seal ring, according to one embodiment. -
FIG. 38A is a cutaway side view of an incision port having a flap seal component, according to one embodiment. -
FIG. 38B is a cutaway side view of an incision port having a flap seal component and coupled to a port seal, according to one embodiment. -
FIG. 38C is a perspective top view of the incision port and a port seal ofFIG. 38B . -
FIG. 39A is a perspective side view of an external pressurized device, according to another embodiment. -
FIG. 39B is a perspective side view of the external pressurized device ofFIG. 39A . -
FIG. 40 is a side view of an external pressurized device having two slots, according to a further embodiment. -
FIG. 41A is a side view of a positioning tube, according to one embodiment. -
FIG. 41B is a top view of the positioning tube ofFIG. 41A . -
FIG. 42 is a perspective view of a stacked incision port, according to one embodiment. -
FIG. 43 is a perspective view of an incision port having two seals, according to one embodiment. -
FIG. 44 is a perspective view of an incision port having two seals, according to another embodiment. -
FIG. 45A is a top view of an incision port, according to a further embodiment. -
FIG. 45B is a perspective view of the incision port ofFIG. 45A . -
FIG. 46A is a top view of an air barrier incision port system, according to one embodiment. -
FIG. 46B is a top view of the air barrier port of the port system ofFIG. 46A . -
FIG. 47 is a perspective side view of a rubber seal incision port, according to one embodiment. -
FIG. 48A is a perspective side view of a dual brush incision port, according to one embodiment. -
FIG. 48B is another perspective side view of the dual brush incision port ofFIG. 48A . -
FIG. 49A is a perspective top view of a triple brush incision port, according to one embodiment. -
FIG. 49B is a perspective side view of the triple brush incision port ofFIG. 49A . -
FIG. 50A is a side view of an insertion device, according to one embodiment. -
FIG. 50B is another side view of the insertion device ofFIG. 50A . -
FIG. 50C is another side view of the insertion device ofFIG. 50A . -
FIG. 51A is a side view of an insertion device, according to another embodiment. -
FIG. 51B is a top view of the insertion device ofFIG. 51A . -
FIG. 52 is a side view of an insertion device, according to a further embodiment. -
FIG. 53 is a side view of a surgical device positioned in a positioning rod, according to one embodiment. -
FIG. 54A is a side view of an internal pressurized bag device, according to one embodiment. -
FIG. 54B is another side view of the internal pressurized bag device ofFIG. 54A . -
FIG. 55 is a side view of another external pressurized system or apparatus, according to one embodiment. -
FIG. 56A is a perspective side view of a top cap, according to one embodiment. -
FIG. 56B is another perspective side view of the top cap ofFIG. 56A . -
FIG. 57A is a perspective side view of a top cap and a canister, according to one embodiment. -
FIG. 57B is another perspective side view of the top cap and canister ofFIG. 57A . -
FIG. 58A is a perspective view of a top cap with a portion of a device assembly positioned therethrough, according to one embodiment. -
FIG. 58B is a perspective view of the underside of the top cap ofFIG. 58A . -
FIG. 59A is a perspective view of a top cap with a portion of a device assembly positioned therethrough, according to one embodiment. -
FIG. 59B is a another perspective view of the top cap ofFIG. 59A . -
FIG. 60 is a cutaway perspective view of a top cap, according to one embodiment. -
FIG. 61A is a perspective side view of a top cap coupled to a canister with a portion of a device assembly positioned therethrough, according to one embodiment. -
FIG. 61B is another perspective side view of the top cap ofFIG. 61A . -
FIG. 62A is a perspective side view of a base coupling component, according to one embodiment. -
FIG. 62B is another perspective side view of the base coupling component ofFIG. 62A . -
FIG. 63A is a perspective side view of a base coupling component and an access port, according to one embodiment. -
FIG. 63B is another perspective side view of the base coupling component and the access port ofFIG. 63A . -
FIG. 63C is a perspective side view of a portion of the base coupling component and the access port ofFIG. 63A . -
FIG. 63D is another perspective side view of a portion of the base coupling component and the access port ofFIG. 63A . -
FIG. 63E is a cutaway side view of the base coupling component and the access port ofFIG. 63A . -
FIG. 64A is side view of an external pressurized system or apparatus with a base coupling component and access port, according to one embodiment. -
FIG. 64B is a top view of the external pressurized system ofFIG. 64A . -
FIG. 65A is a side view of an external pressurized system or apparatus with a base coupling component and access port, according to one embodiment. -
FIG. 65B is another side view of the external pressurized system or apparatus ofFIG. 65A . -
FIG. 66A is a side view of an external pressurized system or apparatus when the robotic device is lowered through an opening created by an access port, according to one embodiment. -
FIG. 66B is another side view of the external pressurized system or apparatus ofFIG. 66A . -
FIG. 67A is a side view of an external pressurized system or apparatus in which the forearms of the robotic device are positioned at an angle of or near 45° in relation to the upper arms, according to one embodiment. -
FIG. 67B is another side view of the external pressurized system or apparatus ofFIG. 67A . -
FIG. 68A is a side view of an external pressurized system or apparatus in which the forearms of the robotic device are positioned in a particular position, according to one embodiment. -
FIG. 68B is another side view of the external pressurized system or apparatus ofFIG. 67A . -
FIG. 69A is a side view of an external pressurized system or apparatus in which the forearms of the robotic device are positioned in an appropriate starting position for a procedure, according to one embodiment. -
FIG. 69B is another side view of the external pressurized system or apparatus ofFIG. 67A . -
FIG. 70 is a side view of an external pressurized system or apparatus having a flexible container, according to another embodiment. -
FIG. 71A is a perspective side view of a base coupling component, according to one embodiment. -
FIG. 71B is another perspective side view of the base coupling component ofFIG. 71A . -
FIG. 72A is a perspective side view of a port attachment having a removable lid and an access port, according to one embodiment. -
FIG. 72B is another perspective side view of the port attachment and access port ofFIG. 72A . -
FIG. 73A is a perspective side view of a port attachment having a removable lid and an access port, according to one embodiment. -
FIG. 73B is another perspective side view of the port attachment and access port ofFIG. 73A . -
FIG. 74A is a cutaway side view of a port attachment having a removable lid and an access port, according to one embodiment. -
FIG. 74B is another cutaway side view of the port attachment and access port ofFIG. 74A . -
FIG. 75A is a perspective side view of an external pressurized insertion device having a port attachment with a removable lid, according to one embodiment. -
FIG. 75B is another perspective side view of the external pressurized insertion device ofFIG. 75A . -
FIG. 75C is another perspective side view of the external pressurized insertion device ofFIG. 75A . -
FIG. 76 is a perspective side view of a top cap having a pressure relief valve, according to one embodiment. -
FIG. 77A is a perspective side view of a top cap having a pressure relief valve and port seal, according to one embodiment. -
FIG. 77B is a perspective cutaway view of the top cap ofFIG. 77A . -
FIG. 78A is a side view of an insertion device having an actuator and sensor package. -
FIG. 78B is another side view of the insertion device ofFIG. 78A . -
FIG. 78C is another side view of the insertion device ofFIG. 78A . -
FIG. 79 is a side cutaway view of an insertion device having a measurement mechanism associated with the top cap, according to one embodiment. -
FIG. 80 is a side cutaway view of an incision port of an insertion device having a measurement mechanism associated with the incision port, according to one embodiment. -
FIG. 81 is a top view of a top cap of an insertion device having a string measurement system, according to one embodiment. -
FIG. 82A is a top view of a top cap of an insertion device having a substantially rigid structure measurement mechanism, according to one embodiment. -
FIG. 82B is an underside view of the top cap ofFIG. 82A . -
FIG. 82C is an underside view of an incision port of the insertion device ofFIG. 82A . -
FIG. 82D is a perspective view of the substantially rigid structure having a pegged ball of the insertion device ofFIG. 82A . -
FIG. 82E is a top view of the incision port ofFIG. 82C . -
FIG. 83 is a cutaway side view of an incision port having an insufflations port, according to one embodiment. -
FIG. 84A is a cutaway side view of an insertion device having a spherically shaped canister, according to one embodiment. -
FIG. 84B is a cutaway side view of an insertion device having a conically shaped canister, according to one embodiment. -
FIG. 85A is a cutaway side view of an insertion device having a canister with vertical rib structures, according to one embodiment. -
FIG. 85B is a cutaway side view of an insertion device having a canister with horizontal rib structures, according to one embodiment. -
FIG. 85C is a cutaway side view of an insertion device having a canister with spiral-shaped rib structures, according to one embodiment. -
FIG. 86A is a side view of a base coupler that can be releasably coupled to a canister, according to one embodiment. -
FIG. 86B is another side view of the base coupler and canister ofFIG. 86A . -
FIG. 86C is another side view of the base coupler and canister ofFIG. 86A . -
FIG. 86D is another side view of the base coupler and canister ofFIG. 86A . -
FIG. 87A is a perspective side view of a top cap and outer handle set, according to one embodiment. -
FIG. 87B is a cutaway side view of the top cap and outer handle set ofFIG. 87A . -
FIG. 87C is a perspective cutaway view of the top cap and outer handle set ofFIG. 87A . -
FIG. 88A is a side view of an insertion device, according to one embodiment. -
FIG. 88B is a perspective view of a top cap of the insertion device ofFIG. 88A . -
FIG. 88C is a perspective view of a mobile seal and outer handle set of the insertion device ofFIG. 88A . -
FIG. 88D is a perspective view of an incision port of the insertion device ofFIG. 88A . -
FIG. 89 is a side view of an insertion device having a substantially non-flexible canister portion and a substantially flexible canister portion, according to one embodiment. - The various embodiments described herein relate to systems, devices, and/or methods for accessing an insufflated cavity of a patient and/or positioning surgical systems or devices into the cavity.
- Certain embodiments provide for insertion of the surgical systems/devices into the cavity while maintaining sufficient insufflation of the cavity. Further embodiments minimize the physical contact of the surgeon or surgical users with the surgical devices/systems during the insertion process. Other implementations enhance the safety of the insertion process for the patient and the systems/devices. For example, some embodiments provide visualization of the system/device as it is being inserted into the patient's cavity to ensure that no damaging contact occurs between the system/device and the patient. In addition, certain embodiments allow for minimization of the incision size/length. Further implementations reduce the complexity of the access/insertion procedure and/or the steps required for the procedure. Other embodiments relate to devices that have minimal profiles, minimal size, or are generally minimal in function and appearance to enhance ease of handling and use.
- It is understood that any of the various embodiments disclosed herein could also be automated or made into fully automatic devices/systems and thus could be used by lightly-trained users, such as on the battlefield or during a space mission or the like.
- One embodiment relates to an external pressurized system or apparatus. For example, one implementation of an external pressurized system or
apparatus 10 is depicted inFIG. 1A . Theapparatus 10 has acanister 12 with atop cap 14 coupled to atop portion 16 of thecanister 12. In this embodiment, thecanister 12 has aport 18 that is coupled to thecanister 12 at abase portion 20 of thecanister 12. Theport 18 is positioned in an incision in theskin 22 of the patient, thereby providing access to acavity 24 of the patient. As shown inFIG. 1B , theapparatus 10 is configured to receive asurgical device 26 such that thedevice 26 can be inserted into thepatient cavity 24 through theport 18 of theapparatus 10. - In one implementation, the
canister 12 is made of a hard plastic, such as, for example, poly(methyl methacrylate) (“PMMA”). Alternatively, thecanister 12 can be made of any known rigid material that can be used in medical devices. It is understood that certain embodiments of thecanister 12 are transparent, such as those depicted in the figures provided. Thetransparent canister 12 allows for the user to see thesurgical device 26 during insertion. Alternatively, thecanister 12 is not transparent and thedevice 26 can be inserted without being able to view thedevice 26 in thecanister 12. -
FIGS. 2A and 2B provide an exploded view of the externalpressurized apparatus 10 according to one embodiment. As discussed above, thetop cap 14, also depicted inFIGS. 3A and 3B , is coupled to thetop portion 16 of thecanister 12. Thetop cap 14 has aseal 30 that is held in place with acover 32. According to one implementation, the cover is coupled to thetop cap 14 with bolts, other similar mechanical fasteners, or any other known mechanism, device, or method for coupling two such components together. - In one implementation as best shown in
FIGS. 2B and 3B , theseal 30 has anorifice 34 defined in theseal 34. As best shown inFIG. 1B , theorifice 34 is configured to receive apositioning rod 28, as described in further detail below. In one embodiment, theseal 30 is made of some type of rubber. Alternatively, theseal 30 can be made of any number of known materials that can be used to provide a fluid seal around a smooth rod, including a gel material or the like. In a further alternative, thetop cap 14 can have any known configuration that provides a seal having an orifice or other type of access for apositioning rod 28 or the like. - As best shown in
FIGS. 2A , 2B, 4A, and 4B, the port 18 (also referred to herein as an “incision port”), in accordance with one implementation, has multiple components. In this particular embodiment, theport 18 has aconnector ring 40, abase ring 42, aport ring 44, and asealable sleeve device 46. Thesealable sleeve device 46 has anupper sleeve ring 46A and alower sleeve ring 46B, both of which are coupled together by aflexible sleeve 46C. In certain embodiments, theflexible sleeve 46C has elastic properties. As best shown inFIGS. 5A and 5B , theport ring 44 has multiple teeth or protrusions 44A defined in a top portion of thering 44 in a circular configuration around ahole 50. In addition, in one embodiment, thering 44 has alip 52 extending from the bottom portion of thering 44 and defining an outer edge of thehole 50. As described below, thislip 52 can be positioned within the incision made in the patient, thereby defining the smallest circumference of the incision. Further, theport ring 44 has threeguide projections 54 extending from the top portion of thering 44, which can aid in keeping thebase ring 42 positioned appropriately when it is placed on top of theport ring 44 as described below. In addition, according to one embodiment, theport ring 44 can also haveindentations 60 around its circumference that allow a user to grasp theport ring 44 during use as described below. Alternatively, theport ring 44 can have any exterior feature or mechanism that a user can use to better grasp thering 44. - As also shown in
FIGS. 5A and 5B , thebase ring 42 has an underside that hasmultiple indentations 42B defined in thering 42. In one embodiment, theindentations 42B correspond to the protrusions 44A in theport ring 44 such that thebase ring 42 andport ring 44 can be coupled and rotational force can be transferred from one to the other, as described in further detail below. Alternatively, the features on thebase ring 42 and theport ring 44 can be ridges that can easily couple together. In a further alternative, the features can be any known features or physical components that can be coupled together to allow for transmission of rotational force as described herein. In addition, as best shown inFIG. 5B , the underside of thebase ring 42 has an exterior lip orridge 62, according to one embodiment. When thebase ring 42 is in contact with theport ring 44, theridge 62 is in slidable contact with theport ring 44. In one implementation, the contact of theridge 62 with theport ring 44 can provide a better seal that theridges 42B, 44A provide alone. As such, this seal can be a secondary seal that can actually be strengthened as thesleeve device 46 is rotated and the tworings - The
connector ring 40 is configured to be coupleable with thecanister 12, as will be described in further detail below. In addition, theconnector ring 40 is coupleable to the rest of theport 18 by being configured to be coupleable to thebase ring 42. In one embodiment, as best shown inFIG. 2B , theconnector ring 40 has multiple threadedholes 40A defined through thering 40 that correspond to multiple threadedholes 42A defined through thebase ring 42, such that screws, bolts, or the like can be inserted into and through the threadedholes rings rings rings - The
base ring 42 is coupleable to theport ring 44. When thebase ring 42 is placed on and in contact with the top of theport ring 44, the protrusions 44A are positioned in theindentations 42B and rotational friction is established such that any rotational force applied to thebase ring 42 will be transmitted to the port ring 44 (or vice versa) without any slippage between the tworings base ring 42 andport ring 44 are coupled such that theholes ring rings - In use, the external
pressurized system 10 can be used to insert a surgical device or system into a cavity of a patient. One method of insertion will now be described, but it is understood that the embodiments disclosed herein are not limited to a single procedure and instead can be used in any procedure that falls within the spirit of the various implementations contemplated herein. - In one embodiment, the
port 18 is placed in an incision in the following manner to create a seal for the incision that fluidly seals the patient's cavity from the ambient air outside the patient. First, an incision is made in the patient that provides access to the patient's target cavity. In one embodiment, the cavity is the peritoneal cavity, but the target could be any known cavity. Once the incision has been made, thesealable sleeve device 46 is positioned in the incision, for example as shown inFIGS. 6A , 6B, 6C, and 6D. In this embodiment, thedevice 46 is positioned throughincision 58. Thedevice 46 is positioned in the incision by inserting thelower sleeve ring 46B (not shown inFIGS. 6A-6D ) through theincision 58 such that thelower ring 46B is positioned within the patient and theupper ring 46A is positioned outside the patient, with thesleeve 46B extending through theincision 58. According to one embodiment, thelower sleeve ring 46B of thedevice 46 is aflexible ring 46B that can be deformed such that thering 46B can be inserted through theincision 58. - In one embodiment, prior to positioning the
sealable sleeve device 46 in theincision 58 as described above, thedevice 46 is first positioned in a similar fashion through thehole 50 in theport ring 44 and thehole 48 in thebase ring 42. That is, thelower sleeve ring 46B is deformed and inserted through thehole 50 and thehole 48, thereby resulting in theupper sleeve ring 46A being positioned on the top portion of the base ring 42 (which is positioned on the top portion of the port ring 44) and thelower sleeve ring 46B being positioned on the bottom portion of theport ring 44. Thelower sleeve ring 46B is then inserted through theincision 58 in the patient as described above. Alternatively, thesealable sleeve device 46 can be positioned through thehole 50 in theport ring 44 and thehole 48 in thebase ring 42 after thedevice 46 has been positioned through theincision 58. - Once the
lower ring 46B is inserted through theincision 58 as shown inFIG. 6A and further positioned in thehole 50 in theport ring 44, theupper ring 46A is positioned over theincision 58 such that theincision 58 is centered within thering 46A, as shown inFIG. 6B . For ease of understanding, theport ring 44 is not depicted in these figures. Thesealable sleeve 46 is then tightened to create a seal and position thelower ring 46B snugly to the underside of theincision 58 and theupper ring 46A snugly to the top portion of thebase ring 42. This tightening occurs by rotating theupper ring 46A. In one embodiment, theupper ring 46A is less flexible (more rigid) than thelower ring 46B, thereby allowing a user to grasp it and rotate it.FIG. 6C depicts thesealable sleeve device 46 after thering 46A has been rotated, thereby causing thesleeve 46C to gather and begin to close the opening in thesleeve 46C (or “collapse on itself”).FIG. 6D shows thesleeve device 46 after the user has successfully rotated thering 46A to the point that a seal is formed in thesleeve 46C by closing the opening therein. - It is understood that the
base ring 42 and theport ring 44 are intended to be generally rotatable relative to each other during the process of positioning theport 18 and thereby sealing theincision 58. That is, when thebase ring 42 is initially positioned on theport ring 44, the tworings rings sleeve device 46, thereby resulting in the seal created by thesleeve device 46 when it is sufficiently constricted. However, when thesleeve device 46, theport ring 44, and thebase ring 42 are positioned in theincision 58 and thesealable sleeve device 46 is tightened to close the hole in theincision 58 as described above, the elasticity of thesleeve 46C urges thebase ring 42 andport ring 44 together as described above, causing the bottom surface of thebase ring 42 and the top surface of theport ring 44 to come into contact such that the ridges 44A on theport ring 44 couple with theridges 42B on thebase ring 42 as described above. The interfacingridges 44A, 42B provide an interface or coupling that will result in rotational coupling of therings rings sleeve device 46 is rotated), the more secure the coupling of the ridges 44A, 44B becomes. - Once the
sleeve device 46, theport ring 44, and thebase ring 42 are positioned in theincision 58 as described above, theconnector ring 40 is coupled to thebase ring 42. In one embodiment as described above, theconnector ring 40 is coupled to thebase ring 42 via nuts or bolts. Alternatively, any standard coupling device or method can be used. Once theconnector ring 40 is coupled to thebase ring 42, theport 18 is fully assembled, as shown inFIGS. 7A and 7B . - According to one embodiment, the coupling of the
connector ring 40 to thebase ring 42 as shown inFIG. 7A , in combination with the tightening of thesleeve device 46 as described above, creates a fluid seal that seals the patient's cavity from the ambient air outside the patient. More specifically, at this point thesealable sleeve device 46 provides a seal as best shown inFIG. 6D . One of ordinary skill in the art understands that this fluidic seal is sufficient to maintain the increased air pressure of the insufflated cavity of the patient. - Once this seal is established, the
canister 12 with the medical device/system 26 positioned inside can be coupled to theconnector ring 40 as best shown inFIG. 1B such that the device/system 26 can then be inserted into theinsufflated cavity 24 of the patient. Prior to that coupling, the device/system 26 (coupled to a positioning rod 28) must be positioned in thecanister 12. While it is understood that any number of known procedures within the spirit of the embodiments contemplated herein could be used to position the device/system 26 in thecanister 12, one implementation provides for—prior to coupling thecanister 12 to theport 18—inserting the device/system 26 through the open end (not shown) at thebase portion 20 of the canister 12 (as best depicted inFIG. 1A ) and inserting thepositioning rod 28 through theorifice 34 defined in theseal 30 in thetop cap 14. It is understood that thepositioning rod 28, in accordance with some embodiments, can have one or more lumens therein that can contain one or more connection components (such as wires, cords, or the like) that connect the device/system 26 to an external controller of some kind, thereby allowing for the controller to control the device/system 26 via the connection component(s). - Once the device/
system 26 is positioned in thecanister 12 with thepositioning rod 28 extending out of thetop cap 14 through theorifice 34 in theseal 30 as best shown inFIG. 1B , thecanister 12 can be coupled to theconnector ring 40. In one embodiment as best shown inFIGS. 8A and 8B , thebase portion 20 of thecanister 12 has at least 2projections 12A extending from thecanister 12 that correspond to theslots 40B in theconnector ring 40. More specifically, in the implementation depicted inFIGS. 8A and 8B , thecanister 12 has 4projections 12A (one of which is not shown) that correspond to 4slots 40B in theconnector ring 40. To couple thecanister 12 to thering 40, the fourprojections 12A are inserted into theslots 40B and thecanister 12 is rotated in a counterclockwise fashion to position theprojections 12A in the fully coupled position in theslots 40B as shown inFIG. 8B . Alternatively, any known coupling mechanism, device, or procedure can be used to couple thecanister 12 to thering 40. - Once the
canister 12 is coupled to theport 18 as best shown inFIG. 9 , a seal has been achieved that fluidically separates and seals fluid within thecanister 12 from fluid outside thecanister 12. At this point, the pressure inside thecanister 12 is increased until it matches the pressure of theinsufflated cavity 24. By equalizing the pressure in thecanister 12 to the pressure in theinsufflated cavity 24, the device/system 26 positioned in thecanister 12 can then be inserted into thecavity 24 through the seal created by thesealable sleeve device 46 without causing a loss of pressure or loss of insufflation in thecavity 24. According to one embodiment, the fluidic seal is maintained in thecanister 12 by the seal created between thecanister 12 and theport 18 and further by the seal created between the positioningrod 28 and theseal 30. More specifically with respect to thepositioning rod 28 and theseal 30, it is understood that therod 28 is sized to contact the inner circumference of theorifice 34 in theseal 30, thereby resulting in an airtight fluidic seal between therod 28 and theseal 30. It is understood that, at this point, if a user wants to adjust the positioning of the device/system 26, the user can do so using thepositioning rod 28. - Once the air pressure in the
canister 12 is substantially the same as the air pressure in theinsufflated cavity 24, the device/system 26 is moved out of thecanister 12, through theport 18 and theincision 58, and into the patient'scavity 24. According to one embodiment as best shown inFIG. 1B , the device/system 26 can be moved through theport 18 and into thecavity 24 using thepositioning rod 28, which is coupled at its distal end to the device/system 26. That is, a user can grasp a proximal end of therod 28 and move therod 28 in a distal direction as desired to move the device/system 26 distally out of thecanister 12 and into thecavity 24. In those implementations in which the device/system is a robotic device having operational arms, the device, including the arms, can be advanced through theport 18 and into theinsufflated cavity 24. It is understood that the user can also turn therod 28 to turn the device/system 26 as needed/desired as well. In this fashion, the user can position the device/system 26 as desired within the patient'scavity 24 in order to perform a procedure. - In alternative embodiments, the
positioning rod 28 can be a larger rod than that depicted in these figures such that therod 28 can have multiple lumens defined within therod 28, including one or more larger lumens that could be used for tool and/or camera insertion. Insufflation after removal of thecanister 12 could also be accomplished through such arod 28. In a further alternative, instead of a rod, a port such as a known SILS port could be used. - Once the device/
system 26 has been inserted into, and is positioned as desired in, the patient'scavity 24, the fluidic seal is re-established between theinsufflated cavity 24 and the interior of thecanister 12 via thesealable sleeve device 46. As a result, the pressure inside thecanister 12 can be lowered until it is substantially equal to the ambient pressure. At that point, thecanister 12 can be de-coupled from theconnector ring 40. That is, according to one embodiment, thecanister 12 is rotated in the clockwise direction, thereby urging theprojections 12A out of theslots 40B in thering 40. Once thecanister 12 is removed, as best shown inFIG. 11 , only theport 18 itself remains with the fluidic seal established by the combination of theport 18 components, including thesealable sleeve device 46 as described above. Thus, the user can freely position and operate the device/system using the positioning rod 28 (and, in some embodiments, the external controller (not shown) connected to the device/system via the connection component(s)). For example, the removal of thecanister 12 can provide for additional accessibility and freedom of movement for therod 28. As such, the medical procedure using the system/device 26 is typically performed once thecanister 12 is removed as shown inFIG. 11 . - Another access and insertion embodiment relates to a balloon seal insertion method and device for inserting a surgical device/system into a patient's cavity and performing a surgical procedure using a balloon seal insertion device that operates to maintain a fluidic seal around the surgical device such that the higher air pressure of the insufflated cavity is not lost during the procedure. One example of a balloon
seal insertion device 100 being used to position and operate asurgical device 102 in a patient'sinsufflated cavity 106 is depicted inFIG. 12 . As depicted, theinsertion device 100 is positioned on the patient's skin (schematically depicted as 106) and through the incision in the skin (not shown). The connectingrod 104 coupled to thedevice 102 is positioned through theinsertion device 100, with thesurgical device 102 positioned within the patient'sinsufflated cavity 108. - As best shown in
FIGS. 12 , 13A, and 13B, theinsertion device 100 can maintain a fluidic seal during a surgical procedure because thedevice 100 has an expandable seal 114 (also referred to as an “expandable balloon” or “balloon” herein) disposed through ahole 112 defined in theport housing 110 of thedevice 100. Theballoon 114 provides a fluidic seal around any surgical device positioned through thehole 112 because theballoon 114 is flexible, expandable, and elastic. As such, as theballoon 114 is inflated, it provides “odd geometry molding,” which means it can be expanded around, come into contact with, and conform to the shape of any object positioned through thehole 112, thereby creating a fluidic seal around that object, regardless of its shape. - As best shown in
FIG. 13B , theinsertion device 100 comprises aport housing 110 that defines ahole 112 as discussed above. As also discussed above, theballoon 114 is positioned within thehole 112. Thehousing 110 further has two balloon inflation/deflation ports deflation port 118. In addition, thehousing 110 has twoattachment components 120 configured to allow for the attachment of thecoupling components 122. Thecoupling components 122 are used to couple thehousing 110 to a standardsealable sleeve 46 as will be discussed below. - The
ports connections connection 128 is a Schrader valve. According to one implementation, a Schrader valve is used forconnection 128 inport 116B to accommodate connection to a standard air pump while also providing a release valve to deflate theballoon seal 114 when necessary. It is understood that any other known valves or connections used with medical devices—such as, for example, any connections using standard UNF or NPT size fittings—can be used in place ofconnections device 100. - It is understood that the
various ports - According to one embodiment, the
balloon 114 has atop ring 140, abottom ring 144, and anexpandable body 142 connecting the tworings balloon 114 can be part of a single integral piece that makes up theballoon 114. Alternatively, theballoon 114 can be made up of separate components. Thetop ring 140 is positioned on and coupled to thetop lip 130 on the top portion of thehole 112, while thebottom ring 144 is positioned on and coupled to thebottom lip 132 on the bottom portion of thehole 112, as best shown inFIGS. 14B and 14C . In accordance with one implementation, therings lips expandable seal 114 can be any known expandable device or component that is used with medical devices and can provide a fluidic seal via odd geometry molding. In one embodiment, theballoon 114 is comprised of latex or some type of rubber. Alternatively, theballoon 114 can be made of any known material used in medical devices that is expandable, elastic, and can provide a fluidic seal via odd geometry molding. - In one implementation, the thickness of the
seal 114 can be modified to influence how theseal 114 operates. For example, various parts of theseal 114 can have different thicknesses to influence the way in which theseal 114 expands when it is inflated. Alternatively, theseal 114 can have a single thickness that can be varied to influence the resistance of theseal 114 when an object is inserted through it. Alternatively, the thickness can be varied for other reasons as well. In a further alternative embodiment, in addition to at least one expandable elastic material, an additional material or materials can be added to theseal 114. For example, a fabric or other type of material that is less elastic and/or less expandable can be included in theseal 114 to influence or control the way theseal 114 expands when it is inflated. For example, a fabric could be included in a top and bottom portion of theseal 114 to prevent theseal 114 from expanding vertically (up or down) and thereby influence theseal 114 to expand horizontally. - In the embodiment as shown, the
attachment components 120 are threaded holes configured to receive screws or bolts or the like. Further, in this implementation, the threadedholes 120 are positioned on opposite sides of thehousing 110. Alternatively, any appropriate knownattachment component 120 can be used to allow for attachment of thecoupling components 122 to thehousing 110. Further, it is understood by one of ordinary skill that the number and positioning of theattachment components 120 on the housing can vary as desired to allow for different configurations and different types ofcoupling components 122. -
FIGS. 14A , 14B, and 14C depict additional details about the configuration of theport housing 110, according to one embodiment. More specifically, as best shown inFIG. 14B (which depicts a cross-section of the housing 110), theport housing 110 has two balloon inflation/deflation lumens 150A, 150B defined in thehousing 110. The balloon inflation/deflation lumen 150A provides a fluid connection between the balloon inflation/deflation port 116A and thehole 112, thereby allowing for inflation or deflation of theexpandable seal 114 via theport 116A. Similarly, the balloon inflation/deflation lumen 150B provides a fluid connection between the balloon inflation/deflation port 116B and thehole 112, thereby also allowing for inflation or deflation of theexpandable seal 114 via theport 116B. - As best shown in
FIG. 14C (which depicts a different cross-section of the housing 110), theport housing 110 also has a cavity insufflation/deflation lumen 152 defined in thehousing 110 that provides a fluid connection between the cavity insufflation/deflation port 118 and patient'scavity 108 which is in fluid communication with the underside of thehousing 110 when the housing is positioned on the incision in the patient. Thislumen 152 thus allows for insufflation or deflation of the patient'scavity 108 via theport 118. - In use, the
device 100 is positioned on theincision 160 in the patient in combination with a standardsealable sleeve device 162 as best shown inFIGS. 16A and 16B . The standardsealable sleeve device 162 is shown inFIG. 15 . It has anupper ring 164 and alower ring 166 that are coupled together by aflexible sleeve 168. According to one embodiment, thedevice 162 is substantially similar to the sealable sleeve device described above with respect toFIGS. 2A , 2B, 6A, 6B, 6C, and 6D. - In one implementation, the
sealable sleeve device 162 is first positioned in theincision 160. It is understood that thesleeve device 162 can be inserted using steps similar to those described above. Alternatively, any known insertion steps can be used to insert thedevice 162 into the incision such that theupper ring 164 is positioned outside of theincision 160 and thelower ring 166 is positioned inside the patient's cavity, with thesleeve 168 disposed through theincision 160 itself, as best shown inFIG. 16A . - Once the
sleeve device 162 is positioned in theincision 160, thehousing 110 is coupled to thesleeve device 162 as best shown inFIGS. 16A and 16B . More specifically, according to one implementation, thehousing 110 is positioned over theupper ring 164 of thesleeve device 162 such that theupper ring 164 is positioned into the circular indentation or notch 170 defined in the bottom of thehousing 110. The configuration of thenotch 170 corresponds to the configuration of theupper ring 164 and thus is configured to receive theupper ring 164 such that thering 164 fits snugly into thenotch 170. - Once the
ring 164 is positioned in thenotch 170, thecoupling components 122 are coupled to theattachment components 120 on thehousing 110 and thereby firmly couple thehousing 110 to thesleeve device 162. Thecoupling components 122 in this embodiment are components having avertical piece 122A and ahorizontal piece 122B. Thevertical pieces 122A are coupled to theattachment components 120 using a screw or bolt or similar mechanism. As best shown inFIG. 16 a, when thevertical pieces 122A are coupled to theattachment components 120, thehorizontal pieces 122B are positioned under thehousing 110 such that they are also positioned under theupper ring 164 disposed in thenotch 170. As such, thecoupling components 122 operate to retain or lock theupper ring 164 in thenotch 170. As a result, the retention of theupper ring 164 into thenotch 170 can provide a fluidic seal between thehousing 110 andsleeve device 162. Alternatively, any appropriate known interface between thehousing 110 andsleeve device 162 that provides a fluidic seal can be used. - Once the
housing 110 andsleeve device 162 are coupled, theballoon 114 can be inflated using eitherport 116A orport 116B or both. When theballoon 114 has been sufficiently inflated such that theexpandable body 142 of theballoon 114 contacts itself, a fluidic seal is created between the patient's cavity and the ambient air outside the patient's body. Once this fluidic seal is established, the patient'scavity 108 can be insufflated usingport 118 to the desired pressure inside thecavity 108 and the appropriate devices and/or instruments can be inserted into thecavity 108 through the expandedballoon 114 seal with loss of pressure inside thecavity 108. - In one particular example as depicted in
FIGS. 17A and 17B , a device/system having tworobotic arms cavity 108 through the expandedballoon 114 seal. More specifically, the firstrobotic arm 180 is inserted into the expandedballoon 114 seal inFIG. 17A . Due to the odd geometry formation of the expandedballoon 114, the fluidic seal is maintained even as thefirst arm 180 is being inserted through theballoon 114. Once thefirst arm 180 is successfully inserted into thecavity 108 and positioned as desired as shown inFIG. 17B using aconnection rod 184, thesecond arm 182 is inserted into theballoon 114 seal. Again, the odd geometry formation of theballoon 114 allows this to occur without losing the fluidic seal and thus without losing the higher pressure of theinsufflated cavity 108. - Returning to
FIG. 12 , this figure depicts a final position of the robotic system having twoarms arms - It is contemplated that alternative embodiments of the balloon seal devices could have more than one balloon seal provided in a single device. Those two or more balloon seals could be provided in various configurations. For example, in one configuration, in addition to the central seal similar to that described above, a second seal could be provided off to one side of the first seal and positioned at an angle so that any device or object inserted through the second seal would be inserted at an angle. It is understood that these two or more balloon seals could be pneumatically connected to the same air pressure source(s), or, alternatively, each seal could be pneumatically separate so that each has its own pressure source and can be set at its own independent level of air pressure.
- Another access and insertion embodiment relates to a rubber seal insertion method and device for inserting a surgical device/system into a patient's cavity and performing a surgical procedure using a rubber seal access/insertion device that operates to maintain a fluidic seal at the incision such that the higher air pressure of the insufflated cavity is not lost during the procedure. One example of a rubber seal access/
insertion device 200 is depicted in cross-sectional view inFIG. 18 . As depicted, the access/insertion device 200 is positioned on the patient's skin (schematically depicted as 202) over theincision 206 in theskin 202 and is coupled to a standardsealable sleeve device 204, which is disposed through theincision 206. - As best shown in
FIGS. 19A and 19B , the access/insertion device 200 has abase ring 210 that is coupleable to thesleeve device 204. Thedevice 200 also has threeseals base ring 210 and the firsttop ring 214. In some embodiments, thedevice 200 has only the first set of seals (212A, 212B, 212C) and the firsttop ring 214. In alternative embodiments such as the implementation as shown, thedevice 200 also has a second set of threeseals top ring 214 and a secondtop ring 218. In this implementation, the first and secondtop rings base ring 210, thereby maintaining the first set ofseals seals top rings holes base ring 210, the firsttop ring 214, and the secondtop ring 218, respectively, and fastened to fix therings rings - According to one embodiment, the fluidic seal created by the set of seals (212A, 212B, 212C, for example) is created by providing separate rubber seals having different types of openings defined in each such seal. For example, as best shown in
FIG. 20 , in this implementation, theseals Seal 212A has two substantiallycircular holes seal 212A. Thehole 230A is larger, is positioned more centrally on theseal 212A, and is intended to receive a surgical device or system such as a robotic surgical device. Thehole 230B is smaller, is positioned closer to an edge of theseal 212A, and is intended to receive a peripheral device or component such as a trocar, a camera, or some other accessory tool. Theseholes - In contrast,
seal 212B has twoslits seal 212B. Theslit 232A is larger and is positioned in a location that corresponds to hole 230A, whileslit 232B is smaller and is positioned in a location that corresponds to hole 230B. Similarly,seal 212C has a larger slit 234A positioned in a location corresponding to hole 230A and slit 232A and further has a smaller slit 234B positioned in a location corresponding to hole 230B and slit 232B. In addition, the slits 234A, 234B inseal 212C are positioned at a 90 degree angle with respect to theslits seal 212B. According to one implementation, the combination of theslits seal 212B with the slits 234A, 234B inseal 212C results in a stronger fluid seal that can withstand the increased pressure of theinsufflated cavity 208 of the patient without the slits opening and allowing that increased pressure to be lost. - By incorporating two sets of seals 212, 216 as shown in
FIGS. 19A , 19B, the overall fluidic seal created by thedevice 200, even when surgical devices are inserted through thedevice 200, is further strengthened. More specifically, as best shown inFIG. 19B , the firsttop ring 214 defines ahole 214B at its center. When the firsttop ring 214 is positioned between the first set of seals 212 and the second set of seals 216, thehole 214B in the firsttop ring 214 creates a cavity between the two sets ofseals 212, 214. As such, according to one embodiment, any loss of the fluidic seal in one set of the seals (either 212 or 214) will not cause a loss of the overall fluidic seal or leak pressure directly from the patient'scavity 208 into the ambient air outside the patient. Hence, the cavity created by the firsttop ring 214 can minimize the overall pressure loss from any such leak. - In accordance with one implementation, each of the
seals - As discussed above, according to certain embodiments, the
device 200 has only one set ofseals top ring 214. While such embodiments do not have the cavity created by the firsttop ring 214 as described above, thedevice 200 with a single set of seals 212 can still provide a sufficient fluidic seal. For example, such adevice 200 would provide a sufficient fluidic seal for insertion of any robotic device having sufficiently smooth external features and surfaces. In addition, adevice 200 with a single set of seals 212 can reduce the size of theoverall device 200 and can potentially reduce any trauma to the surgical device inserted through thedevice 200 as a result of only having to pass through a single set of seals 212. -
FIG. 21 , according to one implementation, depicts a top view of thedevice 200. More specifically,FIG. 21 shows the secondtop ring 218 positioned over theseal 216A. Theholes seal 216A are visible as well. - In use, the rubber seal access/
insertion device 200 can be positioned for use in the following manner. First, as described above with respect to other embodiments, according to one implementation, thesealable sleeve device 204 is first positioned in theincision 206. It is understood that thesleeve device 204 can be inserted using steps similar to those described above. Alternatively, any known insertion steps can be used to insert thedevice 204 into the incision such that theupper ring 240 is positioned outside of theincision 206 and thelower ring 242 is positioned inside the patient's cavity, with thesleeve 244 disposed through theincision 206 itself, as best shown inFIG. 18 . - Once the
sleeve device 204 is positioned in theincision 206, the base ring 210 (and thus the entire device 200) is coupled to thesleeve device 204 as best shown inFIGS. 18 and 22 . More specifically, according to one implementation, thebase ring 210 is positioned over theupper ring 240 of thesleeve device 204 such that theupper ring 240 is positioned into the circular indentation or notch 250 defined in the bottom of thebase ring 210. The configuration of thenotch 250 corresponds to the configuration of theupper ring 240 and thus is configured to receive theupper ring 240 such that thering 240 fits snugly into thenotch 250. - Once the
upper ring 240 is positioned in thenotch 250, thecoupling components 220 are coupled to theattachment components 252 on thebase ring 210 and thereby firmly couple thebase ring 210 to thesleeve device 204. Thecoupling components 220 in this embodiment are components having avertical piece 220A and ahorizontal piece 220B as best shown inFIG. 19A or 22. Thevertical pieces 220A are coupled to theattachment components 252 using a screw or bolt or similar mechanism. As best shown inFIG. 18 , when thevertical pieces 220A are coupled to theattachment components 252, thehorizontal pieces 220B are positioned under thebase ring 210 such that they are also positioned under theupper ring 240 disposed in thenotch 250. As such, thecoupling components 220 operate to retain or lock theupper ring 240 in thenotch 250. As a result, the retention of theupper ring 240 into thenotch 250 can provide a fluidic seal between thebase ring 210 andsleeve device 204. Alternatively, any appropriate known interface between thebase ring 210 andsleeve device 204 that provides a fluidic seal can be used. - Once the
device 200 andsleeve device 204 are coupled as best shown inFIGS. 18 and 23 , a fluidic seal has been established between the patient'scavity 208 and the external air outside of the patient. At this point, the patient's cavity can be insufflated to the desired amount of air pressure. Subsequently, one or more surgical devices can be inserted through the seals 212, 216 at the appropriate holes/slits and into the patient'sinsufflated cavity 208. In one embodiment, each arm of a robotic surgical device can be separately and consecutively inserted through the larger hole (and larger slits) of the seals and into thecavity 208. Alternatively, any known devices can be inserted into thecavity 208 so long as they fit through the holes and slits as contemplated herein. - Another embodiment of an access/insertion device relates to another external pressurized system or apparatus similar to the system or apparatus depicted in
FIGS. 1-11 and described in detail above. Like the device inFIGS. 1-11 , the instant device is coupled to a port that is positioned over and/or in an incision in the skin of the patient, thereby providing access to a cavity of the patient. However, in the instant implementations as shown inFIGS. 24A-38 and discussed below, the external pressurized system/apparatus has a external body having one or more access ports for the insertion of not only surgical devices, but also additional equipment and/or the hands of one or more users or medical professionals, providing access to the interior of the pressurized system/apparatus without loss of the higher pressure inside the system/apparatus. - For example, one implementation of such an external pressurized system or
apparatus 300 is depicted inFIGS. 24A-24F . As best shown inFIGS. 24C (top view) and 24D (perspective view), thedevice 300 has anexternal body 302 having a main tube (also referred to as the “canister”) 304, aleft hand tube 306 with a lefthand access port 308, aright hand tube 310 with a righthand access port 312, and aside access tube 314 with aside access port 316. In addition, themain tube 304 has adevice port 318 coupled to a top portion of thetube 304. - The bottom portion of the
main tube 304 is coupleable to anincision port 320, as best shown inFIGS. 24A and 24B . In turn, as best shown inFIG. 24F , theincision port 320 is coupleable to a standardsealable sleeve device 322, which can be positioned in theincision 324 made in the patient'sskin 326 to access atarget cavity 328 of the patient. Theincision port 320 and its coupling to both themain tube 304 and thesealable sleeve device 322 are described in detail below. - In the depicted implementation, the left and right
hand access ports ports body 302. Further, theside access tube 314 withaccess port 316 can be used for storage of equipment and/or for assistance of another user by inserting her or his hand through theport 316. In addition, thedevice access port 318 can be configured such that various medical devices/systems can be inserted into thebody 302 through theport 318. Alternatively, any of theaccess ports body 302 could have amain tube 304 with one, two, or more than three additional tubes with access ports for various uses, including any of those discussed above. It is also understood that various embodiments contemplated herein include tubes and/or ports that are different sizes or shapes than those depicted. For example, in some implementations, the tubes and/or ports could be square or oval in shape. - In one implementation, the external body 302 (the
main tube 304 and theaccess tubes body 302 can be made of any known rigid material that can be used in medical devices. It is understood that certain embodiments of thebody 302 are transparent, such as those depicted in the figures provided. Thetransparent body 302 allows for the user to see the interior of thetubes body 302 is not transparent and the equipment/devices can be inserted without being able to view them in thedevice 300. - According to one implementation, the
sealable sleeve device 322, as best shown inFIGS. 24F , 29A, 29B, and 30, can be a standard, commercially available device as described in the various embodiments above. Thedevice 322 has anupper ring 420 and alower ring 422 that are coupled together by aflexible sleeve 424. According to one embodiment, thedevice 322 is substantially similar to the sealable sleeve device described above with respect toFIGS. 2A , 2B, 6A, 6B, 6C, and 6D. - According to one embodiment, the
access ports access port 340 in use is depicted inFIG. 25 . As shown in that figure, theport 340 allows for insertion of a hand through theport 340. Anotherexemplary access port 342 is depicted inFIG. 26 . Thisport 342 is the GelSeal® port that is commercially available from Applied Medical in Rancho Santa Margarita, Calif. In this embodiment, theport 342 has abody 344, arigid support ring 346, and amoveable clamp lever 348 that can be used to tighten theport 342 and thus secure theport 342 to any ringed object to which it is attached. More specifically, theclamp lever 348 is depicted in three different positions. In position A, thelever 348 is in the open position A and theport 342 thus has its widest circumference. In position B, thelever 348 is midway between the open position A and the closed position C and theport 342 has a circumference that is less than when it is in the open position A. Finally, in position C, thelever 348 is positioned against theport 342 in the closed position C and theport 342 has its smallest circumference. In use, thelever 348 is typically in position A when theport 342 is positioned and then thelever 348 is moved to position C to clamp theport 342 in place. In one embodiment, thebody 344 is made of the soft, gel-like material in the product as provided by Applied Medical. Alternatively, thebody 344 can be made of any material that allows for objects and/or hands to be inserted through the material such that the fluidic seal is maintained so that the higher pressure of the surgical cavity is not lost when an object is inserted through the material. - In accordance with one implementation as shown in
FIG. 27A , theaccess ports tubes port adaptor ring 350. Theport adaptor ring 350 has afirst ring portion 352 that is sized to mate with any one of thetubes body 302. (In this particular depiction, the lefthand access tube 306 is used as an example.) Thering 350 also has asecond ring portion 354 that is sized to mate with a port—in this case the lefthand access port 308. - According to one embodiment, the
first ring portion 352 is coupled to thetube 306 by positioning thefirst ring portion 352 over the end of thetube 306 and holding thefirst ring portion 352 in place usingthumb screws 356 that are inserted through threadedholes 358A in thefirst ring portion 352 and into threadedholes 358B in thetube 306. Alternatively, any attachment devices or mechanisms, such as bolts, clamps, or the like, can be used to attach thefirst ring portion 352 to the tube 306 (and, by extension, to any of thetubes tube 306 and thefirst ring port 352 to ensure that a fluidic seal is established between the two components. - The
access port 308, in accordance with one implementation, is coupled to thesecond ring portion 354 in a fashion similar to that described above. That is, theclamp lever 308A on theport 308 is placed in position A, and theport 308 is positioned over thesecond ring portion 354. Then thelever 308A is moved into the closed position—position C—such that theport 308 is clamped onto thesecond ring portion 354. Alternatively, any known mechanism or method for coupling a port similar toport 308 to a device component can be used. - According to one embodiment as shown in
FIG. 27B , thedevice access port 318 can have one or more additional structures to allow a user to easily stabilize or position a surgical device within thebody 302 of thedevice 300 prior to or during use. More specifically, thedevice access port 318 in certain implementations has one or more device attachment components 357 (also referred to as “device clips”) positioned along the inner lumen of theport 318. Thedevice clip 357 is configured to retain a device such as apositioning rod 359 within theclip 357, thereby providing a way to couple a portion of the surgical device being used for the intended procedure to the interior of thebody 302. In one embodiment, theattachment component 357 is an actual clip as shown inFIG. 27B . Alternatively, thecomponent 357 can be a notch or other type of specifically configuredindentation 357 defined in the inner lumen of theport 318 that is configured to receive a medical device such as apositioning rod 359 or the like. In a further alternative, theattachment component 357 can be any mechanical or structural mechanism or component that allows for coupling to a medical device. In further embodiments,such attachment components 357 can be positioned elsewhere in thebody 302, such as, for example, on an interior port of another access port or elsewhere on an interior portion of one of the tubes. - In various alternative embodiments, other types of access ports can be used instead of the ports described above and depicted in
FIGS. 24-27B . For example, in one specific alternative implementation, one or more glove ports can be used such as theglove port 360 depicted inFIGS. 28A and 28B . Theglove port 360 has aglove component 362 coupled to aglove port ring 364. In various embodiments, theglove port 360 could be coupled at theglove port ring 362 to one or more of thetubes body 302. In one embodiment, theglove port ring 362 is coupled to the tube via a clamp lever similar to the clamp lever described with respect toFIG. 26 . Alternatively, any known coupling mechanism can be used. Unlike theaccess ports glove port 360 does not require that a fluidic seal be established around the surgeon's arm or whatever object is inserted through it. As such, theglove port 360 can help to ensure that the pressure differential between the patient's cavity and the ambient air outside the patient will be maintained. In one embodiment, theglove port 360 has a pressure relief valve (not shown) that can be used to adjust the volume, thereby accounting for the volume change caused when a user inserts her or his hand into thebody 302 using theglove component 362.FIG. 28B depicts theglove port 360 in use. - As mentioned above, the
incision port 320 is configured to be coupleable to both themain tube 304 and to thesealable sleeve device 322, as shown inFIGS. 24F and 29 . As best shown inFIGS. 24A and 30 , theincision port 320 has abase ring 370. The upper portion of thebase ring 370 can be coupled to aninternal coupling component 372, which can couple to theport seal 450 as described in further detail below. Further, the lower portion of thebase ring 370 can be coupled to external coupling components 374 (also referred to in certain embodiments as “sleeve clamps”), which couple thering 370 to thesealable sleeve device 322. In addition, thebase ring 370 can also be coupled to coupling components 376 (also referred to in certain embodiments as “tube brackets”), which couple thering 370 to themain tube 304 of thedevice 300. -
FIGS. 31A and 31B depict thebase ring 370, according to one implementation. Thering 370 has a curved indentation or notch 378 configured to receive and couple with the bottom portion of themain tube 304. In addition, thering 370 has threebracket receiving components 380 configured to receive thetube brackets 376. Further, as best shown inFIGS. 24F , 30, and 35, the bottom portion of thering 370 defines a circular indentation orlumen 381 that is configured to be positioned over and receive theupper ring 420 of thesleeve device 322. Thering 370 also hasmultiple holes 384 defined in aninterior ring 382. Themultiple holes 384 correlate toholes 436 in thebase plate 430 of theinternal coupling component 372, as described in detail below. Each of thebracket receiving components 380 have aprojection 386 andhorizontal portion 388 on which thetube bracket 376 is positioned and ahole 390 that corresponds to thehole 394 in thetube bracket 376 as described in detail below. In one embodiment, a gasket (not shown), such as a silicon, foam or rubber gasket, is provided between thenotch 378 and the bottom portion of themain tube 304 to strengthen the fluidic seal between the two components. -
FIG. 32 depicts atube bracket 376, according to one embodiment. Thetube bracket 376 has abase portion 392 having ahole 394 defined therein that corresponds to thehole 390 in thebracket receiving component 380 on thebase ring 370. Thebracket 376 also has atube contacting portion 396 having twoholes 398 defined therein that correspond to theholes 404 in the bottom portion of themain tube 302, as described below. - According to one embodiment, the
tube bracket 376 is used to couple themain tube 302 to thebase ring 370, as shown inFIG. 33 . More specifically, thetube bracket 376 is positioned on thebracket receiving components 380, with thebase portion 392 of thebracket 376 positioned on thehorizontal portion 388 and thetube contacting portion 396 positioned on theprojection 386. In that position, thebracket 376 is coupled to thebase ring 370 by inserting a threadedscrew 400 throughhole 394 in thebracket 376 and intohole 390 in thering 370. Further, thebracket 376 is coupled to themain tube 302 by inserting two threadedscrews 402 throughholes 398 in thebracket 376 and intoholes 404 in thetube 302. Thus, thetube 302 is attached in position against theincision port 320 and specifically thebase ring 370 using thebrackets 376. In the embodiments depicted inFIGS. 24A-24F , there are threetube brackets 376—spaced about 120 degrees from each other around the circumference of theport 320—that are used to couple thetube 302 to theport 320. Alternatively, two brackets or more than three brackets could be used in different positions around theport 320. In a further alternative, any known type of coupling mechanism could be used to keep thetube 302 coupled to theport 320. - As discussed above, the
incision port 320 is coupled to thesealable sleeve device 322 using the sleeve clamps 374.FIG. 34 depicts one embodiment of asleeve clamp 374. Theclamp 374 has ahole 406 defined in a top portion of theclamp 374,projections 408 configured to fit into thenotches 410 defined under thebracket receiving components 380 on the base ring 370 (as best shown inFIG. 31B ), and aprojection 412 configured to help retain theupper ring 420 of thesealable sleeve device 322 in position on theclamp 374, as discussed below. Thehole 406 corresponds to thehole 394 in thebracket 376 and thehole 390 in thebase ring 370 such that when thesleeve clamp 374 is positioned under thebracket receiving component 380 of thebase ring 370 and the threaded screw is inserted throughhole 394 andhole 390, it is also threaded intohole 406 such that thesleeve clamp 374 is coupled to thebase ring 370. - As best shown in
FIGS. 30 and 35 , when theport 320 is positioned over thesleeve device 322 such that theupper ring 420 is positioned within thelumen 381 on the bottom portion of thebase ring 370, thesleeve clamp 374 can be coupled to thebase ring 370 as described and theupper ring 420 of thesealable sleeve device 322 is contacted by theclamp 374 and thereby retained in its desired position as shown. Further, thenotch 412 in theclamp 374 can further help to retain theupper ring 420. In one embodiment, a gasket (not shown), such as a foam, rubber, or silicone gasket, is placed between theupper ring 420 and the underside of thebase ring 370, thereby providing a stronger fluidic seal between the two components. - As discussed above, according to one embodiment, the upper portion of the
base ring 370 can be coupled to aninternal coupling component 372, as best shown inFIGS. 24A , 30, and 36. Theinternal coupling component 372 has abase plate 430 and amale component 432 projecting from thebase plate 430. Thebase plate 430 hasmultiple holes 436 defined in theplate 430. Theseholes 436 correspond to theholes 384 defined in theinterior ring 382 of thebase ring 370 such that screws 438 (or bolts or any other known coupling mechanisms) can be used to couple thebase plate 430 to theinterior ring 382 of thebase ring 370 as shown. In addition, the interior portion of themale component 432 has two device attachment components 440 (also referred to herein as “device clips”) (only onesuch clip 440 is shown inFIG. 36 ). Eachdevice clip 440 is configured to be able to allow a user to couple a positioning rod (as described elsewhere herein) or some other device component to theclip 440 before or during a surgical procedure, thereby stabilizing or maintaining the position of the device. - As best shown in
FIG. 36 , themale component 432 has threenotches 434 formed or engineered on its outer circumference (one of which is fully depicted inFIG. 36 ). Thenotches 434 have avertical portion 434A and ahorizontal portion 434B in communication with thevertical portion 434A. Eachnotch 434 is configured to received a corresponding projection formed on an internal circumference of any device intended to couple with themale component 432. As such, to couple the device to themale component 432, the device is positioned over themale component 432 with the projections on the device positioned over the correspondingnotches 434 on themale component 432. The device is then positioned onto themale component 432 such that each projection moves along thevertical portion 434A of thenotch 434 until it reaches thehorizontal portion 434B. At that point, the device can be rotated and thereby move each projection circumferentially along thehorizontal portion 434B of thenotch 434, thereby coupling the device to themale component 432 of theinternal coupling component 372. - In one implementation, as best shown in
FIGS. 37A , 37B, and 37C, one of the components that can be coupled to theinternal coupling component 372 is aport seal 450. Theport seal 450 has aseal clamp 452 coupled to abase seal ring 454. Aseal component 456 is positioned between theclamp 452 and thering 454 so that the coupling of theclamp 452 to thering 454 fixes theseal component 456 in place in theport seal 450. In one embodiment as shown, theseal clamp 452 hasmultiple holes 458 defined in theclamp 452 that correspond to holes (not shown) in thebase seal ring 454 such that threaded screws 460 (or bolts, or the like) can be inserted through theholes 458 and into the holes in thering 454 to couple the two components together. Alternatively, any other known attachment mechanisms can be used. In one embodiment, a gasket (not shown), such as a foam, silicone, or rubber gasket, can be positioned between themale component 432 and thebase seal ring 454 to strengthen the fluidic seal between the two components. - The
seal clamp 452, in one embodiment, has multiple projections 464 extending from the top surface of theclamp 424. These projections 464 can be easily grasped by a user to place theport seal 450 on themale component 432 or remove it therefrom. Further, as best shown inFIG. 37C , the underside of thebase seal ring 454 has threeprojections 462 disposed on the inner circumference of thering 454. The threeprojections 462 correspond to the threenotches 434 defined in the outer circumference of themale component 432 such that thebase seal ring 454 can be coupled to themale component 432 as described above. - According to one implementation, the seal component 456 (also referred to herein as a “flexible seal component” or an “elastic seal component”) is a circular sheet of flexible or elastic material that is configured to allow a device or other equipment to be inserted through the seal component 456 (or to allow the
seal component 456 to be positioned over such equipment, like a positioning rod, as described in further detail below). In one embodiment, theseal component 456 is a circular rubber sheet having a small hole (not shown) in the sheet through which equipment can be inserted. Alternatively, theseal component 456 can be any known material configured to maintain a fluidic seal when a device or equipment is inserted through theseal component 456. - In accordance with one embodiment, a different type of seal component can also be incorporated into the
device 300. As shown inFIGS. 38A , 38B, and 38C, aflap seal component 470 is provided. Theflap seal component 470 has two flaps—afirst flap 472 and asecond flap 474—that contact each other at a midpoint in thecomponent 470. Each of theflaps teeth ridges 472A onflap 472 correspond to theridges 474A onflap 474 and thus interface or couple with each other. In one implementation as shown, theflap seal component 470 is positioned between thebase ring 370 and theinternal coupling component 372. According to one implementation, the configuration of theflaps ridges flaps flaps - In one embodiment as shown in
FIG. 38A , theflap seal component 470 can be incorporated into theincision port 320 and used when theport seal 450 is not coupled to theport 320. Alternatively, as shown inFIG. 38B , theflap seal component 470 can be incorporated into theincision port 320 and used when theport seal 450 is coupled to theport 320. - In use, the various embodiments disclosed or contemplated herein relating to access and insertion systems, devices, and methods that relate specifically to an external device having one or more ports for the insertion of not only medical devices, but also related equipment and/or the hands of one or more medical professionals to access the interior of the device during medical procedures while being able to maintain a higher air pressure within the device that is substantially the same as the insufflated cavity of the patient. According to one implementation, the high pressure is around 18 mmHg above atmospheric pressure, which is around the amount of pressure that is used to insufflate a patient's abdominal cavity during a laparoscopic procedure. Alternatively, any known higher pressure amount that is used during medical procedures can be used.
- The method of using the
device 300, according to one embodiment, includes at least some of the following steps. First, as described above with respect to other embodiments, according to one implementation, thesealable sleeve device 322 is first positioned in the incision 324 (seeFIGS. 24F , 29A, 29B, and 30). It is understood that thesleeve device 322 can be inserted using steps similar to those described above. Alternatively, any known insertion steps can be used to insert thedevice 322 into theincision 324 such that theupper ring 420 is positioned outside of theincision 324 and thelower ring 422 is positioned inside the patient's cavity, with thesleeve 424 disposed through theincision 324 itself, as best shown inFIG. 30 . - Next, the
incision port 320 and thedevice 300 are coupled to thesealable sleeve device 322. As best shown inFIGS. 30 , 33, and 35, thebase ring 370 of theincision port 320 is positioned over theupper ring 420 of thesleeve device 322 such that theupper ring 420 is positioned in thelumen 381 on the bottom portion of thebase ring 370. In addition, the bottom portion of themain tube 304 of thedevice body 302 can be positioned in thecurved notch 378 on thebase ring 370. At this point, both thedevice 300 and the sleeve device are positioned as desired with respect to theincision port 320 and must be coupled to theport 320. To do so, thetube brackets 376 and the sleeve clamps 374 are positioned on thebase ring 370 as described above and fixed in place using the threaded screws 400. Then the threadedscrews 402 are placed as well. As such, theincision port 320 is coupled to both thedevice 300 and thesleeve device 322 and a fluidic seal is created between the interior of thebody 302 and the exterior. - According to one embodiment, at least one medical device or piece of equipment that will be used during the procedure can be placed in the
body 302 prior to coupling thebody 302 to theincision port 320. For example, in one embodiment, thedevice 480 disposed within thebody 302 as best shown inFIGS. 24A , 24B, 24D, and 24F can be positioned within thebody 302 and, in some implementations, secured to a device clip 357 (as shown inFIG. 27B ). More specifically, in the particular embodiment depicted inFIGS. 24A , 24B, 24D, and 24F, thedevice 480 is made up of twoarms 482A, 482B that are positioned within thebody 302. Alternatively, any medical device that will be used for the surgical procedure could be positioned within thebody 302 in the same or a similar fashion. - It is understood, in accordance with one implementation, that the
port seal 450 is not coupled to the internal coupling component 372 (which is coupled to the incision port 320) at this point during the placement of thedevice 300. As such, according to one embodiment, theport seal 450 is stored in theside access tube 314 while thebody 302 is being coupled to theport 320, as best shown inFIGS. 24B , 24C, and 24D. Alternatively, theport seal 450 can be uncoupled from theinternal coupling component 372 and placed in theside access tube 314 prior to positioning the medical device inside thebody 302 and coupling thebody 302 to theincision port 320. - Once the
device 300 is coupled to theincision port 320 and theincision port 320 is coupled to thesealable sleeve device 322, the fluidic seal within thedevice 300 has been established, and the patient's cavity can be insufflated. This insufflation will result in an increase in air pressure within the patient's cavity and within the device 300 (because neither theport seal 450 nor theflap seal 470 is nt coupled to the internal coupling component 372). - Once insufflation is achieved, the
device 480 is positioned through theincision port 320 and into the patient's cavity. More specifically, the user or medical professional inserts her or his hands into the left and righthand access ports incision port 320 and into position within the cavity. At this point, if the medical device has apositioning rod 359, thatrod 359 can be coupled to adevice clip 440 on the interior of themale component 432 of theinternal coupling component 372 of theport 320, thereby establishing, maintaining, or fixing the position of the medical device within the patient's cavity. Alternatively, the device can be positioned and maintained in that position using any type of mechanism or method, including some type of device or method independent of thedevice 300. - Once the medical device is positioned as desired, the
port seal 450 can be positioned in place over the device (or thepositioning rod 359—or rods—of the device). That is, the user reaches in through thehand access ports seal 450 from theside access tube 314 and placed over the device/rod 359 so that the device and/orrod 359 is inserted through theseal component 456 of theseal 450 and then coupled to themale component 432 of theinternal coupling component 372 as described above. - Once the
port seal 450 is in place, thebody 302 can be removed from theincision port 320. More specifically, the user can remove the threadedscrews 402 and then remove themain tube 304 from theport 320. The fluidic seal between the patient's cavity and the ambient air outside the patient's body is maintained by theport seal 450. - The user/medical professional can then begin performing the medical procedure.
- An alternative external pressurized device embodiment is depicted in
FIGS. 39A and 39B . In this embodiment, thedevice 500 is asingle tube 502 having asingle access port 504 disposed at the top of thetube 502. Theaccess port 504 serves to establish a fluidic seal when a medical device or a surgeon's hand is inserted through theport 504. Thetube 502 also has twocamera ports 506 extending from a bottom portion of thetube 502. According to one implementation, thetube 502 is configured to couple to an incision port, including any incision port disclosed elsewhere herein or any known incision port. - A further embodiment depicted in
FIG. 40 is another alternative externalpressurized device 510. Thedevice 510 has atube 514 that is coupleable to anincision port 516 and has twoslots tube 514. Theseslots tube 514 and the exterior of thetube 514. In one embodiment, therod slots 512 are each configured to receive a positioning rod. Thedevice 510 further has twoslot seals 512, with oneseal 512 positioned in each of theslots slots slots tube 514 also has two sets ofdevice attachment components rod clips horizontal clip 515A and anangled clip 515B. - In use, a device can be positioned within the
tube 514 such that a positioning rod coupled to the device extends out of thetube 514 through one of theslots tube 514 by coupling the positioning rod to thehorizontal clip 515A. The patient's cavity can then be insufflated. When ready, the positioning rod can be moved down the slot (511 or 513) such that the device is being moved down the interior of thetube 514 and inserted through theport 516 and into the patient's cavity. At this point, the positioning rod is angled upward and clipped to theangled clip 515B, thereby fixing the positioning of the device inside the patient's cavity. - Another implementation relates to a positioning tube 520 as depicted in
FIGS. 41A and 41B . In this embodiment, the positioning tube 520 can also act as a large positioning rod. The tube 520 has twoguide slots 522 defined in or attached to an inner portion of the tube 520. Theguide slots 522 are each configured to receive apositioning rod 524. In this implementation, each device 526 (or device arm) is coupled to an end of one of thepositioning rods 524 and can be inserted through the tube 520 and into the patient's cavity. Due to the size of the tube 520, thedevices 526 must be inserted one at a time. Alternatively, the tube 520 can be sized so that bothdevices 526 can be inserted at the same time. The tube 520 also has anair lock 528 disposed in the tube 520. Theair lock 528 is configured to be capable of fluidically dividing the tube 520 into two fluidically separate compartments when theair lock 528 is closed. - In use, the positioning tube 520 (having a
robotic arm 526 disposed within the tube 520) can be inserted through any of the various incision ports described elsewhere herein. When the tube 520 is positioned so that the distal end of the tube 520 is extending into the patient's cavity, a seal is created at the top of the top by placing a seal cap (not shown) on the top of the tube 520. Once the inside of the tube 520 is sealed, thepositioning rod 524 can be urged distally and thereby thearm 526 is urged out of the tube 520 and into the patient's cavity. If asecond arm 526 is going to be inserted, theair lock 528 is then closed. That is, theair lock 528 is closed to create a fluidic seal between the top of the tube 520 and the bottom of the tube 520. Once theair lock 528 is in place, the seal cap is removed, and thesecond arm 526 can be positioned in the tube 520. At this point, the seal cap can be replaced, theair lock 528 can be released, and thesecond arm 526 can be inserted into the patient's cavity. - Several additional embodiments relate to various types of incision ports. For example,
FIG. 42 depicts astacked incision port 540. Theport 540 actually has twoaccess ports cavity 546 between the twoaccess ports access ports cavity 546 between the twoaccess ports port 540. In other words, thecavity 546 reduces the amount of air pressure loss because any air pressure loss is lost in the cavity and not lost to the ambient air, thereby reducing the overall loss. - Another incision port embodiment is depicted in
FIG. 43 . Thisincision port 550 actually has two seals combined in the port: arubber seal 552 and aflap seal 554. Theport 550 also has twocamera ports 556 extending out from theport 550. In one embodiment, therubber seal 552 has three different rubber disks (not shown) similar to the different disks depicted inFIG. 20 and described above. The disks in thisrubber seal 552 can have openings/incisions that differ for each disk in the same fashion as the disks shown inFIG. 20 . Alternatively, therubber seal 552 can be similar to any rubber or flexible seal described elsewhere herein. Theflap seal 554, according to one embodiment, is similar to the flap seal depicted inFIGS. 38A-38C . -
FIG. 44 depicts another incision port embodiment. More specifically, this port is a two-seal port 560 having afirst rubber seal 562 and asecond rubber seal 564. Theport 560 also has abase ring 570, amiddle ring 568, and atop ring 566. Themiddle ring 568 creates a cavity (not shown) between the twoseals seals FIG. 42 . According to one embodiment, each sheet ofrubber sheet -
FIGS. 45A and 45B depict a further incision port embodiment. This port is a three-sheetrubber seal port 580 having asingle ring 582 in which three sheets of rubber (only thetop sheet 584 is shown). In one embodiment, each of the three sheets has an opening in it that corresponds to the openings in the other two sheets. In a further embodiment, the openings are similar to those depicted inFIG. 20 and described. Alternatively, each sheet can have two corresponding openings. -
FIGS. 46A and 46B depict a further incision port system embodiment. This system is an airbarrier port system 590 having anair barrier port 592. Thisport 592 is coupled to fourair tubes air intake port 594. In operation, high pressure air is provided at theair intake port 594 and is forced through the fourtubes 596A-D and into theport 592. The fourtube connections port 592 such that the air is forced into a channel (not shown) that encircles thehole 600 in theport 592. The air is then forced through a circular nozzle (not shown) in communication with the channel (not shown) that projects the air out of the nozzle and across thehole 600. The air flow projected across thehole 600, according to one implementation, is both directed and has a high velocity—both of which have an impact on the creation of an air barrier. As a result, an air barrier is created in thehole 600 defined in theport 592. That is, the high velocity air movement across or within thehole 600 creates a fluidic seal that is sufficient to maintain the insufflation of a patient's cavity. -
FIG. 47 depicts another incision port embodiment—in this case, a one-sheetrubber seal port 610 having a single sheet of rubber 612 (other flexible seal material) positioned between abase ring 614 and atop ring 616. In one embodiment, the sheet has slit (not shown) formed in it through which a surgical device or other equipment can be inserted. Alternatively, the sheet can have two slits or other types of openings. - Another incision port embodiment is shown in
FIGS. 48A and 48B . This port is adual brush port 620. Thisport 620 has abody 622 with afirst brush holder 624 and asecond brush holder 626. Thefirst brush 628 is positioned in thefirst brush holder 624 and thesecond brush 630 is positioned in thesecond brush holder 626. Further, thebody 622 has anopening 632 formed in a bottom portion of thebody 622 that can provide access to the patient's cavity. The brush bristles of the twobrushes brush seal 634 such that the mesh of bristles creates a fluidic seal that is sufficient to maintain a patient's insufflated cavity. -
FIGS. 49A and 49B depict another brush port—in this case, atriple brush port 640. Thisport 640 has abody 642 with first, second, andthird brush holders first brush 650 is positioned in thefirst brush holder 644, thesecond brush 652 is positioned in thesecond brush holder 646, and thethird brush 654 is positioned in thethird brush holder 648. Further, thebody 642 has an opening (not shown) formed in a bottom portion of thebody 642 that can provide access to the patient's cavity. The brush bristles of the threebrushes brush seal 656 such that the mesh of bristles creates a fluidic seal that is sufficient to maintain a patient's insufflated cavity. - According to another implementation,
FIGS. 50A , 50B, and 50C depict aninsertion device 670 that can be used to insert both arms of a robotic surgical device into a patient's cavity. Theinsertion device 670 has aninsertion tube 672 through which aninsertion rod 674 is slidably disposed. In addition, the device has afirst arm 676A and asecond arm 676B, both of which are coupled to the distal end of thetube 672. Thefirst arm 676A is coupled to anend bracket 680A coupled to an end of thefirst device body 682A, while thesecond arm 676B is coupled to anend bracket 680B coupled to an end of thesecond device body 682B. Further, theinsertion rod 674 is coupled to two center brackets (only bracket 678A is visible in the figures)—one center bracket 678A coupled to a middle portion of thefirst body 682A and a second center bracket (not shown) coupled to a middle portion of thesecond body 682B. - In use, the
insertion device 670 can be used to insert a two-armed surgical device through a hole (such as an incision, a port, or the like) and into a patient's cavity prior to operating the device within the cavity. To accomplish this insertion, theinsertion device 670 initially maintains an insertion configuration (as best shown inFIG. 50A ) such that the surgical device has its smallest circumferential profile, thereby allowing it to pass through smaller holes. Once the surgical device has been inserted into the patient's cavity, theinsertion device 670 can be moved into its deployed configuration (as best shown inFIG. 50C ) such that the surgical device is in its operational configuration. To accomplish this, a user or surgeon retracts theinsertion rod 674 in a proximal direction (away from the surgical device. This retraction of therod 674 urges the two center brackets (with only center bracket 678A ofbody 682A depicted) in the same proximal direction. Because the twoend brackets arms device bodies FIG. 50B and into the operational configuration depicted inFIG. 50C . At this point, the user or surgeon can use the surgical device, including its twoarms - There are numerous device access and insertion devices and methods disclosed in the instant application. All of the various devices and methods that allow for access to a cavity and insertion of devices having two arms can also generally be used with respect to devices that can be uncoupled into separate arms so as to allow each arm to be inserted individually. In one embodiment, one advantage of inserting each arm separately is that inserting a first arm and then a second arm in a serial manner (and possibly more arms) can likely be accomplished through a smaller incision when compared to inserting both arms simultaneously.
-
FIGS. 51A and 51B depict an alternative embodiment of an insertion device 690 (in the same spirit as the insertion device depicted inFIGS. 50A-C ). While the above embodiment inFIGS. 50A-C depict an insertion device for use with a two-armed device, thisinsertion device 690 is used with asingle arm 704 or with two arms that are inserted separately. That is, in this embodiment, asingle device arm 704 is coupled to theinsertion device 690. As shown, this device is positioned through an insertion tube 692 (which can also be a positioning or support rod). The device has twomoveable rods support rod 692. The firstmoveable rod 694 is coupled at its distal end to a firstrobotic arm 704 and at its proximal end to acontrol lever 698. The secondmoveable rod 696 is coupled at its distal end to a coupling link 700 (that is coupled to the arm 704) and at is proximal end to a coupling link 702 (that is coupled to the lever 698). - In use, the
lever 698 can be actuated to cause the first andsecond rods rods arm 704 and thereby position thearm 704 as desired or needed inside the patient's cavity. - As shown in
FIG. 51B , which is a cross-section of thesupport rod 692, showing that thesupport rod 692 can have twoseparate lumens moveable rods moveable rod 694 is positioned in thefirst lumen 706 and the secondmoveable rod 696 is positioned in thesecond lumen 708. - In a further embodiment, it is understood that this
support rod 692 could have two halves—aright half 710 and aleft half 712—that are coupleable at themating feature 714. Alternatively, the two halves can be coupleable by any known mechanical means. Theright half 710 is configured to hold the first andsecond rods arm 704, while the left half is configured to hold the first andsecond rods -
FIG. 52 depicts another embodiment in which two separate arms can be inserted and positioned separately by using anovertube 722. In thisdevice 720, the firstmoveable rod 724 and secondmoveable rod 726 are still positioned within asupport rod 728. However, in this embodiment, thesupport rod 728 is positioned within anovertube 722. Theovertube 722 can be pass over the top of thesupport rod 728 in order to couple thesupport rod 728 to a second support rod (not shown) or another half of a support rod. This embodiment is another way to couple the two support rods or two halves of a support rod just as themating feature 714 accomplishes that task in the prior embodiment. - Of course, as shown in
FIG. 53 , in any embodiment in which the surgical device or robotic arm has amotor 740 provided that can be positioned in the positioning orsupport rod 744 and is coupled to therobotic arm 742, there is no need for a separate insertion device. Instead, thearm 742 can easily be positioned by actuating themotor 740 and transfer the motive force through the beveled gears 746 and to thearm 742. -
FIGS. 54A and 54B depict a different type of access/insertion device in comparison to the devices described above. Unlike the above devices, which are generally incision ports or devices positioned outside the patient's cavity, the internalpressurized bag device 750 shown in these two figures is initially positioned in the patient's cavity. Thedevice 750 has aport seal 752, anouter sleeve 754, and aninner sleeve 756. Theouter sleeve 754 is releasably sealed at thedistal end 758. That is, theouter sleeve 754 has a releasable seal that can be intentionally broken or released at a desired time during the procedure, as described below. - In use, the
entire device 750 can be positioned through an incision port such that the inner andouter sleeves port seal 752 coupled to the incision port (thereby creating a fluidic seal). Once thedevice 750 is positioned, the patient's cavity can be insufflated, and theouter sleeve 754 can be pressurized to a pressure that is greater than the pressure of the insufflated cavity, thereby expanding theouter sleeve 754 to its maximum expansion (and, in some cases, making theouter sleeve 754 substantially rigid). At this point, the surgical device can be inserted through the incision port and into theouter sleeve 754 and positioned as desired. At this point, theouter sleeve 754 can be removed by releasing the releasable seal at the distal end of thesleeve 754. That is, the releasable seal could be a chemical seal such as an adhesive that can be deactivated by applying a different composition to it. Alternatively, the releasable seal could be a mechanical release such as a pull cord or something of the like. In a further alternative, the releasable seal could be any known mechanism or method for being able to release the seal. Once the seal is released, theouter sleeve 754 can be pulled out of the cavity over theinner sleeve 756 and other components as best shown inFIG. 54B . -
FIG. 55 depicts another implementation of an external pressurized system or apparatus 800. The apparatus 800 has acontainer 802 with atop cap 804 coupled to a top portion of thecontainer 802. In this embodiment, thecontainer 802 has aport 806 that is coupled to thecontainer 802 at a base portion of thecontainer 802. Theport 806 is configured to be positionable in an incision in the skin of the patient, thereby providing access to a cavity of the patient. As shown inFIG. 55 , the apparatus 800 is configured to receive asurgical device 808 such that thedevice 808 can be inserted into the patient cavity through theport 806 of the apparatus 800. - According to one embodiment, in contrast to the
canister 12 described above and depicted inFIGS. 1A-10 , thecontainer 802 in this device 800 is made of a flexible material such as, for example, polyethylene plastic, latex, nylon, or silicone rubber. As such, thecontainer 802 can be manipulated and configurable with respect to the shape of thecontainer 802, and more specifically can be compressed longitudinally such that the height of thecontainer 802 can be reduced during insertion of a robotic device into a patient's cavity. This will be described in further detail herein. - The
top cap 804 is depicted in further detail inFIGS. 56A-61B . As shown inFIGS. 56A and 56B , thetop cap 804 has acap body 810, adetachable cable harness 812, anaccess lumen 814,support rod lumens 816, threadedlumens 818, and aclamp projection 820. Thecap 804 has a notch 822 defined in thecap 804 that is configured to receive theharness 812. In addition, the notch 822 has fivechannels 824A defined or formed in the notch 822. Thechannels 824A match with thechannels 824B defined in thedetachable harness 812 such that when theharness 812 is positioned in the notch 822 and thus coupled with thecap body 810, thechannels 824A and thechannels 824B match up to formlumens 824 as best shown inFIG. 56B . In one implementation, thelumens 824 can be formed in different sizes and configured to receive various cables and/or suction/irrigation tubes the extend from an external controller through thetop cap 804 to thesurgical device 808. - In addition, the
cap body 810 has agroove 826 formed or defined around the outer edge of thebody 810, including the outer edge of theharness 812, such that when theharness 812 is coupled to thebody 810, an O-ring can be positioned around the outer edge of thebody 810 in thegroove 826. -
FIGS. 57A and 57B depict thetop cap 804 being coupled to thecanister 802. Theflexible canister 802 is positioned over the peripheral edge of thebody 810 as best shown inFIG. 57B and an elastic ring (also referred to as an “O-ring”) 828 is positioned around thecanister 802 at thegroove 826 such that a portion of thecanister 802 is positioned between thebody 810 and thering 828 in thegroove 826 and thering 828 urges thecanister 802 into thegroove 826, thereby creating a fluidic seal between thecanister 802 and thetop cap 804. Additionally, in one alternative embodiment, silicone sealant can be applied to thegroove 826 to enhance the strength of the fluidic seal. In accordance with one implementation, the O-ring 828 can also help to secure thecap body 810 and theharness 812 together. In a further alternative, the O-ring 828 can be any elastic member that can be used to maintain a fluidically sealed coupling of thecanister 802 and thetop cap 804. In yet another alternative, any coupling mechanism can be used. -
FIGS. 58A and 58B depict a portion of thedevice assembly 808 being positioned through thetop cap 804. More specifically, thesupport rods 830 coupled to thedevice 808 are slidably positioned through thelumens 816 in thecap body 810. Further, according to one implementation, a portion of thedevice 808 also couples to or mates with thetop cap 804. More specifically, astabilization protrusion 832 on thedevice 808 is coupleable with amating hole 834 defined or formed in an underside of thebody 810 as best shown inFIG. 58B . The positioning of thestabilization protrusion 832 in themating hole 834 creates a pathway fromlumen 814 into and through thestabilization protrusion 832, thereby allowing for passage of additional tools or cameras through the device 800 without losing pressure. - As shown in
FIGS. 59A , 59B, and 60, thetop cap 804 is coupled to thesupport rods 830 with two threadedset screws 840. Theset screws 840 are threaded throughlumens 818 as best shown inFIG. 59B . More specifically, theset screws 840 can be screwed into the threadedlumens 818 until thescrews 840 contact thesupport rods 830. Theset screws 840 are configured to exert pressure on thesupport rods 830, thereby creating frictional resistance that helps to secure thesupport rods 830 and thus thedevice 808 to thetop cap 804. - As best shown in
FIG. 60 , aconnection cable 842 that is coupled at its distal end to therobotic device 808 is positioned through one of thelumens 824. It is understood that other cables can be positioned through theadditional lumens 824 as well. In accordance with one embodiment, the cables are positioned in thechannels harness 812 to thebody 810. Alternatively, one or more of the cables can be inserted through one of thelumens 824 after thebody 810 and harness 812 are coupled together. -
FIGS. 61A and 61B show thecontainer 802 coupled to thetop cap 804. -
FIGS. 62A and 62B depict the base coupling component (also referred to as the “base coupler”) 850 that is coupled to a bottom portion of thecontainer 802. Thebase coupler 850 has anupper groove 852, alower groove 854, and three coupling protrusions (also referred to as “coupling notches”) 856 that extend from a portion of thecoupler 850 between the upper andlower grooves - Like with the
top cap 804 described above, thecontainer 802 is coupled to thebase coupler 850 using an O-ring 858. More specifically, thecontainer 802 is positioned over the upper portion of thecoupler 850 such that thecontainer 802 is positioned over theupper groove 852 and adjacent to or against the threeprotrusions 856. The O-ring 858 is positioned over thecontainer 802 at theupper groove 852 such that the O-ring 858 urges a portion of thecontainer 802 into thegroove 852, thereby creating a fluidic seal between thecontainer 802 and thebase coupler 850. -
FIGS. 63A , 63B, 63C, 63D, and 63E depict the coupling of thebase coupler 850 to theaccess port 806. Theaccess port 806 has a top portion (or “top ring”) 860, a bottom portion (or “bottom ring”) 862, and a middle portion (or “neck”) 864. Thetop ring 860 has three coupling protrusions (also referred to as “coupling tabs”) 866 that extend from a portion of thetop ring 860 and are configured to mate with thecoupling notches 856. - In one embodiment, the
access port 806 is a known standard device used in hand-assisted laparoscopic surgery. As is understood in the art, theaccess port 806 provides a structured open pathway through the cavity wall, such as the abdominal wall. at the incision site. In one particular example, theaccess port 806 is a commerciallyavailable retractor port 806 called the DEXTRUS® Retractor, which is available from Ethicon Endo-Surgery. - As best shown in
FIGS. 63A and 63B , thebase coupler 850 is coupled to theaccess port 806 using an O-ring 868. More specifically, the O-ring 868 is positioned in thelower groove 854 of thecoupler 850 and thetop ring 860 is positioned over the lower portion of thecoupler 850 and the O-ring 868 in thegroove 854 such that the O-ring 868 is compressed between thecoupler 850 and thetop ring 860, thereby creating a fluidic seal between those two components. - As best shown in
FIGS. 63C and 63D , as thetop ring 860 is positioned over the lower portion of thecoupler 850 and the O-ring 868 as described above, thecoupling tabs 866 of theaccess port 806 are coupled with thecoupling notches 856 of thebase coupler 850, thereby enhancing the stability of the coupling of thecoupler 850 and theaccess port 806. -
FIG. 63E depicts the entire coupling of thecontainer 802 to theaccess port 806 via thecoupler 850 as described above. Further,FIGS. 64A and 64B depict the external pressurized insertion device 800 in use, with the device 800 coupled to anaccess port 806 that is positioned in an incision in a patient'sskin 870. - In use, according to one embodiment, the
access port 806 and the external pressurized device 800 are positioned for a surgical procedure in the following manner. As an initial matter, according to one embodiment, therobotic device 808 is positioned inside the insertion device 800 prior to placing theport 806 and the device 800 in the appropriate surgical position. That is, therobotic device 808 is positioned inside thecontainer 802, thesupport rods 830 coupled to thedevice 808 are secured to thetop cap 804 with theset screws 840, any connection cables coupled to thedevice 808 are positioned through thelumens 824 in thetop cap 804, and theflexible container 802 is coupled and fluidically sealed to thetop cap 804 and thebase coupler 850 via the O-rings robotic device 808 is positioned inside the insertion device 800 after positioning theport 806 and device 800. Regardless, as far as positioning theport 806 and device 800, theport 806 is positioned first in certain implementations. That is, in one embodiment, thebottom ring 862 is first inserted through the incision previously made in the patient's cavity wall. Once thering 862 is positioned through the incision and inside the cavity, thering 862 can help constrain theentire port 806 within the incision by expanding to a diameter that is greater than the diameter of the incision, as best shown inFIG. 64A . In one embodiment, thecontainer 802 and thecoupler 850 are coupled to theaccess port 806 prior to positioning theport 806 in the incision. Alternatively, theport 806 is first positioned in the incision, and then thecoupler 850 and the container are coupled to theport 806. Regardless, once theaccess port 806 and insertion device 800 are positioned, the patient's cavity can then be insufflated. Due to the fluidic communication between the cavity and the interior of thecontainer 802 that is created by theaccess port 806, the entire interior of the insertion device 800 will be under the same pressure as the cavity. - In accordance with one implementation, once the
access port 806 and insertion device 800 are positioned correctly, the process of inserting therobotic device 808 into the patient's insufflated cavity can take place in the following manner as best shown inFIGS. 65A-69B . Initially, therobotic device 808 begins with both arms parallel and vertical to the incision, as best shown inFIGS. 65A and 65B. Then, therobot 808 is lowered through the opening created by theaccess port 806 as shown inFIGS. 66A and 66B . In accordance with one embodiment, as best shown by comparingFIGS. 65A and 65B withFIGS. 66A and 66B , as therobot 808 is lowered, theflexible container 802 shrinks in height by allowing portions of the flexible material of thecontainer 802 to “crumple” or begin forming folds such that thetop cap 804 moves closer to theaccess port 806. - As best shown in
FIGS. 67A and 67B , according to one embodiment, once the “elbow joints” of the arms of therobotic device 808 have cleared the cavity wall andaccess port 806, the forearms are rotated at the elbow joints until the forearms are positioned at an angle of or near 45° in relation to the upper arms (as best shown inFIG. 67A ). Concurrently, the “upper arms” are rotated at the “shoulder joints” until the upper arms are positioned at an angle of or near 20°, as best shown inFIG. 67B . This rotation of the forearms and upper arms can help to ensure that thedevice 808 will fit within the patient's target cavity so that any contact of therobotic device 808 with any internal tissues or organs is minimized or eliminated. Alternatively, the forearms and upper arms can be rotated to any angle that minimizes the risk of contact with tissues or organs. - As best shown in
FIGS. 68A and 68B , according to one embodiment, thedevice 808 can be inserted further into the patient's cavity by further positioning the arms of thedevice 808 while thecontainer 802 continues to crumple, thereby resulting in further shrinkage of the insertion device 800. More specifically, the upper arms can be rotated further until they are positioned at an angle of or near 45°, as best shown inFIG. 68B . This process of moving thedevice 808 further into the cavity while positioning the arms to avoid contact with organs or tissues and causing thecontainer 802 to crumple is continued until the shoulder joints of thedevice 808 have cleared the cavity wall andaccess port 806. - At this point, as best shown in
FIGS. 69A and 69B , the forearms can be rotated back to center and the upper arms can be further rotated up, leaving the arms in an appropriate starting position for a surgical procedure. Once in the desired starting position, thedevice 808 can be locked or otherwise stabilized in place using a known external clamping mechanism such as, for example, an Iron Intern®, which is commercially available from Automated Medical Products Corp. -
FIG. 70 depicts another implementation of an external pressurized system orapparatus 900. Theapparatus 900 has acontainer 902 with atop cap 904 coupled to a top portion of thecontainer 902. In this embodiment, thecontainer 902 has aport 906 that is coupled to thecontainer 902 at a base portion of thecontainer 902. Theport 906 is configured to be positionable in an incision in the skin of the patient, thereby providing access to a cavity of the patient. As shown inFIG. 70 , theapparatus 900 is configured to receive asurgical device 908 such that thedevice 908 can be inserted into the patient cavity through theport 906 of theapparatus 900. - According to one embodiment, like the
container 802 described above and depicted inFIGS. 55-69B , thecontainer 902 in thisdevice 900 is made of a flexible material such as, for example, polyethylene plastic, latex, nylon, or silicone rubber. - In this embodiment, the
top cap 904, thecontainer 902, and therobotic device 908 are substantially similar to thetop cap 804 andcontainer 802 depicted and described above. All the various features and components described above apply to thesetop cap 904,container 902, anddevice 908 embodiments as well. -
FIGS. 71A and 71B depict the base coupling component (also referred to as the “base coupler”) 920 that is coupled to a bottom portion of thecontainer 902. Thebase coupler 920 has agroove 922 and threecoupling protrusions 924 that extend from thecoupler 920. In accordance with one implementation, each of thecoupling protrusions 924 has alumen 926 configured to receive athumb screw 928. Thecontainer 902 is coupled to thebase coupler 920 using an O-ring 930. More specifically, thecontainer 902 is positioned over the upper portion of thecoupler 920 such that thecontainer 902 is positioned over thegroove 922 and adjacent to or against the threeprotrusions 924. The O-ring 930 is positioned over thecontainer 902 at thegroove 922 such that the O-ring 930 urges a portion of thecontainer 902 into thegroove 922, thereby creating a fluidic seal between thecontainer 902 and thebase coupler 920. - In this embodiment, the
insertion device 900 has aport attachment 940 that is coupleable to thebase coupler 920 and theaccess port 906 such that theport attachment 940 is positioned between thecoupler 920 and theport 906. Theport attachment 940 has aremovable lid 944 that maintains a fluidic seal when thelid 944 is in place on theport attachment 940, thereby making it possible to maintain insufflation of the patient's cavity even when theinsertion device 900 is not yet coupled to theaccess port 906. -
FIGS. 72A and 72B depict the coupling of theport attachment 940 to theaccess port 906. Theport attachment 940 has threecoupling notches 942 similar to thecoupling notches 856 described and depicted above. In addition, theport attachment 940 has a removable lid 944 (also referred to as a “removable seal component,” “removable lid seal component,” or “removable seal component”) that provides a fluidic seal when it is positioned in its closed position in relation to theport attachment 940. In the embodiment depicted inFIGS. 72A and 72B , theremovable lid 944 is aslidable lid 944. - Like the
access port 806 described and depicted above, this access port 906 (as best shown inFIG. 72A ) has atop ring 946 that has three coupling protrusions (also referred to as “coupling tabs”) 948 that extend from a portion of thetop ring 946 and are configured to mate with thecoupling notches 942 in theport attachment 940. - As best shown in
FIG. 72A , theport attachment 940 has an O-ring 950 that can be positioned between theport attachment 940 and theaccess port 906 such that the O-ring 950 creates a fluidic seal when the two components are coupled together. - In use, the
port attachment 940 can be coupled to theaccess port 906 by positioning the bottom portion of theport attachment 940 in the top portion of thetop ring 946 with the O-ring 950 positioned between the two components, with thecoupling notches 942 on theport attachment 940 mating with thecoupling protrusions 948 on thetop ring 946. - The
port attachment 940 also has another O-ring 952 that is configured to be positioned in thegroove 954 formed in the top of theport attachment 940. In one embodiment, the O-ring 952 can be placed in thegroove 954 to help create an airtight seal when theport attachment 940 is coupled to thebase coupler 920. - Further, the
port attachment 940 also has three threadedlumens 956 in the top of theattachment 940. In one embodiment, theselumens 956 are configured to receive the thumb screws 928 that are positioned through thelumens 926 in thebase coupler 920, thereby allowing for coupling thebase coupler 920 to theport attachment 940 via thescrews 928. Of course, it is understood that other coupling mechanisms besides thumb screws can be used. In various alternative embodiments, any known attachment or coupling mechanism or component can be used. Some non-limiting examples include magnets, quick clamps, quarter turn features, snap-in features, and the like. - As best shown in
FIGS. 73A and 73B , theslidable lid 944 can be moved between a closed position (as shown inFIG. 73B ) and an open position (as shown inFIG. 73A ). In this embodiment, theslidable lid 944 is positioned in theport attachment 940 via alid slot 958 in theport attachment 940. In the open position, tools or robotic devices can be passed through theport attachment 940 and theaccess port 906. In the closed position, a fluid seal is established between thelid 944 and theport attachment 940, which makes it possible to insufflate the patient's cavity prior to attaching theinsertion assembly 900. It is understood that while this embodiment of theremovable lid 944 is aslidable lid 944, any other known method or device for establishing a fluidic seal could be used. Non-limiting examples include a mechanical iris, leaf shutter, or any other known method of providing a removable fluidic seal. -
FIGS. 74A and 74B depict cross-sectional views of the entire lower subassembly as described above, including thebase coupler 920, theport attachment 940, and theaccess port 906. More specifically,FIG. 74A shows theport attachment 940 coupled to theaccess port 906, with theslidable lid 944 fully inserted into theport attachment 940 in the closed position, thereby creating a fluidic seal.FIG. 74B shows all three components coupled together, including thebase coupler 920, theport attachment 940, and theaccess port 906. -
FIGS. 75A , 75B, and 75C depict the externalpressurized insertion device 900 in use, according to one embodiment. Once theaccess port 906 is positioned in the incision as discussed above, theport attachment 940 can be coupled to theport 906, as best shown inFIG. 75A . With theslidable lid 944 in the closed position, a fluidic seal is established between theport attachment 940 and theport 906 such that the patient's cavity can be insufflated to the desired Insufflation pressure. Theinsertion device 900 can then be coupled to theport attachment 940 as best shown inFIG. 75B . Once thebase coupler 920 is coupled to theport attachment 940 such that a fluidic seal is established between the two components, theslidable lid 944 can then be moved to its open position (or fully remove) as best shown inFIG. 75C , thereby providing fluidic communication between the patient's cavity and the interior of theinsertion device 900, resulting in equalized pressure in thedevice 900 and the cavity. Therobotic device 908 can be inserted via any of the same steps as described previously. If thedevice 908 completes the desired surgical procedure and a different robotic device or other type of tool needs to be used, therobotic device 908 can be removed from the cavity, theslidable lid 944 can be replaced in the closed position, and thebase coupler 920 can be removed fromport attachment 940. This allows pressure to be maintained within the cavity, even during tool changes. -
FIG. 76 depicts an alternative embodiment having atop cap 960 that has apressure relief valve 962. During the process of lowering either of therobotic devices insertion device embodiments 800, 900 and into the cavity as described above with respect toinsertion devices 800 and 900, there is a pressure increase in the patient's cavity due to the decreasing change in volume of thecontainer pressure relief valve 962 can be configured to release pressure if the internal insufflation pressure increases above a typical value, thereby aiding the process of inserting therobotic device insertion device 800, 900. - Another implementation of a
top cap 1000 having apressure relief valve 1002 is depicted inFIGS. 77A and 77B . Thiscap 1000 also has a dualport seal component 1004 that can be configured to receive one or more surgical instruments or devices such as a standard laparoscopic tool. Alternatively, it is contemplated that a top cap can have only one of thepressure relief valve 1002 or thedual seal component 1004. - As best shown in
FIG. 77B , according to one implementation, thepressure relief valve 1002 has an adjustment component (also referred to as an adjustment “door,” “wall,” or “button,” or “block”) 1006 that is operably coupled to (or positioned against) one end of atension spring 1008 and has twoholes 1010A, 1010B that are configured to receive retention mechanisms such as bolts, screws, or other such standard devices or components configured to hold theadjustment component 1006 in place. The other end of thespring 1008 is coupled to avalve ball 1012 that is positioned against arim 1016 of anopening 1014 on the underside of thetop cap 1000. Thespring 1008 is configured to urge theball 1012 toward theopening 1014 such that the ball 1012 (which has a larger outer diameter than the inner diameter of the rim 1016) contacts therim 1016 of theopening 1014 and thereby establishes a fluidic seal between theball 1012 and therim 1016. In this embodiment, theadjustment block 1006 is adjusted using the retention mechanisms to move theblock 1006 toward or away from theball 1012, thereby increasing or decreasing, respectively, the force applied by thespring 1008 against the ball 1012 (and thereby increasing or decreasing, respectively, the strength of the seal between theball 1012 and therim 1016 of the opening 1014). Thus, theadjustment block 1006 can be used to adjust the strength of the seal based on the target maximum pressure threshold such that when the target maximum pressure threshold is reached (such as while lowering either of therobotic devices insertion device embodiments 800, 900 as described above), theball 1012 is urged away from therim 1016 and the seal between therim 1016 and theball 1012 is broken such that the pressure is reduced by the gas escaping through thevalve 1002. - In an alternative embodiment, any known pressure relief valve for use in medical devices can be incorporated into the
top cap 1000. - Continuing with
FIG. 77B , the dualport seal component 1004 in this embodiment has two seal components: an elasticcircular seal 1018 defining anopening 1020 and aflap seal 1022 in fluid communication with thecircular seal 1018. The elasticcircular seal 1018 is configured to form a strong seal around the smooth surfaces of a standard laparoscopic tool positioned through theopening 1020. In one implementation, theflap seal 1022 is a secondary seal that provides a fluid seal when no tool is positioned through the dualport seal component 1004. That is, when no tool is positioned therethrough, the twoflaps flaps - In an alternative embodiment, any known port seal component for use in establishing a fluidic seal with a laparoscopic tool positioned therethrough can be used.
- According to various additional implementations, the insertion devices disclosed or contemplated herein can have one or more sensors or other types of measurement mechanisms for measuring the insertion depth of the surgical device being inserted into the patient's cavity.
- As an example,
FIGS. 78A , 78B, and 78C depict anautomatic insertion device 1030 having aflexible container 1038 and an actuator andsensor package 1032. The actuator can be any known actuation device, including, for example, motor and gears, motor and timing belts, linear screw, pneumatics, hydraulics, or the like. The sensor could be any known sensing device, including, for example, a potentiometer, an encoder, optical sensors, or the like. When actuated, the actuator andsensor package 1032 lowers thesurgical device 1034 through the incision. That is, as shown inFIG. 78B , the top portion of thedevice 1030 is urged toward the bottom portion of thedevice 1030 such that the overall height of thedevice 1030 is reduced and thesurgical device 1034 is moved distally out of the bottom portion of theinsertion device 1030. As the insertion occurs, the sensor in thepackage 1032 is configured to read the distance thesurgical device 1034 has been inserted into the patient's cavity. Based on this distance, in one embodiment, the control program of thesurgical device 1034 can actuate the motors of thesurgical device 1034 to move the arms into desirable positions so as to avoid making contact with any organs or a cavity wall. The process can then be reversed to remove thesurgical device 1034 from the incision. In another implementation, anadditional actuator 1036 could be used to grossly position thesurgical device 1034 during the insertion process or during the surgery in order to access multiple quadrants of the patient's cavity. Thisactuator 1034 rotates the upper portion of theinsertion device 1030 relative to the access port. This rotation is possible because of the flexible nature of thecontainer 1038. -
FIG. 79 depicts another embodiment of aninsertion device 1050 having one ormore measurement mechanisms 1054 for measuring the insertion depth of the surgical device that is being inserted into the patient's cavity using theinsertion device 1050. In this embodiment, the insertion depth of the surgical device is determined by measuring the relative distance between thetop cap 1052 and theport 1056. Further, in this embodiment, themeasurement mechanism 1054 is asensor 1054 that is coupled to, integrated into, or otherwise associated with thetop cap 1052. Alternatively, thetop cap 1052 can have two ormore sensors 1054. According to one embodiment, thesensor 1054 uses ultrasonic or infrared energy and transmits the energy toward theport 1056. The energy is reflected by theport 1056 back to thesensor 1054. In this embodiment, thesensor 1054 is a range finder that can utilize the energy reflected back from theport 1056 to determine the distance between thetop cap 1052 and theport 1056. The distance between the top cap 1502 and theport 1056 can then be used to calculate the insertion depth of the surgical device. - In an alternative embodiment using a continuous sensor system, the
insertion device 1050 has not only thesensor 1054 associated with thetop cap 1052, but also a sensor (not shown) associated with theport 1056. In this implementation, thesensor 1054 emits energy that is received by the sensor associated with theport 1056, which triggers the sensor associated with theport 1056 to transmit energy back to thesensor 1054 associated with thetop cap 1052. Thesensor 1054 or a separate controller can then calculate the distance between thetop cap 1052 and theport 1056, which can then be used to calculate the insertion depth of the surgical device. - In a further alternative, the
measurement mechanism 1054 in thetop cap 1052 is acamera 1054. Thecamera 1054 can utilize known image processing techniques on known features of the surgical device to determine the insertion depth of the device. -
FIG. 80 depicts another embodiment relating to aport 1060 of an insertion device having one ormore measurement mechanisms 1062 for measuring the insertion depth of a surgical device. In this implementation, as the surgical device (not shown) is urged through theport 1060 and into the patient's cavity, characteristics of the surgical device can be detected using the measurement mechanism(s) 1060 associated with theport 1060. And those characteristics can be used to estimate or determine the insertion depth of the surgical device. In one embodiment, themeasurement mechanism 1062 is acamera 1062 that can use image processing to capture and recognize the portion of the surgical device that is passing through theopening 1064 in theport 1060. Alternatively, the surgical device can be marked with some type of markers that are easily recognized by the image processing technology. Upon recognition of the device portion or the marker, thecamera 1062 or a separate processor or controller can calculate the insertion depth of the surgical device based on that information. - In a further implementation, the
measurement mechanism 1062 is anRFID sensor 1062 that can sense one or more RFID markers (not shown) that are coupled to or implanted in the surgical device (not shown) passing through theport 1060. Alternatively, the RFID markers in this embodiment could also contain extra information that could be used in a two-way communication system. That is, one or more of the markers associated with the surgical device could be configured to transmit information through the same RF link to the sensor and/or a controller. -
FIG. 81 depicts another embodiment of an insertion device having a measurement mechanism that measures the relative distance between the top cap and the port to determine the insertion depth of the surgical device. This embodiment relates to atop cap 1070 that has astring measurement system 1072, which, in some embodiments, is astring potentiometer system 1072. Thestring measurement system 1072 is a system in which a string is extended from thetop cap 1070 to the port (not shown) at the bottom of the insertion device (not shown) and the amount of string that extends from a rotatable drum is measured. In this embodiment, thesystem 1072 has arotatable sensor 1074, arotatable drum 1076, a spring-loadedstring dispenser 1078, and string (not shown) extending from the dispenser and around thedrum 1076. According to one embodiment, thesensor 1074 is apotentiometer 1074, and in some specific embodiments, thesensor 1074 is a multiple-turn potentiometer 1074. Therotatable sensor 1074 is coupled to therotatable drum 1076 such that thesensor 1074 rotates when thedrum 1076 rotates. In one embodiment as shown, thedrum 1076 is adual drum 1076 having a measurementstring drum half 1076A and a spring-loadedstring drum half 1076B. More specifically, the string that extends down to the port (not shown) of the insertion device (not shown) wraps around the measurementstring drum half 1076A, while a separate spring-loaded string (not shown) that is coupled at the other end to the spring-loadedstring dispenser 1078 wraps around the spring-loadedstring drum half 1076B. - Alternatively, the
system 1072 can have a single string (not shown). For example, in one embodiment, a string (not shown) is coupled directly to therotatable sensor 1074. In a further embodiment, thestring measurement system 1072 can be used to measure the tilt of the insertion device (or the canister of the insertion device). According to one implementation, thestring measurement system 1072 uses three strings to measure the tilt. - In use, the
sensor 1074 can detect the distance between thetop cap 1070 and the port (not shown) by sensing the number of turns of thedrum 1076, as the number of turns is directly related to the length of the string extending down to the port (not shown) and thus directly related to the distance between thetop cap 1070 and the port (not shown). This information can be used to calculate the insertion depth of the surgical device. - In an alternative embodiment, more than one measurement mechanism can be incorporated into an insertion device. That is, a first measurement mechanism can be incorporated into the insertion device to measure the insertion depth of the surgical device while a second measurement mechanism can be incorporated to measure the amount of “tilt” in the insertion device. It is understood that this could be any combination of the measurement devices that are capable of measuring depth and/or tilt. It is further understood that any known device for measuring tilt as described herein can be used within the insertion devices contemplated herein. In this context, “tilt” is intended to mean the angle of the longitudinal axis of the canister in relation to the plane parallel to the radius of the incision port. Several embodiments of the canisters and insertion devices herein are configured to allow for such tilt, which can be utilized to better position the surgical device in the cavity once it has exited the interior of the canister prior to or during a procedure.
-
FIGS. 82A , 82B, 82C, 82D, and 82E depict yet another implementation of an insertion device having a measurement mechanism that measures the relative distance between the top cap and the port to determine the insertion depth of the surgical device. This embodiment relates to atop cap 1090 that has a substantially rigidstructure measurement system 1092. Themeasurement system 1092 is a system in which a substantiallyrigid structure 1094 extends from thetop cap 1090 to theport 1096 at the bottom of the insertion device and the displacement of thestructure 1094 is measured to determine the distance between thetop cap 1090 and theport 1096, which can be used to calculate the insertion depth of the surgical device. - In this embodiment, as shown in
FIG. 82A , the substantially rigid structure is asquare bar 1094 that has acoupler 1098 at the top of thebar 1094. Thebar 1094 extends through aseal 1100 in the top cap 1090 (as best shown inFIG. 82A ), through ahole 1102 in the underside of the top cap 1090 (as best shown inFIG. 82B ), and through ahole 1104 in the port 1096 (as best shown inFIG. 82E ). In one embodiment, thehole 1102 in thetop cap 1090 is square and thus thesquare bar 1094 cannot rotate in relation to the top cap 1090 (and thus can't rotate in relation to the insertion device). According to one implementation, theseal 1100 in thetop cap 1090 is anelastomeric seal 1100. Alternatively, theseal 1100 is any seal that can maintain the pressure in the insertion device with thebar 1094 disposed therethough. - In one embodiment, the actual measurement of the displacement of the
square bar 1094 is accomplished using a string measurement system such as the system described above with respect toFIG. 81 . Thecoupler 1098 on the top end of thesquare bar 1094 is configured to be coupleable to a string (not shown) that is coupled in turn to thedrum 1106 of thestring measurement system 1108. In one embodiment thestring measurement system 1108 operates in the same fashion as the similar system above. - As best shown in
FIGS. 82C , 82D, and 82E, the bottom of thesquare bar 1094 is constrained in theport 1096 via a peggedball 1110 having four pegs that is positioned in acavity 1112 defined in the underside of theport 1096, wherein thecavity 1112 is in fluid communication with thehole 1104 in the top side of theport 1096. Thecavity 1112 is configured to match the configuration of the peggedball 1110 as shown (with the four slots in thecavity 1112 matching with the four pegs of the ball 1110) such that theball 1110 can move within thecavity 1112 in a way that allows angular offset but not rotation about the longitudinal axis of thebar 1094. According to one embodiment, the combination of this constraint and the rotational constraint at thetop cap 1090 allows the surgical device to be maneuvered into the body (that is, the insertion device can be tilted as described elsewhere herein and thereby maneuver and position the surgical device), but will maintain the centerline of the robot lined up with the insertion point. - In an alternative embodiment, the substantially rigid structure is another shape other than square. In a further implementation, the structure can have any shape that can match with a hole in the top cap such that the structure cannot rotate in relation to the top cap. Alternatively, the substantially rigid structure can be made up of more than one bar. For example, in one alternative embodiment, there can be two substantially rigid structures extending from the top cap to the port. In a further alternative, there are three or more structures.
- Various other implementations of measurement mechanisms can be envisioned that fall within the scope and spirit of the embodiments disclosed herein. For example, while various embodiments discussed above relate to measurement of the relative distance between the top cap and the port, other alternative embodiments can measure the relative angular and linear displacement between the top and bottom of the insertion device. In addition, while various embodiments discuss above relate to sensors configured to emit and/or sense particular types of energy (such as infrared or ultrasonic energy), it is understood than any type of wireless technology that would work with a sensor can be used.
- It is understood that any of these measurement technologies can be incorporated into any of the insertion device embodiments disclosed herein.
-
FIG. 83 depicts an alternative embodiment of anincision port 1120 that can be used with any of the insertion devices described above. In this implementation, theincision port 1120 has aslidable lid 1122 similar to the lid depicted inFIGS. 72A-75C . Further, theport 1120 also has aninsufflation port 1124 that is in fluidic communication with the interior lumen or opening of theincision port 1120. In this embodiment, theinsufflation port 1124 is aflow valve port 1124 that is positioned on theport 1120 such that it is below theslidable lid 1122. In one implementation, theinsufflation port 1124 is used to insufflate the patient's cavity or to provide supplemental insufflation during a procedure. In use, thelid 1122 is positioned in the closed position to establish a fluid seal in the cavity (and in the insertion device, as described elsewhere above), and then gas is added to the patient's cavity via theinsufflation port 1124. -
FIGS. 84A and 84B depict alternative insertion device embodiments that, unlike the cylindrical canisters described above, have canisters with different shapes. More specifically,FIG. 84A is aninsertion device 1130 with aflexible canister 1132 that is spherical in shape. Further,FIG. 84B is aninsertion device 1140 with aflexible canister 1142 that is conical in shape. According to one embodiment, during compression, the spherical andconical canisters canisters canisters canisters canisters -
FIGS. 85A , 85B, and 85C depict alternative insertion device embodiments that have canisters that are reinforced with rib structures. More specifically,FIG. 85A is aninsertion device 1150 with aflexible canister 1152 havingvertical rib structures 1154.FIG. 85B is aninsertion device 1160 with aflexible canister 1162 havinghorizontal rib structures 1164. Further,FIG. 85C is aninsertion device 1170 with aflexible canister 1172 having spiral-shapedrib structures 1174. In accordance with one embodiment, the rib structures in these exemplary embodiments create the structure of each canister while the flexible material in the canisters maintain the pressure therein. Alternatively, any combination of the rib structures can also be incorporated into a canister. In one implementation, the rib structures provide reinforcement for each canister such that the structures reduce the amount of undesired bending or collapsing of the canister during use. -
FIGS. 86A , 86B, 86C, 86D depict an embodiment of a base coupler 1182 (of an incision port 1180) that is releasably coupled to thecanister 1184 of the incision device. In this embodiment, the surgical device (not shown) can be positioned in thecanister 1184 prior to the procedure and then releasably coupled to theincision port 1180. Thecoupler 1182 has at least onefixed support 1186 and at least onereleasable latch 1188. According to one embodiment, there are two fixed supports 1186 (one is not visible). Thecanister 1184 has alip 1190 on the bottom of the canister that can couple with thecoupler 1182. In use, thecanister 1184 is positioned against the top of thecoupler 1182 in a tilted position as shown inFIGS. 86B and 86C such that thelip 1190 is positioned under the two fixedsupports 1186. Then the entire bottom of thecanister 1184 is placed into contact with thecoupler 1182, thereby creating a seal between thelip 1190 and thecoupler 1182. When thelip 1190 is positioned correctly, thelatch 1188 is moved into the latched position such that thelip 1190 is retained in its position against thecoupler 1182 via the two fixedsupports 1186 and thelatch 1188 as best shown inFIG. 86D . -
FIGS. 87A , 87B, and 87C depict an embodiment of an insertion device havingtop cap 1200 that is coupled to an outer handle set 1202 such that thetop cap 1200 and handle set 1202 can be moved relative to theflexible canister 1204. Theouter handle set 1202 has anouter ring 1206 that is positioned around the outer circumference of thetop cap 1200 such that there is a fluid seal established between the two components. In one embodiment, the fluidic seal is enhanced by arubber seal 1210 disposed between thetop cap 1200 andouter ring 1206. Further, theset 1202 also has twohandles 1208 coupled to thering 1206 such that a user or medical professional can easily grasp theset 1202. More specifically, as best shown inFIG. 87B , thetop cap 1200 andouter handle set 1202 are moved down over the walls of theflexible canister 1204 such that thecanister 1204 walls are disposed between thetop cap 1200 and thehandle set 1202. Thus, unlike certain embodiments above, thetop cap 1200 is not fixed to the top of thecanister 1204, but rather can be moved distally toward the bottom of thecanister 1204 while pulling the walls of thecanister 1204 through the seal of thetop cap 1200 and outer handle set 1202 so as to reduce any bunching of thecanister walls 1204 during compression of the device. In use, thetop cap 1200 is free to slide within theflexible canister 1204 and is controlled via theouter handle set 1202, which hashandles 1208 that provide direct control of the position and orientation of thetop cap 1200. -
FIGS. 88A , 88B, 88C, and 88D depict an alternative embodiment of aninsertion device 1220 having top cap 1222 (as best shown inFIGS. 88A and 88B , a mobile seal 1224 (as best shown inFIG. 88C , an outer handle set 1226 (as best shown inFIGS. 88A and 88C ) coupled to themobile seal 1224, and an incision port 1228 (as best shown inFIGS. 88A and 88D ). This embodiment differs from the previous embodiment in that thetop cap 1222 in thisdevice 1220 is not mobile and instead is coupled to the proximal end of thedevice 1220 as shown inFIG. 88A . Further, this embodiment has amobile seal 1224 that is capable of moving along the length of thedevice 1220 in the same fashion as thetop cap 1200 described above and depicted inFIGS. 87A-87C . Further, theouter handle set 1226 is coupled to themobile seal 1224, instead of thetop cap 1222. - According to one embodiment, the
top cap 1222 in thisdevice 1220 is the primary seal of thedevice 1220 such that it is not essential that themobile seal 1224 maintains a fluidic seal as it is moved along the length of thedevice 1220. As such, thetop cap 1222 can have all the sealing features and components of any of the top cap embodiments described above, including seals and access openings for wires, suction, irrigation, and auxiliary tools. In accordance with one implementation, themobile seal 1224 is used primarily, along with theouter handle set 1226, to position the surgical device into the patient's cavity. Themobile seal 1224 and theouter handle set 1226 are coupled together, according to one embodiment, in a similar fashion and with similar components as theouter handle set 1202 and thetop cap 1200 described above. When theouter handle set 1226 is moved, themobile seal 1224 moves as well, and thehandle set 1226 andseal 1224 can be moved relative to the canister walls in the same way as thetop cap 1200 and handle set 1202 above. - According to one implementation, the external circumference of the
mobile seal 1224 is non-circular such that coupling theseal 1224 to theouter handle set 1226 restrains themobile seal 1224 from any axial movement in relation to thehandle set 1226. As an example, the outer circumference of theseal 1224 can have the shape of a hexagon or an ellipse. Alternatively, any mechanism or component to restrain such axial movement can be used. - In one embodiment, the interface of the
mobile seal 1224 and outer handle set 1226—where the canister is positioned and must pass through—need not provide a fluidic seal. Further, in certain implementations, the additional mechanisms or components such as ball bearings or surfaces conducive to movement can be incorporated into the interface, thereby enhancing the ability of the canister wall to pass through the interface easily. It is understood that these mechanisms or components can be incorporated into theseal 1224 or thehandle set 1226 or both. -
FIG. 89 depicts an alternative embodiment of aninsertion device 1240 having a substantiallynon-flexible canister portion 1242 that is coupled to aflexible canister portion 1244, which in turn is coupled to theincision port 1246. In this embodiment, the top cap (not shown) can be coupled to an outer handle set similar to that described above such that the top cap can move along thenon-flexible canister portion 1242 with ease. Theflexible canister portion 1244 provides a flexible connection or interface (which could also be described as a “ball joint like” interface) that allows the movement of the surgical device as needed. That is, theflexible canister portion 1244 enhances the ability to tilt theinsertion device 1240 as described above, thereby enhancing the ability to move the surgical device during insertion and during any procedure being performed. In one implementation, the coupling of the top cap and the outer handle set can be a magnetic connection so as to avoid the necessary sealing. Alternatively, different canister shapes and sizes can be envisioned. Further, the flexible canister portion can be located elsewhere on the device. In a further alternative, more than one flexible canister portion can be provided. - It is understood with respect to all of the various embodiments described herein that the medical devices being inserted into the patient are any known medical or surgical devices for performing procedures within a cavity of a patient. In certain embodiments, it is understood that the medical devices are robotic surgical devices having one or two arms. In various alternatives, the robotic surgical devices or systems can have or use three or more arms. In further alternatives, the devices (or additional devices) can be cameras or camera systems. Yet other alternatives, include the use of “helper” tools that can be inserted along with one or more medical devices or robotic devices.
- Although the present invention has been described with reference to preferred embodiments, persons skilled in the art will recognize that changes may be made in form and detail without departing from the spirit and scope of the invention.
Claims (20)
1. A surgical insertion device comprising:
(a) a canister defining a lumen, wherein the canister is sized to receive a surgical device in the lumen;
(b) a top cap coupled to a proximal end of the canister, the top cap comprising at least one lumen defined in the top cap, wherein the at least one lumen is configured to receive a support rod; and
(c) an incision port removably coupled to a distal end of the canister, the incision port comprising a fluidic sealing component configured to maintain a fluidic seal.
2. The surgical insertion device of claim 1 , wherein the lumen is fluidically sealed in relation to ambient air.
3. The surgical insertion device of claim 1 , wherein the canister comprises a flexible material or a substantially rigid material.
4. The surgical insertion device of claim 1 , wherein the canister comprises a flexible portion and a substantially rigid portion.
5. The surgical insertion device of claim 1 , wherein the canister has a cylindrical shape, a spherical shape, or a conical shape.
6. The surgical insertion device of claim 1 , wherein the canister comprises at least one rib structure.
7. The surgical insertion device of claim 1 , wherein the fluidic sealing component comprises a sealable sleeve device, a flexible seal component, a removable lid seal component, or a flap seal component.
8. The surgical insertion device of claim 1 , wherein the top cap comprises at least one of a pressure relief valve, at least one threaded lumen, a detachable cable harness, and a clamp projection.
9. The surgical insertion device of claim 1 , further comprising an outer handle set coupleable to the top cap.
10. The surgical insertion device of claim 1 , further comprising at least one measurement mechanism coupled to the top cap or the incision port.
11. The surgical insertion device of claim 1 , wherein the canister comprises at least one access port, wherein the at least one access port is a hand access port or a side access port.
12. A surgical insertion device comprising:
(a) a flexible canister defining a lumen, wherein the canister is sized to receive a surgical device in the lumen;
(b) a top cap coupled to a proximal end of the canister, the top cap comprising at least one lumen defined in the top cap, wherein the at least lumen is configured to receive a support rod;
(c) an incision port removably coupled to a distal end of the canister, the incision port comprising a fluidic sealing component configured to maintain a fluidic seal; and
(d) a first measurement mechanism coupled with the top cap or the incision port, the first measurement mechanism configured to measure the insertion depth of the surgical device.
13. The surgical insertion device of claim 12 , wherein the first measurement mechanism comprises a sensor, a string measurement system, a substantially rigid structure system, or a camera.
14. The surgical insertion device of claim 12 , wherein the fluidic sealing component comprises a sealable sleeve device, a flexible seal component, a removable lid seal component, or a flap seal component.
15. The surgical insertion device of claim 12 , wherein the top cap comprises at least one of a pressure relief valve, at least one threaded lumen, a detachable cable harness, and a clamp projection.
16. The surgical insertion device of claim 12 , further comprising a second measurement mechanism coupled to the top cap or the incision port, the second measurement mechanism configured to measure any tilt of the flexible canister.
17. A surgical insertion device comprising:
(a) a canister defining a lumen, wherein the canister is sized to receive a surgical device in the lumen, wherein the surgical device is a robotic surgical device comprising two arms;
(b) a top cap coupled to a proximal end of the canister, the top cap comprising a pressure relief valve and at least one lumen defined in the top cap, wherein the at least one lumen is configured to receive a support rod; and
(c) an incision port removably coupled to a distal end of the canister, the incision port comprising a fluidic sealing component configured to maintain a fluidic seal.
18. The surgical insertion device of claim 17 , wherein the fluidic sealing component comprises a sealable sleeve device, a flexible seal component, a removable lid seal component, or a flap seal component.
19. The surgical insertion device of claim 17 , wherein the top cap comprises at least one of at least one threaded lumen, a detachable cable harness, and a clamp projection.
20. The surgical insertion device of claim 17 , further comprising at least one measurement mechanism coupled to the top cap or the incision port.
Priority Applications (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US13/738,706 US20140058205A1 (en) | 2012-01-10 | 2013-01-10 | Methods, Systems, and Devices for Surgical Access and Insertion |
US14/661,465 US20150190170A1 (en) | 2012-01-10 | 2015-03-18 | Methods, Systems and Devices for Surgical Access and Insertion |
US15/890,860 US20190046234A1 (en) | 2012-01-10 | 2018-02-07 | Methods, Systems, and Devices for Surgical Access and Insertion |
US16/999,407 US11883065B2 (en) | 2012-01-10 | 2020-08-21 | Methods, systems, and devices for surgical access and insertion |
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US201261584947P | 2012-01-10 | 2012-01-10 | |
US201261683483P | 2012-08-15 | 2012-08-15 | |
US13/738,706 US20140058205A1 (en) | 2012-01-10 | 2013-01-10 | Methods, Systems, and Devices for Surgical Access and Insertion |
Related Child Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US14/661,465 Continuation US20150190170A1 (en) | 2012-01-10 | 2015-03-18 | Methods, Systems and Devices for Surgical Access and Insertion |
Publications (1)
Publication Number | Publication Date |
---|---|
US20140058205A1 true US20140058205A1 (en) | 2014-02-27 |
Family
ID=48782080
Family Applications (4)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US13/738,706 Abandoned US20140058205A1 (en) | 2012-01-10 | 2013-01-10 | Methods, Systems, and Devices for Surgical Access and Insertion |
US14/661,465 Abandoned US20150190170A1 (en) | 2012-01-10 | 2015-03-18 | Methods, Systems and Devices for Surgical Access and Insertion |
US15/890,860 Abandoned US20190046234A1 (en) | 2012-01-10 | 2018-02-07 | Methods, Systems, and Devices for Surgical Access and Insertion |
US16/999,407 Active 2034-02-24 US11883065B2 (en) | 2012-01-10 | 2020-08-21 | Methods, systems, and devices for surgical access and insertion |
Family Applications After (3)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US14/661,465 Abandoned US20150190170A1 (en) | 2012-01-10 | 2015-03-18 | Methods, Systems and Devices for Surgical Access and Insertion |
US15/890,860 Abandoned US20190046234A1 (en) | 2012-01-10 | 2018-02-07 | Methods, Systems, and Devices for Surgical Access and Insertion |
US16/999,407 Active 2034-02-24 US11883065B2 (en) | 2012-01-10 | 2020-08-21 | Methods, systems, and devices for surgical access and insertion |
Country Status (5)
Country | Link |
---|---|
US (4) | US20140058205A1 (en) |
EP (2) | EP2806941B1 (en) |
JP (1) | JP6377530B2 (en) |
CA (2) | CA3098065C (en) |
WO (1) | WO2013106569A2 (en) |
Cited By (30)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20120253132A1 (en) * | 2011-03-29 | 2012-10-04 | Tyco Healthcare Group Lp | Gear Driven Triangulation |
WO2014144220A1 (en) | 2013-03-15 | 2014-09-18 | Board Of Regents Of The University Of Nebraska | Robotic surgical devices, systems, and related methdos |
US9351761B2 (en) * | 2011-03-25 | 2016-05-31 | Covidien Lp | Access port with integrated flexible sleeve |
US20170071629A1 (en) * | 2015-09-15 | 2017-03-16 | Applied Medical Resources Corporation | Surgical robotic access system |
US9743987B2 (en) | 2013-03-14 | 2017-08-29 | Board Of Regents Of The University Of Nebraska | Methods, systems, and devices relating to robotic surgical devices, end effectors, and controllers |
US9757187B2 (en) | 2011-06-10 | 2017-09-12 | Board Of Regents Of The University Of Nebraska | Methods, systems, and devices relating to surgical end effectors |
US9770305B2 (en) | 2012-08-08 | 2017-09-26 | Board Of Regents Of The University Of Nebraska | Robotic surgical devices, systems, and related methods |
US9883911B2 (en) | 2006-06-22 | 2018-02-06 | Board Of Regents Of The University Of Nebraska | Multifunctional operational component for robotic devices |
US9888966B2 (en) | 2013-03-14 | 2018-02-13 | Board Of Regents Of The University Of Nebraska | Methods, systems, and devices relating to force control surgical systems |
US9956043B2 (en) | 2007-07-12 | 2018-05-01 | Board Of Regents Of The University Of Nebraska | Methods, systems, and devices for surgical access and procedures |
US10111711B2 (en) | 2011-07-11 | 2018-10-30 | Board Of Regents Of The University Of Nebraska | Robotic surgical devices, systems, and related methods |
US10219870B2 (en) | 2012-05-01 | 2019-03-05 | Board Of Regents Of The University Of Nebraska | Single site robotic device and related systems and methods |
WO2019067763A1 (en) | 2017-09-27 | 2019-04-04 | Virtual Incision Corporation | Robotic Surgical Devices with Tracking Camera Technology and Related Systems and Methods |
US10307199B2 (en) | 2006-06-22 | 2019-06-04 | Board Of Regents Of The University Of Nebraska | Robotic surgical devices and related methods |
US10335024B2 (en) | 2007-08-15 | 2019-07-02 | Board Of Regents Of The University Of Nebraska | Medical inflation, attachment and delivery devices and related methods |
US10342561B2 (en) | 2014-09-12 | 2019-07-09 | Board Of Regents Of The University Of Nebraska | Quick-release end effectors and related systems and methods |
US10376322B2 (en) | 2014-11-11 | 2019-08-13 | Board Of Regents Of The University Of Nebraska | Robotic device with compact joint design and related systems and methods |
US10470828B2 (en) | 2012-06-22 | 2019-11-12 | Board Of Regents Of The University Of Nebraska | Local control robotic surgical devices and related methods |
US10582973B2 (en) | 2012-08-08 | 2020-03-10 | Virtual Incision Corporation | Robotic surgical devices, systems, and related methods |
US10702347B2 (en) | 2016-08-30 | 2020-07-07 | The Regents Of The University Of California | Robotic device with compact joint design and an additional degree of freedom and related systems and methods |
US10722319B2 (en) | 2016-12-14 | 2020-07-28 | Virtual Incision Corporation | Releasable attachment device for coupling to medical devices and related systems and methods |
US10751136B2 (en) | 2016-05-18 | 2020-08-25 | Virtual Incision Corporation | Robotic surgical devices, systems and related methods |
US10806538B2 (en) | 2015-08-03 | 2020-10-20 | Virtual Incision Corporation | Robotic surgical devices, systems, and related methods |
US10966700B2 (en) | 2013-07-17 | 2021-04-06 | Virtual Incision Corporation | Robotic surgical devices, systems and related methods |
US11013564B2 (en) | 2018-01-05 | 2021-05-25 | Board Of Regents Of The University Of Nebraska | Single-arm robotic device with compact joint design and related systems and methods |
US11173617B2 (en) | 2016-08-25 | 2021-11-16 | Board Of Regents Of The University Of Nebraska | Quick-release end effector tool interface |
US11284958B2 (en) | 2016-11-29 | 2022-03-29 | Virtual Incision Corporation | User controller with user presence detection and related systems and methods |
US11357595B2 (en) | 2016-11-22 | 2022-06-14 | Board Of Regents Of The University Of Nebraska | Gross positioning device and related systems and methods |
US11883065B2 (en) | 2012-01-10 | 2024-01-30 | Board Of Regents Of The University Of Nebraska | Methods, systems, and devices for surgical access and insertion |
US11903658B2 (en) | 2019-01-07 | 2024-02-20 | Virtual Incision Corporation | Robotically assisted surgical system and related devices and methods |
Families Citing this family (11)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP2343031B1 (en) | 2002-06-05 | 2013-08-07 | Applied Medical Resources Corporation | Wound retractor |
US7704207B2 (en) | 2005-10-14 | 2010-04-27 | Applied Medical Resources Corporation | Circular surgical retractor |
EP3179934B1 (en) | 2014-08-15 | 2019-03-27 | Applied Medical Resources Corporation | Natural orifice surgery system |
CA2968846A1 (en) | 2014-11-25 | 2016-06-02 | Applied Medical Resources Corporation | Circumferential wound retraction with support and guidance structures |
WO2016208711A1 (en) * | 2015-06-24 | 2016-12-29 | キヤノン ユーエスエイ,インコーポレイテッド | Medical equipment guide device |
EP3340905A1 (en) | 2015-08-28 | 2018-07-04 | Atropos Limited | An access port device |
US10575840B2 (en) | 2015-10-07 | 2020-03-03 | Applied Medical Resources Corporation | Wound retractor with multi-segment outer ring |
EP4344607A2 (en) | 2018-11-02 | 2024-04-03 | Boston Scientific Medical Device Limited | Biopsy cap and biopsy cap housing |
US20220330976A1 (en) * | 2019-09-30 | 2022-10-20 | Intuitive Surgical Operations, Inc. | Single port instrument access device |
WO2022130193A1 (en) * | 2020-12-16 | 2022-06-23 | H.S. Hospital Service S.P.A. | Support device to guide treatment instruments in clinical procedures |
WO2023122603A1 (en) * | 2021-12-21 | 2023-06-29 | Board Of Regents, The University Of Texas System | Endoscopic tubular minimally invasive surgical system |
Citations (20)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5672168A (en) * | 1994-10-07 | 1997-09-30 | De La Torre; Roger A. | Laparoscopic access port for surgical instruments or the hand |
US5853395A (en) * | 1997-02-18 | 1998-12-29 | Dexterity, Inc. | Extracorporeal pneumoperitoneum enclosure and method of use |
US5906577A (en) * | 1997-04-30 | 1999-05-25 | University Of Massachusetts | Device, surgical access port, and method of retracting an incision into an opening and providing a channel through the incision |
US20020038077A1 (en) * | 1994-10-07 | 2002-03-28 | General Surgical Innovations, Inc., California Corporation | Laparoscopic access port for surgical instruments or the hand |
US6589167B1 (en) * | 1997-10-08 | 2003-07-08 | Hakko Electric Machine Works Co., Ltd. | Valve and valved trocar jacket tube |
US20050090717A1 (en) * | 1998-12-01 | 2005-04-28 | Frank Bonadio | Wound retractor device |
US20050192483A1 (en) * | 1998-12-01 | 2005-09-01 | Frank Bonadio | Device |
US20050222582A1 (en) * | 2004-04-05 | 2005-10-06 | Thomas Wenchell | Surgical hand access apparatus |
US7377898B2 (en) * | 2003-08-22 | 2008-05-27 | Applied Medical Resources Corporation | Wound retraction apparatus and method |
US20090012433A1 (en) * | 2007-06-18 | 2009-01-08 | Fernstrom John D | Method, apparatus and system for food intake and physical activity assessment |
US20090036745A1 (en) * | 2007-06-05 | 2009-02-05 | Frank Bonadio | Instrument access device |
US20090227843A1 (en) * | 2007-09-12 | 2009-09-10 | Smith Jeffrey A | Multi-instrument access devices and systems |
US20100063364A1 (en) * | 2007-02-01 | 2010-03-11 | Frank Bonadio | Instrument insertion device |
US20100081880A1 (en) * | 2008-09-30 | 2010-04-01 | Ethicon Endo-Surgery, Inc. | Surgical Access Device |
US20100217087A1 (en) * | 2007-06-05 | 2010-08-26 | Frank Bonadio | Instrument access system |
US20100268035A1 (en) * | 2009-04-17 | 2010-10-21 | Oberlaender Martin | Seal For Closing-Off An Access Instrument Into A Body |
US20110282157A1 (en) * | 2003-02-25 | 2011-11-17 | Applied Medical Resources Corporation | Surgical access system |
US20120078058A1 (en) * | 2008-03-03 | 2012-03-29 | Tyco Healthcare Group Lp | Single port device with multi-lumen cap |
US20130066156A1 (en) * | 2010-05-19 | 2013-03-14 | O Nam Seo | Surgical tool guide and protection cap for surgical tool guide |
US8876708B1 (en) * | 2007-03-30 | 2014-11-04 | Covidien Lp | Laparoscopic port assembly |
Family Cites Families (426)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3021358A (en) | 1958-07-28 | 1962-02-13 | Bornstein Joseph | Insecticidal bis-halophenyl di-fluoroaliphatic compounds |
US3870264A (en) | 1973-03-26 | 1975-03-11 | William I Robinson | Stand |
DE2339827B2 (en) | 1973-08-06 | 1977-02-24 | A6 In 3-02 | DENTAL EQUIPMENT |
US4258716A (en) | 1978-02-06 | 1981-03-31 | The University Of Melbourne | Microsurgical instruments |
JPS5519124A (en) | 1978-07-27 | 1980-02-09 | Olympus Optical Co | Camera system for medical treatment |
US4246661A (en) | 1979-03-15 | 1981-01-27 | The Boeing Company | Digitally-controlled artificial hand |
GB2058248B (en) * | 1979-09-12 | 1982-09-22 | Butterworth System Inc | Sealing arrangement |
JPS58132490A (en) | 1982-01-29 | 1983-08-06 | 株式会社日立製作所 | Transmitting mechanism of angle |
JPS5959371A (en) | 1982-09-30 | 1984-04-05 | フアナツク株式会社 | Industrial robot |
US5307447A (en) | 1982-10-29 | 1994-04-26 | Kabushiki Kaisha Toshiba | Control system of multi-joint arm robot apparatus |
GB2130889B (en) | 1982-11-26 | 1986-06-18 | Wolf Gmbh Richard | Rectoscope |
US4610665A (en) * | 1983-01-18 | 1986-09-09 | Terumo Kabushiki Kaisha | Medical instrument |
JPS6076986A (en) | 1983-09-30 | 1985-05-01 | 株式会社東芝 | Robot |
DE3536747A1 (en) | 1984-10-15 | 1986-04-24 | Tokico Ltd., Kawasaki, Kanagawa | Joint mechanism |
DE3525806A1 (en) | 1985-07-19 | 1987-01-29 | Kuka Schweissanlagen & Roboter | TRANSMISSION HEAD FOR MANIPULATORS |
JPS6268293A (en) | 1985-09-20 | 1987-03-28 | 株式会社明電舎 | Manipulator shoulder mechanism |
DE3545068A1 (en) | 1985-12-19 | 1987-06-25 | Kuka Schweissanlagen & Roboter | TRANSMISSION HEAD FOR MANIPULATORS |
DE3612498A1 (en) | 1986-04-14 | 1987-10-29 | Norske Stats Oljeselskap | SELF-DRIVING VEHICLE FOR PIPELINES |
US4787270A (en) | 1987-02-11 | 1988-11-29 | Cincinnati Milacron Inc. | Robotic manipulator |
JP2591968B2 (en) | 1987-12-28 | 1997-03-19 | 株式会社日立製作所 | Industrial robot wrist |
US5019968A (en) | 1988-03-29 | 1991-05-28 | Yulan Wang | Three-dimensional vector processor |
US5187796A (en) | 1988-03-29 | 1993-02-16 | Computer Motion, Inc. | Three-dimensional vector co-processor having I, J, and K register files and I, J, and K execution units |
US5108140A (en) | 1988-04-18 | 1992-04-28 | Odetics, Inc. | Reconfigurable end effector |
US4896015A (en) | 1988-07-29 | 1990-01-23 | Refractive Laser Research & Development Program, Ltd. | Laser delivery system |
US4897014A (en) | 1988-09-06 | 1990-01-30 | Harbor Branch Oceanographic Institution, Inc. | Device for interchange of tools |
US5000745A (en) * | 1988-11-18 | 1991-03-19 | Edward Weck Incorporated | Hemostatis valve |
US5271384A (en) | 1989-09-01 | 1993-12-21 | Mcewen James A | Powered surgical retractor |
US5201325A (en) | 1989-09-01 | 1993-04-13 | Andronic Devices Ltd. | Advanced surgical retractor |
US5176652A (en) * | 1989-12-22 | 1993-01-05 | Cordis Corporation | Hemostasis valve |
US5562448A (en) | 1990-04-10 | 1996-10-08 | Mushabac; David R. | Method for facilitating dental diagnosis and treatment |
JP2914388B2 (en) | 1990-04-17 | 1999-06-28 | 株式会社ユアサコーポレーション | Polymer solid electrolyte |
IT1241622B (en) | 1990-10-04 | 1994-01-25 | Comau Spa | ROBOT WRIST |
IT1241621B (en) | 1990-10-04 | 1994-01-25 | Comau Spa | ARTICULATED ROBOT |
US5176649A (en) | 1991-01-28 | 1993-01-05 | Akio Wakabayashi | Insertion device for use with curved, rigid endoscopic instruments and the like |
US5217003A (en) | 1991-03-18 | 1993-06-08 | Wilk Peter J | Automated surgical system and apparatus |
US5172639A (en) | 1991-03-26 | 1992-12-22 | Gas Research Institute | Cornering pipe traveler |
US5632761A (en) | 1991-05-29 | 1997-05-27 | Origin Medsystems, Inc. | Inflatable devices for separating layers of tissue, and methods of using |
US5370134A (en) | 1991-05-29 | 1994-12-06 | Orgin Medsystems, Inc. | Method and apparatus for body structure manipulation and dissection |
US5417210A (en) | 1992-05-27 | 1995-05-23 | International Business Machines Corporation | System and method for augmentation of endoscopic surgery |
US5284096A (en) | 1991-08-06 | 1994-02-08 | Osaka Gas Company, Limited | Vehicle for use in pipes |
US5674030A (en) | 1991-08-27 | 1997-10-07 | Sika Equipment Ag. | Device and method for repairing building branch lines in inacessible sewer mains |
JP2526537B2 (en) | 1991-08-30 | 1996-08-21 | 日本電装株式会社 | Pipe energy supply system |
JPH05115425A (en) | 1991-10-25 | 1993-05-14 | Olympus Optical Co Ltd | Endoscope |
US6731988B1 (en) | 1992-01-21 | 2004-05-04 | Sri International | System and method for remote endoscopic surgery |
US5631973A (en) | 1994-05-05 | 1997-05-20 | Sri International | Method for telemanipulation with telepresence |
ATE155059T1 (en) | 1992-01-21 | 1997-07-15 | Stanford Res Inst Int | TELEOPERATOR SYSTEM AND TELEPRESENCE METHOD |
US5624380A (en) | 1992-03-12 | 1997-04-29 | Olympus Optical Co., Ltd. | Multi-degree of freedom manipulator |
US5263382A (en) | 1992-04-13 | 1993-11-23 | Hughes Aircraft Company | Six Degrees of freedom motion device |
US5297443A (en) | 1992-07-07 | 1994-03-29 | Wentz John D | Flexible positioning appendage |
US5754741A (en) | 1992-08-10 | 1998-05-19 | Computer Motion, Inc. | Automated endoscope for optimal positioning |
US7074179B2 (en) | 1992-08-10 | 2006-07-11 | Intuitive Surgical Inc | Method and apparatus for performing minimally invasive cardiac procedures |
US5762458A (en) | 1996-02-20 | 1998-06-09 | Computer Motion, Inc. | Method and apparatus for performing minimally invasive cardiac procedures |
US5524180A (en) | 1992-08-10 | 1996-06-04 | Computer Motion, Inc. | Automated endoscope system for optimal positioning |
US5657429A (en) | 1992-08-10 | 1997-08-12 | Computer Motion, Inc. | Automated endoscope system optimal positioning |
US5515478A (en) | 1992-08-10 | 1996-05-07 | Computer Motion, Inc. | Automated endoscope system for optimal positioning |
US5588442A (en) | 1992-08-12 | 1996-12-31 | Scimed Life Systems, Inc. | Shaft movement control apparatus and method |
US5297536A (en) | 1992-08-25 | 1994-03-29 | Wilk Peter J | Method for use in intra-abdominal surgery |
US5458131A (en) | 1992-08-25 | 1995-10-17 | Wilk; Peter J. | Method for use in intra-abdominal surgery |
US5769640A (en) | 1992-12-02 | 1998-06-23 | Cybernet Systems Corporation | Method and system for simulating medical procedures including virtual reality and control method and system for use therein |
US5353807A (en) | 1992-12-07 | 1994-10-11 | Demarco Thomas J | Magnetically guidable intubation device |
CA2112271A1 (en) | 1992-12-28 | 1994-06-29 | Kiichi Suyama | Intrapipe work robot apparatus and method of measuring position of intrapipe work robot |
ES2160118T3 (en) | 1993-01-07 | 2001-11-01 | Medical Innovations Corp | CATETER SYSTEM FOR GASTROSTOMY. |
US6346074B1 (en) | 1993-02-22 | 2002-02-12 | Heartport, Inc. | Devices for less invasive intracardiac interventions |
US6832996B2 (en) | 1995-06-07 | 2004-12-21 | Arthrocare Corporation | Electrosurgical systems and methods for treating tissue |
US5363935A (en) | 1993-05-14 | 1994-11-15 | Carnegie Mellon University | Reconfigurable mobile vehicle with magnetic tracks |
US5791231A (en) | 1993-05-17 | 1998-08-11 | Endorobotics Corporation | Surgical robotic system and hydraulic actuator therefor |
JP3349197B2 (en) | 1993-06-30 | 2002-11-20 | テルモ株式会社 | Trocar tube |
US5441494A (en) | 1993-07-29 | 1995-08-15 | Ethicon, Inc. | Manipulable hand for laparoscopy |
CA2103626A1 (en) | 1993-08-09 | 1995-02-10 | Septimiu Edmund Salcudean | Motion scaling tele-operating system with force feedback suitable for microsurgery |
US5728599A (en) | 1993-10-28 | 1998-03-17 | Lsi Logic Corporation | Printable superconductive leadframes for semiconductor device assembly |
US5876325A (en) | 1993-11-02 | 1999-03-02 | Olympus Optical Co., Ltd. | Surgical manipulation system |
JP3476878B2 (en) | 1993-11-15 | 2003-12-10 | オリンパス株式会社 | Surgical manipulator |
US5458598A (en) | 1993-12-02 | 1995-10-17 | Cabot Technology Corporation | Cutting and coagulating forceps |
WO1995016396A1 (en) | 1993-12-15 | 1995-06-22 | Computer Motion, Inc. | Automated endoscope system for optimal positioning |
US5471515A (en) | 1994-01-28 | 1995-11-28 | California Institute Of Technology | Active pixel sensor with intra-pixel charge transfer |
US5436542A (en) | 1994-01-28 | 1995-07-25 | Surgix, Inc. | Telescopic camera mount with remotely controlled positioning |
US5620417A (en) | 1994-07-07 | 1997-04-15 | Cardiovascular Imaging Systems Incorporated | Rapid exchange delivery catheter |
US5623582A (en) | 1994-07-14 | 1997-04-22 | Immersion Human Interface Corporation | Computer interface or control input device for laparoscopic surgical instrument and other elongated mechanical objects |
US6646541B1 (en) | 1996-06-24 | 2003-11-11 | Computer Motion, Inc. | General purpose distributed operating room control system |
US7053752B2 (en) | 1996-08-06 | 2006-05-30 | Intuitive Surgical | General purpose distributed operating room control system |
US6463361B1 (en) | 1994-09-22 | 2002-10-08 | Computer Motion, Inc. | Speech interface for an automated endoscopic system |
US5797538A (en) | 1994-10-05 | 1998-08-25 | United States Surgical Corporation | Articulating apparatus for applying surgical fasteners to body tissue |
US6071274A (en) | 1996-12-19 | 2000-06-06 | Ep Technologies, Inc. | Loop structures for supporting multiple electrode elements |
US5645520A (en) | 1994-10-12 | 1997-07-08 | Computer Motion, Inc. | Shape memory alloy actuated rod for endoscopic instruments |
US5814062A (en) | 1994-12-22 | 1998-09-29 | Target Therapeutics, Inc. | Implant delivery assembly with expandable coupling/decoupling mechanism |
JP3610110B2 (en) | 1995-02-23 | 2005-01-12 | オリンパス株式会社 | Medical manipulator |
GB2301187B (en) | 1995-05-22 | 1999-04-21 | British Gas Plc | Method of and apparatus for locating an anomaly in a duct |
US5657584A (en) | 1995-07-24 | 1997-08-19 | Rensselaer Polytechnic Institute | Concentric joint mechanism |
US5825982A (en) | 1995-09-15 | 1998-10-20 | Wright; James | Head cursor control interface for an automated endoscope system for optimal positioning |
US6714841B1 (en) | 1995-09-15 | 2004-03-30 | Computer Motion, Inc. | Head cursor control interface for an automated endoscope system for optimal positioning |
US6283951B1 (en) | 1996-10-11 | 2001-09-04 | Transvascular, Inc. | Systems and methods for delivering drugs to selected locations within the body |
US5624398A (en) | 1996-02-08 | 1997-04-29 | Symbiosis Corporation | Endoscopic robotic surgical tools and methods |
US6063095A (en) | 1996-02-20 | 2000-05-16 | Computer Motion, Inc. | Method and apparatus for performing minimally invasive surgical procedures |
US5855583A (en) | 1996-02-20 | 1999-01-05 | Computer Motion, Inc. | Method and apparatus for performing minimally invasive cardiac procedures |
US6436107B1 (en) | 1996-02-20 | 2002-08-20 | Computer Motion, Inc. | Method and apparatus for performing minimally invasive surgical procedures |
US5971976A (en) | 1996-02-20 | 1999-10-26 | Computer Motion, Inc. | Motion minimization and compensation system for use in surgical procedures |
US6699177B1 (en) | 1996-02-20 | 2004-03-02 | Computer Motion, Inc. | Method and apparatus for performing minimally invasive surgical procedures |
US5895417A (en) | 1996-03-06 | 1999-04-20 | Cardiac Pathways Corporation | Deflectable loop design for a linear lesion ablation apparatus |
US5807377A (en) | 1996-05-20 | 1998-09-15 | Intuitive Surgical, Inc. | Force-reflecting surgical instrument and positioning mechanism for performing minimally invasive surgery with enhanced dexterity and sensitivity |
US6544276B1 (en) | 1996-05-20 | 2003-04-08 | Medtronic Ave. Inc. | Exchange method for emboli containment |
US6652480B1 (en) | 1997-03-06 | 2003-11-25 | Medtronic Ave., Inc. | Methods for reducing distal embolization |
US5792135A (en) | 1996-05-20 | 1998-08-11 | Intuitive Surgical, Inc. | Articulated surgical instrument for performing minimally invasive surgery with enhanced dexterity and sensitivity |
US5797900A (en) | 1996-05-20 | 1998-08-25 | Intuitive Surgical, Inc. | Wrist mechanism for surgical instrument for performing minimally invasive surgery with enhanced dexterity and sensitivity |
US6496099B2 (en) | 1996-06-24 | 2002-12-17 | Computer Motion, Inc. | General purpose distributed operating room control system |
US6911916B1 (en) | 1996-06-24 | 2005-06-28 | The Cleveland Clinic Foundation | Method and apparatus for accessing medical data over a network |
US6642836B1 (en) | 1996-08-06 | 2003-11-04 | Computer Motion, Inc. | General purpose distributed operating room control system |
US6364888B1 (en) | 1996-09-09 | 2002-04-02 | Intuitive Surgical, Inc. | Alignment of master and slave in a minimally invasive surgical apparatus |
BR9712831A (en) | 1996-09-13 | 1999-11-16 | Schering Corp | Tricyclic farnesyl protein transferase inhibitors |
US6520951B1 (en) | 1996-09-13 | 2003-02-18 | Scimed Life Systems, Inc. | Rapid exchange catheter with detachable hood |
JP2957134B2 (en) * | 1996-10-08 | 1999-10-04 | 株式会社八光電機製作所 | Valve and valved trocar mantle |
IT1285533B1 (en) | 1996-10-22 | 1998-06-08 | Scuola Superiore Di Studi Universitari E Di Perfezionamento Sant Anna | ENDOSCOPIC ROBOT |
US5845646A (en) | 1996-11-05 | 1998-12-08 | Lemelson; Jerome | System and method for treating select tissue in a living being |
US6058323A (en) | 1996-11-05 | 2000-05-02 | Lemelson; Jerome | System and method for treating select tissue in a living being |
US6286514B1 (en) | 1996-11-05 | 2001-09-11 | Jerome Lemelson | System and method for treating select tissue in a living being |
US6293282B1 (en) | 1996-11-05 | 2001-09-25 | Jerome Lemelson | System and method for treating select tissue in living being |
US6132441A (en) | 1996-11-22 | 2000-10-17 | Computer Motion, Inc. | Rigidly-linked articulating wrist with decoupled motion transmission |
US5993467A (en) | 1996-11-27 | 1999-11-30 | Yoon; Inbae | Suturing instrument with rotatably mounted spreadable needle holder |
US6132368A (en) | 1996-12-12 | 2000-10-17 | Intuitive Surgical, Inc. | Multi-component telepresence system and method |
US6331181B1 (en) | 1998-12-08 | 2001-12-18 | Intuitive Surgical, Inc. | Surgical robotic tools, data architecture, and use |
US5910129A (en) | 1996-12-19 | 1999-06-08 | Ep Technologies, Inc. | Catheter distal assembly with pull wires |
US6332880B1 (en) | 1996-12-19 | 2001-12-25 | Ep Technologies, Inc. | Loop structures for supporting multiple electrode elements |
US6440063B1 (en) * | 1997-04-30 | 2002-08-27 | University Of Massachusetts | Surgical access port and laparoscopic surgical method |
WO1998050093A1 (en) * | 1997-05-02 | 1998-11-12 | United States Surgical Corporation | Trocar seal system |
US6086529A (en) * | 1997-05-13 | 2000-07-11 | Wisconsin Medical, Inc. | Bronchoscopic manifold with compressible diaphragmatic valve for simultaneous airway instrumentation |
US6066090A (en) | 1997-06-19 | 2000-05-23 | Yoon; Inbae | Branched endoscope system |
JP4444493B2 (en) | 1997-08-20 | 2010-03-31 | ザ リージェンツ オブ ザ ユニバーシティ オブ カリフォルニア | Nucleic acid sequences encoding capsaicin receptors and capsaicin receptor related polypeptides and uses thereof |
US6714839B2 (en) | 1998-12-08 | 2004-03-30 | Intuitive Surgical, Inc. | Master having redundant degrees of freedom |
US6139563A (en) | 1997-09-25 | 2000-10-31 | Allegiance Corporation | Surgical device with malleable shaft |
JP3342021B2 (en) | 1997-10-17 | 2002-11-05 | サーコン コーポレーション | Medical device system that penetrates tissue |
US6240312B1 (en) | 1997-10-23 | 2001-05-29 | Robert R. Alfano | Remote-controllable, micro-scale device for use in in vivo medical diagnosis and/or treatment |
FR2771280B1 (en) | 1997-11-26 | 2001-01-26 | Albert P Alby | RESILIENT VERTEBRAL CONNECTION DEVICE |
US5989224A (en) * | 1998-02-23 | 1999-11-23 | Dexide Corporation | Universal seal for use with endoscopic cannula |
US6810281B2 (en) | 2000-12-21 | 2004-10-26 | Endovia Medical, Inc. | Medical mapping system |
US7169141B2 (en) | 1998-02-24 | 2007-01-30 | Hansen Medical, Inc. | Surgical instrument |
US20020095175A1 (en) | 1998-02-24 | 2002-07-18 | Brock David L. | Flexible instrument |
US7090683B2 (en) | 1998-02-24 | 2006-08-15 | Hansen Medical, Inc. | Flexible instrument |
US6692485B1 (en) | 1998-02-24 | 2004-02-17 | Endovia Medical, Inc. | Articulated apparatus for telemanipulator system |
JP3019150B2 (en) * | 1998-04-07 | 2000-03-13 | 株式会社八光メディカル | Trocar mantle with valve |
US6309403B1 (en) | 1998-06-01 | 2001-10-30 | Board Of Trustees Operating Michigan State University | Dexterous articulated linkage for surgical applications |
US6030365A (en) | 1998-06-10 | 2000-02-29 | Laufer; Michael D. | Minimally invasive sterile surgical access device and method |
US6352503B1 (en) | 1998-07-17 | 2002-03-05 | Olympus Optical Co., Ltd. | Endoscopic surgery apparatus |
WO2000007503A1 (en) | 1998-08-04 | 2000-02-17 | Intuitive Surgical, Inc. | Manipulator positioning linkage for robotic surgery |
US6468265B1 (en) | 1998-11-20 | 2002-10-22 | Intuitive Surgical, Inc. | Performing cardiac surgery without cardioplegia |
US6659939B2 (en) | 1998-11-20 | 2003-12-09 | Intuitive Surgical, Inc. | Cooperative minimally invasive telesurgical system |
US6459926B1 (en) | 1998-11-20 | 2002-10-01 | Intuitive Surgical, Inc. | Repositioning and reorientation of master/slave relationship in minimally invasive telesurgery |
US6852107B2 (en) | 2002-01-16 | 2005-02-08 | Computer Motion, Inc. | Minimally invasive surgical training using robotics and tele-collaboration |
US6951535B2 (en) | 2002-01-16 | 2005-10-04 | Intuitive Surgical, Inc. | Tele-medicine system that transmits an entire state of a subsystem |
US6554790B1 (en) | 1998-11-20 | 2003-04-29 | Intuitive Surgical, Inc. | Cardiopulmonary bypass device and method |
US6398726B1 (en) | 1998-11-20 | 2002-06-04 | Intuitive Surgical, Inc. | Stabilizer for robotic beating-heart surgery |
US6162171A (en) | 1998-12-07 | 2000-12-19 | Wan Sing Ng | Robotic endoscope and an autonomous pipe robot for performing endoscopic procedures |
US6620173B2 (en) | 1998-12-08 | 2003-09-16 | Intuitive Surgical, Inc. | Method for introducing an end effector to a surgical site in minimally invasive surgery |
US6309397B1 (en) | 1999-12-02 | 2001-10-30 | Sri International | Accessories for minimally invasive robotic surgery and methods |
US6522906B1 (en) | 1998-12-08 | 2003-02-18 | Intuitive Surgical, Inc. | Devices and methods for presenting and regulating auxiliary information on an image display of a telesurgical system to assist an operator in performing a surgical procedure |
US6493608B1 (en) | 1999-04-07 | 2002-12-10 | Intuitive Surgical, Inc. | Aspects of a control system of a minimally invasive surgical apparatus |
USD444555S1 (en) | 1998-12-08 | 2001-07-03 | Intuitive Surgical, Inc. | Interface for a medical instrument |
USD441862S1 (en) | 1998-12-08 | 2001-05-08 | Intuitive Surgical, Inc. | Portion of an interface for a medical instrument |
US6770081B1 (en) | 2000-01-07 | 2004-08-03 | Intuitive Surgical, Inc. | In vivo accessories for minimally invasive robotic surgery and methods |
US6720988B1 (en) | 1998-12-08 | 2004-04-13 | Intuitive Surgical, Inc. | Stereo imaging system and method for use in telerobotic systems |
US7125403B2 (en) | 1998-12-08 | 2006-10-24 | Intuitive Surgical | In vivo accessories for minimally invasive robotic surgery |
US6799065B1 (en) | 1998-12-08 | 2004-09-28 | Intuitive Surgical, Inc. | Image shifting apparatus and method for a telerobotic system |
USD441076S1 (en) | 1998-12-08 | 2001-04-24 | Intuitive Surgical, Inc. | Adaptor for a medical instrument |
USD438617S1 (en) | 1998-12-08 | 2001-03-06 | Intuitive Surgical, Inc. | Portion of an adaptor for a medical instrument |
US6451027B1 (en) | 1998-12-16 | 2002-09-17 | Intuitive Surgical, Inc. | Devices and methods for moving an image capture device in telesurgical systems |
US6394998B1 (en) | 1999-01-22 | 2002-05-28 | Intuitive Surgical, Inc. | Surgical tools for use in minimally invasive telesurgical applications |
US8636648B2 (en) | 1999-03-01 | 2014-01-28 | West View Research, Llc | Endoscopic smart probe |
US6159146A (en) | 1999-03-12 | 2000-12-12 | El Gazayerli; Mohamed Mounir | Method and apparatus for minimally-invasive fundoplication |
JP3596340B2 (en) | 1999-03-18 | 2004-12-02 | 株式会社日立製作所 | Surgical insertion device |
US6424885B1 (en) | 1999-04-07 | 2002-07-23 | Intuitive Surgical, Inc. | Camera referenced control in a minimally invasive surgical apparatus |
US6565554B1 (en) | 1999-04-07 | 2003-05-20 | Intuitive Surgical, Inc. | Friction compensation in a minimally invasive surgical apparatus |
US6594552B1 (en) | 1999-04-07 | 2003-07-15 | Intuitive Surgical, Inc. | Grip strength with tactile feedback for robotic surgery |
US6820653B1 (en) | 1999-04-12 | 2004-11-23 | Carnegie Mellon University | Pipe inspection and repair system |
US6292678B1 (en) | 1999-05-13 | 2001-09-18 | Stereotaxis, Inc. | Method of magnetically navigating medical devices with magnetic fields and gradients, and medical devices adapted therefor |
US7637905B2 (en) | 2003-01-15 | 2009-12-29 | Usgi Medical, Inc. | Endoluminal tool deployment system |
US6788018B1 (en) | 1999-08-03 | 2004-09-07 | Intuitive Surgical, Inc. | Ceiling and floor mounted surgical robot set-up arms |
US6454775B1 (en) | 1999-12-06 | 2002-09-24 | Bacchus Vascular Inc. | Systems and methods for clot disruption and retrieval |
US6661571B1 (en) | 1999-09-21 | 2003-12-09 | Olympus Optical Co., Ltd. | Surgical microscopic system |
US7217240B2 (en) | 1999-10-01 | 2007-05-15 | Intuitive Surgical, Inc. | Heart stabilizer |
US6817972B2 (en) | 1999-10-01 | 2004-11-16 | Computer Motion, Inc. | Heart stabilizer |
US6936001B1 (en) | 1999-10-01 | 2005-08-30 | Computer Motion, Inc. | Heart stabilizer |
US6312435B1 (en) | 1999-10-08 | 2001-11-06 | Intuitive Surgical, Inc. | Surgical instrument with extended reach for use in minimally invasive surgery |
US6206903B1 (en) | 1999-10-08 | 2001-03-27 | Intuitive Surgical, Inc. | Surgical tool with mechanical advantage |
US6491691B1 (en) | 1999-10-08 | 2002-12-10 | Intuitive Surgical, Inc. | Minimally invasive surgical hook apparatus and method for using same |
JP3326472B2 (en) | 1999-11-10 | 2002-09-24 | 独立行政法人 航空宇宙技術研究所 | Articulated robot |
US6702805B1 (en) | 1999-11-12 | 2004-03-09 | Microdexterity Systems, Inc. | Manipulator |
US6548982B1 (en) | 1999-11-19 | 2003-04-15 | Regents Of The University Of Minnesota | Miniature robotic vehicles and methods of controlling same |
US6591239B1 (en) | 1999-12-09 | 2003-07-08 | Steris Inc. | Voice controlled surgical suite |
US6817975B1 (en) | 2000-01-14 | 2004-11-16 | Intuitive Surgical, Inc. | Endoscope |
US20020013601A1 (en) | 2000-01-28 | 2002-01-31 | Nobles Anthony A. | Cavity enlarger method and apparatus |
US7039453B2 (en) | 2000-02-08 | 2006-05-02 | Tarun Mullick | Miniature ingestible capsule |
US6428539B1 (en) | 2000-03-09 | 2002-08-06 | Origin Medsystems, Inc. | Apparatus and method for minimally invasive surgery using rotational cutting tool |
WO2001074260A1 (en) | 2000-03-24 | 2001-10-11 | Johns Hopkins University | Peritoneal cavity device and method |
US6468203B2 (en) | 2000-04-03 | 2002-10-22 | Neoguide Systems, Inc. | Steerable endoscope and improved method of insertion |
US6984203B2 (en) | 2000-04-03 | 2006-01-10 | Neoguide Systems, Inc. | Endoscope with adjacently positioned guiding apparatus |
US6837846B2 (en) | 2000-04-03 | 2005-01-04 | Neo Guide Systems, Inc. | Endoscope having a guide tube |
US6610007B2 (en) | 2000-04-03 | 2003-08-26 | Neoguide Systems, Inc. | Steerable segmented endoscope and method of insertion |
US6974411B2 (en) | 2000-04-03 | 2005-12-13 | Neoguide Systems, Inc. | Endoscope with single step guiding apparatus |
US6508413B2 (en) | 2000-04-06 | 2003-01-21 | Siemens Westinghouse Power Corporation | Remote spray coating of nuclear cross-under piping |
US6450104B1 (en) | 2000-04-28 | 2002-09-17 | North Carolina State University | Modular observation crawler and sensing instrument and method for operating same |
DE10025285A1 (en) | 2000-05-22 | 2001-12-06 | Siemens Ag | Fully automatic, robot-assisted camera guidance using position sensors for laparoscopic interventions |
US6645196B1 (en) | 2000-06-16 | 2003-11-11 | Intuitive Surgical, Inc. | Guided tool change |
FR2812067B1 (en) | 2000-07-18 | 2003-05-16 | Commissariat Energie Atomique | MOBILE ROBOT ABLE TO WORK IN PIPES OR OTHER NARROW PASSAGES |
US6746443B1 (en) | 2000-07-27 | 2004-06-08 | Intuitive Surgical Inc. | Roll-pitch-roll surgical tool |
US6902560B1 (en) | 2000-07-27 | 2005-06-07 | Intuitive Surgical, Inc. | Roll-pitch-roll surgical tool |
US6726699B1 (en) | 2000-08-15 | 2004-04-27 | Computer Motion, Inc. | Instrument guide |
US6860877B1 (en) | 2000-09-29 | 2005-03-01 | Computer Motion, Inc. | Heart stabilizer support arm |
US6475215B1 (en) | 2000-10-12 | 2002-11-05 | Naim Erturk Tanrisever | Quantum energy surgical device and method |
US6601468B2 (en) | 2000-10-24 | 2003-08-05 | Innovative Robotic Solutions | Drive system for multiple axis robot arm |
DE10055293A1 (en) | 2000-11-03 | 2002-05-29 | Storz Karl Gmbh & Co Kg | Device for holding and positioning an endoscopic instrument |
CA2429040C (en) | 2000-11-27 | 2010-06-08 | Tyco Healthcare Group Lp | Tissue sampling and removal apparatus and method |
WO2002043569A2 (en) | 2000-11-28 | 2002-06-06 | Intuitive Surgical, Inc. | Endoscopic beating-heart stabilizer and vessel occlusion fastener |
KR100802429B1 (en) | 2000-12-06 | 2008-02-13 | 혼다 기켄 고교 가부시키가이샤 | Multi-finger hand device |
JP4655175B2 (en) | 2000-12-19 | 2011-03-23 | ソニー株式会社 | MANIPULATOR SYSTEM, MASTER MANIPULATOR, SLAVE MANIPULATOR, CONTROL METHOD THEREOF, AND RECORDING MEDIUM |
US6840938B1 (en) | 2000-12-29 | 2005-01-11 | Intuitive Surgical, Inc. | Bipolar cauterizing instrument |
US6934589B2 (en) | 2000-12-29 | 2005-08-23 | Medtronic, Inc. | System and method for placing endocardial leads |
US7519421B2 (en) | 2001-01-16 | 2009-04-14 | Kenergy, Inc. | Vagal nerve stimulation using vascular implanted devices for treatment of atrial fibrillation |
KR100380181B1 (en) | 2001-02-10 | 2003-04-11 | 한국과학기술연구원 | Micro Robot for Test the Large Intestines |
US6871563B2 (en) | 2001-02-26 | 2005-03-29 | Howie Choset | Orientation preserving angular swivel joint |
DE60205353T2 (en) | 2001-03-07 | 2006-04-20 | Carnegie Mellon University | ROBOT SYSTEM FOR INSPECTION OF GAS LINES |
US6512345B2 (en) | 2001-03-30 | 2003-01-28 | The Regents Of The University Of Michigan | Apparatus for obstacle traversion |
US6870343B2 (en) | 2001-03-30 | 2005-03-22 | The University Of Michigan | Integrated, proportionally controlled, and naturally compliant universal joint actuator with controllable stiffness |
US6774597B1 (en) | 2001-03-30 | 2004-08-10 | The Regents Of The University Of Michigan | Apparatus for obstacle traversion |
AU2002307762A1 (en) | 2001-04-18 | 2002-10-28 | Bbms Ltd. | Navigating and maneuvering of an in vivo vechicle by extracorporeal devices |
US6783524B2 (en) | 2001-04-19 | 2004-08-31 | Intuitive Surgical, Inc. | Robotic surgical tool with ultrasound cauterizing and cutting instrument |
US6994708B2 (en) | 2001-04-19 | 2006-02-07 | Intuitive Surgical | Robotic tool with monopolar electro-surgical scissors |
US6687571B1 (en) | 2001-04-24 | 2004-02-03 | Sandia Corporation | Cooperating mobile robots |
KR100413058B1 (en) | 2001-04-24 | 2003-12-31 | 한국과학기술연구원 | Micro Robotic Colonoscope with Motor Locomotion |
KR100426613B1 (en) | 2001-05-19 | 2004-04-08 | 한국과학기술연구원 | Micro robot driving system |
KR100402920B1 (en) | 2001-05-19 | 2003-10-22 | 한국과학기술연구원 | Micro robot |
US7607440B2 (en) | 2001-06-07 | 2009-10-27 | Intuitive Surgical, Inc. | Methods and apparatus for surgical planning |
US6440085B1 (en) | 2001-06-12 | 2002-08-27 | Jacek Krzyzanowski | Method of assembling a non-metallic biopsy forceps jaw and a non-metallic biopsy forceps jaw |
US9226699B2 (en) | 2002-04-19 | 2016-01-05 | Sanofi-Aventis Deutschland Gmbh | Body fluid sampling module with a continuous compression tissue interface surface |
US6817974B2 (en) | 2001-06-29 | 2004-11-16 | Intuitive Surgical, Inc. | Surgical tool having positively positionable tendon-actuated multi-disk wrist joint |
EP1408846B1 (en) | 2001-06-29 | 2012-03-07 | Intuitive Surgical Operations, Inc. | Platform link wrist mechanism |
US20040243147A1 (en) | 2001-07-03 | 2004-12-02 | Lipow Kenneth I. | Surgical robot and robotic controller |
US20050083460A1 (en) | 2001-07-16 | 2005-04-21 | Nippon Sheet Glass Co., Ltd. | Semi-transmitting mirror-possessing substrate, and semi-transmitting type liquid crystal display apparatus |
JP4744026B2 (en) | 2001-07-30 | 2011-08-10 | オリンパス株式会社 | Capsule endoscope and capsule endoscope system |
US6676684B1 (en) | 2001-09-04 | 2004-01-13 | Intuitive Surgical, Inc. | Roll-pitch-roll-yaw surgical tool |
US6728599B2 (en) | 2001-09-07 | 2004-04-27 | Computer Motion, Inc. | Modularity system for computer assisted surgery |
US6764441B2 (en) | 2001-09-17 | 2004-07-20 | Case Western Reserve University | Peristaltically self-propelled endoscopic device |
US6587750B2 (en) | 2001-09-25 | 2003-07-01 | Intuitive Surgical, Inc. | Removable infinite roll master grip handle and touch sensor for robotic surgery |
AU2002332031A1 (en) | 2001-10-02 | 2003-04-14 | Arthrocare Corporation | Apparatus and methods for electrosurgical removal and digestion of tissue |
US6835173B2 (en) | 2001-10-05 | 2004-12-28 | Scimed Life Systems, Inc. | Robotic endoscope |
US7182025B2 (en) | 2001-10-17 | 2007-02-27 | William Marsh Rice University | Autonomous robotic crawler for in-pipe inspection |
AU2002356817A1 (en) | 2001-10-17 | 2003-04-28 | William Marsh Rice University | Autonomous robotic crawler for in-pipe inspection |
US6730021B2 (en) | 2001-11-07 | 2004-05-04 | Computer Motion, Inc. | Tissue spreader with force measurement, force indication or force limitation |
KR100417163B1 (en) | 2001-11-12 | 2004-02-05 | 한국과학기술연구원 | Micro capsule robot |
US7294146B2 (en) | 2001-12-03 | 2007-11-13 | Xtent, Inc. | Apparatus and methods for delivery of variable length stents |
US6839612B2 (en) | 2001-12-07 | 2005-01-04 | Institute Surgical, Inc. | Microwrist system for surgical procedures |
US6793653B2 (en) | 2001-12-08 | 2004-09-21 | Computer Motion, Inc. | Multifunctional handle for a medical robotic system |
US20030114731A1 (en) | 2001-12-14 | 2003-06-19 | Cadeddu Jeffrey A. | Magnetic positioning system for trocarless laparoscopic instruments |
US6780191B2 (en) | 2001-12-28 | 2004-08-24 | Yacmur Llc | Cannula system |
US6676660B2 (en) | 2002-01-23 | 2004-01-13 | Ethicon Endo-Surgery, Inc. | Feedback light apparatus and method for use with an electrosurgical instrument |
US7967816B2 (en) | 2002-01-25 | 2011-06-28 | Medtronic, Inc. | Fluid-assisted electrosurgical instrument with shapeable electrode |
US7637919B2 (en) | 2002-01-30 | 2009-12-29 | Olympus Corporation | Anastomosis system for performing anastomosis in body |
AU2003218050A1 (en) | 2002-02-11 | 2003-09-04 | Arthrocare Corporation | Electrosurgical apparatus and methods for laparoscopy |
EP1351009B1 (en) | 2002-03-05 | 2006-07-12 | WIWA WILHELM WAGNER GMBH & CO. KG | Device and process for lining a pipe |
TW200304608A (en) | 2002-03-06 | 2003-10-01 | Z Kat Inc | System and method for using a haptic device in combination with a computer-assisted surgery system |
US8010180B2 (en) | 2002-03-06 | 2011-08-30 | Mako Surgical Corp. | Haptic guidance system and method |
US7831292B2 (en) | 2002-03-06 | 2010-11-09 | Mako Surgical Corp. | Guidance system and method for surgical procedures with improved feedback |
US20030179308A1 (en) | 2002-03-19 | 2003-09-25 | Lucia Zamorano | Augmented tracking using video, computed data and/or sensing technologies |
JP3869291B2 (en) | 2002-03-25 | 2007-01-17 | オリンパス株式会社 | Capsule medical device |
JP3917885B2 (en) | 2002-04-08 | 2007-05-23 | オリンパス株式会社 | Capsule endoscope system |
US6860346B2 (en) | 2002-04-19 | 2005-03-01 | Regents Of The University Of Minnesota | Adjustable diameter wheel assembly, and methods and vehicles using same |
US7674270B2 (en) | 2002-05-02 | 2010-03-09 | Laparocision, Inc | Apparatus for positioning a medical instrument |
FR2839440B1 (en) | 2002-05-13 | 2005-03-25 | Perception Raisonnement Action | POSITIONING SYSTEM ON A PATIENT OF AN OBSERVATION AND / OR INTERVENTION DEVICE |
US8142365B2 (en) * | 2002-05-31 | 2012-03-27 | Vidacare Corporation | Apparatus and method for accessing the bone marrow of the sternum |
US20030230372A1 (en) | 2002-06-13 | 2003-12-18 | Kurt Schmidt | Method for placing objects on the inner wall of a placed sewer pipe and device for carrying out said method |
US6801325B2 (en) | 2002-06-25 | 2004-10-05 | Intuitive Surgical, Inc. | Method and devices for inspecting and calibrating of stereoscopic endoscopes |
WO2004014940A2 (en) | 2002-08-13 | 2004-02-19 | Wyeth | PEPTIDES AS SOLUBILIZING EXCIPIENTS FOR TRANSFORMING GROWTH FACTOR ß PROTEINS |
WO2004016224A2 (en) | 2002-08-19 | 2004-02-26 | Pharmacia Corporation | Antisense modulation of vegf co-regulated chemokine-1 expression |
US6776165B2 (en) | 2002-09-12 | 2004-08-17 | The Regents Of The University Of California | Magnetic navigation system for diagnosis, biopsy and drug delivery vehicles |
JP4133188B2 (en) | 2002-10-07 | 2008-08-13 | 株式会社ハーモニック・ドライブ・システムズ | Robot hand finger unit |
US7794494B2 (en) | 2002-10-11 | 2010-09-14 | Boston Scientific Scimed, Inc. | Implantable medical devices |
JP3700848B2 (en) | 2002-10-23 | 2005-09-28 | Necエンジニアリング株式会社 | Micro light source position measuring device |
US6936003B2 (en) | 2002-10-29 | 2005-08-30 | Given Imaging Ltd | In-vivo extendable element device and system, and method of use |
JP4148763B2 (en) | 2002-11-29 | 2008-09-10 | 学校法人慈恵大学 | Endoscopic surgery robot |
JP3686947B2 (en) | 2002-12-09 | 2005-08-24 | 国立大学法人 東京大学 | High-rigid forceps tip structure for active forceps and active forceps including the same |
WO2004071284A1 (en) | 2003-02-11 | 2004-08-26 | Olympus Corporation | Overtube, producing method and placing method of the same, and method of treating intra-abdominal cavity |
US7083615B2 (en) | 2003-02-24 | 2006-08-01 | Intuitive Surgical Inc | Surgical tool having electrocautery energy supply conductor with inhibited current leakage |
US7105000B2 (en) | 2003-03-25 | 2006-09-12 | Ethicon Endo-Surgery, Inc. | Surgical jaw assembly with increased mechanical advantage |
JP3752494B2 (en) | 2003-03-31 | 2006-03-08 | 株式会社東芝 | Master-slave manipulator, control device and control method thereof |
JP4329394B2 (en) | 2003-04-30 | 2009-09-09 | 株式会社島津製作所 | Small photographing device |
DE10323216B3 (en) | 2003-05-22 | 2004-12-23 | Siemens Ag | Endoscope apparatus has cameras which are provided at respective ends of endoscope capsule, such that one of camera is tilted or rotated to change photography range |
US7121781B2 (en) | 2003-06-11 | 2006-10-17 | Intuitive Surgical | Surgical instrument with a universal wrist |
JP4532188B2 (en) | 2003-06-30 | 2010-08-25 | カール−ツアイス−スチフツング | Holding device, in particular for medical optical instruments, with means for compensating the load rotational moment |
GB0315479D0 (en) | 2003-07-02 | 2003-08-06 | Paz Adrian | Virtual ports devices |
US7126303B2 (en) | 2003-07-08 | 2006-10-24 | Board Of Regents Of The University Of Nebraska | Robot for surgical applications |
US7960935B2 (en) | 2003-07-08 | 2011-06-14 | The Board Of Regents Of The University Of Nebraska | Robotic devices with agent delivery components and related methods |
US20080058989A1 (en) | 2006-04-13 | 2008-03-06 | Board Of Regents Of The University Of Nebraska | Surgical camera robot |
US7042184B2 (en) | 2003-07-08 | 2006-05-09 | Board Of Regents Of The University Of Nebraska | Microrobot for surgical applications |
US20100081875A1 (en) | 2003-07-15 | 2010-04-01 | EndoRobotics Inc. | Surgical Device For Minimal Access Surgery |
US7066879B2 (en) | 2003-07-15 | 2006-06-27 | The Trustees Of Columbia University In The City Of New York | Insertable device and system for minimal access procedure |
US20050021069A1 (en) | 2003-07-24 | 2005-01-27 | Gerald Feuer | Inflatable apparatus for accessing body cavity and methods of making |
JP2005074031A (en) | 2003-09-01 | 2005-03-24 | Pentax Corp | Capsule endoscope |
JP4128504B2 (en) | 2003-09-05 | 2008-07-30 | オリンパス株式会社 | Capsule endoscope |
JP4128505B2 (en) | 2003-09-05 | 2008-07-30 | オリンパス株式会社 | Capsule endoscope |
US7993384B2 (en) | 2003-09-12 | 2011-08-09 | Abbott Cardiovascular Systems Inc. | Delivery system for medical devices |
DE10343494B4 (en) | 2003-09-19 | 2006-06-14 | Siemens Ag | Magnetically navigable device for use in the field of medical endoscopy |
US7594815B2 (en) | 2003-09-24 | 2009-09-29 | Toly Christopher C | Laparoscopic and endoscopic trainer including a digital camera |
US7789825B2 (en) | 2003-09-29 | 2010-09-07 | Ethicon Endo-Surgery, Inc. | Handle for endoscopic device |
US20050096502A1 (en) | 2003-10-29 | 2005-05-05 | Khalili Theodore M. | Robotic surgical device |
US7147650B2 (en) | 2003-10-30 | 2006-12-12 | Woojin Lee | Surgical instrument |
US8162925B2 (en) | 2003-11-07 | 2012-04-24 | Carnegie Mellon University | Robot for minimally invasive interventions |
US7429259B2 (en) | 2003-12-02 | 2008-09-30 | Cadeddu Jeffrey A | Surgical anchor and system |
US7036509B2 (en) * | 2003-12-04 | 2006-05-02 | Emphasys Medical, Inc. | Multiple seal port anesthesia adapter |
US7625338B2 (en) | 2003-12-31 | 2009-12-01 | Given Imaging, Ltd. | In-vivo sensing device with alterable fields of view |
US8187234B2 (en) * | 2004-01-29 | 2012-05-29 | Navilyst Medical, Inc. | Pressure activated safety valve with anti-adherent coating |
WO2006033671A2 (en) | 2004-04-15 | 2006-03-30 | Wilson-Cook Medical Inc. | Endoscopic surgical access devices and methods of articulating an external accessory channel |
US7857767B2 (en) | 2004-04-19 | 2010-12-28 | Invention Science Fund I, Llc | Lumen-traveling device |
US7998060B2 (en) | 2004-04-19 | 2011-08-16 | The Invention Science Fund I, Llc | Lumen-traveling delivery device |
US9801527B2 (en) | 2004-04-19 | 2017-10-31 | Gearbox, Llc | Lumen-traveling biological interface device |
US20070244520A1 (en) | 2004-04-19 | 2007-10-18 | Searete Llc | Lumen-traveling biological interface device and method of use |
US8353897B2 (en) | 2004-06-16 | 2013-01-15 | Carefusion 2200, Inc. | Surgical tool kit |
US7241290B2 (en) | 2004-06-16 | 2007-07-10 | Kinetic Surgical, Llc | Surgical tool kit |
MXPA06015146A (en) | 2004-06-24 | 2007-10-23 | Philip L Gildenberg | Semi-robotic suturing device. |
EP1773227B1 (en) | 2004-06-24 | 2016-04-13 | ArthroCare Corporation | Electrosurgical device having planar vertical electrodes |
US20050288555A1 (en) | 2004-06-28 | 2005-12-29 | Binmoeller Kenneth E | Methods and devices for illuminating, vievwing and monitoring a body cavity |
US9968290B2 (en) | 2004-06-30 | 2018-05-15 | Given Imaging Ltd. | Apparatus and methods for capsule endoscopy of the esophagus |
US20060046226A1 (en) | 2004-08-27 | 2006-03-02 | Bergler Hans J | Dental imaging system and method of use |
JP2008518731A (en) | 2004-11-08 | 2008-06-05 | ザ ジョンズ ホプキンス ユニバーシティー | Biopsy forceps |
US8128680B2 (en) | 2005-01-10 | 2012-03-06 | Taheri Laduca Llc | Apparatus and method for deploying an implantable device within the body |
US20060152591A1 (en) | 2005-01-13 | 2006-07-13 | Sheng-Feng Lin | Automatic focus mechanism of an image capturing device |
US7763015B2 (en) | 2005-01-24 | 2010-07-27 | Intuitive Surgical Operations, Inc. | Modular manipulator support for robotic surgery |
US8463439B2 (en) | 2009-03-31 | 2013-06-11 | Intuitive Surgical Operations, Inc. | Optic fiber connection for a force sensing instrument |
US20060247516A1 (en) * | 2005-04-08 | 2006-11-02 | Hess Christopher J | Tissue marker and method for use |
US7785251B2 (en) | 2005-04-22 | 2010-08-31 | Wilk Patent, Llc | Port extraction method for trans-organ surgery |
US20060241570A1 (en) | 2005-04-22 | 2006-10-26 | Wilk Patent, Llc | Intra-abdominal medical method |
US20110020779A1 (en) | 2005-04-25 | 2011-01-27 | University Of Washington | Skill evaluation using spherical motion mechanism |
US7762960B2 (en) | 2005-05-13 | 2010-07-27 | Boston Scientific Scimed, Inc. | Biopsy forceps assemblies |
US7708687B2 (en) | 2005-05-27 | 2010-05-04 | Bern M Jonathan | Endoscope propulsion system and method |
US20070123748A1 (en) | 2005-07-14 | 2007-05-31 | Dwight Meglan | Robot for minimally invasive interventions |
US20070135803A1 (en) * | 2005-09-14 | 2007-06-14 | Amir Belson | Methods and apparatus for performing transluminal and other procedures |
US20070106113A1 (en) | 2005-11-07 | 2007-05-10 | Biagio Ravo | Combination endoscopic operative delivery system |
US7761137B2 (en) | 2005-12-16 | 2010-07-20 | Suros Surgical Systems, Inc. | Biopsy site marker deployment device |
US7762825B2 (en) | 2005-12-20 | 2010-07-27 | Intuitive Surgical Operations, Inc. | Electro-mechanical interfaces to mount robotic surgical arms |
US7930065B2 (en) | 2005-12-30 | 2011-04-19 | Intuitive Surgical Operations, Inc. | Robotic surgery system including position sensors using fiber bragg gratings |
US7785333B2 (en) | 2006-02-21 | 2010-08-31 | Olympus Medical Systems Corp. | Overtube and operative procedure via bodily orifice |
EP1815949A1 (en) | 2006-02-03 | 2007-08-08 | The European Atomic Energy Community (EURATOM), represented by the European Commission | Medical robotic system with manipulator arm of the cylindrical coordinate type |
EP1815950A1 (en) | 2006-02-03 | 2007-08-08 | The European Atomic Energy Community (EURATOM), represented by the European Commission | Robotic surgical system for performing minimally invasive medical procedures |
US20060253109A1 (en) | 2006-02-08 | 2006-11-09 | David Chu | Surgical robotic helping hand system |
WO2007111571A1 (en) | 2006-03-27 | 2007-10-04 | Nanyang Technological University | Surgical robotic system for flexible endoscopy |
US8251900B2 (en) * | 2009-03-06 | 2012-08-28 | Ethicon Endo-Surgery, Inc. | Surgical access devices and methods providing seal movement in predefined paths |
US8206294B2 (en) * | 2008-09-30 | 2012-06-26 | Ethicon Endo-Surgery, Inc. | Surgical access device with flexible seal channel |
US8585733B2 (en) | 2006-04-19 | 2013-11-19 | Vibrynt, Inc | Devices, tools and methods for performing minimally invasive abdominal surgical procedures |
US7862573B2 (en) | 2006-04-21 | 2011-01-04 | Darois Roger E | Method and apparatus for surgical fastening |
CA2650474A1 (en) | 2006-04-24 | 2007-11-08 | Synecor, Llc | Natural orifice surgical system |
US7731727B2 (en) | 2006-04-26 | 2010-06-08 | Lsi Solutions, Inc. | Medical instrument to place a pursestring suture, open a hole and pass a guidewire |
US7691103B2 (en) | 2006-04-29 | 2010-04-06 | Board Of Regents, The University Of Texas System | Devices for use in transluminal and endoluminal surgery |
EP2034921B1 (en) | 2006-06-19 | 2018-10-10 | Robarts Research Institute | Apparatus for guiding a medical tool |
US9579088B2 (en) | 2007-02-20 | 2017-02-28 | Board Of Regents Of The University Of Nebraska | Methods, systems, and devices for surgical visualization and device manipulation |
US8679096B2 (en) | 2007-06-21 | 2014-03-25 | Board Of Regents Of The University Of Nebraska | Multifunctional operational component for robotic devices |
CA2991346C (en) | 2006-06-22 | 2020-03-10 | Board Of Regents Of The University Of Nebraska | Magnetically coupleable robotic devices and related methods |
WO2008008457A2 (en) | 2006-07-13 | 2008-01-17 | Bovie Medical | Surgical sealing and cutting apparatus |
US8231610B2 (en) | 2006-09-06 | 2012-07-31 | National Cancer Center | Robotic surgical system for laparoscopic surgery |
US8551114B2 (en) | 2006-11-06 | 2013-10-08 | Human Robotics S.A. De C.V. | Robotic surgical device |
EP2082159B1 (en) | 2006-11-13 | 2013-04-10 | Raytheon Company | Serpentine robotic crawler |
US7935130B2 (en) | 2006-11-16 | 2011-05-03 | Intuitive Surgical Operations, Inc. | Two-piece end-effectors for robotic surgical tools |
EP2097029A1 (en) | 2006-12-27 | 2009-09-09 | Boston Scientific Limited | Rf ablation probe array advancing device |
US7655004B2 (en) | 2007-02-15 | 2010-02-02 | Ethicon Endo-Surgery, Inc. | Electroporation ablation apparatus, system, and method |
US8700213B2 (en) | 2007-03-01 | 2014-04-15 | Tokyo Institute Of Technology | Maneuvering system having inner force sense presenting function |
US8591399B2 (en) | 2007-04-25 | 2013-11-26 | Karl Storz Endovision, Inc. | Surgical method utilizing transluminal endoscope and instruments |
US9596980B2 (en) | 2007-04-25 | 2017-03-21 | Karl Storz Endovision, Inc. | Endoscope system with pivotable arms |
US8444631B2 (en) | 2007-06-14 | 2013-05-21 | Macdonald Dettwiler & Associates Inc | Surgical manipulator |
US8702590B2 (en) | 2007-07-02 | 2014-04-22 | M.S.T. Medical Surgery Technologies Ltd | System for positioning endoscope and surgical instruments |
DE102007031957A1 (en) | 2007-07-10 | 2009-01-22 | Pierburg Gmbh | Combined non-return and control valve |
CA2690808C (en) | 2007-07-12 | 2016-09-27 | Board Of Regents Of The University Of Nebraska | Methods and systems of actuation in robotic devices |
EP2626028B1 (en) | 2007-08-14 | 2020-04-22 | Koninklijke Philips N.V. | Robotic instrument systems and methods utilizing optical fiber sensors |
WO2009023851A1 (en) | 2007-08-15 | 2009-02-19 | Board Of Regents Of The University Of Nebraska | Modular and cooperative medical devices and related systems and methods |
JP2010536435A (en) | 2007-08-15 | 2010-12-02 | ボード オブ リージェンツ オブ ザ ユニバーシティ オブ ネブラスカ | Medical inflation, attachment and delivery devices and associated methods |
GB2454017A (en) | 2007-10-26 | 2009-04-29 | Prosurgics Ltd | A control assembly |
JP5364255B2 (en) | 2007-10-31 | 2013-12-11 | テルモ株式会社 | Medical manipulator |
EP2217132B1 (en) | 2007-11-02 | 2013-05-15 | The Trustees of Columbia University in the City of New York | Insertable surgical imaging device |
US8758342B2 (en) | 2007-11-28 | 2014-06-24 | Covidien Ag | Cordless power-assisted medical cauterization and cutting device |
US20100262162A1 (en) | 2007-12-28 | 2010-10-14 | Terumo Kabushiki Kaisha | Medical manipulator and medical robot system |
US20090305210A1 (en) | 2008-03-11 | 2009-12-10 | Khurshid Guru | System For Robotic Surgery Training |
US8020741B2 (en) | 2008-03-18 | 2011-09-20 | Barosense, Inc. | Endoscopic stapling devices and methods |
US8328802B2 (en) | 2008-03-19 | 2012-12-11 | Covidien Ag | Cordless medical cauterization and cutting device |
US8641663B2 (en) | 2008-03-27 | 2014-02-04 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Robotic catheter system input device |
US9895813B2 (en) | 2008-03-31 | 2018-02-20 | Intuitive Surgical Operations, Inc. | Force and torque sensing in a surgical robot setup arm |
US8727966B2 (en) | 2008-03-31 | 2014-05-20 | Intuitive Surgical Operations, Inc. | Endoscope with rotationally deployed arms |
WO2009144729A1 (en) | 2008-05-28 | 2009-12-03 | Technion Research & Development Foundation Ltd. | Laparoscopic camera array |
US20100010294A1 (en) | 2008-07-10 | 2010-01-14 | Ethicon Endo-Surgery, Inc. | Temporarily positionable medical devices |
US8771270B2 (en) | 2008-07-16 | 2014-07-08 | Intuitive Surgical Operations, Inc. | Bipolar cautery instrument |
WO2010009292A1 (en) | 2008-07-18 | 2010-01-21 | Boston Scientific Scimed, Inc. | Endoscope with guide |
WO2010022088A1 (en) | 2008-08-18 | 2010-02-25 | Encision, Inc. | Enhanced control systems including flexible shielding and support systems for electrosurgical applications |
US20100069710A1 (en) | 2008-09-02 | 2010-03-18 | Ken Yamatani | treatment method |
US8834353B2 (en) | 2008-09-02 | 2014-09-16 | Olympus Medical Systems Corp. | Medical manipulator, treatment system, and treatment method |
EP2361042B1 (en) | 2008-09-12 | 2016-11-30 | Ethicon Endo-Surgery, Inc. | Ultrasonic device for fingertip control |
US8328761B2 (en) * | 2008-09-30 | 2012-12-11 | Ethicon Endo-Surgery, Inc. | Variable surgical access device |
US20110230894A1 (en) | 2008-10-07 | 2011-09-22 | The Trustees Of Columbia University In The City Of New York | Systems, devices, and methods for providing insertable robotic sensory and manipulation platforms for single port surgery |
ITFI20080201A1 (en) | 2008-10-20 | 2010-04-21 | Scuola Superiore Di Studi Universit Ari E Di Perfe | ENDOLUMINAL ROBOTIC SYSTEM |
US8147405B2 (en) * | 2008-10-30 | 2012-04-03 | Ethicon Endo-Surgery, Inc. | Surgical access port with multilayered tortuous path seal |
KR101075363B1 (en) | 2008-10-31 | 2011-10-19 | 정창욱 | Surgical Robot System Having Tool for Minimally Invasive Surgery |
US20100145340A1 (en) * | 2008-12-05 | 2010-06-10 | Kyphon Sarl | Introducer Tool for Bone Measurement |
US8858547B2 (en) | 2009-03-05 | 2014-10-14 | Intuitive Surgical Operations, Inc. | Cut and seal instrument |
EP2286756B1 (en) | 2009-08-21 | 2013-04-03 | Novineon Healthcare Technology Partners Gmbh | Surgical manipulator means |
JP2011045500A (en) | 2009-08-26 | 2011-03-10 | Terumo Corp | Medical manipulator |
US8465476B2 (en) | 2009-09-23 | 2013-06-18 | Intuitive Surgical Operations, Inc. | Cannula mounting fixture |
US8545515B2 (en) | 2009-09-23 | 2013-10-01 | Intuitive Surgical Operations, Inc. | Curved cannula surgical system |
US8888687B2 (en) | 2009-10-28 | 2014-11-18 | Boston Scientific Scimed, Inc. | Method and apparatus related to a flexible assembly at a distal end portion of a medical device |
US8870759B2 (en) | 2009-12-04 | 2014-10-28 | Covidien Lp | Suspension system for minimally invasive surgery |
WO2011075693A1 (en) | 2009-12-17 | 2011-06-23 | Board Of Regents Of The University Of Nebraska | Modular and cooperative medical devices and related systems and methods |
WO2011118646A1 (en) | 2010-03-24 | 2011-09-29 | 株式会社安川電機 | Robot hand and robot device |
US20110238080A1 (en) | 2010-03-25 | 2011-09-29 | Date Ranjit | Robotic Surgical Instrument System |
US9498298B2 (en) | 2010-04-23 | 2016-11-22 | Kenneth I. Lipow | Ring form surgical effector |
IT1399603B1 (en) | 2010-04-26 | 2013-04-26 | Scuola Superiore Di Studi Universitari E Di Perfez | ROBOTIC SYSTEM FOR MINIMUM INVASIVE SURGERY INTERVENTIONS |
JP5311294B2 (en) | 2010-04-28 | 2013-10-09 | 株式会社安川電機 | Robot contact position detector |
US9918787B2 (en) | 2010-05-05 | 2018-03-20 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Monitoring, managing and/or protecting system and method for non-targeted tissue |
US20120116362A1 (en) | 2010-06-25 | 2012-05-10 | Kieturakis Maciej J | Single port laparoscopic access with laterally spaced virtual insertion points |
US8437884B2 (en) | 2010-07-28 | 2013-05-07 | GM Global Technology Operations LLC | System and method for detecting vehicle motion |
WO2013022423A1 (en) | 2010-08-06 | 2013-02-14 | Board Of Regents Of The University Of Nebraska | Methods and systems for handling or delivering materials for natural orifice surgery |
DE102010040405B4 (en) | 2010-09-08 | 2017-07-27 | Siemens Healthcare Gmbh | Instrument system for an endoscopic robot |
EP3714821A1 (en) | 2011-06-10 | 2020-09-30 | Board of Regents of the University of Nebraska | Surgical end effector |
EP2732344B1 (en) | 2011-07-11 | 2019-06-05 | Board of Regents of the University of Nebraska | Robotic surgical system |
CA3098065C (en) | 2012-01-10 | 2023-10-31 | Board Of Regents Of The University Of Nebraska | Methods, systems, and devices for surgical access and insertion |
EP3845190B1 (en) | 2012-05-01 | 2023-07-12 | Board of Regents of the University of Nebraska | Single site robotic device and related systems |
EP3943255B1 (en) | 2012-06-22 | 2023-06-14 | Board of Regents of the University of Nebraska | Local control robotic surgical devices |
US9839480B2 (en) | 2012-07-09 | 2017-12-12 | Covidien Lp | Surgical adapter assemblies for use between surgical handle assembly and surgical end effectors |
EP2882331A4 (en) | 2012-08-08 | 2016-03-23 | Univ Nebraska | Robotic surgical devices, systems, and related methods |
CA2906772C (en) | 2013-03-15 | 2021-09-21 | Board Of Regents Of The University Of Nebraska | Robotic surgical devices, systems and related methods |
US9797486B2 (en) | 2013-06-20 | 2017-10-24 | Covidien Lp | Adapter direct drive with manual retraction, lockout and connection mechanisms |
US10966700B2 (en) | 2013-07-17 | 2021-04-06 | Virtual Incision Corporation | Robotic surgical devices, systems and related methods |
US9918713B2 (en) | 2013-12-09 | 2018-03-20 | Covidien Lp | Adapter assembly for interconnecting electromechanical surgical devices and surgical loading units, and surgical systems thereof |
CN105813580B (en) | 2013-12-12 | 2019-10-15 | 柯惠Lp公司 | Gear train for robotic surgical system |
US10080552B2 (en) | 2014-04-21 | 2018-09-25 | Covidien Lp | Adapter assembly with gimbal for interconnecting electromechanical surgical devices and surgical loading units, and surgical systems thereof |
JP7306155B2 (en) | 2019-08-22 | 2023-07-11 | スズキ株式会社 | vehicle power transmission |
-
2013
- 2013-01-10 CA CA3098065A patent/CA3098065C/en active Active
- 2013-01-10 WO PCT/US2013/021027 patent/WO2013106569A2/en active Application Filing
- 2013-01-10 CA CA2860754A patent/CA2860754C/en active Active
- 2013-01-10 US US13/738,706 patent/US20140058205A1/en not_active Abandoned
- 2013-01-10 EP EP13735936.0A patent/EP2806941B1/en active Active
- 2013-01-10 JP JP2014552300A patent/JP6377530B2/en active Active
- 2013-01-10 EP EP21204612.2A patent/EP3970784A1/en active Pending
-
2015
- 2015-03-18 US US14/661,465 patent/US20150190170A1/en not_active Abandoned
-
2018
- 2018-02-07 US US15/890,860 patent/US20190046234A1/en not_active Abandoned
-
2020
- 2020-08-21 US US16/999,407 patent/US11883065B2/en active Active
Patent Citations (23)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20020038077A1 (en) * | 1994-10-07 | 2002-03-28 | General Surgical Innovations, Inc., California Corporation | Laparoscopic access port for surgical instruments or the hand |
US5672168A (en) * | 1994-10-07 | 1997-09-30 | De La Torre; Roger A. | Laparoscopic access port for surgical instruments or the hand |
US5853395A (en) * | 1997-02-18 | 1998-12-29 | Dexterity, Inc. | Extracorporeal pneumoperitoneum enclosure and method of use |
US5906577A (en) * | 1997-04-30 | 1999-05-25 | University Of Massachusetts | Device, surgical access port, and method of retracting an incision into an opening and providing a channel through the incision |
US6142936A (en) * | 1997-04-30 | 2000-11-07 | University Of Massachusetts | Surgical access port and method for accessing a patient's body cavity |
US6589167B1 (en) * | 1997-10-08 | 2003-07-08 | Hakko Electric Machine Works Co., Ltd. | Valve and valved trocar jacket tube |
US20100063362A1 (en) * | 1998-12-01 | 2010-03-11 | Frank Bonadio | Wound retractor device |
US20050090717A1 (en) * | 1998-12-01 | 2005-04-28 | Frank Bonadio | Wound retractor device |
US20050192483A1 (en) * | 1998-12-01 | 2005-09-01 | Frank Bonadio | Device |
US8317691B2 (en) * | 1998-12-01 | 2012-11-27 | Atropos Limited | Wound retractor device |
US20110282157A1 (en) * | 2003-02-25 | 2011-11-17 | Applied Medical Resources Corporation | Surgical access system |
US7377898B2 (en) * | 2003-08-22 | 2008-05-27 | Applied Medical Resources Corporation | Wound retraction apparatus and method |
US20050222582A1 (en) * | 2004-04-05 | 2005-10-06 | Thomas Wenchell | Surgical hand access apparatus |
US20100063364A1 (en) * | 2007-02-01 | 2010-03-11 | Frank Bonadio | Instrument insertion device |
US8876708B1 (en) * | 2007-03-30 | 2014-11-04 | Covidien Lp | Laparoscopic port assembly |
US20090036745A1 (en) * | 2007-06-05 | 2009-02-05 | Frank Bonadio | Instrument access device |
US20100217087A1 (en) * | 2007-06-05 | 2010-08-26 | Frank Bonadio | Instrument access system |
US20090012433A1 (en) * | 2007-06-18 | 2009-01-08 | Fernstrom John D | Method, apparatus and system for food intake and physical activity assessment |
US20090227843A1 (en) * | 2007-09-12 | 2009-09-10 | Smith Jeffrey A | Multi-instrument access devices and systems |
US20120078058A1 (en) * | 2008-03-03 | 2012-03-29 | Tyco Healthcare Group Lp | Single port device with multi-lumen cap |
US20100081880A1 (en) * | 2008-09-30 | 2010-04-01 | Ethicon Endo-Surgery, Inc. | Surgical Access Device |
US20100268035A1 (en) * | 2009-04-17 | 2010-10-21 | Oberlaender Martin | Seal For Closing-Off An Access Instrument Into A Body |
US20130066156A1 (en) * | 2010-05-19 | 2013-03-14 | O Nam Seo | Surgical tool guide and protection cap for surgical tool guide |
Cited By (65)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US9883911B2 (en) | 2006-06-22 | 2018-02-06 | Board Of Regents Of The University Of Nebraska | Multifunctional operational component for robotic devices |
US10959790B2 (en) | 2006-06-22 | 2021-03-30 | Board Of Regents Of The University Of Nebraska | Multifunctional operational component for robotic devices |
US10307199B2 (en) | 2006-06-22 | 2019-06-04 | Board Of Regents Of The University Of Nebraska | Robotic surgical devices and related methods |
US10376323B2 (en) | 2006-06-22 | 2019-08-13 | Board Of Regents Of The University Of Nebraska | Multifunctional operational component for robotic devices |
US10695137B2 (en) | 2007-07-12 | 2020-06-30 | Board Of Regents Of The University Of Nebraska | Methods, systems, and devices for surgical access and procedures |
US9956043B2 (en) | 2007-07-12 | 2018-05-01 | Board Of Regents Of The University Of Nebraska | Methods, systems, and devices for surgical access and procedures |
US10335024B2 (en) | 2007-08-15 | 2019-07-02 | Board Of Regents Of The University Of Nebraska | Medical inflation, attachment and delivery devices and related methods |
US9351761B2 (en) * | 2011-03-25 | 2016-05-31 | Covidien Lp | Access port with integrated flexible sleeve |
US20120253132A1 (en) * | 2011-03-29 | 2012-10-04 | Tyco Healthcare Group Lp | Gear Driven Triangulation |
US9179933B2 (en) * | 2011-03-29 | 2015-11-10 | Covidien Lp | Gear driven triangulation |
US9757187B2 (en) | 2011-06-10 | 2017-09-12 | Board Of Regents Of The University Of Nebraska | Methods, systems, and devices relating to surgical end effectors |
US10350000B2 (en) | 2011-06-10 | 2019-07-16 | Board Of Regents Of The University Of Nebraska | Methods, systems, and devices relating to surgical end effectors |
US11065050B2 (en) | 2011-06-10 | 2021-07-20 | Board Of Regents Of The University Of Nebraska | Methods, systems, and devices relating to surgical end effectors |
US11832871B2 (en) | 2011-06-10 | 2023-12-05 | Board Of Regents Of The University Of Nebraska | Methods, systems, and devices relating to surgical end effectors |
US10111711B2 (en) | 2011-07-11 | 2018-10-30 | Board Of Regents Of The University Of Nebraska | Robotic surgical devices, systems, and related methods |
US11595242B2 (en) | 2011-07-11 | 2023-02-28 | Board Of Regents Of The University Of Nebraska | Robotic surgical devices, systems and related methods |
US11032125B2 (en) | 2011-07-11 | 2021-06-08 | Board Of Regents Of The University Of Nebraska | Robotic surgical devices, systems and related methods |
US11909576B2 (en) | 2011-07-11 | 2024-02-20 | Board Of Regents Of The University Of Nebraska | Robotic surgical devices, systems, and related methods |
US11883065B2 (en) | 2012-01-10 | 2024-01-30 | Board Of Regents Of The University Of Nebraska | Methods, systems, and devices for surgical access and insertion |
US11529201B2 (en) | 2012-05-01 | 2022-12-20 | Board Of Regents Of The University Of Nebraska | Single site robotic device and related systems and methods |
US10219870B2 (en) | 2012-05-01 | 2019-03-05 | Board Of Regents Of The University Of Nebraska | Single site robotic device and related systems and methods |
US11819299B2 (en) | 2012-05-01 | 2023-11-21 | Board Of Regents Of The University Of Nebraska | Single site robotic device and related systems and methods |
US11484374B2 (en) | 2012-06-22 | 2022-11-01 | Board Of Regents Of The University Of Nebraska | Local control robotic surgical devices and related methods |
US10470828B2 (en) | 2012-06-22 | 2019-11-12 | Board Of Regents Of The University Of Nebraska | Local control robotic surgical devices and related methods |
US11617626B2 (en) | 2012-08-08 | 2023-04-04 | Board Of Regents Of The University Of Nebraska | Robotic surgical devices, systems and related methods |
US9770305B2 (en) | 2012-08-08 | 2017-09-26 | Board Of Regents Of The University Of Nebraska | Robotic surgical devices, systems, and related methods |
US11051895B2 (en) | 2012-08-08 | 2021-07-06 | Board Of Regents Of The University Of Nebraska | Robotic surgical devices, systems, and related methods |
US11832902B2 (en) | 2012-08-08 | 2023-12-05 | Virtual Incision Corporation | Robotic surgical devices, systems, and related methods |
US10624704B2 (en) | 2012-08-08 | 2020-04-21 | Board Of Regents Of The University Of Nebraska | Robotic devices with on board control and related systems and devices |
US10582973B2 (en) | 2012-08-08 | 2020-03-10 | Virtual Incision Corporation | Robotic surgical devices, systems, and related methods |
US11806097B2 (en) | 2013-03-14 | 2023-11-07 | Board Of Regents Of The University Of Nebraska | Methods, systems, and devices relating to robotic surgical devices, end effectors, and controllers |
US10743949B2 (en) | 2013-03-14 | 2020-08-18 | Board Of Regents Of The University Of Nebraska | Methods, systems, and devices relating to force control surgical systems |
US9888966B2 (en) | 2013-03-14 | 2018-02-13 | Board Of Regents Of The University Of Nebraska | Methods, systems, and devices relating to force control surgical systems |
US10603121B2 (en) | 2013-03-14 | 2020-03-31 | Board Of Regents Of The University Of Nebraska | Methods, systems, and devices relating to robotic surgical devices, end effectors, and controllers |
US9743987B2 (en) | 2013-03-14 | 2017-08-29 | Board Of Regents Of The University Of Nebraska | Methods, systems, and devices relating to robotic surgical devices, end effectors, and controllers |
US11633253B2 (en) | 2013-03-15 | 2023-04-25 | Virtual Incision Corporation | Robotic surgical devices, systems, and related methods |
EP2996545A4 (en) * | 2013-03-15 | 2017-02-15 | Board of Regents of the University of Nebraska | Robotic surgical devices, systems, and related methdos |
WO2014144220A1 (en) | 2013-03-15 | 2014-09-18 | Board Of Regents Of The University Of Nebraska | Robotic surgical devices, systems, and related methdos |
US10667883B2 (en) | 2013-03-15 | 2020-06-02 | Virtual Incision Corporation | Robotic surgical devices, systems, and related methods |
US10966700B2 (en) | 2013-07-17 | 2021-04-06 | Virtual Incision Corporation | Robotic surgical devices, systems and related methods |
US11826032B2 (en) | 2013-07-17 | 2023-11-28 | Virtual Incision Corporation | Robotic surgical devices, systems and related methods |
US11576695B2 (en) | 2014-09-12 | 2023-02-14 | Virtual Incision Corporation | Quick-release end effectors and related systems and methods |
US10342561B2 (en) | 2014-09-12 | 2019-07-09 | Board Of Regents Of The University Of Nebraska | Quick-release end effectors and related systems and methods |
US11406458B2 (en) | 2014-11-11 | 2022-08-09 | Board Of Regents Of The University Of Nebraska | Robotic device with compact joint design and related systems and methods |
US10376322B2 (en) | 2014-11-11 | 2019-08-13 | Board Of Regents Of The University Of Nebraska | Robotic device with compact joint design and related systems and methods |
US11872090B2 (en) | 2015-08-03 | 2024-01-16 | Virtual Incision Corporation | Robotic surgical devices, systems, and related methods |
US10806538B2 (en) | 2015-08-03 | 2020-10-20 | Virtual Incision Corporation | Robotic surgical devices, systems, and related methods |
US20170071629A1 (en) * | 2015-09-15 | 2017-03-16 | Applied Medical Resources Corporation | Surgical robotic access system |
US10368908B2 (en) * | 2015-09-15 | 2019-08-06 | Applied Medical Resources Corporation | Surgical robotic access system |
US10751136B2 (en) | 2016-05-18 | 2020-08-25 | Virtual Incision Corporation | Robotic surgical devices, systems and related methods |
US11826014B2 (en) | 2016-05-18 | 2023-11-28 | Virtual Incision Corporation | Robotic surgical devices, systems and related methods |
US11173617B2 (en) | 2016-08-25 | 2021-11-16 | Board Of Regents Of The University Of Nebraska | Quick-release end effector tool interface |
US10702347B2 (en) | 2016-08-30 | 2020-07-07 | The Regents Of The University Of California | Robotic device with compact joint design and an additional degree of freedom and related systems and methods |
US11357595B2 (en) | 2016-11-22 | 2022-06-14 | Board Of Regents Of The University Of Nebraska | Gross positioning device and related systems and methods |
US11813124B2 (en) | 2016-11-22 | 2023-11-14 | Board Of Regents Of The University Of Nebraska | Gross positioning device and related systems and methods |
US11701193B2 (en) | 2016-11-29 | 2023-07-18 | Virtual Incision Corporation | User controller with user presence detection and related systems and methods |
US11284958B2 (en) | 2016-11-29 | 2022-03-29 | Virtual Incision Corporation | User controller with user presence detection and related systems and methods |
US11786334B2 (en) | 2016-12-14 | 2023-10-17 | Virtual Incision Corporation | Releasable attachment device for coupling to medical devices and related systems and methods |
US10722319B2 (en) | 2016-12-14 | 2020-07-28 | Virtual Incision Corporation | Releasable attachment device for coupling to medical devices and related systems and methods |
WO2019067763A1 (en) | 2017-09-27 | 2019-04-04 | Virtual Incision Corporation | Robotic Surgical Devices with Tracking Camera Technology and Related Systems and Methods |
US11051894B2 (en) | 2017-09-27 | 2021-07-06 | Virtual Incision Corporation | Robotic surgical devices with tracking camera technology and related systems and methods |
US11013564B2 (en) | 2018-01-05 | 2021-05-25 | Board Of Regents Of The University Of Nebraska | Single-arm robotic device with compact joint design and related systems and methods |
US11504196B2 (en) | 2018-01-05 | 2022-11-22 | Board Of Regents Of The University Of Nebraska | Single-arm robotic device with compact joint design and related systems and methods |
US11950867B2 (en) | 2018-01-05 | 2024-04-09 | Board Of Regents Of The University Of Nebraska | Single-arm robotic device with compact joint design and related systems and methods |
US11903658B2 (en) | 2019-01-07 | 2024-02-20 | Virtual Incision Corporation | Robotically assisted surgical system and related devices and methods |
Also Published As
Publication number | Publication date |
---|---|
CA3098065C (en) | 2023-10-31 |
CA2860754A1 (en) | 2013-07-18 |
US11883065B2 (en) | 2024-01-30 |
EP2806941B1 (en) | 2021-10-27 |
JP2015507506A (en) | 2015-03-12 |
US20190046234A1 (en) | 2019-02-14 |
US20210244439A1 (en) | 2021-08-12 |
CA2860754C (en) | 2020-12-29 |
EP3970784A1 (en) | 2022-03-23 |
CA3098065A1 (en) | 2013-07-18 |
EP2806941A2 (en) | 2014-12-03 |
JP6377530B2 (en) | 2018-08-22 |
WO2013106569A3 (en) | 2014-10-23 |
EP2806941A4 (en) | 2015-12-09 |
WO2013106569A2 (en) | 2013-07-18 |
US20150190170A1 (en) | 2015-07-09 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US20210244439A1 (en) | Methods, Systems, and Devices for Surgical Access and Insertion | |
US20210236164A1 (en) | Devices for and methods of performing minimally-invasive surgical procedures through a single incision | |
JP5436280B2 (en) | Flexible port seal | |
JP5694675B2 (en) | Articulated surgical portal apparatus with spring | |
US7297106B2 (en) | Medical treating instrument | |
CN102210598B (en) | Surgical access method and assembly including sleeve and port | |
US20110112371A1 (en) | Multi-instrument access devices and systems | |
JP6871279B2 (en) | Cannula assembly for robot-assisted pressure-controlled laparoscopic surgery | |
EP2958502B1 (en) | Surgical access device including lateral moving seal cooperating with bellows attached to proximal wall of cannula house | |
US20120078058A1 (en) | Single port device with multi-lumen cap | |
US20080097332A1 (en) | Surgical access port | |
US20100234689A1 (en) | Medical Instrument For Creating An Access For A Minimally Invasive Intervention | |
JP2007500034A (en) | Medical instruments | |
US20140114126A1 (en) | Universal endoscope attachment system and related methods of use | |
US11660114B2 (en) | Tissue containment systems and related methods | |
US11344287B2 (en) | Laparoscopic surgical instrument | |
US20210401462A1 (en) | Systems, devices, and methods for preventing or reducing loss of insufflation during a laparoscopic surgical procedure | |
JP2023548139A (en) | Distal tips of surgical tools and related methods | |
GB2504962A (en) | Closed port for single incision laparoscopic surgery |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
AS | Assignment |
Owner name: BOARD OF REGENTS OF THE UNIVERSITY OF NEBRASKA, NE Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:FREDERICK, TOM;FARRITOR, SHANE;MONDRY, JACK;AND OTHERS;SIGNING DATES FROM 20130219 TO 20130507;REEL/FRAME:030381/0800 |
|
AS | Assignment |
Owner name: US ARMY, SECRETARY OF THE ARMY, MARYLAND Free format text: CONFIRMATORY LICENSE;ASSIGNOR:UNIVERSITY OF NEBRASKA MEDICAL CENTER;REEL/FRAME:030665/0557 Effective date: 20130219 |
|
STCB | Information on status: application discontinuation |
Free format text: ABANDONED -- FAILURE TO RESPOND TO AN OFFICE ACTION |